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. 2021 Mar;106(3):231-237.
doi: 10.1136/archdischild-2020-320549. Epub 2020 Dec 22.

New screening approach to detecting congenital syphilis in China: a retrospective cohort study

Fang Hu  1 , Shuai-Jun Guo  2   3 , Jian-Jun Lu  4   5 , Ning-Xuan Hua  1 , Yan-Yan Song  1 , Sui-Fang Lin #  6 , Sui Zhu #  7
Affiliations

New screening approach to detecting congenital syphilis in China: a retrospective cohort study

Fang Hu et al. Arch Dis Child. 2021 Mar.

Erratum in

Abstract

Background: Diagnosis of congenital syphilis (CS) is not straightforward and can be challenging. This study aimed to evaluate the validity of an algorithm using timing of maternal antisyphilis treatment and titres of non-treponemal antibody as predictors of CS.

Methods: Confirmed CS cases and those where CS was excluded were obtained from the Guangzhou Prevention of Mother-to-Child Transmission of syphilis programme between 2011 and 2019. We calculated sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) using receiver operating characteristics (ROC) in two situations: (1) receiving antisyphilis treatment or no-treatment during pregnancy and (2) initiating treatment before 28 gestational weeks (GWs), initiating after 28 GWs or receiving no treatment for syphilis seropositive women.

Results: Among 1558 syphilis-exposed children, 39 had confirmed CS. Area under the curve, sensitivity and specificity of maternal non-treponemal titres before treatment and treatment during pregnancy were 0.80, 76.9%, 78.7% and 0.79, 69.2%, 88.7%, respectively, for children with CS. For the algorithm, ROC results showed that PPV and NPV for predicting CS were 37.3% and 96.4% (non-treponemal titres cut-off value 1:8 and no antisyphilis treatment), 9.4% and 100% (non-treponemal titres cut-off value 1:16 and treatment after 28 GWs), 4.2% and 99.5% (non-treponemal titres cut-off value 1:32 and treatment before 28 GWs), respectively.

Conclusions: An algorithm using maternal non-treponemal titres and timing of treatment during pregnancy could be an effective strategy to diagnose or rule out CS, especially when the rate of loss to follow-up is high or there are no straightforward diagnostic tools.

Keywords: microbiology; statistics.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Description of the evaluated algorithm. CS, congenital syphilis.
Figure 2
Figure 2
ROC curves of titres of non-treponemal titres before treatment and maternal antisyphilis treatment during pregnancy. AUC, area under the curve; ROC, receiver operating characteristic.
Figure 3
Figure 3
ROC curves of timing of maternal syphilis treatment in three groups. AUC, area under the curve; ROC, receiver operating characteristic.
See this image and copyright information in PMC

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References

    1. Plotzker RE, Murphy RD, Stoltey JE. Congenital syphilis prevention: strategies, evidence, and future directions. Sex Transm Dis 2018;45:S29–37. 10.1097/OLQ.0000000000000846 - DOI - PubMed
    1. Hussen S, Tadesse BT. Prevalence of syphilis among pregnant women in sub-Saharan Africa: a systematic review and meta-analysis. Biomed Res Int 2019;2019:1–10. 10.1155/2019/4562385 - DOI - PMC - PubMed
    1. Korenromp EL, Rowley J, Alonso M, et al. . Global burden of maternal and congenital syphilis and associated adverse birth outcomes-Estimates for 2016 and progress since 2012. PLoS One 2019;14:e0211720. 10.1371/journal.pone.0211720 - DOI - PMC - PubMed
    1. Feliz MC, de Medeiros ARP, Rossoni AM, et al. . Adherence to the follow-up of the newborn exposed to syphilis and factors associated with loss to follow-up. Rev Bras Epidemiol 2016;19:727–39. 10.1590/1980-5497201600040004 - DOI - PubMed
    1. Slutsker JS, Hennessy RR, Schillinger JA. Factors Contributing to Congenital Syphilis Cases - New York City, 2010-2016. MMWR Morb Mortal Wkly Rep 2018;67:1088–93. 10.15585/mmwr.mm6739a3 - DOI - PMC - PubMed

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