The prevention and management of congenital syphilis: an overview and recommendations

Area of Science:

• Public Health
• Maternal and Child Health
• Infectious Diseases

Background:

• Congenital syphilis remains a significant global health issue, with over a million infants affected annually.
• Inadequate antenatal care and inconsistent sexually transmitted infection (STI) control programs contribute to the high incidence.
• Despite established policies, sporadic syphilis screening in pregnant women leads to undetected and untreated infections.

Purpose of the Study:

• To highlight the challenges in congenital syphilis prevention and diagnosis.
• To evaluate the cost-effectiveness of antenatal syphilis screening and treatment programs.
• To propose improved strategies for diagnosis and management, particularly in resource-limited settings.

Main Methods:

• Review of existing literature on congenital syphilis prevalence, screening, and treatment.
• Analysis of program implementation challenges, including service organization and cost barriers.
• Evaluation of diagnostic test availability and appropriateness for different resource settings.

Main Results:

• Decentralized screening, on-site testing, and immediate treatment can effectively reduce congenital syphilis cases.
• Antenatal syphilis screening and treatment programs demonstrate cost-effectiveness comparable to established public health interventions.
• Current diagnostic methods are often unavailable in high-need areas, and existing guidelines may be unsuitable for resource-limited settings.

Conclusions:

• Addressing weak service organization and screening costs is vital for effective congenital syphilis control.
• Recommendations include an infant treatment approach based on maternal serological status and infant clinical signs, suitable for resource-limited environments.
• Enhanced accessibility and tailored strategies are necessary to combat congenital syphilis globally.