Sexual and reproductive health

Dual test for syphilis and HIV

A simple, proven, and inexpensive dual test for syphilis and HIV, combined with a web-linked hand-held optical reading device, could improve the quality, acceptability, and uptake of testing and treatment in rural areas to accelerate elimination of MTCT of syphilis and HIV.

“In Zambia, if we’re going to be successful in eliminating pediatric AIDS, we also have to prevent congenital syphilis…It is simply unacceptable for this disease to continue to plague women and children.”
Susan Strasser, Zambia Director, Elizabeth Glaser Pediatric AIDS Foundation

Why do we care?

  • Globally, syphilis caused 300,000 stillbirths and neonatal deaths in 2008, and 390,000 children were newly infected with HIV in 2010
    - These are preventable deaths
  • Newborns in Zambia are at great risk
    - 5.3% of antenatal attendees are seropositive for syphilis
    - 12.3% of antenatal attendees are seropositive for HIV
    - Syphilis-positive pregnant women are two times more likely to be seropositive for HIV
  • We have an opportunity to make a difference in Zambia
    - 94% of antenatal attendees were tested for HIV
    - Only 43% of antenatal attendees were tested for syphilis
  • Innovative strategies are needed to ensure that all pregnant women are tested for syphilis and HIV in early pregnancy
Image showing test devices

What will we do?

  • Assess laboratory performance of newly available dual rapid diagnostic tests (RDTs) for syphilis & HIV
  • Field test the highest performing RDT along with a web-linked handheld optical reader offering patient-tailored care algorithms

What will we learn?

  • Dual RDT performance
  • Acceptability of dual testing by patients and staff 
  • Effect of optical reader on improving testing quality and data management
  • Feasibility of web-based surveillance to improve program and procurement
  • Acceptability of patient-tailored care algorithms
  • Changes in utilization of health services

What difference will this innovation make?

  • We can help eliminate mother-to-child transmission of syphilis and HIV in 600,000 infants born in Zambia each year
  • Improved data can provide evidence for informed public health decisionmaking
  • Generic protocol can be used for other countries interested in scaling up integrated antenatal services
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