title: Syphilis test availability and uptake at medical facilities in southern China.
abstract: OBJECTIVE
  To examine syphilis testing capacity, screening coverage rates and types of syphilis tests used in medical facilities in southern China.
  
  
  METHODS
  Eleven of the 14 municipalities in Guangdong province participated. Data on syphilis testing capacity, screening coverage and types of syphilis tests used were collected from all types of public medical facilities offering prenatal care (n = 109). A total of 494 680 women who delivered during 2004-2008 were studied.
  
  
  RESULTS
  In 2008, 54 196 pregnant women (43.1%) were not screened for syphilis. Among such women, 32 863 (60.6%) attended clinics without any syphilis testing capacity and 21 333 (39.4%) attended clinics that performed testing but were not screened. The likelihood of not having syphilis test capacity was much higher for hygiene stations (odds ratio, OR: 10; 95% confidence interval, CI: 4-25), services at the township level (OR: 33; 95% CI: 10-100) and services with ≤ 1000 deliveries per year (OR: 1.002; 95% CI: 1.001-1.003). These same service characteristics correlated with lower screening coverage rates (P < 0.01). Only one antenatal clinic had the capacity to conduct both treponemal and non-treponemal tests for diagnosing syphilis.
  
  
  CONCLUSIONS
  Syphilis screening is available in very few of the basic medical facilities offering prenatal care where most neonates in southern China are delivered. In light of this and of the increasing incidence of syphilis in the area, expanding point-of-care rapid syphilis testing is a priority.
authors.affiliation: Guangdong Provincial Center for STI Control & Prevention, Division of STD Control, No.10 Xian Lie Dong Heng Rd, Guangzhou 510500, China. yanglg3@yahoo.com
authors.forename: Li-Gang
authors.initials: LG
authors.lastname: Yang
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Tucker
authors.forename: Cheng
authors.initials: C
authors.lastname: Wang
authors.forename: Song-Ying
authors.initials: SY
authors.lastname: Shen
authors.forename: Xiang-Sheng
authors.initials: XS
authors.lastname: Chen
authors.forename: Bin
authors.initials: B
authors.lastname: Yang
authors.forename: Rosanna
authors.initials: R
authors.lastname: Peeling
mesh_terms: D000372:Agglutination Tests; D016009:Chi-Square Distribution; D002681:China / Q000453:epidemiology; D016001:Confidence Intervals; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006801:Humans; D008403:Mass Screening; D016017:Odds Ratio; D011247:Pregnancy; D011295:Prenatal Care; D015995:Prevalence; D012307:Risk Factors; D013587:Syphilis / Q000175:diagnosis*; D013588:Syphilis Serodiagnosis; D014210:Treponema pallidum / Q000302:isolation & purification*
references.citation: Sex Transm Infect. 2006 Dec;82 Suppl 5:v38-43
references.pmid: 17215276
references.citation: Sex Transm Infect. 2009 Sep;85(5):383-90
references.pmid: 19357129
references.citation: J Infect Dis. 2007 Dec 1;196(11):1654-61
references.pmid: 18008249
references.citation: Bull World Health Organ. 2004 Jun;82(6):410-6
references.pmid: 15356932
references.citation: Curr Opin Infect Dis. 2011 Feb;24(1):50-5
references.pmid: 21150594
references.citation: Lancet. 2009 Apr 18;373(9672):1322-4
references.pmid: 19376436
references.citation: BMC Health Serv Res. 2010 Mar 07;10:58
references.pmid: 20205942
references.citation: J Acquir Immune Defic Syndr. 2010 Feb;53 Suppl 1:S48-53
references.pmid: 20104110
references.citation: Sex Transm Dis. 2009 Nov;36(11):714-20
references.pmid: 19773681
references.citation: Lancet. 2008 Nov 29;372(9653):1914-1923
references.pmid: 18930536
references.citation: Southeast Asian J Trop Med Public Health. 2009 Jul;40(4):861-70
references.pmid: 19842425
references.citation: Trop Med Int Health. 2005 Sep;10(9):934-43
references.pmid: 16135202
references.citation: Am J Obstet Gynecol. 1998 Jan;178(1 Pt 1):131-5
references.pmid: 9465816
references.citation: Sex Transm Dis. 2007 Jul;34(7 Suppl):S31-6
references.pmid: 17592388
references.citation: Int J Infect Dis. 2010 Sep;14 Suppl 3:e45-8
references.pmid: 20137991
references.citation: BMC Health Serv Res. 2008 Jan 23;8:19
references.pmid: 18215313
references.citation: Lancet. 2007 Jan 13;369(9556):132-8
references.pmid: 17223476
references.citation: N Engl J Med. 2010 May 6;362(18):1658-61
references.pmid: 20445179
references.citation: Sex Transm Dis. 2006 Nov;33(11):670-4
references.pmid: 16641827
references.citation: BMC Public Health. 2010 Dec 30;10:793
references.pmid: 21192782
references.citation: Sex Transm Dis. 2008 Dec;35(12):1022-4
references.pmid: 18830135
references.citation: Obstet Gynecol Int. 2010;2010:
references.pmid: 20706693
references.citation: Cent Afr J Med. 2003 Jul-Aug;49(7-8):90-3
references.pmid: 15214281
references.citation: Health Policy Plan. 2001 Mar;16(1):29-34
references.pmid: 11238427
references.citation: Lancet Infect Dis. 2010 Jun;10(6):381-6
references.pmid: 20510278
references.citation: Sex Transm Dis. 2006 May;33(5):284-8
references.pmid: 16641821
references.citation: Sex Transm Dis. 2007 Jul;34(7 Suppl):S55-60
references.pmid: 17139234
references.citation: Sex Transm Infect. 2007 Aug;83(5):347-50
references.pmid: 17693449
references.citation: Clin Microbiol Rev. 1995 Jan;8(1):1-21
references.pmid: 7704889