Introduction:Mongolia's health ministry prioritizes control of Sexually Transmitted Infections,including syphilis screening and treatment in antenatal care(ANC).Methods:Adult syphilis prevalence trends were fitted...Introduction:Mongolia's health ministry prioritizes control of Sexually Transmitted Infections,including syphilis screening and treatment in antenatal care(ANC).Methods:Adult syphilis prevalence trends were fitted using the Spectrum-STI estimation tool,using data from ANC surveys and routine screening over 1997e2016.Estimates were combined with programmatic data to estimate numbers of treated and untreated pregnant women with syphilis and associated incidence congenital syphilis(CS)and CS-attributable adverse birth outcomes(ABO),which we compared with CS case reports.Results:Syphilis prevalence in pregnant women was estimated at 1.7%in 2000 and 3.0%in 2016.We estimated 652 CS cases,of which 410 ABO,in 2016.Far larger,annually increasing numbers of CS cases and ABO were estimated to have been prevented:1654 cases,of which 789 ABO in 2016thanks to increasing coverages of ANC(99%in 2016),ANC-based screening(97%in 2016)and treatment of women diagnosed(81%in 2016).The 42 CS cases reported nationally over 2016(liveborn infants only)represented 27%of liveborn infants with clinical CS,but only 7%of estimated CS cases among women found syphilis-infected in ANC,and 6%of all estimated CS cases including those born to women with undiagnosed syphilis.Discussion/Conclusion:Mongolia's ANC-based syphilis screening program is reducing CS,but maternal prevalence remains high.To eliminate CS(target:<50 cases per 100,000 live births),Mongolia should strengthen ANC services,limiting losses during referral for treatment,and under-diagnosis of CS including still-births and neonatal deaths,and expand syphilis screening and prevention programs.展开更多
基金The project was funded by the World Health Organization,Department of Reproductive Health and Research
文摘Introduction:Mongolia's health ministry prioritizes control of Sexually Transmitted Infections,including syphilis screening and treatment in antenatal care(ANC).Methods:Adult syphilis prevalence trends were fitted using the Spectrum-STI estimation tool,using data from ANC surveys and routine screening over 1997e2016.Estimates were combined with programmatic data to estimate numbers of treated and untreated pregnant women with syphilis and associated incidence congenital syphilis(CS)and CS-attributable adverse birth outcomes(ABO),which we compared with CS case reports.Results:Syphilis prevalence in pregnant women was estimated at 1.7%in 2000 and 3.0%in 2016.We estimated 652 CS cases,of which 410 ABO,in 2016.Far larger,annually increasing numbers of CS cases and ABO were estimated to have been prevented:1654 cases,of which 789 ABO in 2016thanks to increasing coverages of ANC(99%in 2016),ANC-based screening(97%in 2016)and treatment of women diagnosed(81%in 2016).The 42 CS cases reported nationally over 2016(liveborn infants only)represented 27%of liveborn infants with clinical CS,but only 7%of estimated CS cases among women found syphilis-infected in ANC,and 6%of all estimated CS cases including those born to women with undiagnosed syphilis.Discussion/Conclusion:Mongolia's ANC-based syphilis screening program is reducing CS,but maternal prevalence remains high.To eliminate CS(target:<50 cases per 100,000 live births),Mongolia should strengthen ANC services,limiting losses during referral for treatment,and under-diagnosis of CS including still-births and neonatal deaths,and expand syphilis screening and prevention programs.
