PT  - JOURNAL ARTICLE
AU  - M Temmerman
AU  - P Gichangi
AU  - K Fonck
AU  - L Apers
AU  - P Claeys
AU  - L Van Renterghem
AU  - D Kiragu
AU  - G Karanja
AU  - J Ndinya-Achola
AU  - J Bwayo
TI  - Effect of a syphilis control programme on pregnancy outcome in Nairobi, Kenya
AID  - 10.1136/sti.76.2.117
DP  - 2000 Apr 01
TA  - Sexually Transmitted Infections
PG  - 117--121
VI  - 76
IP  - 2
4099  - http://sti.bmj.com/content/76/2/117.short
4100  - http://sti.bmj.com/content/76/2/117.full
SO  - Sex Transm Infect2000 Apr 01; 76
AB  - Objectives: To assess the impact of a syphilis control programme of pregnant women on pregnancy outcome in Kenya. Method: Women who came to deliver to Pumwani Maternity Hospital (PMH) between April 1997 and March 1998 were tested for syphilis. Reactive rapid plasma reagin (RPR) tests were titrated and confirmed with treponema haemagglutination test (TPHA). Equal numbers of RPR and TPHA negative women were enrolled. Antenatal syphilis screening and treatment history were examined from the antenatal cards. Results: Of 22 466 women giving birth, 12 414 (55%) were tested for syphilis. Out of these, 377 (3%) were RPR reactive of whom 296 were confirmed by TPHA. Syphilis seroreactive women had a more risky sexual behaviour and coexistent HIV antibody positivity; 26% were HIV seropositive compared with 11% among syphilis negative mothers. The incidence of adverse obstetric outcome defined as low birth weight and stillbirth, was 9.5%. Syphilis seropositive women had a higher risk for adverse obstetric outcome (OR 4.1, 95% CI 2.4–7.2). Antenatal treatment of RPR reactive women significantly improved pregnancy outcome but the risk of adverse outcome remained 2.5-fold higher than the risk observed in uninfected mothers. Conclusions: These data confirm the adverse effect of syphilis on pregnancy outcome. This study also shows the efficacy of antenatal testing and prompt treatment of RPR reactive mothers on pregnancy outcome.