Audit of antenatal screening for syphilis and HIV in migrant and refugee women on the Thai-Myanmar border: a descriptive study

<h4>Objective</h4><p>The antenatal prevalence of syphilis and HIV/AIDS in migrants and refugees is poorly documented. The aim of this study was to audit the first year of routine syphilis screening in the same population and reassess the trends in HIV rates.</p><h4>Meth...

Täydet tiedot

Bibliografiset tiedot
Päätekijät: McGready, R, Kang, J, Watts, I, Tyrosvoutis, M, Torchinsky, M, Htut, A, Tun, N, Keereecharoen, L, Wangsing, C, Hanboonkunupakarn, B, Nosten, F
Aineistotyyppi: Journal article
Julkaistu: F1000 2015
_version_ 1826305495892230144
author McGready, R
Kang, J
Watts, I
Tyrosvoutis, M
Torchinsky, M
Htut, A
Tun, N
Keereecharoen, L
Wangsing, C
Hanboonkunupakarn, B
Nosten, F
author_facet McGready, R
Kang, J
Watts, I
Tyrosvoutis, M
Torchinsky, M
Htut, A
Tun, N
Keereecharoen, L
Wangsing, C
Hanboonkunupakarn, B
Nosten, F
author_sort McGready, R
collection OXFORD
description <h4>Objective</h4><p>The antenatal prevalence of syphilis and HIV/AIDS in migrants and refugees is poorly documented. The aim of this study was to audit the first year of routine syphilis screening in the same population and reassess the trends in HIV rates.</p><h4>Methods</h4><p>From August 2012 to July 2013, 3600 pregnant women were screened for HIV (ELISA) and syphilis (VDRL with TPHA confirmation) at clinics along the Thai-Myanmar border.</p><h4>Results</h4><p>Seroprevalence for HIV 0.47% (95% CI 0.30-0.76) (17/3,599), and syphilis 0.39% (95% CI 0.23-0.65) (14/3,592), were low. Syphilis was significantly lower in refugees (0.07% 95% CI 0.01-0.38) (1/1,469), than in migrants (0.61% 95% CI 0.36-1.04) (13/2,123). The three active (VDRL≥1:8 and TPHA reactive) syphilis cases with VDRL titres of 1:32 were easy to counsel and treat. Women with low VDRL titres (&gt;75% were &lt; 1:8) and TPHA reactive results, in the absence of symptoms and both the woman and her husband having only one sexual partner in their lifetime, and the inability to determine the true cause of the positive results presented ethical difficulties for counsellors.</p><h4>Conclusion</h4><p>As HIV and syphilis testing becomes available in more and more settings, the potential impact of false positive results should be considered, especially in populations with low prevalence for these diseases. This uncertainty must be considered in order to counsel patients and partners accurately and safely about the results of these tests, without exposing women to increased risk for abuse or abandonment. Our findings highlight the complexities of counselling patients about these tests and the global need for more conclusive syphilis testing strategies.</p>
first_indexed 2024-03-07T06:33:42Z
format Journal article
id oxford-uuid:f6e64fdf-742b-4be5-81a4-0692f7af635c
institution University of Oxford
last_indexed 2024-03-07T06:33:42Z
publishDate 2015
publisher F1000
record_format dspace
spelling oxford-uuid:f6e64fdf-742b-4be5-81a4-0692f7af635c2022-03-27T12:38:25ZAudit of antenatal screening for syphilis and HIV in migrant and refugee women on the Thai-Myanmar border: a descriptive studyJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:f6e64fdf-742b-4be5-81a4-0692f7af635cSymplectic Elements at OxfordF10002015McGready, RKang, JWatts, ITyrosvoutis, MTorchinsky, MHtut, ATun, NKeereecharoen, LWangsing, CHanboonkunupakarn, BNosten, F<h4>Objective</h4><p>The antenatal prevalence of syphilis and HIV/AIDS in migrants and refugees is poorly documented. The aim of this study was to audit the first year of routine syphilis screening in the same population and reassess the trends in HIV rates.</p><h4>Methods</h4><p>From August 2012 to July 2013, 3600 pregnant women were screened for HIV (ELISA) and syphilis (VDRL with TPHA confirmation) at clinics along the Thai-Myanmar border.