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Rapid Syphilis Could Prevent Congenital Disease and Stillbirths in Haiti

Congenital syphilis is a major preventable public health problem in many developing countries, frequently causing stillbirths or neonatal death and disabling children who survive. Often undiagnosed or untreated, syphilis is passed from mother to child -- even when mothers take part in prenatal programs to prevent the spread of HIV.

Now, new research from Weill Cornell Medical College and the Groupe Haitien d'Etude du Sarcome de Kaposi et des Infections Opportunistes (GHESKIO) published in the May issue of the open-access journal PLoS Medicine finds that integrating a new rapid syphilis test into prenatal HIV testing programs in Haiti can prevent more than 2,000 cases of stillbirth, neonatal death or congenital syphilis.

'We have shown that by working with the HIV prevention program infrastructure, we can better prevent transmission of syphilis from mother to child at minimal incremental cost. These findings not only give guidance to public health efforts in Haiti, but may serve as a model for projecting the benefits of similar efforts in Africa and in other resource-poor settings,' says Dr. Bruce R. Schackman, lead author of the study and associate professor and chief of the Division of Health Policy in the Department of Public Health at Weill Cornell Medical College.

Researchers compared three strategies for screening pregnant women for syphilis. The first strategy, the standard of care in rural Haitian areas without access to syphilis laboratory testing, is assessing symptoms and treating if symptoms are found. The second, considered the standard in urban areas, is a blood test for antibody response to the syphilis bacterium -- an approach that requires a one-week waiting period for follow-up and treatment. The third strategy is rapid testing that permits immediate diagnosis and treatment initiation at a single clinic visit.

According to the World Health Organization (WHO), there are more than 20 rapid syphi
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