Before 1996, syphilis screening for pregnant women in Haiti's Artibonite region -- about 100 miles north of Port-au-Prince -- entailed drawing blood at the dispensaries, transporting it to a central laboratory, returning the results and then treating women who showed signs of the sexually transmitted disease, she said. Unfortunately, that screening strategy failed, and congenital syphilis rates in the region were 550 per 100,000 live births.
The new study showed that by testing pregnant women at the dispensaries at small laboratories on site, health workers cut the congenital syphilis rate to an average of 137 cases per 100,000 live births since 1996. In 1998, the rate was only 95 cases per 100,000.
A laboratory for performing Rapid Plasma Reagin tests was installed at each dispensary. The cost, including training, was about $3,000 at each. No new construction was required, nor was new staff hired. Workers stored sun-generated electricity in 6-volt batteries for conversion to alternating current for a centrifuge and rotator. They stored reagents in propane-powered refrigerators.
During the study, blood samples tested on-site also were re-analyzed at the central laboratory to ensure the work was done correctly. Health workers gave patients penicillin the same day they were tested. While rates of syphilis in pregnant women remained the same over time there, follow-up data collection showed the marked drop in babies born infected.
"We are quite proud of this," said Behets, who spends most of her working time in developing nations with high levels of AIDS and other sexually transmitted diseases. "It shows that it's possible with minimal resources to bring medical discoveries to the poorest of the poor even in remote areas."
More than 90 percent of Haitian women in the Artibonite region deliver their babies at home unattended by
Contact: David Williamson
University of North Carolina at Chapel Hill