</p><h4>Results</h4><p>Seroprevalence for HIV 0.47% (95% CI 0.30-0.76) (17/3,599), and syphilis 0.39% (95% CI 0.23-0.65) (14/3,592), were low. Syphilis was significantly lower in refugees (0.07% 95% CI 0.01-0.38) (1/1,469), than in migrants (0.61% 95% CI 0.36-1.04) (13/2,123). The three active (VDRL≥1:8 and TPHA reactive) syphilis cases with VDRL titres of 1:32 were easy to counsel and treat. Women with low VDRL titres (&gt;75% were &lt; 1:8) and TPHA reactive results, in the absence of symptoms and both the woman and her husband having only one sexual partner in their lifetime, and the inability to determine the true cause of the positive results presented ethical difficulties for counsellors.</p><h4>Conclusion</h4><p>As HIV and syphilis testing becomes available in more and more settings, the potential impact of false positive results should be considered, especially in populations with low prevalence for these diseases. This uncertainty must be considered in order to counsel patients and partners accurately and safely about the results of these tests, without exposing women to increased risk for abuse or abandonment. Our findings highlight the complexities of counselling patients about these tests and the global need for more conclusive syphilis testing strategies.</p>
spellingShingle McGready, R
Kang, J
Watts, I
Tyrosvoutis, M
Torchinsky, M
Htut, A
Tun, N
Keereecharoen, L
Wangsing, C
Hanboonkunupakarn, B
Nosten, F
Audit of antenatal screening for syphilis and HIV in migrant and refugee women on the Thai-Myanmar border: a descriptive study
title Audit of antenatal screening for syphilis and HIV in migrant and refugee women on the Thai-Myanmar border: a descriptive study
title_full Audit of antenatal screening for syphilis and HIV in migrant and refugee women on the Thai-Myanmar border: a descriptive study
title_fullStr Audit of antenatal screening for syphilis and HIV in migrant and refugee women on the Thai-Myanmar border: a descriptive study
title_full_unstemmed Audit of antenatal screening for syphilis and HIV in migrant and refugee women on the Thai-Myanmar border: a descriptive study
title_short Audit of antenatal screening for syphilis and HIV in migrant and refugee women on the Thai-Myanmar border: a descriptive study
title_sort audit of antenatal screening for syphilis and hiv in migrant and refugee women on the thai myanmar border a descriptive study
work_keys_str_mv AT mcgreadyr auditofantenatalscreeningforsyphilisandhivinmigrantandrefugeewomenonthethaimyanmarborderadescriptivestudy
AT kangj auditofantenatalscreeningforsyphilisandhivinmigrantandrefugeewomenonthethaimyanmarborderadescriptivestudy
AT wattsi auditofantenatalscreeningforsyphilisandhivinmigrantandrefugeewomenonthethaimyanmarborderadescriptivestudy
AT tyrosvoutism auditofantenatalscreeningforsyphilisandhivinmigrantandrefugeewomenonthethaimyanmarborderadescriptivestudy
AT torchinskym auditofantenatalscreeningforsyphilisandhivinmigrantandrefugeewomenonthethaimyanmarborderadescriptivestudy
AT htuta auditofantenatalscreeningforsyphilisandhivinmigrantandrefugeewomenonthethaimyanmarborderadescriptivestudy
AT tunn auditofantenatalscreeningforsyphilisandhivinmigrantandrefugeewomenonthethaimyanmarborderadescriptivestudy
AT keereecharoenl auditofantenatalscreeningforsyphilisandhivinmigrantandrefugeewomenonthethaimyanmarborderadescriptivestudy
AT wangsingc auditofantenatalscreeningforsyphilisandhivinmigrantandrefugeewomenonthethaimyanmarborderadescriptivestudy
AT hanboonkunupakarnb auditofantenatalscreeningforsyphilisandhivinmigrantandrefugeewomenonthethaimyanmarborderadescriptivestudy
AT nostenf auditofantenatalscreeningforsyphilisandhivinmigrantandrefugeewomenonthethaimyanmarborderadescriptivestudy