Introduction Although majority of countries in the European Union (EU/EEA) offer antenatal screening for HIV and syphilis, mother-to-child transmission (MTCT) is still occurring. We aim to analyse the performance and effectiveness of antenatal screening programmes to strengthen these programmes across the EU/EEA
Methods Surveillance for HIV and syphilis, including congenital syphilis (CS), in EU/EEA is coordinated by the European Centre for Disease Prevention and Control. Data reported by Member States covering the period 2006–2011 were analysed. Information on country of birth and probable country of infection were used to identify where HIV transmission might have occurred. Rates of HIV and CS per 100,000 live births as well as rates of HIV and syphilis among women of reproductive age (15–49 years) were used to compare mother-to-child transmission across the EU/EEA.
Results In 2006–2011, 592 cases of HIV-MTCT and 566 CS were reported (rate: 1.8/100000 population and 2.0/100000 respectively). 41393 cases of HIV infection and 18750 cases of syphilis were reported in women of reproductive age (rates: 5.7/100000 and 3.1/100000, respectively). Cases of HIV-MTCT and CS were reported by 20 and 16 countries respectively. Rates ranged between 0.2 and 21.8 for HIV and 0.1 and 39.8 for CS. Rates of HIV-MTCT and HIV in women of reproductive age were higher than the EU/EEA average in France, Latvia, Portugal and the UK. Similarly, rates of CS and syphilis were higher than the EU/EEA average in Bulgaria, Latvia, Romania, Lithuania and Slovakia.
Conclusions Surveillance data suggest an unequal performance across EU/EEA in preventing mother-to-child transmission of HIV and syphilis. Understanding of the epidemiological determinants at national level, identification of pregnant women with high HIV and syphilis burden and barriers for access to antenatal care, will inform revision of antenatal screening practices and will allow strengthening of prevention interventions towards key populations.
- antenatal screening
- congenital syphilis
- HIV MTCT