title: The need for further integration of services to prevent mother-to-child transmission of HIV and syphilis in Mwanza City, Tanzania.
abstract: OBJECTIVE
  To assess the operational integration of maternal HIV testing and syphilis screening in Mwanza, Tanzania.
  
  
  METHODS
  Interviews were conducted with 76 health workers (HW) from three antenatal clinics (ANC) and three maternity wards in 2008-2009 and 1137 consecutive women admitted for delivery. Nine ANC health education sessions and client flow observations were observed.
  
  
  RESULTS
  Only 25.0% of HWs reported they had received training in both prevention of mother-to-child transmission (PMTCT) and syphilis screening. HIV and syphilis tests were sometimes performed in different rooms and results recorded in separate registers with different formats and the results were not always given by the same person. At delivery, most women had been tested for both HIV (79.4%) and syphilis (88.1%) during pregnancy. Of those not tested antenatally for each infection, 70.1% were tested for HIV at delivery but none for syphilis.
  
  
  CONCLUSIONS
  Integration of maternal HIV and syphilis screening was limited. Integrated care guidelines and related health worker training should address this gap.
authors.affiliation: National Institute for Medical Research (NIMR), Mwanza, Tanzania. Electronic address: rbalira@yahoo.com.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Balira
authors.affiliation: London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: David
authors.initials: D
authors.lastname: Mabey
authors.affiliation: MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: Helen
authors.initials: H
authors.lastname: Weiss
authors.affiliation: MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, London, UK.
authors.forename: David Anthony
authors.initials: DA
authors.lastname: Ross
authors.affiliation: National Institute for Medical Research (NIMR), Mwanza, Tanzania.
authors.forename: John
authors.initials: J
authors.lastname: Changalucha
authors.affiliation: London School of Hygiene and Tropical Medicine, London, UK; Mwanza Intervention Trials Unit, NIMR, Mwanza, Tanzania.
authors.forename: Deborah
authors.initials: D
authors.lastname: Watson-Jones
mesh_terms: D000328:Adult; D019033:Delivery of Health Care, Integrated / Q000592:standards*; D005260:Female; D015658:HIV Infections / Q000635:transmission*; D006282:Health Personnel / Q000193:education; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D008403:Mass Screening; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000276:immunology; D011295:Prenatal Care / Q000379:methods*; D013587:Syphilis / Q000635:transmission*; D013636:Tanzania
keywords: HIV; Integration; PMTCT; Pregnancy; Syphilis