Syphilis in pregnant women in Zambia

Because of the high incidence of congenital syphilis at the University Teaching Hospital, Lusaka, Zambia, the potential risks of congenital infection and fetal loss due to syphilis were assessed by screening 202 antenatal patients, 340 pregnant women admitted to the hospital whose pregnancies ended in either spontaneous abortion or stillbirth, and 469 consecutive babies delivered at the hospital. Primary serological screening was performed with the rapid plasma reagin test, and reactive sera were confirmed by the Treponema pallidum haemagglutination test. In all cases detailed histories were obtained and patients were examined for clinical signs of syphilis. The TPHA test result was reactive in 12.5% of antenatal patients and in 42% of women who aborted in the later half of pregnancy. Among 469 consecutive babies delivered at the hospital, 30 had reactive results to the TPHA test; of these two were stillborn and four had signs of congenital syphilis at birth. Thus, syphilis appears to affect adversely an appreciably high number of pregnant women in Zambia. For this reason a special campaign to screen adequately and treat pregnant women and neonates is needed.