1
|
Zhang M, Qu H, Xu F, Xia J, Hui X, Zhang H, Shi C, He J, Cao Y, Hu M. Factors associated with adverse pregnancy outcomes of maternal syphilis in Henan, China, 2016-2022. Epidemiol Infect 2023; 151:e170. [PMID: 37743831 PMCID: PMC10600900 DOI: 10.1017/s0950268823001589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 09/11/2023] [Accepted: 09/13/2023] [Indexed: 09/26/2023] Open
Abstract
Maternal syphilis not only seriously affects the quality of life of pregnant women themselves but also may cause various adverse pregnancy outcomes (APOs). This study aimed to analyse the association between the related factors and APOs in maternal syphilis. 7,030 pregnant women infected with syphilis in Henan Province between January 2016 and December 2022 were selected as participants. Information on their demographic and clinical characteristics, treatment status, and pregnancy outcomes was collected. Multivariate logistic regression models and chi-squared automatic interaction detector (CHAID) decision tree models were used to analyse the factors associated with APOs. The multivariate logistic regression results showed that the syphilis infection history (OR = 1.207, 95% CI, 1.035-1.409), the occurrence of abnormality during pregnancy (OR = 5.001, 95% CI, 4.203-5.951), not receiving standard treatment (OR = 1.370, 95% CI, 1.095-1.716), not receiving any treatment (OR = 1.313, 95% CI, 1.105-1.559), and a titre ≥1:8 at diagnosis (OR = 1.350, 95%CI, 1.079-1.690) and before delivery (OR = 1.985, 95%CI, 1.463-2.694) were risk factors. A total of six influencing factors of APOs in syphilis-infected women were screened using the CHAID decision tree model. Integrated prevention measures such as early screening, scientific eugenics assessment, and standard syphilis treatment are of great significance in reducing the incidence of APOs for pregnant women infected with syphilis.
Collapse
Affiliation(s)
- Meng Zhang
- Department of Health Care, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Huimin Qu
- Department of Health Care, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Feng Xu
- Department of Health Care, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Junfen Xia
- Department of Health Care, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaoqing Hui
- Department of Health Care, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hongyan Zhang
- Department of Health Care, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Cannan Shi
- Department of Health Care, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Junjian He
- Department of Health Care, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Yuan Cao
- Department of Health Care, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Mengcai Hu
- Department of Health Care, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| |
Collapse
|
2
|
David A, Posfay-Barbe KM, Aguiar Nogueira C, Toutous Trellu L. Congenital syphilis in Switzerland: a marker of inequality? A mini-review. Front Public Health 2023; 11:1265725. [PMID: 37780442 PMCID: PMC10536148 DOI: 10.3389/fpubh.2023.1265725] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 08/31/2023] [Indexed: 10/03/2023] Open
Abstract
Syphilis remains a global public health problem, with growing incidence in most regions of the world, particularly among women of childbearing age. This alarming trend has led to an increase in cases of congenital syphilis, resulting in devastating consequences. While the implementation of measures by the World Health Organization (WHO) and various governments has contributed to a decline in the global incidence of congenital syphilis, many countries are facing an escalating crisis, as incidence continues to rise. This mini-review aims to provide an overview of the current state of this disease in different parts of the world, focusing on the most affected populations and highlighting congenital syphilis as a marker of vulnerability. It also focuses on Switzerland, a country with a robust economy, to identify shortcomings in the healthcare system that contribute to the persistence of congenital syphilis, even though the infection is easily detectable and treatable. In conclusion, this mini-review highlights the persistent risk of congenital syphilis worldwide, regardless of country prevalence or economic status, and underscores the need for sustained efforts to reach underserved women, emphasizing the vital role of comprehensive training for healthcare professionals.
