Background Untreated or inadequately treated maternal syphilis infection may be transmitted from mother to child resulting in congenital syphilis (CS) infection. In South Africa (SA), CS is a notifiable medical condition (NMC). The NMC surveillance system (NMCSS) was improved by introducing an electronic notification application, a new case notification form and training resources in July 2017. We describe CS surveillance in SA and report on experiences from implementing an improved NMCSS from August 2017 to December 2019. Methods We present the CS case definition, data collected by the CS case investigation and notification forms and data flow through the NMCSS. Descriptive statistics were used to analyse CS notifications received from August 2017 to December 2019. Qualitative inductive analysis of the stakeholder communications diary was conducted to identify CS surveillance challenges. Results There were 418 CS notifications submitted from 80 facilities in 35 out of 52 districts. Of the notified cases, 194 (46.8%) were male and the median age at notification was 7 days (interquartile range: 3–16 days). The majority were diagnosed in hospital (98.6%). KwaZulu–Natal Province notified the most cases (52.9%) followed by Gauteng (28.0%). Challenges in CS surveillance included the lack of awareness of the CS case definition, completed paper-based notifications not reaching the NMCSS and the limited ability of the system to distinguish improved notifications from increase in disease burden. Conclusion Improved CS surveillance through NMCSS was implemented in SA. Training, support and mentoring on CS and the notification system will be needed to inform elimination efforts.

中文翻译：

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2017-19 年南非先天性梅毒病例监测：经验、挑战和机遇

背景 未经治疗或治疗不当的母体梅毒感染可能会从母婴传播，导致先天性梅毒 (CS) 感染。在南非 (SA)，CS 是一种应呈报的医疗状况 (NMC)。通过在 2017 年 7 月引入电子通知应用程序、新病例通知表和培训资源，改进了 NMC 监视系统 (NMCSS)。我们描述了南非的 CS 监视，并报告了 2017 年 8 月至 2019 年 12 月实施改进的 NMCSS 的经验。方法 我们介绍 CS 病例定义、CS 病例调查和通知表收集的数据以及通过 NMCSS 的数据流。描述性统计用于分析 2017 年 8 月至 2019 年 12 月收到的 CS 通知。对利益相关者沟通日记进行了定性归纳分析，以确定 CS 监控挑战。结果 52 个区中有 35 个的 80 个设施提交了 418 份 CS 通知。在通报的病例中，194 例（46.8%）为男性，通报时的中位年龄为 7 天（四分位距：3-16 天）。大多数是在医院诊断出来的（98.6%）。夸祖鲁-纳塔尔省通报的病例最多（52.9%），其次是豪登省（28.0%）。CS 监测的挑战包括缺乏对 CS 病例定义的认识、完成的纸质通知未到达 NMCSS 以及系统区分改进通知与疾病负担增加的能力有限。结论 通过 NMCSS 改进的 CS 监测已在 SA 中实施。训练，