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dc.contributor.author
Althabe, Fernando
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dc.contributor.author
Chomba, Elwyn
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Tshefu, Antoinette K
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Banda, Ernest
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Belizán, María Melina Eleonora
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dc.contributor.author
Bergel, Eduardo
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Berrueta, Amanda Mabel
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Bertrand, Jane
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Bose, Carl
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Cafferata, Maria Luisa
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Carlo, Waldemar A
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Ciganda, Alvaro
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Donnay, France
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Garcia Elorrio, Ezequiel
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Gibbons, Luz
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Klein, Karen
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Liljestrand, Jerker
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Lusamba, Paul D
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Mavila, Arlette K
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Mazzoni, Agustina
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Nkamba, Dalau M
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Mwanakalanga, Friday H
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Mwapule Tembo, Abigail
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Mwenechanya, Musaku
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Pyne Mercier, Lee
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Spira, Cintia
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Wetshikoy, Jean D
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Xiong, Xu
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Buekens, Pierre
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dc.date.available
2021-07-02T16:08:26Z
dc.date.issued
2019-05
dc.identifier.citation
Althabe, Fernando; Chomba, Elwyn; Tshefu, Antoinette K; Banda, Ernest; Belizán, María Melina Eleonora; et al.; A multifaceted intervention to improve syphilis screening and treatment in pregnant women in Kinshasa, Democratic Republic of the Congo and in Lusaka, Zambia: a cluster randomised controlled trial; Elsevier; The Lancet Global Health; 7; 5; 5-2019; e655-e663
dc.identifier.uri
http://hdl.handle.net/11336/135420
dc.description.abstract
Background: Despite international recommendations, coverage of syphilis testing in pregnant women and treatment of those found seropositive remains limited in sub-Saharan Africa. We assessed whether combining the provision of supplies with a behavioural intervention was more effective than providing supplies only, to improve syphilis screening and treatment during antenatal care. Methods: In this 18-month, cluster randomised controlled trial, we randomly assigned (1:1) 26 urban antenatal care clinics in Kinshasa, Democratic Republic of the Congo, and Lusaka, Zambia, to receive a behavioural intervention (opinion leader selection, academic detailing visits, reminders, audits and feedback, and supportive supervision) plus supplies for syphilis testing and treatment (intervention group) or to receive supplies only (control group). The primary outcomes were proportion of pregnant women who had syphilis screening out of the total who attended the clinic; and the proportion of women who had treatment with benzathine benzylpenicillin out of those who tested positive for syphilis at their first antenatal care visit. This trial is registered at ClinicalTrials.gov, number NCT02353117. Findings: The 18-month study period was Feb 1, 2016, to July 14, 2017. 18 357 women were enrolled at the 13 intervention clinics and 17 679 women were enrolled at the 13 control clinics at their first antenatal care visit. Syphilis screening was done in a median of 99·9% (IQR 99·0–100·0) of women in the intervention clinics and 93·8% (85·0–98·9) in the control clinics (absolute difference 6·1% [95% CI 1·1–14·1]; p=0·00092). Syphilis treatment at the first visit was done in a median of 100% (IQR 99·7–100·0) of seropositive women in intervention clinics and 43·2% (2·6–83·2) of seropositive women in control clinics (absolute difference 56·8% [12·8–99·0]; p=0·0028). Interpretation: A behavioural intervention, together with the provision of supplies, can lead to more than 95% of women being screened and treated for syphilis. The sole provision of supplies is sufficient to reach such levels of screening coverage but is not sufficient to ensure high levels of treatment. Funding: Bill & Melinda Gates Foundation.
