Het nuttig effect van serologische screening op syfilis in de zwangerschap in de regio Amsterdam, 1991-1995

Objective. To evaluate the results of screening of pregnant women for syphilis in the region of Amsterdam, the Netherlands. Design. Descriptive study and cost-benefit analysis. Methods. In the period 1991-1995, physicians and midwives from the Amsterdam region sent serum samples of pregnant women to the Regional Public Health Laboratory of the Municipal Health Service (GG and GD) to be screened for syphilis. All physicians who had sent in specimens with a positive result of the Treponema pallidum haemagglutination assay (TPHA) and a confirming test result were asked, in the year of the screening, by telephone or in writing, what diagnosis they had made in the woman in question. Collection of these data was handled bij the social nursing staffs of the outpatient clinics for sexually transmitted diseases in Amsterdam. The costs of laboratory tests and follow-up of the children were compared with the positive effects of special treatment and education avoided by antibiotic treatment. Results. 54,344 serum samples were sent in. In the city of Amsterdam the coverage was 87.4%. In 81 women (0.15%) all the serological tests for syphilis were positive. From this group, 37 women had already been treated and 24 women were treated as a result of this screening programme (most of them had a foreign nationality), 10 for early syphilis and 14 for syphilis of unknown duration, preventing the birth of an estimated five to six children with congenital syphilis. The cost-benefit ratio was 1:15. Conclusion. Continuation of screening for syphilis during pregnancy in the Amsterdam region remains useful.