The amount of penicillin needed to prevent mother-to-child transmission of syphilis

摘要

Syphilis is unique among sexually transmitted diseases in that it remains curable (with minimal reports of resistance) with a single dose of penicillin, formulated for this purpose as long-acting benzathine penicillin. 1 , 2 Pregnant women with untreated syphilis experience adverse birth outcomes in over half of untreated pregnancies. These outcomes include stillbirth, organ deformities, prematurity and neonatal death. 3 The World Health Organization (WHO) estimates that 930 000 pregnant women have probable active syphilis (transmissible during pregnancy) annually which results in approximately 350 000 adverse birth outcomes per year. 4 Most maternal syphilis cases and adverse pregnancy outcomes occur in low- and middle-income countries, and more than half occur in sub-Saharan African countries. 4 WHO estimates that global syphilis prevalence is 0.5% (95% uncertainty interval, UI: 0.4–0.6%) which corresponds to a global incidence of 5.6 million (95% UI: 4–8 million) syphilis cases per year among people aged 15–49 years. 5 From these estimates, it is possible to calculate the amount of penicillin needed for syphilis treatment on a global scale. However, the difference between the global needs and what is currently produced is not possible to quantify as there is no global monitoring of availability.