Syphilis control during pregnancy: effectiveness and sustainability of a decentralized program

Am J Public Health. 2001 May;91(5):705-7. doi: 10.2105/ajph.91.5.705.


Objectives: This study sought to assess the performance, effectiveness, and costs of a decentralized antenatal syphilis screening program in Nairobi, Kenya.

Methods: Health clinic data, quality control data, and costs were analyzed.

Results: The rapid plasma reagin (RPR) seroprevalence was 3.4%. In terms of screening, treatment, and partner notification, the program's performance was adequate. The program's effectiveness was problematic because of false-negative and false-positive RPR results. The cost per averted case was calculated to be US$95 to US$112.

Conclusions: The sustainability of this labor-intensive program is threatened by costs and logistic constraints. Alternative strategies, such as the mass epidemiologic treatment of pregnant women in high-prevalence areas, should be considered.

Publication types

  • Evaluation Study
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cost-Benefit Analysis
  • Female
  • Humans
  • Infectious Disease Transmission, Vertical / prevention & control*
  • Kenya / epidemiology
  • Mass Screening / organization & administration*
  • Pregnancy
  • Pregnancy Complications, Infectious / epidemiology
  • Pregnancy Complications, Infectious / microbiology
  • Pregnancy Complications, Infectious / prevention & control*
  • Prenatal Care / organization & administration*
  • Program Evaluation
  • Syphilis / epidemiology
  • Syphilis / prevention & control*