Background. Despite the availability of rapid diagnostic tests and inexpensive treatment for pregnant women, maternal-child\r\nsyphilis transmission remains a leading cause of perinatal morbidity and mortality in developing countries. In Haiti, more than\r\n3000 babies are born with congenital syphilis annually. Methods and Findings. From 2007 to 2011, we used a sequential time\r\nseries,multi-intervention study design in fourteen clinics throughout Haiti to improve syphilis testing and treatment in pregnancy.\r\nThe two primary interventions were the introduction of a rapid point-of-care syphilis test and systems strengthening based on\r\nquality improvement (QI) methods. Syphilis testing increased from 91.5% prediagnostic test to 95.9% after (?? < 0.001) and further\r\nincreased to 96.8% (?? < 0.001) after the QI intervention. Despite high rates of testing across all time periods, syphilis treatment\r\nlagged behind and only increased from70.3% to 74.7% after the introduction of rapid tests (?? = 0.27), but it improved significantly\r\nfrom 70.2% to 84.3% (?? < 0.001) after the systems strengthening QI intervention. Conclusion. Both point-of-care diagnostic\r\ntesting and health systems-based quality improvement interventions can improve the delivery of specific evidence-based healthcare\r\ninterventions to prevent congenital syphilis at scale in Haiti. Improved treatment rates for syphilis were seen only after the use of\r\nsystems-based quality improvement approaches.
Loading....