Factors associated with failure to screen for syphilis during antenatal care in Ghana: a case control study
Identifieur interne : 000345 ( Main/Exploration ); précédent : 000344; suivant : 000346Factors associated with failure to screen for syphilis during antenatal care in Ghana: a case control study
Auteurs : Edward Tieru Dassah [Ghana] ; Yaw Adu-Sarkodie [Ghana] ; Philippe Mayaud [Royaume-Uni]Source :
- BMC Infectious Diseases [ 1471-2334 ] ; 2015.
Descripteurs français
- KwdFr :
- Adolescent, Adulte, Adulte d'âge moyen, Complications de la grossesse et maladies infectieuses (), Complications de la grossesse et maladies infectieuses (diagnostic), Facteurs de risque, Femelle, Ghana (épidémiologie), Grossesse, Humains, Issue de la grossesse, Jeune adulte, Modèles logistiques, Nouveau-né, Odds ratio, Prise en charge prénatale (normes), Service de santé pour les femmes, Syphilis (), Syphilis (diagnostic), Syphilis (transmission), Études cas-témoins, Évaluation de résultat (soins).
- MESH :
- diagnostic : Complications de la grossesse et maladies infectieuses, Syphilis.
- normes : Prise en charge prénatale.
- épidémiologie : Ghana, Syphilis.
- Adolescent, Adulte, Adulte d'âge moyen, Complications de la grossesse et maladies infectieuses, Facteurs de risque, Femelle, Grossesse, Humains, Issue de la grossesse, Jeune adulte, Modèles logistiques, Nouveau-né, Odds ratio, Service de santé pour les femmes, Syphilis, Études cas-témoins, Évaluation de résultat (soins).
- Wicri :
- geographic : Ghana.
English descriptors
- KwdEn :
- Adolescent, Adult, Case-Control Studies, Female, Ghana (epidemiology), Humans, Infant, Newborn, Logistic Models, Middle Aged, Odds Ratio, Outcome Assessment (Health Care), Pregnancy, Pregnancy Complications, Infectious (diagnosis), Pregnancy Complications, Infectious (prevention & control), Pregnancy Outcome, Prenatal Care (standards), Risk Factors, Syphilis (diagnosis), Syphilis (prevention & control), Syphilis (transmission), Women's Health Services, Young Adult.
- MESH :
- geographic , epidemiology : Ghana.
- diagnosis : Pregnancy Complications, Infectious, Syphilis.
- prevention & control : Pregnancy Complications, Infectious, Syphilis.
- standards : Prenatal Care.
- transmission : Syphilis.
- Adolescent, Adult, Case-Control Studies, Female, Humans, Infant, Newborn, Logistic Models, Middle Aged, Odds Ratio, Outcome Assessment (Health Care), Pregnancy, Pregnancy Outcome, Risk Factors, Women's Health Services, Young Adult.
Abstract
There is little data regarding the effect of ramping up new screening interventions on their uptake by target populations into routine care services in developing countries. This study aimed to determine patient-level factors associated with failure of pregnant women to get screened for syphilis during antenatal care, in the context of a national rollout of rapid syphilis point of care tests (POCTs) in Ghana.
An unmatched 1:2 case control study conducted among women admitted for delivery in two district hospitals in the Ashanti Region of Ghana from August to October 2010, 7 to 9 months after the introduction of POCTs in the region. Cases were women who had not been screened for syphilis during antenatal care and controls were women who had been screened. Patient-reported factors for being unscreened were examined using logistic regression to obtain odds ratios (ORs) and 95% confidence intervals (CIs).
160 consecutive unscreened and 327 screened women were recruited. Most women had good knowledge of syphilis (58.7% among unscreened women vs. 64.2% among screened; P = 0.24). Factors associated with failure to get screened were: attending antenatal care in a private health facility (adjusted OR, 11.09; 95% CI 5.48-22.48), previous adverse pregnancy outcome (adjusted OR, 1.98; 95% CI 1.22-3.23) and not being screened for HIV during the current pregnancy (adjusted OR, 2.78; 95% CI 1.50-5.13). The odds of being unscreened also increased with decreasing doses of intermittent preventive treatment for malaria in pregnancy received (P trend < 0.001) and decreasing education level (P trend = 0.02).
Significant risk factors for not being screened, following the national rollout of syphilis POCTs, related to the type of health facility where antenatal care was received and some of the women’s personal characteristics. Targeting of private medical facilities to include syphilis POCTs and support other neglected public health interventions should be a priority.
