Decreased Congenital Syphilis Incidence in Haiti’s Rural Artibonite Region Following Decentralized Prenatal Screening

Congenital syphilis can be prevented by testing pregnant women with a serological test developed by Wassermann in 1906 and by treating seropositive women with penicillin, discovered by Fleming in 1928.1,2 Unfortunately, more than 70 years later, congenital syphilis is still a leading cause of perinatal death in many developing countries.3–11 Before 1996, syphilis screening for pregnant women in Haiti’s Artibonite region was done by drawing blood at community dispensaries, transporting the blood to a central laboratory, returning test results to the dispensary, and then treating seropositive women at a follow-up visit. Unfortunately, this centralized prenatal screening strategy failed, and rates of congenital syphilis in the Artibonite region in 1995 were 550 cases per 100 000 live births.9 A decentralized prenatal screening strategy was implemented in 1996.