Prevalence and management of syphilis at primary healthcare level in the Free State, South Africa

Background: Maternal syphilis (MS) is of special concern because of the risks of vertical transmission resulting in high rates of stillbirths and neonatal infections, especially in low- and middle-income countries (LMICs), such as South Africa (SA). Objectives: To assess the clinical management of...

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Main Authors: Olive P. Khaliq, Ahmad Jassen, Nomakhuwa E. Tabane, Jagidesa Moodley
Format: Article
Language:English
Published: AOSIS 2025-05-01
Series:Southern African Journal of Infectious Diseases
Subjects:
Online Access:https://sajid.co.za/index.php/sajid/article/view/724
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author Olive P. Khaliq
Ahmad Jassen
Nomakhuwa E. Tabane
Jagidesa Moodley
author_facet Olive P. Khaliq
Ahmad Jassen
Nomakhuwa E. Tabane
Jagidesa Moodley
author_sort Olive P. Khaliq
collection DOAJ
description Background: Maternal syphilis (MS) is of special concern because of the risks of vertical transmission resulting in high rates of stillbirths and neonatal infections, especially in low- and middle-income countries (LMICs), such as South Africa (SA). Objectives: To assess the clinical management of MS at two primary healthcare clinics. Method: This was a retrospective evaluation of the antenatal records from 2020 to 2023 at two clinics in the Free State, SA. Demographic and clinical data, including MS mono rapid plasma reagin test and HIV status measured using the mono rapid HIV test, foetal and perinatal outcomes were collected. Results: 668 records were reviewed. Fifteen tested (2.3%) positive for MS, but only 12/15 received complete treatment. Of the syphilis negative women, only 365 (55.3%) were retested. 28% of all pregnant women were HIV-positive. Four of the 15 (27%) women with MS had HIV, while 11 of the 15 (73%) of the HIV-negative pregnant women had syphilis. Among syphilis-exposed neonates, two had complications due to syphilis exposure and one had low birthweight despite maternal treatment. Conclusion: The prevalence of MS at the study sites was 2.3%. 44.7% of the women who tested negative for syphilis were not retested, and three women with syphilis did not receive complete treatment. Incomplete treatment of the mothers’ results in complications in syphilis-exposed neonates. There is an urgent need for continuing training for the nurses and midwives on antenatal screening and treatment protocols for MS at primary healthcare settings in the Free State, SA. Contribution: This work will benefit the community by alerting the Department of Health on the short comings found at antenatal care clinics, with the goal to improve the management of pregnant women.
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spelling doaj-art-9ffef5ca025649188d1ebd866addfaa42025-08-20T02:05:20ZengAOSISSouthern African Journal of Infectious Diseases2312-00532313-18102025-05-01401e1e710.4102/sajid.v40i1.724343Prevalence and management of syphilis at primary healthcare level in the Free State, South AfricaOlive P. Khaliq0Ahmad Jassen1Nomakhuwa E. Tabane2Jagidesa Moodley3Department of Paediatrics and Child Health, Faculty of Health Sciences, School of Clinical Medicine, University of the Free State, BloemfonteinDepartment of Paediatrics and Child Health, Faculty of Health Sciences, School of Clinical Medicine, University of the Free State, BloemfonteinDepartment of Paediatrics and Child Health, Faculty of Health Sciences, School of Clinical Medicine, University of the Free State, BloemfonteinDepartment of Obstetrics and Gynaecology, School of Medicine, University of KwaZulu-Natal, DurbanBackground: Maternal syphilis (MS) is of special concern because of the risks of vertical transmission resulting in high rates of stillbirths and neonatal infections, especially in low- and middle-income countries (LMICs), such as South Africa (SA). Objectives: To assess the clinical management of MS at two primary healthcare clinics. Method: This was a retrospective evaluation of the antenatal records from 2020 to 2023 at two clinics in the Free State, SA. Demographic and clinical data, including MS mono rapid plasma reagin test and HIV status measured using the mono rapid HIV test, foetal and perinatal outcomes were collected. Results: 668 records were reviewed. Fifteen tested (2.3%) positive for MS, but only 12/15 received complete treatment. Of the syphilis negative women, only 365 (55.3%) were retested. 28% of all pregnant women were HIV-positive. Four of the 15 (27%) women with MS had HIV, while 11 of the 15 (73%) of the HIV-negative pregnant women had syphilis. Among syphilis-exposed neonates, two had complications due to syphilis exposure and one had low birthweight despite maternal treatment. Conclusion: The prevalence of MS at the study sites was 2.3%. 44.7% of the women who tested negative for syphilis were not retested, and three women with syphilis did not receive complete treatment. Incomplete treatment of the mothers’ results in complications in syphilis-exposed neonates. There is an urgent need for continuing training for the nurses and midwives on antenatal screening and treatment protocols for MS at primary healthcare settings in the Free State, SA. Contribution: This work will benefit the community by alerting the Department of Health on the short comings found at antenatal care clinics, with the goal to improve the management of pregnant women.https://sajid.co.za/index.php/sajid/article/view/724maternal syphilisscreeningmanagementpregnancycongenital syphilisnewborns.
spellingShingle Olive P. Khaliq
Ahmad Jassen
Nomakhuwa E. Tabane
Jagidesa Moodley
Prevalence and management of syphilis at primary healthcare level in the Free State, South Africa
Southern African Journal of Infectious Diseases
maternal syphilis
screening
management
pregnancy
congenital syphilis
newborns.
title Prevalence and management of syphilis at primary healthcare level in the Free State, South Africa
title_full Prevalence and management of syphilis at primary healthcare level in the Free State, South Africa
title_fullStr Prevalence and management of syphilis at primary healthcare level in the Free State, South Africa
title_full_unstemmed Prevalence and management of syphilis at primary healthcare level in the Free State, South Africa
title_short Prevalence and management of syphilis at primary healthcare level in the Free State, South Africa
title_sort prevalence and management of syphilis at primary healthcare level in the free state south africa
topic maternal syphilis
screening
management
pregnancy
congenital syphilis
newborns.
url https://sajid.co.za/index.php/sajid/article/view/724
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AT ahmadjassen prevalenceandmanagementofsyphilisatprimaryhealthcarelevelinthefreestatesouthafrica
AT nomakhuwaetabane prevalenceandmanagementofsyphilisatprimaryhealthcarelevelinthefreestatesouthafrica
AT jagidesamoodley prevalenceandmanagementofsyphilisatprimaryhealthcarelevelinthefreestatesouthafrica