Resurgence of congenital syphilis: new strategies against an old foe
Open accessAbstract
Congenital syphilis is a major global cause of fetal loss, stillbirth, neonatal death, and congenital infection. In 2020, the global rate of congenital syphilis was 425 cases per 100 000 livebirths-substantially higher than WHO's elimination target of 50 cases per 100 000 livebirths. Case rates are rising in many high-income countries, but remain low compared with those in low-income and middle-income settings. This Review aims to summarise the current epidemiology and knowledge on transmission and treatment of syphilis in pregnancy, and proposes measures to reduce the rising incidence seen worldwide. We also describe emerging diagnostic and treatment tools to prevent vertical transmission and improve management of congenital syphilis. Finally, we outline a programme of public health priorities, which include research, clinical, and preventive strategies.
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In the last five years, a resurgence of syphilis among pregnant women in several regions has led to a concerning rise in congenital syphilis cases.
“In the last five years, a resurgence of syphilis among pregnant women in several regions has led to a concerning rise in congenital syphilis cases.”
From Syphilis in pregnancy: A practical guide for prenatal care providers (2025) · cites this paper as [4]
The Introduction and the section on increasing congenital syphilis rates (pages unavailable in our copy) report rising congenital syphilis in several high-income countries over the last decade. The latter section also reports increased maternal syphilis prevalence in the Americas between 2012 and 2016. These passages support the broad concern, but not a resurgence among pregnant women across several regions specifically in the last five years. (LLM, conf=0.85)
Experimental — accuracy not yet measuredDespite the WHO's 2007 policy on global elimination of congenital syphilis, the burden of morbidity and mortality due to syphilis continues and has resurged, affecting both low- and middle-income and high-income countries.
“Despite the World Health Organization's (WHO) policy in 2007 on the global elimination of congenital syphilis, 2 the burden of morbidity and mortality due to syphilis continues to persist and in recent years has resurged, affecting both low‐ and middle‐income as well as high‐income countries (Figure 1). 4”
From Syphilis in pregnancy: A practical guide for prenatal care providers (2025) · cites this paper as [4]
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References 79 · Cited by 84
Research works printed but not linked: 3
- Domingues CSB, Duarte G, Passos MRL, Sztajnbok DC das N, Menezes MLB. Brazilian Protocol for Sexually Transmitted Infections, 2020: congenital syphilis and child exposed to syphilis. Rev Soc Bras Med Trop 2021; 54: e2020597.
- Gayet-Ageron A, Sednaoui P, Lautenschlager S, et al. Use of Treponema pallidum PCR in testing of ulcers for diagnosis of primary syphilis. Emerg Infect Dis 2015; 21: 127-9.
- Gayet-Ageron A, Laurent F, Schrenzel J, et al. Performance of the 47-kilodalton membrane protein versus DNA polymerase I genes for detection of Treponema pallidum by PCR in ulcers. J Clin Microbiol 2015; 53: 976-80.
- Authors
- Moseley, P., Bamford, A., Eisen, S., Lyall, H., Kingston, M., Thorne, C., Piñera, C., Rabie, H., Prendergast, A. J., & Kadambari, S.
- Affiliations
- The University of Queensland (AU)
- Great Ormond Street Hospital (GB)
- University College London Hospitals NHS Foundation Trust (GB)
- Imperial College Healthcare NHS Trust (GB)
- Manchester University NHS Foundation Trust (GB)
- University College London (GB)
- University of Chile (CL)
- Stellenbosch University (ZA)
- Queen Mary University of London (GB)
- Corresponding author
- Kadambari, Seilesh
- ORCID
- Venue
- The Lancet Infectious Diseases
- Publisher
- Elsevier BV
- Published
- 2024-01
- Volume
- 24
- Issue
- 1
- Pages
- e24-e35
- ISSN
- 1473-3099 (ISSN-L)
- OpenAlex
- W4385973004
- Cited by
- 84
- References
- 79
- Citations by year
- 2026: 28 · 2025: 32 · 2024: 21 · 2023: 3
- FWCI
- 2.98
- Type
- journal article
- Language
- en
- Open access
- green
- discovery.ucl.ac.uk
- Licence
- Locations
- The Lancet Infectious Diseases (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Queen Mary Research Online (Queen Mary University of London) (submittedVersion)
- Universidad de Chile (submittedVersion, cc-by-nc-nd)
- Topics
- Health Sciences › Medicine › Physiology › Syphilis Diagnosis and Treatment
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Neonatal and Maternal Infections
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Historical Medical Research and Treatments
- Keywords
- congenital syphilis, vertical transmission, maternal syphilis, incidence trends, prenatal screening, syphilis treatment, prevention, public health priorities, stillbirth, neonatal death
- MeSH terms
- Female, Humans, Infant, Newborn, Pregnancy, Pregnancy Complications, Infectious, Prenatal Care, Syphilis, Syphilis, Congenital, Infectious Disease Transmission, Vertical, Stillbirth
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