Perceptions, attitude and uptake of rapid syphilis testing services in antenatal clinics in North-Western Tanzania.

Infection with syphilis during pregnancy could cause spontaneous abortion, low birth weight and stillbirth. To prevent adverse pregnancy outcomes caused by syphilis, the World Health Organization (WHO) recommends syphilis screening and treatment of all pregnant women attending antenatal care (ANC) services. Rapid syphilis testing (RST) demonstration project was introduced at ANC clinics in Tanzania in 2009, to assess the feasibility, acceptability and its impact on uptake of syphilis screening service. Data collection was composed of in-depth interviews with health workers and pregnant women attending ANC. Additionally, from the health facility registers we extracted information on the uptake of antenatal care services, including number of pregnant women screened and treated for syphilis. Introduction of RST at health facilities was appreciated by pregnant women attending ANC and health workers. Following the introduction of RST services at ANC clinics, we observed a significant increase of the uptake of syphilis screening. Pregnant women appreciated RST service since it reduced the frequency of their visits to the health facilities and shortened the duration that they spent at the clinics. Moreover, the provision of same-day screening and treatment services helped women to save money that they would have to spend on transportation for the follow up visits. Health workers felt that RST simplified procedures to diagnose syphilis, and enabled the health workers to test and treat large numbers of clients in a shorter period of time. Our study demonstrates that, it is feasible to introduce RST service in antenatal clinics. The RST was appreciated by health workers and pregnant women, since it simplifies syphilis screening procedures, saves the time that pregnant women used to waste to wait for the results, and saves the cost that women would have to spend on transportation to come back for treatment.

[1]  R. Peeling,et al.  Introduction of Syphilis Point-of-Care Tests, from Pilot Study to National Programme Implementation in Zambia: A Qualitative Study of Healthcare Workers’ Perspectives on Testing, Training and Quality Assurance , 2015, PloS one.

[2]  D. Thomson,et al.  Assessing predictors of delayed antenatal care visits in Rwanda: a secondary analysis of Rwanda demographic and health survey 2010 , 2014, BMC Pregnancy and Childbirth.

[3]  V. Müller,et al.  Why Sexually Transmitted Infections Tend to Cause Infertility: An Evolutionary Hypothesis , 2014, PLoS pathogens.

[4]  A. Baqui,et al.  Factors Associated with Four or More Antenatal Care Visits and Its Decline among Pregnant Women in Tanzania between 1999 and 2010 , 2014, PloS one.

[5]  H. Tan,et al.  Reported Estimates of Adverse Pregnancy Outcomes among Women with and without Syphilis: A Systematic Review and Meta-Analysis , 2014, PloS one.

[6]  L. Joseph,et al.  Poor Reporting of Outcomes Beyond Accuracy in Point-of-Care Tests for Syphilis: A Call for a Framework , 2014, AIDS research and treatment.

[7]  S. Kouanda,et al.  Barriers to antenatal syphilis screening in Burkina Faso , 2014, The Pan African medical journal.

[8]  J. Katz,et al.  Born Too Soon: Care during pregnancy and childbirth to reduce preterm deliveries and improve health outcomes of the preterm baby , 2013, Reproductive Health.

[9]  D. Kaye,et al.  Timing and reasons for coming late for the first antenatal care visit by pregnant women at Mulago hospital, Kampala Uganda , 2013, BMC Pregnancy and Childbirth.

[10]  L. Newman,et al.  Untreated maternal syphilis and adverse outcomes of pregnancy: a systematic review and meta-analysis. , 2013, Bulletin of the World Health Organization.

[11]  S. Hawkes,et al.  Early Antenatal Care: Does It Make a Difference to Outcomes of Pregnancy Associated with Syphilis? A Systematic Review and Meta-Analysis , 2013, PloS one.

[12]  L. Say,et al.  Global Estimates of Syphilis in Pregnancy and Associated Adverse Outcomes: Analysis of Multinational Antenatal Surveillance Data , 2013, PLoS medicine.

[13]  R. Peeling,et al.  The Impact of Syphilis Screening among Female Sex Workers in China: A Modelling Study , 2013, PloS one.

[14]  M. Hamel,et al.  Factors Affecting Antenatal Care Attendance: Results from Qualitative Studies in Ghana, Kenya and Malawi , 2013, PloS one.

[15]  R. Peeling,et al.  Rapid Syphilis Testing Uptake for Female Sex Workers at Sex Venues in Southern China: Implications for Expanding Syphilis Screening , 2012, PloS one.

[16]  M. Mathai,et al.  Status of Emergency Obstetric Care in Six Developing Countries Five Years before the MDG Targets for Maternal and Newborn Health , 2012, PloS one.

