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https://hdl.handle.net/2440/55643
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Type: | Journal article |
Title: | Impact of on-site testing for maternal syphilis on treatment delays, treatment rates, and perinatal mortality in rural South Africa: a randomised controlled trial |
Author: | Myer, L. Wilkinson, David Lombard, Carl Zuma, Khangelani Rotchford, Karen Karim, S. S. Abdool |
Citation: | Sexually Transmitted Infections, 2003; 79(3):208-213 |
Publisher: | British Med Journal Publ Group |
Issue Date: | 2003 |
ISSN: | 1368-4973 |
School/Discipline: | Rural Clinical School |
Abstract: | Background: Syphilis remains a significant cause of preventable perinatal death in developing countries, with many women remaining untested and thus untreated. Syphilis testing in the clinic (on-site testing) may be a useful strategy to overcome this. We studied the impact of on-site syphilis testing on treatment delays and rates, and perinatal mortality. Methods: We conducted a cluster randomised controlled trial among seven pairs of primary healthcare clinics in rural South Africa, comparing on-site testing complemented by laboratory confirmation versus laboratory testing alone. Intervention clinics used the on-site test conducted by primary care nurses, with results and treatment available within an hour. Control clinics sent blood samples to the provincial laboratory, with results returned 2 weeks later. Results: Of 7134 women seeking antenatal care with available test results, 793 (11.1%) tested positive for syphilis. Women at intervention clinics completed treatment 16 days sooner on average (95% confidence interval: 11 to 21), though there was no significant difference in the proportion receiving adequate treatment at intervention (64%) and control (69%) clinics. There was also no significant difference in the proportion experiencing perinatal loss (3.3% v 5.1%; adjusted risk difference: −0.9%; 95% CI −4.4 to 2.7). Conclusions: Despite reducing treatment delays, the addition of on-site syphilis testing to existing laboratory testing services did not lead to higher treatment rates or reduce perinatal mortality. However on-site testing for syphilis may remain an important option for improving antenatal care in settings where laboratory facilities are not available. |
Description: | Copyright © 2007 by the BMJ Publishing Group Ltd. |
DOI: | 10.1136/sti.79.3.208 |
Appears in Collections: | Rural Clinical School publications |
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