TY - JOUR
T1 - Low male partner attendance after syphilis screening in pregnant women leads to worse birth outcomes
T2 - The Syphilis Treatment of Partners (STOP) randomised control trial
AU - Parkes-Ratanshi, Rosalind
AU - Mbazira Kimeze, Joshua
AU - Nakku-Joloba, Edith
AU - Hamill, Matthew M.
AU - Namawejje, Mariam
AU - Kiragga, Agnes
AU - Kayogoza Byamugisha, Josaphat
AU - Rompalo, Anne
AU - Gaydos, Charlotte
AU - Manabe, Yukari C.
N1 - Funding Information:
Rosalind Parkes-Ratanshi receives grant funding through the IDI from Janssen, the pharmaceutical company of Johnson and Johnson. The other authors have no conflicts of interest to disclose.
Funding Information:
The authors thank the patients and staff of the Mulago and Kasangati ANC clinics, the STI clinic at Mulago and the IDI Sexual and Reproductive Health Clinic. This study was funded by Foundation for the National Institutes of Health (5U54EB007958 to Charlotte Gaydos). The funders had no role in the design of the study, in the collection, analysis and interpretation of data or in the writing of the manuscript. With regard to the availability of data and material, because this is clinical data, the source documents will not be available online, but the authors can be contacted directly for more information.
Publisher Copyright:
© 2020 Journal compilation
PY - 2020/6
Y1 - 2020/6
N2 - Background: Maternal syphilis causes poor birth outcomes, including congenital syphilis. Testing and treatment of partners prevents reinfection, but strategies to improve partner attendance are failing. The aim of this study was to determine the effectiveness of three partner notification strategies. Methods: Pregnant women with a positive point-of-care treponemal test at three antenatal clinics (ANCs) in Kampala, Uganda, were randomised 1: 1: 1 to receive either notification slips (NS standard of care), NS and a text messages (SMS) or NS and telephone calls. The primary outcome was the proportion of partners who attended the ANC and were treated for syphilis. Results: Between 2015 and 2016, 17 130 pregnant women were screened 601 (3.5%) had a positive treponemal result, and 442 were enrolled in the study. Only 81 of 442 partners (18.3% 23/152 (15.1%), 31/144 (21.5%) and 27/146 (18.5%) in the NS only, NS + SMS and NS + telephone call groups respectively) attended an ANC for follow-up there were no significant differences between the groups. Twelve per cent of women attended the ANC with their male partner, and this proportion increased over time. Partner non-treatment was independently associated with adverse birth outcomes (odds ratio 2.75 95% confidence interval 2.36-3.21 P < 0.001). Conclusions: Only 18.3% of partners of pregnant women who tested positive for syphilis received treatment. Female partners of non-attendant men had worse birth outcomes. Encouraging men to accompany women to the ANC and testing both may address the urgent need to treat partners of pregnant women in sub-Saharan Africa to reduce poor fetal outcomes.
AB - Background: Maternal syphilis causes poor birth outcomes, including congenital syphilis. Testing and treatment of partners prevents reinfection, but strategies to improve partner attendance are failing. The aim of this study was to determine the effectiveness of three partner notification strategies. Methods: Pregnant women with a positive point-of-care treponemal test at three antenatal clinics (ANCs) in Kampala, Uganda, were randomised 1: 1: 1 to receive either notification slips (NS standard of care), NS and a text messages (SMS) or NS and telephone calls. The primary outcome was the proportion of partners who attended the ANC and were treated for syphilis. Results: Between 2015 and 2016, 17 130 pregnant women were screened 601 (3.5%) had a positive treponemal result, and 442 were enrolled in the study. Only 81 of 442 partners (18.3% 23/152 (15.1%), 31/144 (21.5%) and 27/146 (18.5%) in the NS only, NS + SMS and NS + telephone call groups respectively) attended an ANC for follow-up there were no significant differences between the groups. Twelve per cent of women attended the ANC with their male partner, and this proportion increased over time. Partner non-treatment was independently associated with adverse birth outcomes (odds ratio 2.75 95% confidence interval 2.36-3.21 P < 0.001). Conclusions: Only 18.3% of partners of pregnant women who tested positive for syphilis received treatment. Female partners of non-attendant men had worse birth outcomes. Encouraging men to accompany women to the ANC and testing both may address the urgent need to treat partners of pregnant women in sub-Saharan Africa to reduce poor fetal outcomes.
KW - maternal syphilis
KW - mobile phones
KW - mother to child transmission
KW - partner notification
UR - http://www.scopus.com/inward/record.url?scp=85086720860&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85086720860&partnerID=8YFLogxK
U2 - 10.1071/SH19092
DO - 10.1071/SH19092
M3 - Article
C2 - 32527365
AN - SCOPUS:85086720860
SN - 1448-5028
VL - 17
SP - 214
EP - 222
JO - Sexual Health
JF - Sexual Health
IS - 3
ER -