[17]  Rosanna W. Peeling,et al.  Point-of-Care Tests to Strengthen Health Systems and Save Newborn Lives: The Case of Syphilis , 2012, PLoS medicine.

[18]  G. Guest,et al.  Encouraging contraceptive uptake by motivating men to communicate about family planning: the Malawi Male Motivator project. , 2011, American journal of public health.

[19]  N. Low,et al.  Effectiveness of interventions to improve screening for syphilis in pregnancy: a systematic review and meta-analysis. , 2011, The Lancet. Infectious diseases.

[20]  Z. Bhutta,et al.  Effectiveness of interventions to screen and manage infections during pregnancy on reducing stillbirths: a review , 2011, BMC public health.

[21]  S. Cousens,et al.  Lives Saved Tool supplement detection and treatment of syphilis in pregnancy to reduce syphilis related stillbirths and neonatal mortality , 2011, BMC public health.

[22]  J. Pavlin,et al.  A growing global network’s role in outbreak response: AFHSC-GEIS 2008-2009 , 2011, BMC public health.

[23]  Jill S. Huppert,et al.  Perceptions of an Ideal Point-of-Care Test for Sexually Transmitted Infections – A Qualitative Study of Focus Group Discussions with Medical Providers , 2010, PloS one.

[24]  J. Changalucha,et al.  Trends in HIV & syphilis prevalence and correlates of HIV infection: results from cross-sectional surveys among women attending ante-natal clinics in Northern Tanzania , 2010, BMC public health.

[25]  S. Cousens,et al.  High ANC coverage and low skilled attendance in a rural Tanzanian district: a case for implementing a birth plan intervention , 2010, BMC pregnancy and childbirth.

[26]  Z. Bhutta,et al.  Global report on preterm birth and stillbirth (3 of 7): evidence for effectiveness of interventions , 2010, BMC pregnancy and childbirth.

[27]  W. Van Damme,et al.  Using targeted vouchers and health equity funds to improve access to skilled birth attendants for poor women: a case study in three rural health districts in Cambodia , 2010, BMC pregnancy and childbirth.

[28]  Gary L Darmstadt,et al.  Reducing stillbirths: screening and monitoring during pregnancy and labour , 2009, BMC pregnancy and childbirth.

[29]  B. Stray-Pedersen,et al.  ' s response to reviews Title : Prevalence of sexually transmitted infections among pregnant women with known HIV status in northern Tanzania , 2009 .

[30]  Charles W Warren,et al.  Evaluation of the use of Global Youth Tobacco Survey (GYTS) data for developing evidence-based tobacco control policies in Turkey , 2008, BMC public health.

[31]  M. Matee,et al.  HIV-1, HSV-2 and syphilis among pregnant women in a rural area of Tanzania: Prevalence and risk factors , 2008, BMC infectious diseases.

[32]  Mafizur Rahman,et al.  Syphilis screening in the antenatal care: a cross-sectional study from Botswana , 2006, BMC International Health and Human Rights.

[33]  M. Matee,et al.  Surveillance of HIV and syphilis infections among antenatal clinic attendees in Tanzania-2003/2004 , 2006, BMC public health.

[34]  R. Hayes,et al.  Antenatal syphilis screening in sub‐Saharan Africa: lessons learned from Tanzania , 2005, Tropical medicine & international health : TM & IH.

[35]  M Beksinska,et al.  Sexually transmitted infections in pregnancy : prevalence , impact on pregnancy outcomes , and approach to treatment in developing countries , 2004 .

[36]  W. Miller,et al.  Barriers to asymptomatic screening and other STD services for adolescents and young adults: focus group discussions , 2004, BMC public health.

[37]  R. Peeling,et al.  Diagnostic tools for preventing and managing maternal and congenital syphilis: an overview. , 2004, Bulletin of the World Health Organization.

[38]  R. Steen,et al.  The prevention and management of congenital syphilis: an overview and recommendations. , 2004, Bulletin of the World Health Organization.

[39]  John J. B. Allen,et al.  Patients' perception of their depressive illness. , 2003, Journal of Psychiatric Research.

[40]  D. Watson-Jones,et al.  Syphilis in pregnancy in Tanzania. I. Impact of maternal syphilis on outcome of pregnancy. , 2002, The Journal of infectious diseases.

[41]  Nyongeza ya Tatu,et al.  United Republic of Tanzania , 2002, National Accounts Statistics: Main Aggregates and Detailed Tables 2019.

[42]  S. Gloyd,et al.  Antenatal syphilis in sub-Saharan Africa: missed opportunities for mortality reduction. , 2001, Health policy and planning.

[43]  P. Nyasulu,et al.  Decision making for women to access prevention of mother to child transmission services in Blantyre and Balaka Districts, Malawi. , 2011 .