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Sex Transm Infect doi:10.1136/sti.2006.023416

Screening for syphilis in pregnancy in Nigeria-Must continue!

  1. Samuel Sunday Taiwo (samtaiwo2003{at}yahoo.com)
  1. Ladoke Akintola University of Technology, Nigeria
    1. Yemisi Olukemi Adesiji (drmrsadesiji{at}yahoo.com)
    1. Ladoke Akintola University of Technology, Ogbomoso, Nigeria
      1. Daniel Adebode Adekanle (adekanle{at}yahoo.co.uk)
      1. Ladoke Akintola University of Technology, Ogbomoso, Nigeria
        • Published Online First 10 May 2007

        Abstract

        Objective: The objective was to determine the seroprevalence rate of syphilis among pregnant women attending the antenatal clinics of a Teaching and a State Specialist hospital in Nigeria, in order to ascertain whether maternal screening should be incorporated into routine antenatal care of our hospitals

        Methods: Screening test for syphilis for 505 newly booked pregnant women was first carried out by the qualitative Rapid Plasma Reagin (RPR) using the RPR-SlideTM test kit and all reactive sera were then subjected to the quantitative RPR test to estimate the titer of each sample. The Treponema pallidum haemagglutination antibody (TPHA) test was used as confirmatory test of all positive RPR sera.

        Results: Fifty women (9.9%) were positive for RPR; 15 (2.97%) were positive for TPHA, giving a sero-prevalence rate of 2.97%. Thirty two women (6.34%) were RPR positive at 1:2, 7 (1.39%) at 1:4 and 11 (2.2%) at 1:8. Two of the women positive for RPR at 1:2 were TPHA positive, 2 of the 7 positive at 1:4 were TPHA positive, while all 11 positive women at 1:8 were TPHA positive. In all, 70% of all RPR positive women screened were biological false positives. Eleven of the 15 women had high titre active syphilis (RPR ≥ 1:8, TPHA+) while 4 had low titre active syphilis (RPR < 1:8, TPHA+).

        Conclusions: The 2.97% sero-prevalence rate obtained after accounting for biological false positives is considered high. Screening for syphilis in pregnancy should be incorporated into routine antenatal practice in our hospitals.

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