Syphilis still a leading killer of newborns in the world

If a pregnant woman who is infected does not receive early and effective treatment, she can then transmit the infection to her unborn infant. PHOTO | FILE | NATION MEDIA GROUP

Syphilis remains a leading cause of baby loss globally, responsible for more than 200,000 stillbirths and newborn deaths every single year.

New data on congenital syphilis, released by the World Health Organisation, shows that that there were more than half a million (around 661,000) total cases of congenital syphilis in 2016.

The report comes in the wake of shortage of Benzathine Penicillin G (BPG) globally, the only drug used to treat and to prevent mother-to-child transmission of syphilis.

Syphilis is unique among sexually transmitted diseases in that it remains curable with a single dose of Benzathine penicillin, with no documented risk of resistance.

If a pregnant woman who is infected does not receive early and effective treatment, she can then transmit the infection to her unborn infant. This is known as ‘congenital syphilis’, which is often fatal. It can also cause low birth weight, prematurity, and other congenital deformities.

Congenital syphilis is the second leading cause of preventable stillbirth globally, preceded only by malaria.

Out of the 661,000 total cases of congenital syphilis, there were 355,000 newborn deaths and ailments.

This is despite the fact that congenital syphilis – when the infection is transmitted during pregnancy or childbirth – is easily preventable and treatable.

Addressing the second African Union Conference in Maternal, Newborn and Child Health in Nairobi last year, Health Cabinet Secretary Sicily Kariuki said that despite heavy investments in maternal and child health, Africa continues to face challenges related to geographical barriers and quality of care.

“The causes of maternal and child deaths are preventable; it is therefore incumbent upon us all to address these factors. We need to intensify efforts to keep girls in school and in the short term, diminish HIV, syphilis, polio and other diseases that continue to take a toll on mothers and children,” she stressed.

She called upon the delegates to innovate strategies that will assist countries in the continent and beyond to reduce maternal and child morbidity and mortality.

GLOBAL BURDEN

Syphilis is one of the most common sexually transmitted infections globally, with approximately six million new cases worldwide each year.

Congenital syphilis is easily preventable and treatable – as long as testing and treatment are provided to pregnant women early during antenatal care. The risk of adverse outcomes to the foetus is minimal if a pregnant woman, infected with syphilis, receives testing and adequate treatment with benzathine penicillin, early in pregnancy – ideally before the second trimester.

The estimates by WHO showed that the overall global burden of congenital syphilis decreased over the 2012 to 2016 research period, although non-significantly, from around 750,000 to 660,000 cases. The research also found some improvements in screening, treatment, and surveillance of maternal syphilis. Estimated adverse birth outcomes due to congenital syphilis decreased slightly from 397,000 to 355,000.

Despite the decrease between 2012 and 2016, the numbers of affected women and infants remains unacceptably high.

“It is crucial that all women are provided with early syphilis screening and treatment as part of high-quality antenatal care for a positive experience of pregnancy,” says WHO.

In addition, health systems and programmes need to ensure that all women diagnosed with syphilis, as well as their infants, are effectively treated – and that their sexual partners are reached for testing and treatment. Countries can also work to reduce syphilis prevalence across populations, by ensuring that testing, treatment and partner referral for the infection are put into action, beyond that of antenatal care.

In recent years 12 countries have been validated by WHO as having eliminated mother-to-child transmission of syphilis and / or HIV.

“Monitoring the scale up of screening and treatment of pregnant women remains paramount to measure progress towards the goal of eliminating mother-to-child transmission. Measuring how many adults and infants are affected by syphilis with regional and national-level estimation is crucial to guide health systems’ capacity to strengthen the prevention, detection and treatment of syphilis,” says the global health agency.