Pregnancy loss, infant death, and suffering: legacy of syphilis and gonorrhoea in Africa.

Schulz, K F; Cates, W; O'Mara, P R

doi:10.1136/sti.63.5.320

Cited by 131Reproductive tract infections researchSyphilis Diagnosis and TreatmentHIV/AIDS Research and Interventions

Pregnancy loss, infant death, and suffering: legacy of syphilis and gonorrhoea in Africa.

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Schulz, K F, Cates, W, O'Mara, P R·1987·Sexually Transmitted Infections

DOI 10.1136/sti.63.5.320PMC PMC1194101

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Abstract

Africa in the 1980s appears to be facing problems associated with syphilis and gonorrhoea during pregnancy similar in severity and magnitude to those faced by the western world in the early 1900s. From a review of published reports, the prevalence of syphilis seroreactivity in pregnant women in many parts of Africa is at least 10%. Assuming this level of seroreactivity, we estimate that 5% to 8% of all pregnancies surviving past 12 weeks will have an adverse outcome caused by syphilis, such as spontaneous abortion, perinatal or infant death, or a living infant with syphilis. Our findings on gonorrhoea during pregnancy are almost as startling. The prevalence of gonorrhoea in pregnant women in many parts of Africa is at least 10% and it approaches 20% in some areas. The incidence of gonococcal ophthalmia neonatorum in neonates appears to be between 2% and 4%. We recommend commitment of health resources to initiatives to prevent and control sexually transmitted disease in Africa and additional research into the cost effectiveness of different prevention and control approaches.

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There is systematic misclassification of deaths in cause-of-death data sources, particularly for congenital syphilis, whooping cough, measles, and HIV/AIDS.
“Second, there is systematic misclassification of deaths in cause of death data sources, particularly for congenital syphilis,53,54 whooping cough,55 measles,56 and HIV/AIDS.57”
From Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. (2012) · cites this paper as [53]
In “Incidence of Congenital Syphilis” (page unavailable), the paper says its estimate of syphilis-related deaths is too low partly because many stillborn infants lack clinical evidence of congenital syphilis. This supports underrecognition of syphilis-related deaths, but the paper does not specifically establish systematic misclassification in cause-of-death data sources. This citation is attached to congenital syphilis, not the other diseases listed. (LLM, conf=0.80)
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Authors: Schulz, K. F., Cates, W., & O'Mara, P. R.
Affiliations: Centers for Disease Control and Prevention (US)
ORCID: Schulz, K F
Venue: Sexually Transmitted Infections
Publisher: BMJ
Published: 1987-10-01
Volume: 63
Issue: 5
Pages: 320-325
ISSN: 0007-134X (ISSN-L)
1368-4973
DOI: 10.1136/sti.63.5.320
PMC: PMC1194101
OpenAlex: W2041632232
Cited by: 131
References: 32
Citations by year: 2026: 1 · 2024: 1 · 2022: 1 · 2021: 1 · 2020: 1 · 2019: 3 · 2018: 1 · 2017: 1 · 2016: 5 · 2015: 1 · 2014: 6 · 2013: 5 · 2012: 7
FWCI: 2.41
Type: journal article
Language: en
Open access: bronze
doi.org
Locations: Sexually Transmitted Infections (publishedVersion)
PubMed Central (publishedVersion)
PubMed (publishedVersion)
HighWire Press Open Archive (submittedVersion)
Topics: Life Sciences › Immunology and Microbiology › Microbiology › Reproductive tract infections research
Health Sciences › Medicine › Physiology › Syphilis Diagnosis and Treatment
Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
Keywords: maternal syphilis, miscarriage, perinatal death, infant death, congenital syphilis, gonococcal ophthalmia neonatorum, seroprevalence, STD prevention, Africa
MeSH terms: Abortion, Spontaneous, Africa, Female, Gonorrhea, Humans, Infant Mortality, Infant, Newborn, Ophthalmia Neonatorum, Pregnancy, Pregnancy Complications, Infectious, Syphilis, Syphilis, Congenital

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Pregnancy loss, infant death, and suffering: legacy of syphilis and gonorrhoea in Africa.

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