Routine antenatal syphilis screening - a case against

Abstract

To highlight the deficiencies associated with the routine antenatal syphilis screening as it is done now in the University College Hospital, Ibadan, and determine the cost effectiveness or otherwise of syphilis screening using as parameter the specificity of the method of screening as well as the gravity of the disease. The results of VDRL tests performed on pregnant women attending the antenatal clinic of the University College Hospital, Ibadan, in a 10- year period, January 1988 to December 1997 were analysed for seropositivity as well as congenital syphilis. The case notes of 110 sero- reactive patients were retrieved and analysed for pregnancy outcome. The prevalence rate of seropositive patients was 1.1%. Only 3 of the seropositive had repeated tests and were treated empirically with high doses of penicillin. There was no case of congenital syphilis. This study has shown that the syphilis screening as it is done now is not cost-effective. If VDRL test is to be continued, efforts must be mad e to reintroduce TPHA-test, which is more specific-specificity; it wastes a lot of time and money of the patients. Hence it is not cost effective. If VDRL test is to be continued efforts must be made to reintroduce TPHA-test, which is more specific.