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Congenital syphilis as a notifiable disease
1Department of Paediatrics and Child Health, Johannesburg Hospital.
Summary
A review of congenital syphilis notification in Johannesburg found that the program was ineffective. Few mothers received antenatal care or treatment, and notification rates remained very low, failing to meet program goals.
Area of Science:
- Public Health
- Infectious Diseases
- Maternal and Child Health
Background:
- Congenital syphilis poses a significant risk to newborns.
- Effective notification programs are crucial for disease control and public health surveillance.
- Johannesburg implemented a new congenital syphilis notification program in 1991.
Purpose of the Study:
- To evaluate the effectiveness of the newly introduced congenital syphilis notification program.
- To assess the impact of the program on healthcare provider awareness and accurate problem evaluation.
Main Methods:
- A retrospective review of congenital syphilis notifications at Johannesburg Hospital.
- Data collected from May 1, 1991, to April 30, 1992.
- Analysis of Wassermann reaction (WR)-positive mothers and their pregnancy outcomes.
Main Results:
- 209 WR-positive mothers delivered during the study period.
- High rates of adverse pregnancy outcomes: 5.7% stillbirths, 3.8% incomplete abortions, 0.96% early neonatal deaths.
- Low antenatal care (21.5%) and documented treatment rates (20% of those with care) among WR-positive mothers.
- Only 12.0% of 200 potentially notifiable cases were actually notified.
Conclusions:
- The congenital syphilis notification program failed to increase awareness among healthcare providers.
- The program was ineffective in accurately evaluating the extent of congenital syphilis.
- Significant improvements in antenatal care and syphilis treatment are needed to reduce congenital syphilis rates.