Congenital syphilis: A public health problem in Ciudad Juarez, Chihuahua, Mexico

Purpose:

Elimination of congenital syphilis with community participation, diagnosis and treatment of HIV and other sexually transmitted infections (STI) with integrated actions.

Background:

STI represent a major risk factor for HIV transmission; syphilis and congenital syphilis are responsible for premature death and abortion. In Mexico, STI are a significant cause of morbidity even though underreporting is estimated to be over 80%. Chihuahua State (U.S. – Mexico Border) is at the top of national reporting of congenital syphilis.

Methods:

Between September and December of 2008, six public health units and a women's hospital implemented an integrated strategy of health education, free and voluntary access to diagnosis and treatment, to all pregnant women requesting medical care. Also, commercial sex workers from Ciudad Juarez were contacted and provided with the same services as requested. A questionnaire was administered to sex workers.

Results:

935 women were attended, 15 (1.6%) resulted positive for syphilis; six time higher than the Mexican mean value for pregnant women with syphilis (0.3). 10 of 15 babies born to syphilitic mothers were diagnosed with congenital syphilis, twice the average number of cases reported yearly in Juarez since 2002.

Of 299 sex workers contacted, 50% reported babies dying before 12 months; 35% had either abortion or stillborn history; 108 (36%) were randomly blood drowned and 18% were positive for syphilis.

Conclusions and recommendations:

Active surveillance and enhanced services to detect syphilis is critical to interrupt transmission and eliminate congenital syphilis.

Ensuring health services for commercial sex workers is mandatory to achieve equity.