Symptomatic congenital syphilis in a tertiary neonatal unit in Cape Town, South Africa: High morbidity and mortality in a preventable disease
Autor: | Lloyd Tooke, Shakti Pillay |
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Rok vydání: | 2019 |
Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Context (language use) law.invention Tertiary Care Centers 03 medical and health sciences Syphilis Serodiagnosis South Africa Young Adult 0302 clinical medicine law Pregnancy Intensive Care Units Neonatal Medicine Humans 030212 general & internal medicine Syphilis Risk factor Pregnancy Complications Infectious Retrospective Studies 030504 nursing business.industry Syphilis Congenital Infant Newborn Retrospective cohort study Prenatal Care General Medicine medicine.disease Intensive care unit Congenital syphilis Apgar Score Apgar score Female 0305 other medical science business |
Zdroj: | South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde. 109(9) |
ISSN: | 2078-5135 |
Popis: | Background. Despite preventive measures and effective treatment, congenital syphilis continues to impact significantly on neonatal morbidity and mortality. There has been no recent South African (SA) published literature reviewing congenital syphilis, particularly in the context of a tertiary neonatal setting. Objectives. To describe the clinical features of symptomatic neonates with congenital syphilis and to identify modifiable patient, clinical and health facility factors that contributed to syphilis infection. Methods. All positive serological tests for syphilis performed in neonates at Groote Schuur Hospital (GSH), Cape Town, SA, between 1 January 2011 and 31 December 2013 were obtained. Folders were reviewed, and neonates with clinical signs of congenital syphilis were included. Results. Of 50 symptomatic neonates, 19 (38%) died. Twenty-eight mothers (56%) were unbooked and therefore received no antenatal care. Most mothers (98%) were inadequately treated. Health worker-related failures included poor notification and partner tracing as well as failure to recheck syphilis serology after 32 weeks’ gestation in mothers who initially tested negative. Thirty-four neonates required intensive care unit admission. Two significant predictors of mortality were 1-minute and 5-minute Apgar scores |
Databáze: | OpenAIRE |
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