Non-effective partner notification system: a missed opportunity for the reduction of sexually transmitted infections in sub-Saharan Africa

Abstract

It is well know that common sexually transmitted infections (STI) promote HIV/AIDS infections in the community. Partner notification is one of the recommended strategies used for STI control. Antenatal syphilis screening, treatment of syphilis-positive pregnant women and their partner (partners) treatment may decrease the number of new syphilis cases, cases of congenital syphilis and diminish maternal morbidity and mortality.

Objective: The aim of the study was to assess the adequacy and effectiveness of partner notification and treatment system of rapid plasma reagin (RPR) positive patients of antenatal clinics (ANC) in Swaziland as an example of a country in sub-Saharan Africa.

Material and methods: It was a prospective study of the incidence of syphilis in the group of pregnant women attending antenatal clinics (ANC), and a study of the results of their partners' notification. The data for this study were collected prospectively from routine records of ANC attendees.

Results: The positive Rapid Plasma Reagin (RPR) test was established in 19% (n = 2034) screened patients. 38% out of all RPR-positive patients were not informed of their RPR status. The typical syphilis treatment was given in 42% of all RPR-positive pregnant women. Only 5% of partners of the RPR-positive pregnant women were traced, checked and correctly treated.

Conclusions: The usual way of syphilis screening and partner notification in a country like Swaziland is not effective, and there is a need to develop other, African-specific methods of syphilis screening and partners' notification. Most probably without the effective STI management in Africa the battle against HIV/AIDS epidemic will be extremely difficult if not impossible.