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APHA Scientific Session and Event Listing

Julia Valderrama, MD, MPH, HIV/AIDS Unit, Pan American Health Organization, 525 Twenty-third Street, Washington, DC 20037, 202 974 3596, juliaval@hotmail.com

In 1995, during the 116 Meeting of the Pan American Health Organizationxs Executive Committee, a Regional Plan for the Elimination of Congenital syphilis (ECS) was developed. The “3 by 5” initiative brought opportunities for countries to retake the ECS commitment. Advocacy activities resulted in the determination of four countries (Peru, El Salvador, Honduras, Dominican Republic) to prioritize the control/prevention of congenital syphilis. Methods: Analysis of country assessments, strategic and operational plans and literature review. Results: Common issues identified in the countries were unattained political commitment; barriers to access antenatal care services and to get tests results (i.e. test results were not provided during the same visit); low health providers and users' perception about the severity of the problem, and lack of strategic information for decision making. Detection rate during pregnancy ranged from 18.8% to 68.4%; maternal syphilis prevalence and congenital syphilis ranged between 1.2% and 6.2% and 2.5 and 1 per 1000 live births. In all these countries congenital syphilis was a notifiable disease but maternal syphilis was not considered as such. Conclusions: Maternal and congenital syphilis continue to be a problem. Prevention of mother to child transmission of HIV programs represents an opportunity to integrate activities for the prevention of congenital syphilis. Health providers need to be empowered to make decisions based on their patients' individual circumstances and equipped to document gaps in service provision. The lack of a perfect indicator to measure cases of congenital syphilis should not represent a barrier to act.

Learning Objectives: