Introduction: Congenital syphilis (CS) remains a condition of serious clinical and public health importance, particularly in the Aboriginal populations of northern Australia, which have seen a recent resurgence in cases. In 2005, the Northern Territory (NT) Centre for Disease Control (CDC) published guidelines for management of infants at risk of CS. We audited the management and outcomes of infants at risk of CS who were born between 2005 and 2013 in the Darwin and Katherine regions of the NT.
Methods: Data, including serology, clinical examination, treatment, follow-up and infant outcomes at 12 months, were extracted from the Syphilis Register, medical and pathology records to assess clinician compliance with the CDC guidelines.
Results: Thirty-three infants were identified as being at risk of CS, 26 low risk and 7 high risk. Hospital management at birth conformed well with the guidelines, with 85% of low risk, and 100% of high risk infants receiving treatment and 92% of low risk and 86% of high risk having appropriate serology. Follow-up was poorly compliant, with only 48% of infants completing serological follow-up and less than 15% undergoing clinical examination. No definitive case of CS was identified among the at-risk children.
Conclusions: Overall, peri-natal management of infants was performed well, but follow-up was poor. Effective systems to transfer care from hospitals to primary care are required to improve this. The fact that no infant had direct evidence of syphilis infection suggests consideration should be given to modifying the Australian surveillance case definition.
|Number of pages||8|
|Journal||Communicable diseases intelligence (2018)|
|Publication status||Published - 1 Jan 2018|