Low male partner attendance after syphilis screening in pregnant women leads to worse birth outcomes; The Syphilis Treatment Of Partners (STOP) randomized controlled trial
Abstract
Background Maternal syphilis causes poor birth outcomes including congenital syphilis. Testing and treatment of partners prevents re-infection, however strategies to improve partner attendance are failing. This study aimed to determine the effectiveness of 3 partner notification strategies. Methods Pregnant women with a positive, point-of-care treponemal test at three antenatal clinics (ANC) in Kampala, Uganda were randomized 1:1:1 to receive a) notification slips (NS) (standard of care) b) NS and text messages (SMS) c) NS and phone calls. The primary outcome was the proportion of partners who attended ANC and were treated for syphilis. Results Between 2015-2016 17,130 pregnant women were screened; 601(3.5%) with a positive treponemal result were identified and 442 enrolled. Of 81/442 (18.3%) partners (23/153 (15.1%), 31/145 (21.5%) and 27/147 (18.5%) in the NS only, NS+SMS, and NS+phone call arms respectively attended ANC for follow up; no statistical difference was seen between the arms. 12% of women attended ANC with their male partner; increasing over time. Partner non-treatment was independently associated with adverse birth outcomes OR (95%CI) 2.75 (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 ANC and testing both may address the urgent need to treat partners of pregnant women in…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 17,130 participants or records.
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