Congenital Syphilis Elimination Cost-Effectiveness Analysis

Investigator: James Kahn, MD, MPH
Sponsor: World Health Organization (WHO)

Location(s): Burundi; Comoros; Djibouti; Madagascar; Malawi; Mauritius; Mozambique; Rwanda; Tanzania; Zambia; Zimbabwe; Cameroon; Central African Republic; Chad; Congo (Brazzaville); Gabon; Sao Tome and Principe; Sudan; Tunisia; Botswana; Namibia; South Africa; Swaziland; Benin; Burkina Faso; Ivory Coast; Ghana; Guinea; Mali; Nigeria; Sierra Leone; Togo; Kazakhstan; Kyrgyzstan; Uzbekistan; China; Mongolia; Afghanistan; Bangladesh; India; Maldives; Nepal; Sri Lanka; Cambodia; Indonesia; Viet Nam; Laos; Malaysia; Myanmar; Thailand; Philippines; Jordan; Oman; Saudi Arabia; Belarus; Czech Republic; Estonia; Germany; Hungary; Lithuania; Macedonia; Moldova; Romania; United Kingdom; Costa Rica; El Salvador; Guatemala; Honduras; Mexico; Panama; Argentina; Bolivia; Brazil; Chile; Colombia; Ecuador; Guyana; Paraguay; Peru; Uruguay; Antigua and Barbuda; Cuba; Dominica; Dominican Republic; Grenada; Trinidad and Tobago; Fiji; Kiribati; Papua New Guinea


In order to prevent fetal and infant deaths caused by maternal syphilis, WHO launched the Initiative for the Global Elimination of Congenital Syphilis in 2007. Elimination of congenital syphilis (ECS) is an important and attainable component of global efforts to achieve the Millennium Development Goals (MDGs) 4 (reduce child mortality), 5 (improve maternal health), and 6 (combat HIV/AIDS, malaria, and other diseases). Surveillance, monitoring, and evaluation are together considered one of the four critical pillars of ECS efforts, in addition to advocacy, access to maternal,newborn, and child health (MNCH) services, and screening and treatment of pregnant women. Furthermore, in order to support local and national MNCH monitoring systems and attainment of the MDGs, ECS surveillance, monitoring, and evaluation must be implemented within existing information systems for sexually transmitted infections (STIs), HIV, and MNCH.
The overall goal of the Initiative for the Global Elimination of Congenital Syphilis is to eliminate congenital syphilis as a public health problem by 2015 (5). The specific goal of the elimination effort is to prevent maternal-to-child transmission of syphilis and resultant perinatal morbidity and mortality. This can be achieved by strengthening antenatal care and reproductive and sexual health programmes to ensure:
1. early antenatal care for all women, with universal syphilis screening and prompt treatment of those infected
2. treatment of all neonates born to syphilis-seropositive mothers
3. treatment of all sexual partners of infected women, promotion of condom use during pregnancy, and counselling of all women on how to prevent infection.