Population Council Projects | Introducing Syphilis Rapid Strip Tests in Bolivian Antenatal Care Settings

PROJECT
Introducing Syphilis Rapid Strip Tests in Bolivian Antenatal Care Settings

Syphilis infection has particularly serious consequences for pregnant women. Congenital syphilis can lead to stillbirths, premature births, and neonatal death. It also causes meningitis, vasculitis, and other serious complications in the newborn. For this reason, Population Council researchers carried out this project designed to address maternal and congenital syphilis in Bolivia. The World Health Organization recommends syphilis testing at least once during pregnancy, preferably in the first or second trimester. Unfortunately, however, most hospitals in Latin America do not offer routine syphilis testing to women seeking antenatal care. This project assessed whether rapid syphilis strip tests could improve diagnosis and treatment among pregnant women seeking antenatal care in 37 rural health centers and four urban maternity hospitals in the provinces of La Paz, Santa Cruz, Chuquisaca, and Cochamba, Bolivia.

In all, 8,900 women attending urban hospitals and 2,718 women attending rural clinics for antenatal care were tested, using the Abbott Determine Rapid Syphilis TP assay. Some 5 percent of these women (577) had positive results; 81.5 percent (470) of those who test positive received all three recommended doses of penicillin, and 84.9 percent (325) of their partners completed treatment. Over 95.0 percent of participants and clinical and laboratory personnel found this testing method acceptable.

In 2005, based on the study findings, the Bolivia Ministry of Health expanded its universal maternal and child health insurance coverage to include these rapid strip tests in rural settings.

Location

La Paz, Santa Cruz, Chuquisaca, and Cochabamba, Bolivia

Duration

July 2002–December 2005

Population Council researchers

Claudia Diaz, Sandra G. Garcia, Rita Revollo, Freddy Tinajeros

Non-Council collaborators

Davida Becker, Alissa Fishbane, Shannon Johnson, Kara Richmond (consultants)

Daniel Grossman (Ibis Reproductive Health)

Carolina de Hilari (Save the Children)

Carol Levin, Matthew Steele (Program for Appropriate Technology in Health)

Bolivia Ministry of Health

Donor

Bill & Melinda Gates Foundation