To establish the prevalence of syphilis in pregnant women in Mozambique and evaluate present diagnostic methods, 1468 pregnant women in eight of the country's 10 provinces were examined using the Venereal Disease Research Laboratory (VDRL) test. Positive serum samples were also analysed using the Treponema pallidum haemagglutination (TPHA) assay and one group was also analysed using the fluorescent treponemal antibody absorbed (FTA-ABS) test. The prevalence of VDRL seroreactivity was found to be between 4.5% and 14.6%, whereas the prevalence of treponemal disease as verified by TPHA or FTA-ABS tests was between 1.6% and 9.8%. It is concluded that syphilis is relatively common among pregnant women in Mozambique. The predictive value of a positive VDRL test, when adequately performed, was
PIP: Two groups of pregnant women were studied. Group 1 comprised 755 pregnant women examined during a nationwide study of maternal morbidity in 1982-83 carried out in 6 of the country's 10 provinces. In group 1, 21% of the women were in the first trimester, 41% in the second, and 38% in the third. Group 2 consisted of 713 pregnant women chosen at random in the antenatal care units of Beira and Maputo. Of the 1468 women studied, almost 40% lived in rural areas. In group 1, each woman was interviewed about her obstetric history and socioeconomic status. Clinical examination included measurement of upper arm circumference, triceps skinfolds thickness, weight, height, and uterine height. A blood sample was taken for hematological and serological analyses. In group 2, the study had to be limited to serum sampling. The Venereal Disease Research Laboratory (VDRL) test was performed on all serum samples. The treponema pallidum hemagglutination assay (TPHA) was performed on all serum samples showing positive reactions in the VDRL test. The fluorescent treponemal antibody absorbed (FTA-ABS) test was performed in Stockholm on all VDRL positive serum samples from group 1. In group 1, the VDRL test was performed on 601 serum samples at the nearby district or provincial hospital. A positive VDRL test reaction was found in 4.5% to 14.6% of the women examined, and 1.6% to 9.8% showed evidence of treponemal infection as confirmed by the TPHA or FTA-ABS, or both. In the whole study population, 93 of the 121 reactors to the VDRL test were shown to have treponemal infection, giving a 77% predictive value of a positive VDRL test reaction. All VDRL positive serum samples from patients in group 1 underwent not only TPHA but also FTA-ABS analysis, and all but one of the 36 TPHA positive serum samples were also FTA-ABS positive. Of the 46 serum samples analyzed in Maputo and Stockholm, 44 gave similar results.