Collapse
|
3
|
Warzywoda S, Fowler JA, Nourse C, Wu M, Britton S, Rowling D, Griffin P, Lazarou M, Hamilton Z, Dean JA. Syphilis in pregnancy: a qualitative investigation of healthcare provider perspectives on barriers to syphilis screening during pregnancy in south-east Queensland. Sex Health 2023; 20:330-338. [PMID: 37245957 DOI: 10.1071/sh22193] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 05/08/2023] [Indexed: 05/30/2023]
Abstract
BACKGROUND Increasing rates of syphilis in pregnancy (SiP) in Australia and other high-income countries, has led to the resurgence of congenital syphilis. Suboptimal syphilis screening during pregnancy has been identified as a key contributing factor. METHODS This study aimed to explore, from the perspective of multidisciplinary healthcare providers (HCPs), the barriers to optimal screening during the antenatal care (ANC) pathway. Semi-structured interviews conducted with 34 HCPs across multiple disciplines practising in south-east Queensland (SEQ) were analysed through a process of reflexive thematic analysis. RESULTS Barriers were found to occur at the system level of ANC, through difficulties in patient engagement in care, limitations in the current model of health care delivery and limitations in the communication pathways across health care disciplines; and at the individual HCP level, through HCP knowledge and awareness of epidemiological changes in syphilis in SEQ, and adequately assessing patient risk. CONCLUSION It is imperative that the healthcare systems and HCPs involved in ANC address these barriers to improve screening in order to optimise management of women and prevent congenital syphilis cases in SEQ.
Collapse
Affiliation(s)
- Sarah Warzywoda
- The University of Queensland, Faculty of Medicine, School of Public Health, 288 Herston Road, Herston, Qld 4006, Australia
| | - James A Fowler
- The University of Queensland, Faculty of Medicine, School of Public Health, 288 Herston Road, Herston, Qld 4006, Australia
| | - Clare Nourse
- The University of Queensland, Faculty of Medicine, School of Medicine, 288 Herston Road, Herston, Qld 4006, Australia; and Infection Management and Prevention Service, Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, 501 Stanley Street, South Brisbane, Qld 4101, Australia
| | - Mandy Wu
- The University of Queensland, Faculty of Medicine, School of Medicine, 288 Herston Road, Herston, Qld 4006, Australia; and Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, 501 Stanley Street, South Brisbane, Qld 4101, Australia
| | - Sumudu Britton
- The University of Queensland, Faculty of Medicine, School of Medicine, 288 Herston Road, Herston, Qld 4006, Australia; and Department of Infectious Diseases, Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, 7 Butterfield Street, Herston, Qld 4029, Australia
| | - Diane Rowling
- Metro North Public Health Unit, Metro North Hospital and Health Service, Bryden Street, Windsor, Qld 4030, Australia
| | - Paul Griffin
- The University of Queensland, Faculty of Medicine, School of Medicine, 288 Herston Road, Herston, Qld 4006, Australia; and Mater Health Brisbane, Raymond Terrace, South Brisbane, Qld 4101, Australia
| | - Mattea Lazarou
- The University of Queensland, Faculty of Medicine, School of Public Health, 288 Herston Road, Herston, Qld 4006, Australia; and Queensland Children's Hospital, Children's Health Queensland Hospital and Health Service, 501 Stanley Street, South Brisbane, Qld 4101, Australia
| | - Zoe Hamilton
- The University of Queensland, Faculty of Medicine, School of Public Health, 288 Herston Road, Herston, Qld 4006, Australia
| | - Judith A Dean
- The University of Queensland, Faculty of Medicine, School of Public Health, 288 Herston Road, Herston, Qld 4006, Australia
| |
Collapse
|
4
|
Freyne B, Nourse C, Walls T. Congenital Syphilis: Controversies and Questions: A Global Perspective. Pediatr Infect Dis J 2023; 42:e166-e169. [PMID: 36728111 DOI: 10.1097/inf.0000000000003808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Bridget Freyne
- From the Department of Paediatric Infectious Diseases, Children's Health Ireland, Dublin, Ireland
- Division of Women & Children's Health, School of Medicine, University College Dublin, Ireland
| | - Clare Nourse
- Division of Women & Children's Health, School of Medicine, University College Dublin, Ireland
- Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - Tony Walls
- Department of Paediatrics, University of Otago, Christchurch, New Zealand
- Research for Children Aotearoa, New Zealand https://www.healthprecinct.org.nz/research-for-children-aotearoa/
| |
Collapse
|