Universal syphilis screening program increases testing, diagnoses among pregnant people
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Key takeaways:
- Pre-intervention, only 6.2% encounters included syphilis testing, which increased to 52.4% postintervention.
- Testing resulted in three cases of syphilis pre-intervention and 16 post-intervention.
DENVER — A universal opt-out ED syphilis screening program led to a significant increase in syphilis testing and case diagnoses among pregnant patients, researchers reported.
“I developed a universal syphilis screening program in the emergency department in 2019 after observing many patients coming through with sexually transmitted infections (STIs) or early pregnancies and limited ability to access outpatient care,” Kimberly A. Stanford, MD, MPH, associate professor of medicine at the University of Chicago, told Healio.
“We noticed that we were finding many new patients with syphilis, including pregnant patients, and we wanted to understand and quantify how this screening program affected our patients and whether it was a useful intervention,” Stanford said.
She added, “Although the screening program is for all emergency department (ED) patients, when congenital syphilis numbers started to rise, we wanted to find out if this type of intervention would be useful to address congenital syphilis as well.”
According to study, which was presented at the Conference on Retroviruses and Opportunistic Infections, Stanford and colleagues retrospectively reviewed data gathered from an opt-out syphilis screening program for all pregnant ED patients aged younger than 65 years. Data were gathered 2 years before and after the screening program was implemented.
Throughout the study period, there were a total of 9,165 ED encounters involving pregnant patients. In the 2 years before the intervention, 296 of 4,764 (6.2%) encounters included testing for syphilis, which increased almost eightfold after the intervention to 2,307 of 4,401 (52.4%). Before the intervention, there were three cases of syphilis identified, which increased to 16 after the intervention.
Additionally, the researchers found that only five (31.2%) out of all of the pregnant patients diagnosed with syphilis through the screening program were tested for other STIs.
“Many women who may be vulnerable to congenital syphilis have limited or no access to prenatal care, but many of them visit the ED early in their pregnancy,” Stanford said. “This ED visit represents a critical opportunity to intervene on the congenital syphilis epidemic, and universal ED syphilis screening programs must be a component of our strategy to reduce syphilis in this country.”
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Stanford K, et al. Abstract 1160. Presented at: Conference on Retroviruses and Opportunistic Infections; March 3-6, 2024; Denver.
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