Notification and management of congenital syphilis in the Northern Territory 2009 to 2014
DOI:
https://doi.org/10.33321/cdi.2015.39.36Keywords:
syphilis, congenital syphilis, notification, paediatric, mother-to-child transmission, pregnancy, Northern Territory, Indigenous populationAbstract
Objective: To determine whether cases of congenital syphilis in the Northern Territory between 2009 and 2014 were correctly notified based on probable or confirmed case criteria stipulated by the Communicable Diseases Network Australia (CDNA).
Methods: Pregnant women with positive syphilis serology defined as reactive treponemal test and rapid plasma reagin titre ≥1:8 were identified from the Northern Territory Syphilis Register Information System. Risk classification was performed based on local guidelines, and CDNA criteria for probable/confirmed cases of congenital syphilis were applied to determine whether cases were appropriately notified.
Results: Thirty-four cases of positive maternal syphilis serology in pregnancy were identified from 31 women; all were Indigenous. Twenty-one cases fulfilled criteria for probable congenital syphilis; 1 case was formally notified to the Centre for Disease Control. Twenty cases (95%) fulfilling CDNA criteria for probable congenital syphilis were not notified over the study period.
Conclusions: Application of standard case definitions significantly increases the rate of congenital syphilis cases in the Northern Territory. Improved education regarding CDNA criteria for notification of congenital syphilis is necessary for clinicians and public health staff. Emerging evidence has supported the recent simplification of CDNA criteria for notification of congenital syphilis, effective 1 July 2015. Commun Dis Intell 2015;39(3):E323–E328.
Downloads
References
Mandell G BJ, Dolin R. Mandell, Douglas and Bennett’s Principles and Practice of Infectious DiseaseS. 7th edn: Churchill Livingstone Elsevier; 2010.
Hawkes SJ, Gomez GB, Broutet N. Early antenatal care: does it make a difference to outcomes of pregnancy associated with syphilis? A systematic review and meta-analysis. PLoS One 2013;8(2):e56713.
Newman L, Kamb M, Hawkes S, Gomez G, Say L, Seuc A, et al. Global estimates of syphilis in pregnancy and associated adverse outcomes: analysis of multinational antenatal surveillance data. PLoS Med 2013;10(2):e1001396.
Skog S BI, Bullen J, Fethers K, Smith K, Lum G, et al. Guidelines for the investigation and treatment of infants at risk of congenital syphilis in the Northern Territory. Centre for Disease Control; 2005.
Communicable Diseases Network Australia. Syphilis (Congenital) case definition. 2010.
Qin J, Yang T, Xiao S, Tan H, Feng T, Fu H. Reported estimates of adverse pregnancy outcomes among women with and without syphilis: a systematic review and meta-analysis. 2014.
Mak DB, Holman CD. Age at first episode of venereal syphilis in an aboriginal population: an application of survival analysis. Aust N Z J Public Health 1998;22(6):704–708.
Gray E. Northern Territory Congenital Syphilis Guidelines: Women with positive syphilis serology in pregnancy. Northern Territory Department of Health; 2014.
Marks M, Solomon AW, Mabey DC. Endemic treponemal diseases. Trans R Soc Trop Med Hyg 2014;108(10):601–607.
Kamb ML, Newman LM, Riley PL, Mark J, Hawkes SJ, Malik T, et al. A road map for the global elimination of congenital syphilis. 2010.
Workowski K BG. Sexually Transmitted Diseases Guidelines. Center for Surveillance, Epidemiology and Laboratory Services, Centers for Disease Control and Prevention; 2015. MMWR Morbidity and Mortality Weekly Recommendations and Reports: p. 34–49.
Wendel GD, Jr., Sheffield JS, Hollier LM, Hill JB, Ramsey PS, Sanchez PJ. Treatment of syphilis in pregnancy and prevention of congenital syphilis. Clin Infect Dis 2002;35(Suppl 2):S200–S209.
Rac MW, Bryant SN, Cantey JB, McIntire DD, Wendel GD Jr, Sheffield JS. Maternal titers after adequate syphilotherapy during pregnancy. Clin Infect Dis 2015;60(5):686–690.
STD surveillance definitions: Syphilis, congenital. In: USA Centers for Disease Control and Prevention; Atlanta: 2013.
Galvao TF, Silva MT, Serruya SJ, Newman LM, Klausner JD, Pereira MG, et al. Safety of benzathine penicillin for preventing congenital syphilis: a systematic review. PLoS One 2013;8(2):e56463.
Downloads
Published
How to Cite
License
Copyright (c) 2015 Communicable Diseases Intelligence
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
