Ten-Year Trends of Syphilis in Sero-Surveillance of Pregnant Women in Rwanda & Correlates of Syphilis-HIV Co-Infection

Syphilis can be transmitted by pregnant women to their children and is a public health problem in Africa. 

A cross-sectional survey was conducted in 24 antenatal clinics from 2002 to 2003 and increased to 30 sites from 2005 to 2011. Participants were tested for syphilis and HIV. Multi-variate logistic regression was performed to identify risks associated with syphilis and its co-infection with HIV. 

Results showed that 

• syphilis decreased from 3.8% in 2002 to 2.0% in 2011. 
• Syphilis in the HIV-infected participants increased from 6.0% in 2002 to 10.8% in 2011, 
• but decreased from 3.7% to 1.7% in the HIV-negative participants. 
• In 2011, syphilis in urban participants was 2.7% and 1.4% in rural ones. 
• HIV-infected participants screened positive for syphilis more frequently in both rural and urban areas. 
• Older participants (25-49 years) residing in urban areas and women with secondary or high education were less likely to screen positive for syphilis. 
• HIV-syphilis co-infection was more likely in women residing in urban areas, but less likely in women with secondary/high education. 

In conclusion, syphilis increased in HIV-positive pregnant women, but decreased in HIV-negative women. Positive HIV status and young age were associated risks for syphilis. HIV-syphilis co-infection was associated with a lower level of education and urban residence.

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By:   Mutagoma M1, Balisanga H2, Remera E2, Gupta N3, Malamba SS4, Riedel DJ5, Nsanzimana S6.

• 1Rwanda Biomedical Center, Ministry of Health, Kigali, Rwanda mutagoma@gmail.com.
• 2Rwanda Biomedical Center, Ministry of Health, Kigali, Rwanda.
• 3Global Health Equity, Brigham & Women's Hospital, Boston, MA, USA Partners in Health / Inshuti Mu Buzima, Rwinkwavu, Rwanda.
• 4U.S. Centers for Disease Control and Prevention (CDC), Center for Global Health (CGH), Division of Global HIV/AIDS (DGHA), Rwanda.
• 5Institute of Human Virology and Division of Infectious Diseases, University of Maryland School of Medicine, Baltimore, Maryland, MD, USA.
• 6Rwanda Biomedical Center, Ministry of Health, Kigali, Rwanda Swiss Tropical and Public Health Institute, University of Basel, Basel, Switzerland. 

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