Antibiotics for syphilis diagnosed during pregnancy

RHL practical aspects by E Farrell, RC Pattinson

FIRST CONTACT (PRIMARY CARE) LEVEL

All pregnant patients should be screened for syphilis at the primary health care level, especially in under-resourced settings because of the disease's high incidence, contribution to perinatal mortality and because it is treatable. Rapid on-site testing (RPR) should be available at this level, since it has been shown to be a practical method to prevent congenital syphilis in under-resourced settings, where patients are often lost to follow-up (1, 2).The test itself is easy and needs no special equipment (3). It is also cost–effective (4) and of great value in reducing deaths due to congenital syphilis (3).

Penicillin should be available in all primary health care facilities and administered preferably immediately if the test proves to be positive.

REFERRAL HOSPITAL (SECONDARY CARE) LEVEL

The above recommendations for primary care level of care also apply at this level.

AT HOME OR IN THE COMMUNITY

The public should be educated about prevention measures, such as condom use, and about the need to attend antenatal care early in pregnancy for testing and treatment.

References

  • Patel A, Moodley D, Moodley J. An evaluation of on-site testing for syphilis. Tropical doctor 2001;31:79-82.
  • Pattinson RCF. On-site screening for syphilis—the time has come. South African medical journal 1998;88:780.
  • Delport SD, van den Berg JHY. On-site screening for syphilis at an antenatal clinic. South African medical journal 1998;88:43-44.
  • Wilkinson D, Sach ME. Accuracy of on-site screening for syphilis among women attending a rural mobile antenatal clinic. South African medical journal 1998;88:783–785.

This document should be cited as: E Farrell, RC Pattinson. Antibiotics for syphilis diagnosed during pregnancy: RHL practical aspects (last revised: 11 November 2002). The WHO Reproductive Health Library; Geneva: World Health Organization.

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