Congenital Syphilis - A Leading Worldwide Cause of Newborn Death

The Statistics

On the 27th of February 2019, the World Health Organisation (WHO) reported that in 2016, it is estimated that there were more than half a million total cases of congenital syphilis, which resulted in more than 200 000 stillbirths and neonatal deaths. From 2012 to 2016, the estimates showed that the overall global burden of congenital syphilis has reduced albeit not significantly, from around 750,000 to 660,000 cases. Despite the decrease in this time period, the numbers of affected women and infants remains unacceptably high and therefore it is crucial that all women are provided with early syphilis screening and treatment.

Congenital Syphilis at a glance

Syphilis is one of the most common sexually transmitted infections globally, with approximately 6 million new cases each year. Congenital syphilis on the other hand, is the transmission of syphilis from an infected mother (which did not get adequate and/or early treatment) to the baby during pregnancy. Mother-to-child transmission of syphilis can result in a number of serious consequences for the health of newborn infants, including stillbirth, neonatal death, low-birth-weight, prematurity, and other congenital deformities.

Fortunately, as long as testing and treatment are provided to pregnant women early during antenatal care, congenital syphilis becomes very preventable and even treatable. Adequate treatment using Benzylpenicillin (Penicilin G) ideally before the second trimester, reduced risk of adverse outcomes to the fetus.

To date, congenital syphilis is the second leading cause of preventable stillbirth globally, preceded only by malaria.

Learning from Malaysia’s success

On the 8th of October 2018, Malaysia became the first country in the World Health Organization (WHO) Western Pacific Region to be certified as having completely eliminated not just the mother-to-child transmission of syphilis, but also the vertical transmission of HIV. With that recognition, Malaysia joined the exclusive club of only 12 countries in the world validated by WHO as having eliminated mother-to-child transmission of syphilis and / or HIV.

It all started in 1998, when Malaysia became one of the earliest adopter and implementer of the national prevention of mother-to-child transmission (PMTCT) of HIV and syphilis in maternal and child health services. It took 2 decades of careful planning, determined and coordinated allocation of government budget and a solid and far-reaching implementation of policies to make Malaysia’s antenatal care, a robust one. Today, while a number of Malaysians take them for granted, antenatal testing and treatment for HIV and syphilis are provided free of charge, and virtually all women have access to quality health services including contraception and safe delivery, assisted by skilled attendants.

According to Mr Eamonn Murphy, UNAIDS Regional Director for Asia and the Pacific, “This elimination is a remarkable achievement that puts Malaysia at the forefront of the global effort to ensure that no child is born with HIV or congenital syphilis. A combination of political commitment, stronger systems for health, and timely prevention, diagnosis and treatment is the key to success,” before adding “All countries should follow Malaysia’s example and ensure that every child has an HIV-free start to his or her life.”

Monitoring the scale up of screening and treatment of pregnant women remains paramount to measure progress towards this goal. Measuring how many adults and infants are affected by syphilis with regional and national-level estimation is crucial to guide health systems’ capacity to strengthen the prevention, detection and treatment of syphilis.

Hello Health Group does not provide medical advice, diagnosis or treatment.