title: Assessment of the impact of rapid syphilis tests on syphilis screening and treatment of pregnant women in Zambia.
abstract: OBJECTIVE
  To evaluate the impact of rapid syphilis tests (RSTs) on syphilis testing and treatment in pregnant women in Kalomo District, Zambia.
  
  
  METHODS
  In March 2012, health workers at all 35 health facilities in Kalomo Distract were trained in RST use and penicillin treatment. In March 2013, data were retrospectively abstracted from 18 randomly selected health facilities and stratified into three time intervals: baseline (6months prior to RST introduction), midline (0-6 months after RST introduction), and endline (7-12 months after RST introduction).
  
  
  RESULTS
  Data collected on 4154 pregnant women showed a syphilis-reactive seroprevalence of 2.7%. The proportion of women screened improved from baseline (140/1365, 10.6%) to midline (976/1446, 67.5%), finally decreasing at endline (752/1337, 56.3%) (P<0.001). There was no significant difference in the proportion of syphilis-seroreactive pregnant women who received 1 dose of penicillin before (1/2, 50%) or after (5/48, 10.4%; P=0.199) RST introduction with low treatment rates throughout.
  
  
  CONCLUSIONS
  With RST scale-up in Zambia and other resource-limited settings, same-day test and treatment with penicillin should be prioritized to achieve the goal of eliminating congenital syphilis.
authors.affiliation: Center for Global Health and Development, Boston University, Boston, MA, USA; Department of Pediatrics, Boston Medical Center, Boston, MA, USA. Electronic address: rachael.bonawitz@bmc.org.
authors.forename: Rachael E
authors.initials: RE
authors.lastname: Bonawitz
authors.affiliation: Zambia Center for Applied Health Research and Development, Lusaka, Zambia.
authors.forename: Julie
authors.initials: J
authors.lastname: Duncan
authors.affiliation: Center for Global Health and Development, Boston University, Boston, MA, USA.
authors.forename: Emily
authors.initials: E
authors.lastname: Hammond
authors.affiliation: Zambia Center for Applied Health Research and Development, Lusaka, Zambia.
authors.forename: Leoda
authors.initials: L
authors.lastname: Hamomba
authors.affiliation: Zambia Center for Applied Health Research and Development, Lusaka, Zambia.
authors.forename: Jane
authors.initials: J
authors.lastname: Nambule
authors.affiliation: Zambia Center for Applied Health Research and Development, Lusaka, Zambia.
authors.forename: Kennedy
authors.initials: K
authors.lastname: Sambambi
authors.affiliation: Zambia Center for Applied Health Research and Development, Lusaka, Zambia.
authors.forename: Victor
authors.initials: V
authors.lastname: Musonda
authors.affiliation: Global Health, Boston University School of Public Health, Boston, MA, USA.
authors.forename: Alana
authors.initials: A
authors.lastname: Calise
authors.affiliation: Center for Global Health and Development, Boston University, Boston, MA, USA.
authors.forename: Anna
authors.initials: A
authors.lastname: Knapp
authors.affiliation: US Centers for Disease Control and Prevention, Lusaka, Zambia.
authors.forename: Jonas
authors.initials: J
authors.lastname: Mwale
authors.affiliation: US Centers for Disease Control and Prevention, Lusaka, Zambia.
authors.forename: James
authors.initials: J
authors.lastname: McCauley
authors.affiliation: Center for Global Health and Development, Boston University, Boston, MA, USA; Global Health, Boston University School of Public Health, Boston, MA, USA.
authors.forename: Donald
authors.initials: D
authors.lastname: Thea
authors.affiliation: Center for Global Health and Development, Boston University, Boston, MA, USA; Department of Pediatrics, Boston Medical Center, Boston, MA, USA; Global Health, Boston University School of Public Health, Boston, MA, USA.
authors.forename: Julie M
authors.initials: JM
authors.lastname: Herlihy
mesh_terms: D000328:Adult; D005260:Female; D062489:Health Impact Assessment / Q000706:statistics & numerical data*; D006801:Humans; D008403:Mass Screening / Q000379:methods / Q000706:statistics & numerical data*; D010406:Penicillins / Q000627:therapeutic use; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis* / Q000188:drug therapy; D011296:Prenatal Diagnosis / Q000379:methods / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013587:Syphilis / Q000175:diagnosis* / Q000188:drug therapy; D013997:Time Factors; D015024:Zambia
chemical_list: D010406:Penicillins
keywords: Antenatal care; Congenital syphilis; Penicillin; Rapid syphilis tests