The scientists decentralized prenatal syphilis screening, shifting blood testing from a regional hospital out to 14 community dispensaries. Those dispensaries enjoy almost none of the amenities people in developed countries take for granted, including running water and electricity, and many are inaccessible by motor vehicle.
A report on the public health effort and its success appears in the March issue of the American Journal of Public Health.
"This study shows that even in a very rural, very poor area, an effective program for syphilis control in pregnant women is feasible," said Dr. Frieda M. T. Behets of the University of North Carolina at Chapel Hill, one of the chief authors. "Our experience shows that even in rudimentary clinics that lack running water and electricity, staff with minimal formal training can carry out serologic screening for syphilis and treat pregnant women successfully."
Behets is research associate professor of medicine and research assistant professor of epidemiology, respectively, at the UNC schools of medicine and public health. Other authors of the report are Dr. Daniel W. Fitzgerald, Dr. Johanne Preval, Lauren Schulwolf, Vidya Bommi and Pascal Chaillet, all of Hospital Albert Schweitzer in Deschapelles, Haiti. Fitzgerald, also a faculty member at Cornell University Medical College, was first author.
"This is very important for other developing countries with similar problems," Behets said. "In Madagascar, for example, where I have been working recently, I have been pleading for a similar program for more than five years, but I have been told repeatedly that this is not feasible. Madagascar
Contact: David Williamson
University of North Carolina at Chapel Hill