Congenital syphilis rate (live births and stillbirth)
Export Indicator
Progress in eliminating vertical transmission of syphilis
Untreated syphilis infection in pregnancy can result in stillbirth, neonatal death and congenital disease (collectively defined as "congenital syphilis"). Untreated syphilis infection in pregnancy also increases the risk of vertical transmission of HIV. Given the high efficacy, appropriate simplicity and low cost of syphilis testing and treatment, global and regional initiatives to eliminate the vertical transmission of syphilis are well established. The rate of congenital syphilis is a measure of national surveillance and the impact of programmatic interventions to eliminate vertical transmission of syphilis.
Number of reported congenital syphilis cases (live births and stillbirths) in the past 12 months
Number of live births in the past 12 months
Numerator/denominator
Routine health information systems.
Annual
None
It is important to indicate in the comment section the case definition of congenital syphilis used in your country and to highlight any major differences between the national case definition and the global surveillance case definition (see page 16 of the World Health Organization [WHO] Global guidance on criteria and processes for validation: elimination of mother-to-child transmission of HIV, syphilis and hepatitis B, available at https://iris.who.int/ bitstream/handle/10665/349550/9789240039360-eng.pdf?sequence=1).
In particular, countries should note whether or not their national case definition counts stillbirths.
Please comment on the extent to which the data are deemed representative of the national population. If a country is unable to report on the denominator, WHO will use the denominator from the United Nations Population Division
Diagnosing congenital syphilis is most reliable when specific diagnostic tests are used, but these are unfortunately seldom available. In most countries, therefore, diagnosis relies on clinical history of maternal testing and treatment and clinical examination of the infant, which makes surveillance challenging. Although WHO has a global case definition for surveillance purposes, the actual case definition may vary between and within countries and regions.
Given the difficulties in diagnosing congenital syphilis - and depending on the case definition used - underreporting and overreporting can be a problem. The likely magnitude of such reporting errors should always be considered when looking at rates of congenital syphilis over time.
Methods for surveillance and monitoring of congenital syphilis elimination within existing systems. Geneva: World Health Organization; 2011 (https://extranet.who.int/iris/restricted/handle/10665/44790).
Global guidance on criteria and processes for validation: elimination of mother-to-child transmission of HIV and syphilis. Geneva: World Health Organization; 2017 (http://www.who.int/reproductivehealth/publications/emtct-hiv-syphilis/en/).