Estimating disease burden of maternal syphilis and associated adverse pregnancy outcomes in India, Nigeria, and Zambia in 2012.
Estimating disease burden of maternal syphilis and associated adverse pregnancy outcomes in India, Nigeria, and Zambia in 2012.
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DOI：
10.1016/j.ijgo.2015.04.014
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发表时间：
2015-06-01
期刊：
影响因子：
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通讯作者：
Newman, Lori M
中科院分区：
文献类型：
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作者：
Chen, Xiang-Sheng;Khaparde, Sunil;Newman, Lori M
目的：为了估计产妇梅毒及其相关的不良妊娠结局在印度，尼日利亚，和Zambia.METHODS：一个在线估计工具被用来生成点估计和不确定性范围的产妇梅毒和不良妊娠结局由于母婴传播（MTCT）。印度、尼日利亚和赞比亚国家以下一级产前保健覆盖率、梅毒血清阳性率、梅毒筛查和治疗覆盖率的最新数据（2010-2012年）被用于估算2012年的疾病负担。对三种筛查和治疗方案进行了敏感性分析（当前覆盖率、当前覆盖率减20%以及符合世卫组织消除梅毒母婴传播目标的理想覆盖率）。据估计，在印度、尼日利亚和赞比亚，共有103 960、74 798和9072名孕妇可能患有活动性梅毒，导致53 187人，分别有37 045例和2973例不良结局;在印度、尼日利亚和赞比亚，在当前的服务覆盖范围内，约有1.6%、4.8%和37.0%的不良结局得以避免。疾病负担在印度和尼日利亚的次国家分布差异显着，但在整个Zambia.Conclusions平均分布：所获得的结果表明，在印度，尼日利亚和赞比亚的孕产妇梅毒和相关的不良后果的持续，无法避免的高负担。这些国家必须大幅度扩大梅毒筛查和治疗，以实现消除母婴传播梅毒。
OBJECTIVE: To estimate maternal syphilis and its associated adverse pregnancy outcomes in India, Nigeria, and Zambia.METHODS: An online estimation tool was used to generate point estimates and uncertainty ranges of maternal syphilis and adverse pregnancy outcomes due to mother-to-child transmission (MTCT). The most recent data (2010-2012) on antenatal care coverage, syphilis seroprevalence, and syphilis screening and treatment coverage at the subnational level in India, Nigeria, and Zambia were used to estimate disease burden for 2012. Sensitivity analysis was conducted for three screening and treatment scenarios (current coverages, current coverages minus 20%, and ideal coverages consistent with WHO targets for eliminating MTCT of syphilis).RESULTS: A total of 103 960, 74 798, and 9072 pregnant women with probable active syphilis were estimated to occur in India, Nigeria, and Zambia, resulting in 53 187, 37 045, and 2973 adverse outcomes, respectively; approximately 1.6%, 4.8%, and 37.0% of these were averted under the current service coverages in India, Nigeria, and Zambia. The disease burden varied significantly in its subnational distribution within India and Nigeria, but was distributed evenly across Zambia.CONCLUSIONS: The obtained results suggest an ongoing, unaverted high burden of maternal syphilis and associated adverse outcomes in India, Nigeria, and Zambia. Screening and treatment for syphilis must be scaled-up significantly in these countries to achieve elimination of MTCT of syphilis.