Congenital Syphilis Prevention Challenges, Pacific Coast of Colombia, 2018-2022

Abstract

High incidences of congenital syphilis have been reported in areas along the Pacific coast of Colombia. In this retrospective study, conducted during 2018-2022 at a public hospital in Buenaventura, Colombia, we analyzed data from 3,378 pregnant women. The opportunity to prevent congenital syphilis was missed in 53.1% of mothers because of the lack of syphilis screening. Characteristics of higher maternal social vulnerability and late access to prenatal care decreased the probability of having >1 syphilis screening test, thereby increasing the probability of having newborns with congenital syphilis. In addition, the opportunity to prevent congenital syphilis was missed in 41.5% of patients with syphilis because of the lack of treatment, which also increased the probability of having newborns with congenital syphilis. We demonstrate the urgent need to improve screening and treatment capabilities for maternal syphilis, particularly among pregnant women who are more socially vulnerable.

Keywords: Colombia; bacteria; congenital syphilis; early diagnosis; health disparate; infectious; mass screening; minority and vulnerable populations; pregnancy complications; pregnancy tests; social vulnerability.

Figure 1

Syphilis screening and percentage of newborns with congenital syphilis by year of mothers’ entry into the prenatal care program at a public hospital, Buenaventura, Colombia, 2018–2022. Maternal syphilis screening has improved progressively over the years, though the number of mothers who participated in the prenatal care program dropped in 2020. In addition, variability was observed in the percentage of newborns with congenital syphilis, which decreased from 3.1% to 1.8% in the evaluated period, although the percentage increased slightly from 2021 to 2022. Scales for the y-axes differ substantially to underscore patterns but do not permit direct comparisons.

Figure 2

Multivariate analysis of factors associated with the lack of >1 maternal syphilis screening test in prenatal care program, Buenaventura, Colombia, 2018–2022. Vertical red dashed line indicates the nonassociation reference point. aOR, adjusted odds ratio; PCP, prenatal care program.