title: The Impact of Integration of Rapid Syphilis Testing during Routine Antenatal Services in Rural Kenya.
abstract: We evaluated the integration of rapid syphilis tests (RSTs) and penicillin treatment kits into routine antenatal clinic (ANC) services in two rural districts in Nyanza Province, Kenya. In February 2011, nurses from 25 clinics were trained in using RSTs and documenting test results and treatment. During March 2011-February 2012, free RSTs and treatment kits were provided to clinics for use during ANC visits. We analyzed ANC registry data from eight clinics during the 12-month periods before and during RST program implementation and compared syphilis testing, diagnosis, and treatment during the two periods. Syphilis testing at first ANC visit increased from 18% (279 of 1,586 attendees) before the intervention to 70% (1,123 of 1,614 attendees) during the intervention (P < 0.001); 35 women (3%) tested positive during the intervention period compared with 1 (<1%) before (P < 0.001). Syphilis treatment was not recorded according to training recommendations; seven clinics identified 28 RST-positive women and recorded 34 treatment kits as used. Individual-level data from three high-volume clinics supported that the intervention did not negatively affect HIV test uptake. Integrating RSTs into rural ANC services increased syphilis testing and detection. Record keeping on treatment of syphilis in RST-positive women remains challenging.
authors: Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Office of the Director, Office of Health Equity, 1600 Clifton Road Mailstop E07, Atlanta, GA 30333, USA ; Division of Applied Sciences, Epidemic Intelligence Service, Centers for Disease Control and Prevention, Scientific Education and Professional Development Program Office, Atlanta, GA 30333, USA.
authors: Eleanor
authors: 0000-0003-4415-5410
authors: E
authors: Fleming
authors: Safe Water and AIDS Project, Kisumu 40100, Kenya.
authors: Jared
authors: 0000-0002-1787-9037
authors: J
authors: Oremo
authors: Division of Applied Sciences, Epidemic Intelligence Service, Centers for Disease Control and Prevention, Scientific Education and Professional Development Program Office, Atlanta, GA 30333, USA ; Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Atlanta, GA 30333, USA.
authors: Katherine
authors: K
authors: O'Connor
authors: Safe Water and AIDS Project, Kisumu 40100, Kenya.
authors: Aloyce
authors: A
authors: Odhiambo
authors: Centers for Disease Control and Prevention, Center for Global Health, Office of the Director, Atlanta, GA 30333, USA.
authors: Tun
authors: T
authors: Ye
authors: Kenya Medical Research Institute (KEMRI), Kisian 40100, Kenya.
authors: Simon
authors: 0000-0002-7474-0357
authors: S
authors: Oswago
authors: Kenya Medical Research Institute (KEMRI), Kisian 40100, Kenya.
authors: Clement
authors: C
authors: Zeh
authors: Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Atlanta, GA 30333, USA.
authors: Robert
authors: 0000-0002-1861-0734
authors: R
authors: Quick
authors: Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Office of the Director, Office of Health Equity, 1600 Clifton Road Mailstop E07, Atlanta, GA 30333, USA.
authors: Mary L
authors: 0000-0002-0584-2771
authors: ML
authors: Kamb