At the recent 2024 Conference on Retroviruses and Opportunistic Infections (CROI), a groundbreaking syphilis screening program was highlighted for its success in reducing congenital syphilis cases. Dr. Kimberly Stanford, Associate Professor of Medicine at the University of Chicago, discussed the program with Miguel Gomez, Director of HIV.gov.
Chicago, like many other areas, has seen a rise in syphilis and congenital syphilis cases. In response to this concerning trend, Dr. Stanford and her team implemented a routine syphilis screening program in a large urban hospital’s emergency department (ED). The program, which was non-targeted and opt-out, led to a significant increase in the proportion of pregnant individuals screened for syphilis, rising from 6% to 50%.
One of the most impactful findings of the program was the 750% increase in the number of syphilis cases diagnosed among pregnant individuals, jumping from 2 to 15 cases. What was particularly striking was that none of the pregnant women diagnosed with syphilis had presented with symptoms of a sexually transmitted infection, indicating that without the routine screening, these cases would have gone undetected.
The results underscore the missed opportunities for syphilis diagnosis and the prevention of congenital syphilis under the previous standard of care. By screening all pregnant individuals for syphilis and providing early treatment, congenital syphilis can be entirely prevented. Dr. Stanford emphasized that the emergency department, often a primary source of healthcare for communities with limited access to care, presents a crucial opportunity for syphilis detection and prevention.
Dr. Stanford noted that many emergency departments have already incorporated routine HIV screening and highlighted the ease with which syphilis screening can be added to existing protocols, yielding significant results. The intervention in Chicago successfully increased the number of pregnant women screened and diagnosed, making a substantial impact on syphilis detection and prevention.
The study conducted by Dr. Stanford and her colleagues, titled ‘Routine Emergency Department Screening Increases Syphilis Diagnosis Among Pregnant Patients,’ provides valuable insights into the effectiveness of routine syphilis screening programs. Their findings offer a compelling case for the integration of syphilis screening into standard emergency department practices to combat the rise of syphilis and congenital syphilis cases.
