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Plan for the Control and Elimination of Congenital Syphilis in Ciudad Juárez: An outstanding public health debt

 

Objectives:
Eliminate congenital syphilis with a comprehensive approach seeking HIV / AIDS prevention, other sexually transmitted infections (STIs) and some risk factors.


Background:

STIs represent a serious global public health problem and enhance the transmission of HIV. Syphilis and congenital syphilis, adversely affect infant mortality and Mexico is no exception; where STIs cause significant overall morbidity, the situation becomes aggravated given the underreporting of more than 80% of estimated cases. This problem is even worse in the United States-Mexico Border, having Chihuahua as one the Mexican State in the country with the highest number of reported cases of congenital syphilis, identifying Ciudad Juarez as a reservoir of the disease.

 

Methods:
Between 1 / 09 and 30/12 of 2008, an intervention occurred in 7 units of public health with an information strategy, access to free diagnosis and treatment for all women seeking prenatal services. Moreover, using the same strategy, commercial sex workers from a sector of the city were contacted, as well as a questionnaire given to participants.

Results:
935 women received care and 15 (1.6%) tested positive for syphilis, a value 6 times higher than the national average of pregnant women with syphilis in Mexico (0.3%). Thirteen of 15 diagnosed women were detected during labor, and 10 of the 15 infants were diagnosed with congenital syphilis.
299 sex-workers were contacted, 50% reported children dying before reaching one year of age and 35% with having abortions or having babies born dead. 108 (36%) of 299 were randomly sampled (blood) for analysis and 20 (18%) were confirmed with syphilis, in contrast to similar studies where fewer than 10% are positive.

Conclusions and recommendations:
1. Regular screening for this disease among women of reproductive age is an effective and necessary strategy to achieve the goal of congenital syphilis elimination.
2. Securing access to health services for commercial sex workers is essential for achieving the goal of elimination and health equity.

 

Authors:
Sánchez, Martha1; Duque, Jorge1; Castellanos, Luis Gerardo2; Guzmán, Alfredo3,  Escobedo, Luis4
Sanitary District II, Ciudad Juarez, Chihuahua COESIDA, PAHO / WHO U.S.-Mexico Border Office, Texas Dept. of Health 

Related Links:

PAHO Mother-to-Child Transmission of HIV and Syphilis

WHO Eliminating congenital syphilis

WHO Report: The global elimination of congenital syphilis: rationale and strategy for action

Oficial Mexican NORM NOM-039-SSA2-2002, For the control and prevention of sexually transmitted infectious diseases transmisión sexual


For more information please contact:

Lorely Ambriz, M.S.I.S
, Knowledge Management & Communication Advisor
Pan American Health Organization (PAHO) / A Regional Office of the World Health Organization (WHO) United States-Mexico Border Office
5400 Suncrest Dr. Ste. C-4  El Paso, TX 79912
Office (915) 845-5950 Ext. 42523 / Cel (915) 449-3040  / Fax  (915) 845-4361
This e-mail address is being protected from spambots. You need JavaScript enabled to view it   / www.borderinfo.org 

 

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