title: Assessing compliance with a county board order for third trimester syphilis screening in Maricopa County, Arizona.
abstract: OBJECTIVE
  Due to high rates of congenital syphilis, a Maricopa County board order was issued in 2003 to increase prenatal syphilis screening. The provisions of this order included prenatal syphilis screening during the first prenatal visit, to be repeated during the third trimester, and again at delivery. The purpose of the study was to evaluate syphilis screening practices and barriers to screening among obstetric providers.
  
  
  METHODS
  Maricopa County medical providers who delivered at least 21 infants (97.2% of all deliveries) in 2008 according to live birth records were surveyed by telephone.
  
  
  RESULTS
  A total of 146 surveys were completed representing 76% (319/421) of the delivering providers and 83% of delivered infants for 2008. All of the represented prenatal care providers reported testing their patients for syphilis at the first trimester, and 284 (89%) reported screening again during the third trimester.
  
  
  CONCLUSIONS
  All of the surveyed providers reported screening at least once for syphilis during pregnancy and most reported re-screening during the third trimester as recommended by the Maricopa County board order. Similar public health screening guidance should be considered in areas where congenital syphilis rates are high and/or where syphilis is prevalent among women of childbearing age. A local health order of this type is a simple intervention that can provide practice guidance on emerging health issues.
authors: University of Illinois College of Medicine, Peoria, IL, USA. mcollier@isdh.in.gov
authors: Melissa G
authors: MG
authors: Collier
authors: Melanie M
authors: MM
authors: Taylor
authors: Michelle M
authors: MM
authors: Winscott
authors: Tom
authors: T
authors: Mickey
authors: Bob
authors: B
authors: England
mesh_terms: D001130:Arizona; D005260:Female; D019983:Guideline Adherence / Q000331:legislation & jurisprudence; D019538:Health Care Surveys; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D007407:Interviews as Topic; D008403:Mass Screening / Q000331:legislation & jurisprudence*; D009774:Obstetrics / Q000379:methods; D011159:Population Surveillance / Q000379:methods; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000331:legislation & jurisprudence; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis*; D011263:Pregnancy Trimester, Third; D011634:Public Health / Q000331:legislation & jurisprudence; D013587:Syphilis / Q000175:diagnosis*; D013588:Syphilis Serodiagnosis; D013590:Syphilis, Congenital / Q000517:prevention & control*