Url:
DOI: 10.1186/s12879-015-0868-1
PubMed: 25888254
PubMed Central: 4364573
Affiliations:
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Le document en format XML
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<term>Humans</term>
<term>Infant, Newborn</term>
<term>Logistic Models</term>
<term>Middle Aged</term>
<term>Odds Ratio</term>
<term>Outcome Assessment (Health Care)</term>
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<term>Pregnancy Complications, Infectious (prevention & control)</term>
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<term>Prenatal Care (standards)</term>
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<term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Complications de la grossesse et maladies infectieuses ()</term>
<term>Complications de la grossesse et maladies infectieuses (diagnostic)</term>
<term>Facteurs de risque</term>
<term>Femelle</term>
<term>Ghana (épidémiologie)</term>
<term>Grossesse</term>
<term>Humains</term>
<term>Issue de la grossesse</term>
<term>Jeune adulte</term>
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<term>Odds ratio</term>
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<term>Syphilis (diagnostic)</term>
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<term>Adulte d'âge moyen</term>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>There is little data regarding the effect of ramping up new screening interventions on their uptake by target populations into routine care services in developing countries. This study aimed to determine patient-level factors associated with failure of pregnant women to get screened for syphilis during antenatal care, in the context of a national rollout of rapid syphilis point of care tests (POCTs) in Ghana.</p>
</sec>
<sec><title>Methods</title>
<p>An unmatched 1:2 case control study conducted among women admitted for delivery in two district hospitals in the Ashanti Region of Ghana from August to October 2010, 7 to 9 months after the introduction of POCTs in the region. Cases were women who had not been screened for syphilis during antenatal care and controls were women who had been screened. Patient-reported factors for being unscreened were examined using logistic regression to obtain odds ratios (ORs) and 95% confidence intervals (CIs).</p>
</sec>
<sec><title>Results</title>
<p>160 consecutive unscreened and 327 screened women were recruited. Most women had good knowledge of syphilis (58.7% among unscreened women vs. 64.2% among screened; P = 0.24). Factors associated with failure to get screened were: attending antenatal care in a private health facility (adjusted OR, 11.09; 95% CI 5.48-22.48), previous adverse pregnancy outcome (adjusted OR, 1.98; 95% CI 1.22-3.23) and not being screened for HIV during the current pregnancy (adjusted OR, 2.78; 95% CI 1.50-5.13). The odds of being unscreened also increased with decreasing doses of intermittent preventive treatment for malaria in pregnancy received (P trend < 0.001) and decreasing education level (P trend = 0.02).</p>
</sec>
<sec><title>Conclusion</title>
<p>Significant risk factors for not being screened, following the national rollout of syphilis POCTs, related to the type of health facility where antenatal care was received and some of the women’s personal characteristics. Targeting of private medical facilities to include syphilis POCTs and support other neglected public health interventions should be a priority.</p>
</sec>
</div>
</front>
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</listBibl>
</div1>
</back>
</TEI>
<affiliations><list><country><li>Ghana</li>
<li>Royaume-Uni</li>
</country>
<region><li>Angleterre</li>
<li>Grand Londres</li>
</region>
<settlement><li>Londres</li>
</settlement>
</list>
<tree><country name="Ghana"><noRegion><name sortKey="Dassah, Edward Tieru" sort="Dassah, Edward Tieru" uniqKey="Dassah E" first="Edward Tieru" last="Dassah">Edward Tieru Dassah</name>
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<name sortKey="Adu Sarkodie, Yaw" sort="Adu Sarkodie, Yaw" uniqKey="Adu Sarkodie Y" first="Yaw" last="Adu-Sarkodie">Yaw Adu-Sarkodie</name>
<name sortKey="Adu Sarkodie, Yaw" sort="Adu Sarkodie, Yaw" uniqKey="Adu Sarkodie Y" first="Yaw" last="Adu-Sarkodie">Yaw Adu-Sarkodie</name>
<name sortKey="Dassah, Edward Tieru" sort="Dassah, Edward Tieru" uniqKey="Dassah E" first="Edward Tieru" last="Dassah">Edward Tieru Dassah</name>
</country>
<country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Mayaud, Philippe" sort="Mayaud, Philippe" uniqKey="Mayaud P" first="Philippe" last="Mayaud">Philippe Mayaud</name>
</region>
</country>
</tree>
</affiliations>
</record>
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