ELIMINATION OF CONGENITAL SYPHILIS IN UKRAINE: ANALYSIS AND THE EMERGING ISSUES

Lyudmyla Derevyanko

Abstract


The objective of this study is to analyze the indicators of the process of elimination of mother-to-child transmission of syphilis in Ukraine thus helping to prepare for elimination of this process according to the WHO targets and criteria.

Epidemiological and clinical data of 237 women who had syphilis before or during pregnancy and babies born to them (238) from 1999 to 2007 years were presented. In addition were used statistical forms of the Public Health Center and Center for Medical Statistics of the Ministry of Health of Ukraine for the incidence of syphilis and HIV in women of reproductive age, pregnant women and children born to them, including those who were diagnosed with congenital syphilis (CS) and HIV infection.

Analysis of the causes of СS suggests that the main risk factors in Ukraine were the lack of prenatal care in 44 % and treatment in 99 % of pregnant women with syphilis. Besides out-of-date normative base regulating STI diagnostic and care create delay in diagnostics and treatment of pregnant women and their newborns.

In addition, the delay with prenatal diagnosis and treatment, late infection, quality of diagnostics, iatrogenic errors, refusal of women from current requirement for hospitalization, reinfection, and birth at home can be attributed to risk factors for CS.

Despite the main target indicator of CS elimination has been achieved, process indicators of syphilis as coverage of syphilis testing and treatment of pregnant women as well as other additional requirements have not reached yet.

On the way to the CS elimination Ukraine is facing a few challenges. There is an urgent need on further year the new strategy on STI/СS prevention with targets and targets indicators. In addition national protocols of the treatment of pregnant women should be adapted according to the European Guidelines as well as comprehensive data is required for surveillance and monitoring of CS elimination.


Keywords


congenital syphilis; HIV; mother-to-child transmission; elimination

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References


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DOI: http://dx.doi.org/10.21303/2504-5679.2017.00515

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