Low male partner attendance after syphilis screening in pregnant women leads to worse birth outcomes: the Syphilis Treatment of Partners (STOP) randomised control trial

Rosalind Parkes-Ratanshi; Joshua Mbazira Kimeze; Edith Nakku-Joloba; Matthew M. Hamill; Mariam Namawejje; Agnes Kiragga; Josaphat Kayogoza Byamugisha; Anne Rompalo; Charlotte Gaydos; Yukari C. Manabe

doi:10.1071/SH19092

RESEARCH ARTICLE (Open Access)

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Low male partner attendance after syphilis screening in pregnant women leads to worse birth outcomes: the Syphilis Treatment of Partners (STOP) randomised control trial

Rosalind Parkes-Ratanshi ^A ^B ^F , Joshua Mbazira Kimeze ^A , Edith Nakku-Joloba ^C , Matthew M. Hamill

^D , Mariam Namawejje ^A , Agnes Kiragga ^A , Josaphat Kayogoza Byamugisha ^E , Anne Rompalo ^D , Charlotte Gaydos ^D and Yukari C. Manabe ^D

+ Author Affiliations

- Author Affiliations

^A Infectious Diseases Institute, Makerere University College of Health Sciences, PO Box 22418, Kampala, Uganda.

^B Institute of Public Health, University of Cambridge, Forvie Site, Cambridge CB2 0SR, UK.

^C School of Public Health, Makerere University College of Health Sciences, PO Box 7072, Kampala, Uganda.

^D Division of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, 1830 E. Monument Street, Room 8031, Baltimore, MD 21287, USA.

^E School of Medicine, Makerere University College of Health Sciences, PO Box 7072, Kampala, Uganda.

^F Corresponding author. Email: rp549@medschl.cam.ac.uk

Sexual Health 17(3) 214-222 https://doi.org/10.1071/SH19092
Submitted: 28 May 2019 Accepted: 9 October 2019 Published: 12 June 2020

Journal compilation © CSIRO 2020 Open Access CC BY-NC-ND

Abstract

Background: Maternal syphilis causes poor birth outcomes, including congenital syphilis. Testing and treatment of partners prevents reinfection, but strategies to improve partner attendance are failing. The aim of this study was to determine the effectiveness of three partner notification strategies. Methods: Pregnant women with a positive point-of-care treponemal test at three antenatal clinics (ANCs) in Kampala, Uganda, were randomised 1 : 1 : 1 to receive either notification slips (NS; standard of care), NS and a text messages (SMS) or NS and telephone calls. The primary outcome was the proportion of partners who attended the ANC and were treated for syphilis. Results: Between 2015 and 2016, 17 130 pregnant women were screened; 601 (3.5%) had a positive treponemal result, and 442 were enrolled in the study. Only 81 of 442 partners (18.3%; 23/152 (15.1%), 31/144 (21.5%) and 27/146 (18.5%) in the NS only, NS + SMS and NS + telephone call groups respectively) attended an ANC for follow-up; there were no significant differences between the groups. Twelve per cent of women attended the ANC with their male partner, and this proportion increased over time. Partner non-treatment was independently associated with adverse birth outcomes (odds ratio 2.75; 95% confidence interval 2.36–3.21; P < 0.001). Conclusions: Only 18.3% of partners of pregnant women who tested positive for syphilis received treatment. Female partners of non-attendant men had worse birth outcomes. Encouraging men to accompany women to the ANC and testing both may address the urgent need to treat partners of pregnant women in sub-Saharan Africa to reduce poor fetal outcomes.

Additional keywords: maternal syphilis, mobile phones, mother to child transmission, partner notification.

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