Congenital syphilis is making a worrying comeback globally, with alarming increases in cases, according to recent research. Between 2016 and 2023, the number of new congenital syphilis cases surged from 700,000 to approximately 1.5 million. Scientists from the Kenya Medical Research Institute (Kemri) are particularly concerned about this trend, noting that gaps in testing and diagnostics, especially at lower-level healthcare facilities, are contributing to the rise in infections.
Congenital syphilis occurs when a mother with syphilis passes the infection to her baby during pregnancy. The World Health Organization (WHO) points out that syphilis in mothers often does not exhibit symptoms, making it difficult to detect and treat early, which can lead to severe complications for the unborn child. The infection can cause birth defects, stillbirth, or even death in the first few days or weeks of life. As a result, the disease continues to be a significant cause of neonatal mortality worldwide.
In Kenya, the situation is particularly troubling. Dr. Victor Akelo, a medical epidemiologist at Kemri, explained at the 15th Kemri Annual Scientific and Health Conference that the country has seen a notable increase in syphilis cases, especially among pregnant women. In studies conducted by Kemri, it was found that between two and six percent of pregnant women tested positive for syphilis. This may seem low, but Dr. Akelo highlighted the catastrophic impact a single infected mother can have on her child. If left untreated, syphilis in pregnancy can result in the death of the baby or serious health issues, even before the baby reaches the age of 28 days.
Kemri’s data suggests that approximately 10 to 12 percent of neonatal deaths in Kenya are linked to congenital syphilis, a stark reminder of the need for urgent action. Dr. Akelo emphasized that syphilis is treatable if diagnosed early, noting that substantial progress was made in reducing syphilis rates in Kenya after 2012, primarily due to increased investment in diagnostic tools. However, the re-emergence of the disease is partly due to disruptions in the supply chain and gaps in the ability to detect and track cases, especially in rural areas.
One of the major challenges in combating congenital syphilis is ensuring pregnant women attend regular antenatal care visits. In Kenya, a significant number of women still fail to seek timely medical attention during pregnancy, putting both their health and their babies’ lives at risk. According to Kemri data, 41 out of every 1,000 babies born in the country die before their fifth birthday, with some regions experiencing even higher rates. The global target is to reduce this number to less than 25 deaths per 1,000 live births, highlighting the urgent need for improvements in healthcare services.
In response to this growing issue, experts emphasize the importance of strengthening prevention strategies. Routine antenatal screening for syphilis is crucial, as it allows for early diagnosis and treatment with penicillin, which can prevent the transmission of the infection to the baby. Additionally, partner tracing and treatment are essential to ensure that the infection does not spread. Health education campaigns promoting safe sex practices and addressing the risks of illicit drug use are also critical in reducing syphilis rates.
Clinicians are urged to conduct thorough examinations of pregnant women to identify potential syphilis cases. This includes taking detailed medical histories and performing confirmatory tests known as treponemal tests, which can detect the bacteria responsible for syphilis. Public health measures to promote early detection and timely treatment, especially for high-risk mothers, are urgently needed to curb the rising number of congenital syphilis cases.
Overall, while syphilis is a preventable and treatable condition, addressing the gaps in healthcare infrastructure and raising awareness about the importance of early detection and treatment are key to preventing further harm to mothers and babies.
