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- W4212961696 abstract "The Lancet Editors (July 11, p104)1The LancetCuba: defeating AIDS and advancing global health.Lancet. 2015; 386: 104Scopus (7) Google Scholar recently commented on successes in Cuba in elimination of mother-to-child transmission of HIV infection as a public health threat; however, this Editorial neglected to address the important point that this was a dual effort to validate the elimination of mother-to-child transmission of both HIV infection and syphilis. WHO certified that Cuba had eliminated mother-to-child transmission not only of HIV, but also of syphilis. We were not surprised that The Lancet would omit one of the most neglected, but still common, sexually transmitted infections. Syphilis affects more pregnancies worldwide than does HIV infection.2Klausner JD The sound of silence: missing the opportunity to save lives at birth.Bull World Health Organ. 2013; 91 (158A): 158Crossref PubMed Scopus (18) Google Scholar Maternal syphilis infections cause hundreds of thousands of adverse outcomes of pregnancy, including fetal loss or stillbirth, prematurity or low birthweight, neonatal death, and syphilis infection in the infant.3Newman L Kamb M Hawkes S et al.Global estimates of syphilis in pregnancy and associated adverse outcomes: analysis of multinational antenatal surveillance data.PLoS Med. 2013; 10: e1001396Crossref PubMed Scopus (250) Google Scholar In women with HIV, syphilis infection during pregnancy is associated with more than a 2·7 times increased risk of mother-to-child HIV transmission.4Mwapasa V Rogerson SJ Kwiek JJ et al.Maternal syphilis infection is associated with increased risk of mother-to-child transmission of HIV in Malawi.AIDS. 2006; 20: 1869-1877Crossref PubMed Scopus (97) Google Scholar The similarities in screening recommendations for HIV infection and syphilis (ie, testing at first antenatal visit) provide an important opportunity to strengthen efforts to eliminate congenital syphilis together with prevention of mother-to-child transmission of HIV—both high-priority initiatives that can help countries to reach common goals of improved maternal health and decreased mortality of children aged younger than 5 years.2Klausner JD The sound of silence: missing the opportunity to save lives at birth.Bull World Health Organ. 2013; 91 (158A): 158Crossref PubMed Scopus (18) Google Scholar Rapid, dual point-of-care tests have been created that can detect antibodies to both HIV and Treponema pallidum, the organism that causes syphilis. Emergence of dual rapid tests for HIV infection and syphilis can result in earlier detection, reduced loss to follow-up, expanded case finding outside clinical settings, and enhanced global control of syphilis and HIV. Results of studies have shown that dual tests are accurate and reproducible in both field5Omoding D Katawera V Siedner M Boum 2nd, Y Evaluation of the SD Bioline HIV/Syphilis Duo assay at a rural health center in Southwestern Uganda.BMC Res Notes. 2014; 7: 746Crossref PubMed Scopus (26) Google Scholar and laboratory6Bristow CC Adu-Sarkodie Y Ondondo RO et al.Multi-site laboratory evaluation of a dual HIV/syphilis point-of-care rapid test for simultaneous detection of HIV and syphilis.Open Forum Infect Dis. 2014; 1: ofu015Crossref Scopus (35) Google Scholar settings. However, compared with no syphilis testing, even moderate performance is associated with enhanced detection and treatment of infections. With those findings, donors and national health programmes should feel confident that further investments in the implementation of dual testing would produce expected benefits through increased uptake of testing and streamlined procurement and implementation that can lead to improved maternal and newborn health outcomes. Cuba can be the first of many to eliminate mother-to-child transmission of syphilis and HIV infection, and dual rapid tests can make programme integration an achievable reality. We declare no competing interests. Cuba: defeating AIDS and advancing global healthOn June 30, Cuba became the world's first country to eliminate mother-to-child transmission of HIV. As WHO Director-General Margaret Chan noted, this achievement is a “major victory” and “an important step towards having an AIDS-free generation”. Full-Text PDF" @default.
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- W4212961696 date "2015-10-01" @default.
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- W4212961696 title "Cuba: defeating mother-to-child transmission of syphilis" @default.
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- W4212961696 doi "https://doi.org/10.1016/s0140-6736(15)00485-7" @default.
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