Abstract

Introduction

Congenital syphilis remains a significant cause of newborn mortality and long-term neurodevelopmental problems in some low- and middle-income countries. This study was done in Honiara, Solomon Islands to determine the incidence of babies born to mothers with a positive venereal disease research laboratory (VDRL) test and a positive Treponema pallidum haemagglutination assay (TPHA); to determine the VDRL status of newborns and features of congenital syphilis; and to estimate the proportion of stillbirths associated with syphilis.

Methodology

All neonates born to VDRL-positive mothers, including stillbirths were included between April and July 2019. Neonates were examined, investigated and treated.

Results

Among 1534 consecutive births, 1469 were live births and 65 (4.2%) were stillbirths. One hundred and forty-three neonates were born to VDRL-positive mothers: 130 (90.1%) were live infants and 13 (8.9%) stillbirths. Of the 130 VDRL-exposed live-born infants, 72 (55%) had reactive VDRL and a positive TPHA and 7 (9.7%) had clinical signs of congenital syphilis. Five of the infants with clinical signs of syphilis infection had a 4-fold higher VDRL titre than their mother. Four infants of VDRL-positive mothers died during admission, all of whom had clinical signs of syphilis. Ninety percent of affected infants were born to mothers who were not treated or only partially treated during pregnancy.

Conclusions

In this study, 1:210 live-born babies had clinical and serological evidence of congenital syphilis, and evidence of Treponema infection was found disproportionately in stillbirths. In a setting where Treponema infections are common, an empirical approach to prevention may be needed.

中文翻译：

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先天性梅毒在所罗门群岛霍尼亚拉。

摘要

介绍

在一些中低收入国家，先天性梅毒仍然是新生儿死亡和长期神经发育问题的重要原因。这项研究是在所罗门群岛的霍尼亚拉进行的，​​目的是通过性病研究实验室（VDRL）测试阳性和梅毒螺旋体血凝试验（TPHA）阳性来确定母亲所生婴儿的发生率；确定新生儿的VDRL状况和先天性梅毒的特征；并估计与梅毒有关的死产比例。

方法

VDRL阳性母亲出生的所有新生儿（包括死胎）都包括在2019年4月至7月之间。对新生儿进行了检查，调查和治疗。

结果

在1534例连续分娩中，有1469例活产，有65例（4.2％）是死产。VDRL阳性母亲有143例新生儿：活婴儿130例（90.1％），死产13例（8.9％）。在130名VDRL暴露的活产婴儿中，有72名（55％）患有反应性VDRL和TPHA阳性，还有7名（9.7％）具有先天性梅毒的临床体征。有梅毒感染临床症状的婴儿中有五个婴儿的VDRL滴度比其母亲高4倍。VDRL阳性母亲的四名婴儿在入院时死亡，所有婴儿都有梅毒的临床症状。百分之九十的受影响婴儿出生于母亲，她们在怀孕期间未接受治疗或仅接受过部分治疗。

结论

在这项研究中，1：210的活产婴儿具有先天性梅毒的临床和血清学证据，并且死胎中不成比例地发现了梅毒螺旋体感染的证据。在常见的梅毒螺旋体感染的情况下，可能需要经验性的预防方法。