Congenital syphilis: an economic evaluation of a prevention program in China

F.C. Hong, J.B. Liu, T.J. Feng, X.L. Liu, P. Pan, H. Zhou, Y.M. Cai, L. Ling, X.M. Huang, D. Zhang, Y.J. Zhang, M.P.A. Zeegers

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BACKGROUND: Until now there has been no data to show the effectiveness or benefits of screening for syphilis in gravidas in China. This study was to assess the effectiveness of a program preventing mother-to-child-transmission of syphilis and to reveal factors impacting the benefit. METHODS: A cohort of 159,017 gravidas were screened for syphilis by serologic methods and infected individuals were treated with 3 injections of 2.4 million units of benzathine penicillin in Shenzhen in 2005. The pregnancy outcomes were compared for this cost-effectiveness analysis in 2 scenarios, intervention with screening and treatment versus no intervention. RESULTS: Eight hundred twenty-seven pregnant women (0.52%) were diagnosed with syphilis and treated subsequently. Of these, 200 gestations ended in miscarriage. Four babies were diagnosed with congenital syphilis; 25 neonates with low birth weight; 1 died after birth. The total cost was $636,748. On average, every $770 identified 1 infected mother. Every $4391 prevented 1 congenital syphilis; every $5135 prevented 1 low birth weight; and every $7075 prevented 1 death. One disability adjusted life year could be saved by $215. In total the program reached a benefit to cost ratio of 21.76. Sensitivity analyses revealed that this ratio was mainly impacted by the prevalence of syphilis in pregnant women and the rate of miscarriage. CONCLUSIONS: Screening for antenatal syphilis combined with intervening during gestation is highly effective in China. Reducing the percentage of spontaneous/induced abortion would be one of the most effective methods of further increasing the benefits of this screening.
Original languageEnglish
Pages (from-to)26-31
JournalSexually Transmitted Diseases
Issue number1
Publication statusPublished - 1 Jan 2010

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Hong, F. C., Liu, J. B., Feng, T. J., Liu, X. L., Pan, P., Zhou, H., Cai, Y. M., Ling, L., Huang, X. M., Zhang, D., Zhang, Y. J., & Zeegers, M. P. A. (2010). Congenital syphilis: an economic evaluation of a prevention program in China. Sexually Transmitted Diseases, 37(1), 26-31.