Resurgence of congenital syphilis: new strategies against an old foe

Philip Moseley; Alasdair Bamford; Sarah Eisen; Hermione Lyall; Margaret Kingston; Claire Thorne; Cecilia Piñera; Helena Rabie; Andrew J Prendergast; Seilesh Kadambari

doi:10.1016/S1473-3099(23)00314-6

Resurgence of congenital syphilis: new strategies against an old foe

Lancet Infect Dis. 2024 Jan;24(1):e24-e35. doi: 10.1016/S1473-3099(23)00314-6. Epub 2023 Aug 18.

Authors

Affiliations

¹ University of Queensland Frazer Institute, University of Queensland, Brisbane, QLD, Australia.
² Department of Paediatric Infectious Diseases, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK; University College London Great Ormond Street Institute of Child Health, London, UK.
³ University College London Hospitals NHS Foundation Trust, London, UK.
⁴ Imperial College Healthcare NHS Trust, London, UK.
⁵ Manchester University NHS Foundation Trust, Manchester, UK.
⁶ University College London Great Ormond Street Institute of Child Health, London, UK.
⁷ Medicine Faculty, Universidad de Chile, Santiago, Chile.
⁸ Department of Paediatrics and Child Health, Stellenbosch University, Stellenbosch, South Africa; Tygerberg Academic Hospital, Cape Town, South Africa.
⁹ Zvitambo Institute for Maternal and Child Health Research, Harare, Zimbabwe; Blizard Institute, Queen Mary University of London, London, UK.
¹⁰ Department of Paediatric Infectious Diseases, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK; University College London Great Ormond Street Institute of Child Health, London, UK. Electronic address: seilesh.kadambari@gosh.nhs.uk.

PMID: 37604180
DOI: 10.1016/S1473-3099(23)00314-6

Abstract

Congenital syphilis is a major global cause of fetal loss, stillbirth, neonatal death, and congenital infection. In 2020, the global rate of congenital syphilis was 425 cases per 100 000 livebirths-substantially higher than WHO's elimination target of 50 cases per 100 000 livebirths. Case rates are rising in many high-income countries, but remain low compared with those in low-income and middle-income settings. This Review aims to summarise the current epidemiology and knowledge on transmission and treatment of syphilis in pregnancy, and proposes measures to reduce the rising incidence seen worldwide. We also describe emerging diagnostic and treatment tools to prevent vertical transmission and improve management of congenital syphilis. Finally, we outline a programme of public health priorities, which include research, clinical, and preventive strategies.

Publication types

Review

MeSH terms

Female
Humans
Infant, Newborn
Infectious Disease Transmission, Vertical / prevention & control
Pregnancy
Pregnancy Complications, Infectious* / epidemiology
Pregnancy Complications, Infectious* / prevention & control
Prenatal Care
Stillbirth / epidemiology
Syphilis* / diagnosis
Syphilis* / drug therapy
Syphilis* / epidemiology
Syphilis, Congenital* / epidemiology
Syphilis, Congenital* / prevention & control