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P3.353 Congenital Syphilis in Buenaventura, Colombia: Description of a Case Series in a Neglected Pacific Coast Town
  1. M A Castrillon1,
  2. A R Cruz1,
  3. Y Minota2,
  4. L C Rubiano1,3,
  5. M C Castaño3,
  6. M Perez1,
  7. J C Salazar4,5,1
  1. 1CIDEIM, Cali, Colombia
  2. 2Hospital Departamental de Buenaventura, Buenaventura, Colombia
  3. 3Secretaria de Salud Departamental del Valle, Cali, Colombia
  4. 4University of Connecticut Health Center, Farmington, CT, United States
  5. 5Connecticut Children´s Medical Center, Hartford, CT, United States

Abstract

Background Syphilis in pregnant women is a world-wide health problem leading to serious adverse outcomes. Although there are strategies to prevent congenital syphilis (CS) through antenatal screening, disease burden still remains high especially in low-resourced settings. Buenaventura, a municipality in the Colombian Pacific-Coast, is endemic for gestational syphilis (GS) and accounts for the 6.6% of CS in Colombia. This study describes the CS problem in Buenaventura, giving rise to strategies that could generate positive impact in prevention of syphilis mother-to-child transmission.

Methods A retrospective health record review of CS patients and mothers that attended to the Buenaventura Hospital during a 7-month period, 2011, was conducted. Demographic, antenatal care (ANC), syphilis diagnosis/treatment information from GS patients, and clinical information from CS cases was collected. A descriptive analysis of the information was performed, analysed using SSPS 20.0. Study procedures were approved by CIDEIM´s human subject’s board.

Results 100 clinical records were reviewed; 89 and 92 cases met definitions for CS and GS respectively. All GS mothers lived in the municipality of Buenaventura, mainly in urban areas. The majority (80%) were affiliated to private health-care providers. Although 70% of GS mothers attended to at least one ANC visit, and 64% had at least one VDRL test, only 10% received adequate antibiotic therapy, and 2% of the partners were treated. Stillbirths and early neonatal deaths (7/82), preterm births (15/82) were the main finding in the CS population. All infants were hospitalised for intravenous antibiotic treatment.

Conclusions The high CS incidence in Buenaventura (7/1000 live-births), is the result of lack of appropriate ANC, which ultimately leads to failures in syphilis screening and adequate treatment. CS prevention strategies should be focused in early syphilis screening in pregnancy, with the now-a-day available point-of-care tests, and treating within the same visit with at least one dose of penicillin.

  • congenital syphilis
  • gestational syphilis
  • Syphilis

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