Is routine antenatal screening for syphilis in Nigeria still justified clinically and economically?
OBJECTIVE
To determine the seroprevalence and cost effectiveness of antenatal syphilis screening at the University of Maiduguri Teaching Hospital (UMTH), Maiduguri, Nigeria.


METHODS
A retrospective chart analysis of venereal disease research laboratory (VDRL) results among pregnant women at the UMTH, Maiduguri, Nigeria, during a 10-year period (from 1st January 1999 to 31st December 2008) was undertaken.


RESULTS
A total of 18,712 women registered for antenatal care during the study period. Of these, 18,101 had serological screening for syphilis. Only 12 of the 18,101 screened were seropositive by VDRL, 9 (75%) were confirmed by Treponema pallidum hemagglutination assay (TPHA), giving a seroprevalence rate of 0.05%. Three (25%) were biological false-positive. The peak age-specific incidence of 0.02% was in the 20-24 year-age group. There was zero prevalence in the age groups 15-19 and >40 years. There was no case of congenital syphilis seen. The cost for VDRL testing per patient in UMTH is US$2. The total amount of money spent on VDRL tests over the study period was US$37,424.


CONCLUSIONS
The seroprevalence rate of syphilis is extremely low in this study. This calls for a review of the policy of routine antenatal serology screening for syphilis in Maiduguri, Nigeria.
Department of Obstetrics & Gynaecology, University of Maiduguri Teaching Hospital, PO Box 1414, Maiduguri, Borno State, Nigeria. mbbukar07@yahoo.com
Mohammed
M
Bukar
Bala M
BM
Audu
Usman I
UI
Takai
Bamidele B
BB
Ajayi
Abubakar A
AA
Kullima
D002308:Cardiolipins / Q000032:analysis; D002784:Cholesterol / Q000032:analysis; D003955:Diagnostic Tests, Routine / Q000592:standards / Q000706:statistics & numerical data*; D005260:Female; D006386:Hemagglutination Tests; D006801:Humans; D008403:Mass Screening / Q000706:statistics & numerical data*; D009549:Nigeria / Q000453:epidemiology; D010713:Phosphatidylcholines / Q000032:analysis; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology; D011295:Prenatal Care / Q000191:economics / Q000379:methods; D011296:Prenatal Diagnosis / Q000706:statistics & numerical data; D015995:Prevalence; D012189:Retrospective Studies; D016036:Seroepidemiologic Studies; D013587:Syphilis / Q000175:diagnosis* / Q000191:economics / Q000453:epidemiology; D014210:Treponema pallidum / Q000302:isolation & purification
D002308:Cardiolipins; D010713:Phosphatidylcholines; C054448:VDRL antigen; D002784:Cholesterol