dc.format
application/pdf
dc.language.iso
eng
dc.publisher
Elsevier
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dc.rights
info:eu-repo/semantics/openAccess
dc.rights.uri
https://creativecommons.org/licenses/by/2.5/ar/
dc.subject
Syphilis
dc.subject
Pregnant women
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Democratic Republic of the Congo
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Zambia
dc.subject.classification
Otras Ciencias de la Salud
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dc.subject.classification
Ciencias de la Salud
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dc.subject.classification
CIENCIAS MÉDICAS Y DE LA SALUD
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dc.title
A multifaceted intervention to improve syphilis screening and treatment in pregnant women in Kinshasa, Democratic Republic of the Congo and in Lusaka, Zambia: a cluster randomised controlled trial
dc.type
info:eu-repo/semantics/article
dc.type
info:ar-repo/semantics/artículo
dc.type
info:eu-repo/semantics/publishedVersion
dc.date.updated
2021-06-30T17:49:56Z
dc.identifier.eissn
2214-109X
dc.journal.volume
7
dc.journal.number
5
dc.journal.pagination
e655-e663
dc.journal.pais
Países Bajos
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dc.journal.ciudad
Amsterdam
dc.description.fil
Fil: Althabe, Fernando. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina. Instituto de Efectividad Clínica y Sanitaria; Argentina. Organizacion Mundial de la Salud; Argentina
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Fil: Chomba, Elwyn. University Teaching Hospital of Lusaka; Zambia
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Fil: Tshefu, Antoinette K. University of Kinshasa; República Democrática del Congo
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Fil: Banda, Ernest. University Teaching Hospital of Lusaka; Zambia
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Fil: Belizán, María Melina Eleonora. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
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Fil: Bergel, Eduardo. Instituto de Efectividad Clínica y Sanitaria; Argentina
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Fil: Berrueta, Amanda Mabel. Instituto de Efectividad Clínica y Sanitaria; Argentina
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Fil: Bertrand, Jane. University of Tulane; Estados Unidos
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Fil: Bose, Carl. University of North Carolina; Estados Unidos
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Fil: Cafferata, Maria Luisa. Instituto de Efectividad Clínica y Sanitaria; Argentina
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Fil: Carlo, Waldemar A. University of Alabama at Birmingahm; Estados Unidos
dc.description.fil
Fil: Ciganda, Alvaro. Instituto de Efectividad Clínica y Sanitaria; Argentina
dc.description.fil
Fil: Donnay, France. University of Tulane; Estados Unidos
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Fil: Garcia Elorrio, Ezequiel. Instituto de Efectividad Clínica y Sanitaria; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina
dc.description.fil
Fil: Gibbons, Luz. Instituto de Efectividad Clínica y Sanitaria; Argentina
dc.description.fil
Fil: Klein, Karen. Instituto de Efectividad Clínica y Sanitaria; Argentina
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Fil: Liljestrand, Jerker. Bill And Melinda Gates Foundation; Estados Unidos
dc.description.fil
Fil: Lusamba, Paul D. University of Kinshasa; República Democrática del Congo
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Fil: Mavila, Arlette K. University of Kinshasa; República Democrática del Congo
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Fil: Mazzoni, Agustina. Instituto de Efectividad Clínica y Sanitaria; Argentina
dc.description.fil
Fil: Nkamba, Dalau M. University of Kinshasa; República Democrática del Congo
dc.description.fil
Fil: Mwanakalanga, Friday H. University Teaching Hospital Lusaka; Zambia
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Fil: Mwapule Tembo, Abigail. University Teaching Hospital Lusaka; Zambia
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Fil: Mwenechanya, Musaku. University Teaching Hospital Lusaka; Zambia
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Fil: Pyne Mercier, Lee. Bill And Melinda Gates Foundation; Estados Unidos
dc.description.fil
Fil: Spira, Cintia. Instituto de Efectividad Clínica y Sanitaria; Argentina
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Fil: Wetshikoy, Jean D. University of Kinshasa; República Democrática del Congo
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Fil: Xiong, Xu. University of Tulane; Estados Unidos
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Fil: Buekens, Pierre. University of Tulane; Estados Unidos
dc.journal.title
The Lancet Global Health
dc.relation.alternativeid
info:eu-repo/semantics/altIdentifier/url/https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6465956/
dc.relation.alternativeid
info:eu-repo/semantics/altIdentifier/doi/https://doi.org/10.1016/S2214-109X(19)30075-0
dc.relation.alternativeid
info:eu-repo/semantics/altIdentifier/url/https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(19)30075-0/fulltext
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