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Open AccessArticle

Prevent Mother-to-Child Transmission (PMTCT) Programs and Enhancement of Maternal Healthcare Infrastructure to Improve Early Detection of Maternal Syphilis in Shanghai, China

by Li Du 1, Yang Li 2,3,*, Hui Jin 1, Cheng Huang 2,3, Yibin Gu 2,3, Liping Zhu 1,* and Biao Xu 2,3,4
1
Shanghai Center for Women and Children’s Health, Shanghai 200062, China
2
Department of Epidemiology, School of Public Health, Fudan University, Shanghai 200032, China
3
Key Lab of Health Technology Assessment, National Health Commission of the People’s Republic of China, Fudan University, Shanghai 200032, China
4
Department of Public Health Sciences (Global Health/IHCAR), Karolinska Institutet, Stockholm 17177, Sweden
*
Authors to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2019, 16(6), 1002; https://doi.org/10.3390/ijerph16061002
Received: 11 January 2019 / Revised: 12 March 2019 / Accepted: 12 March 2019 / Published: 20 March 2019
(This article belongs to the Special Issue Women's Reproductive and Maternal Health)
This study aimed to compare the screening and diagnosis of maternal syphilis in Shanghai between the national and municipal prevent mother-to-child transmission (PMTCT) of syphilis policies, and then to assess whether PMTCT programs and enhancing healthcare infrastructure could bring about an early detection of maternal syphilis. Detection of maternal syphilis was initiated in 2001 and then scaled-up in 2011 along with the enhancement of antenatal healthcare infrastructure. The initial five-year periods of municipal and national PMTCT policies were defined as the “exploring period” (2002–2006) and the “comprehensive period” (2011–2015). The demographic and gestational weeks (GW) of syphilis screening and diagnosis were analyzed to identify the factors affecting early detection. During the study period, maternal syphilis screening increased from 83,718 in 2002 to 243,432 in 2015. Of the 1,894,062 pregnant women screened, 1526 and 2714 participants were diagnosed with maternal syphilis in 2002–2006 and 2011–2015, respectively. The average age of diagnosis was 28.36 years and non-residents accounted for 71.1%. In the comprehensive period, more women received early syphilis screening (14.0% vs. 10.8%) and diagnosis (13.3% vs. 7.3%) within 12 GWs compared with the exploring period. Significantly, early detection grew during 2011–2015, which was not seen in the exploring period. Multivariate analysis revealed a greater possibility for infected women to be diagnosed within 16 GWs (OR = 2.76) in the comprehensive period, but those who were non-residents and unemployed were less likely to receive early detection. In conclusion, early detection of maternal syphilis has been remarkably improved. More emphasis is required on the development of pro-vulnerable policies and the implementation of tailored health education to improve the accessibility of routine antenatal care and awareness of syphilis prevention. View Full-Text
Keywords: syphilis; preventing mother-to-child transmission; early detection; Shanghai syphilis; preventing mother-to-child transmission; early detection; Shanghai
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Du, L.; Li, Y.; Jin, H.; Huang, C.; Gu, Y.; Zhu, L.; Xu, B. Prevent Mother-to-Child Transmission (PMTCT) Programs and Enhancement of Maternal Healthcare Infrastructure to Improve Early Detection of Maternal Syphilis in Shanghai, China. Int. J. Environ. Res. Public Health 2019, 16, 1002.

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