Factors affecting the effectiveness of prenatal screening programmes for syphilis
| Factors in favour of a prenatal syphilis screening programme | Why has syphilis remained a major cause of stillbirth and neonatal mortality? |
|---|---|
| Most countries have a national policy for prenatal syphilis screening | Implementation rate of national policy has remained poor due to lack of political commitment and funding |
| Stillbirth and neonatal mortality cannot be attributed to syphilis unless women are screened early in pregnancy | Syphilis in pregnancy is invisible or asymptomatic. Lack of knowledge regarding possible causes of adverse pregnancy outcome |
| 75–85% of women attend antenatal clinics; affordable diagnostic tests for screening are available | Most clinics lack the capacity to offer screening on a consistent basis due to personnel shortage, supply chain failures for tests, gloves and other consumables |
| Infection can be cured and transmission to fetus can be prevented with inexpensive curative therapy | Failure to comply with the same-day test and treatment (STAT) strategy, requiring women to return for results and treatment, stock-out of drugs |
| Prenatal screening for syphilis is one of the most cost-effective public health interventions | Lack of capacity for assessing the impact and cost-effectiveness of adopting a new diagnostic technology |