title: Serological survey of HIV and syphilis in pregnant women in Madagascar.
abstract: OBJECTIVE
  Peripartal transmission of human immunodeficiency virus (HIV) and Treponema pallidum, the causative agent of syphilis, leads to severe consequences for newborns. Preventive measures require awareness of the maternal infection. Although HIV and syphilis testing in Madagascar could be theoretically carried out within the framework of the national pregnancy follow-up scheme, the required test kits are rarely available at peripheral health centres. In this study, we screened blood samples of pregnant Madagascan women for HIV and syphilis seroprevalence to estimate the demand for systemic screening in pregnancy.
  
  
  METHODS
  Retrospective anonymous serological analysis for HIV and syphilis was performed in plasma samples from 1232 pregnant women that were taken between May and July 2010 in Ambositra, Ifanadiana, Manakara, Mananjary, Moramanga and Tsiroanomandidy (Madagascar) during pregnancy follow-up. Screening was based on Treponema pallidum haemagglutination tests for syphilis and rapid tests for HIV, with confirmation of positive screening results on line assays.
  
  
  RESULTS
  Out of 1232 pregnant women, none were seropositive for HIV and 37 (3%) were seropositive for Treponema pallidum.
  
  
  CONCLUSIONS
  Our findings are in line with previous studies that describe considerable syphilis prevalence in the rural Madagascan population. The results suggest a need for screening to prevent peripartal Treponema pallidum transmission, while HIV is still rare. If they are known, Treponema pallidum infections can be easily, safely and inexpensively treated even in pregnancy to reduce the risk of transmission.
authors.affiliation: Department of Tropical Medicine at the Bernhard Nocht Institute, German. frickmann@bni-hamburg.de
authors.forename: Hagen
authors.initials: H
authors.lastname: Frickmann
authors.forename: Norbert G
authors.initials: NG
authors.lastname: Schwarz
authors.forename: Mirko
authors.initials: M
authors.lastname: Girmann
authors.forename: Ralf M
authors.initials: RM
authors.lastname: Hagen
authors.forename: Sven
authors.initials: S
authors.lastname: Poppert
authors.forename: Sabine
authors.initials: S
authors.lastname: Crusius
authors.forename: Andreas
authors.initials: A
authors.lastname: Podbielski
authors.forename: Jean N
authors.initials: JN
authors.lastname: Heriniaina
authors.forename: Tsiriniaina
authors.initials: T
authors.lastname: Razafindrabe
authors.forename: Jean P
authors.initials: JP
authors.lastname: Rakotondrainiarivelo
authors.forename: Jürgen
authors.initials: J
authors.lastname: May
authors.forename: Raphaël
authors.initials: R
authors.lastname: Rakotozandrindrainy
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D006678:HIV; D015658:HIV Infections / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D006301:Health Services Needs and Demand; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008270:Madagascar / Q000453:epidemiology; D008403:Mass Screening; D008875:Middle Aged; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D015995:Prevalence; D012189:Retrospective Studies; D012424:Rural Population; D016036:Seroepidemiologic Studies; D013587:Syphilis / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D013588:Syphilis Serodiagnosis; D014210:Treponema pallidum; D055815:Young Adult