Assessment of the impact of rapid syphilis tests on syphilis screening and treatment of pregnant women in Zambia.
Assessment of the impact of rapid syphilis tests on syphilis screening and treatment of pregnant women in Zambia.
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DOI：
10.1016/j.ijgo.2015.04.015
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发表时间：
2015-06
期刊：
影响因子：
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通讯作者：
Herlihy JM
中科院分区：
文献类型：
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作者：
Bonawitz RE;Duncan J;Hammond E;Hamomba L;Nambule J;Sambambi K;Musonda V;Calise A;Knapp A;Mwale J;McCauley J;Thea D;Herlihy JM
评价快速梅毒检测（RST）对赞比亚卡洛莫区孕妇梅毒检测和治疗的影响。2012年3月，卡洛莫区所有35个卫生机构的卫生工作者接受了RST使用和青霉素治疗方面的培训。2013年3月，从18家随机选择的医疗机构中回顾性提取数据，并将其分为三个时间间隔：基线（引入顺铂前6个月），中线（引入顺铂后0-6个月）和终点（引入顺铂后7-12个月）。4154名孕妇的数据显示梅毒反应性血清阳性率为2.7%。接受筛查的女性比例从基线（140/1365，10.6%）到中线（976/1446，67.5%）有所改善，最终在终点（752/1337，56.3%）下降（P < 0.001）。梅毒血清反应性妊娠妇女在使用青霉素治疗前（1/2，50%）或治疗后（5/48，10.4%; P = 0.199）接受1剂青霉素治疗的比例无显著差异，整个治疗率较低。随着在赞比亚和其他资源有限的环境中扩大规模，应优先考虑当天检测和青霉素治疗，以实现消除先天性梅毒的目标。
To evaluate the impact of rapid syphilis tests (RSTs) on syphilis testing and treatment in pregnant women in Kalomo District, Zambia. In March 2012, health workers at all 35 health facilities in Kalomo Distract were trained in RST use and penicillin treatment. In March 2013, data were retrospectively abstracted from 18 randomly selected health facilities and stratified into three time intervals: baseline (6 months prior to RST introduction), midline (0–6 months after RST introduction), and endline (7–12 months after RST introduction). Data collected on 4154 pregnant women showed a syphilis-reactive seroprevalence of 2.7%. The proportion of women screened improved from baseline (140/1365, 10.6%) to midline (976/1446, 67.5%), finally decreasing at endline (752/1337, 56.3%) (P < 0.001). There was no significant difference in the proportion of syphilis-seroreactive pregnant women who received 1 dose of penicillin before (1/2, 50%) or after (5/48, 10.4%; P = 0.199) RST introduction with low treatment rates throughout. With RST scale-up in Zambia and other resource-limited settings, same-day test and treatment with penicillin should be prioritized to achieve the goal of eliminating congenital syphilis.