Introduction: In March 2022, the gynecology-obstetrics department of the Western Guiana Hospital Center (CHOG) reported to the Guyana Regional Health Agency a sharp increase since 2021 in the number of pregnant women with positive serology. syphilis accompanied by a worrying increase in the number of congenital syphilis. Hospital data made it possible to confirm an increase limited to western Guyana and along the Maroni River. In order to better characterize the epidemiological situation of syphilis in western Guyana since 2020 and the profile of women at risk, an additional investigation was set up by the Guyana unit of Public Health France. Method: A descriptive analysis of the epidemiological trends of syphilis in the general population in western Guyana from 2020 to 2022 as well as the characteristics of pregnant women followed at CHOG in 2021 and 2022 and having positive syphilis serology was carried out using the data biological and medical records from CHOG. Results: Between 2020 and 2022, more than 9,000 people were screened on average each year at CHOG and the positivity rate increased 17-fold during this period. In 2021, 51 pregnant women who had positive syphilis serology during pregnancy were followed at CHOG, and among them, 22 gave birth to a child with confirmed or probable congenital syphilis. Over the period 2021-2022, nearly 80% of pregnant women with syphilis were diagnosed in the 2nd or 3rd trimester of pregnancy and 90% of them did not benefit from pregnancy monitoring in accordance with recommendations (number of consultations and ultrasounds, quarter of first consultation and/or number of serologies). Compared to women whose child was born free of the infection, those who gave birth to a newborn suffering from congenital syphilis in 2021 were younger (21 years old compared to 24 years old), the child was more often premature ( 38% of cases versus 11%) and the treatment was administered later in the pregnancy. Nearly one in five women whose child was born with congenital syphilis became infected during pregnancy. Conclusion: The elimination of congenital syphilis is defined as a public health priority by the World Health Organization (WHO). The increase in stays for syphilis in pregnant women accompanied by a drop in stays for congenital syphilis in children in 2022 at CHOG seems to show the effectiveness of the measures put in place from 2021 to improve screening and treatment. care of women with positive syphilis serology during pregnancy (3 screenings during pregnancy, protocol and treatment pathway). Two major issues in the fight against congenital syphilis in Western Guyana have been identified: early detection of syphilis during pregnancy and screening and treatment of partners. Actions must be put in place to achieve the target set by the WHO of less than 50 cases of congenital syphilis per 100,000 births by 2030.
Auteur : Devos Sophie, Guyot Marion, Succo Tiphanie, Hcini Najeh
Year of publication: 2024
Pages : 30 p.
Collection : Studies and surveys