1. What is this study about?

This is an analysis and discussion of the congenital syphilis cases and Rapid Plasma Reagin (RPR) positive results from children <2 years that were submitted to the Notifiable Medical Conditions (NMC) surveillance platform during 2023.

 2. Why does this matter?

Congenital syphilis is a condition caused by the mother-to-child transmission of syphilis, a bacterial sexually transmitted infection. If a woman with syphilis falls pregnant or acquires syphilis during the course of the pregnancy and the infection goes undetected or untreated, it can be transferred to the unborn child and could lead to the death of an unborn child (miscarriage or stillbirth), slow growth during pregnancy, preterm birth, or illness in the child. Congenital syphilis is a common but preventable cause of pregnancy loss and neonatal death and has been earmarked for elimination by the World Health Organisation. This analysis reports on South Africa’s progress towards the elimination of congenital syphilis in 2023.

 3. What drew your interest in this area of research?

Congenital syphilis is a category 2 notifiable medical condition, meaning healthcare providers are required by law to report cases within seven days of making a diagnosis. In collaboration with colleagues from the NMC programme at the National Institute for Communicable Diseases (NICD), we regularly analyse these reports for trends over time and for gaps in the prevention programme. The WHO set an elimination target of 50 per 100 000 live births. We were interested in this analysis in order to determine the case rate for South Africa, nationally and provincially. 

4. What was your role in the study?

I led the analysis and drafting of the report.

 5. Why should people read this article?

Healthcare providers, policy makers, researchers, and the general public should read this report in order to understand the status of congenital syphilis and surveillance in the country, the progress made towards the elimination of congenital syphilis, and the limitations of the available data.

6. What impact do you hope this study will have on public health policy and access to healthcare?

The report will raise awareness of congenital syphilis as an ongoing public health challenge, galvanise support and resources for interventions to improve detection and treatment among pregnant women and their infants. The access to screening and treatment for syphilis among pregnant women is high in the country, but there are gaps in the returning of results and the starting of treatment. Scaling up rapid testing and making sure there are no stock-outs of the benzathine penicillin needed for treatment will go a long way in preventing mother-to-child transmission of syphilis.

Dr Tendesayi Kufa-Chakezha is an epidemiologist in the Centre for HIV and STI at the National Institute for Communicable Diseases.

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