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Indicator name:
Congenital syphilis reported rate
Data type:
Rate
Indicator Id:
4493
Topic:
Mortality and burden of disease
Rationale:
Untreated syphilis infection in pregnancy can result in stillbirth, neonatal death and congenital disease (collectively defined as “congenital syphilis”). Untreated syphilis infection in pregnancy also increases the risk of vertical transmission of HIV. Given the high efficacy, appropriate simplicity and low cost of syphilis testing and treatment, global and regional initiatives to eliminate the vertical transmission of syphilis are well established. The rate of congenital syphilis is a measure of national surveillance and the impact of programmatic interventions to eliminate vertical transmission of syphilis.
Definition:
Congenital syphilis rate expressed per 100 000 live births.
Numerator: Number of reported congenital syphilis cases (live births and stillbirth) in the past 12 months
Denominator: Number of live births. Source: National estimates of live births per year provided by countries.
Method of measurement
Diagnosing congenital syphilis is most reliable when specific diagnostic tests are used, but these are unfortunately seldom available. In most countries, therefore, diagnosis relies on clinical history of maternal testing and treatment and clinical examination of the infant, which makes surveillance challenging.  Congenital syphilis case definitions vary between and within countries and regions. Countries are encouraged to report on this indicator using a national case definition that is compatible with the global surveillance case definition for congenital syphilis.  (see page 17 of Global guidance on criteria and processes for validation: elimination of mother-to-child transmission of HIV, syphilis and hepatitis B virus (who.int)
Method of estimation:
Data based on:
1. Country reports to Global AIDS Monitoring (GAM) process (formerly Global AIDS response progress reporting (GARPR)).
2. Country reports to European Centre for Disease Prevention and Control (ECDC).
3. Official national statistics available online.
Preferred data sources:
Surveillance systems; All references to Kosovo should be understood to be in the context of the United Nations Security Council resolution 1244 (1999)
Facility reporting system
Unit of Measure:
Cases per 100 000 live births
Expected frequency of data dissemination:
Annual
Expected frequency of data collection:
Annual
Comments:
Countries are asked to communicate on the extent to which the data are felt to be representative of the national population.  Given the difficulties in diagnosing congenital syphilis—and depending on the case definition used—underreporting and overreporting can be a problem. The likely magnitude of such reporting errors should always be considered when looking at rates of congenital syphilis over time.
Contact person email:
jrowley@who.int
Name:
Jane Rowley
Links:
Methods for surveillance and monitoring of congenital syphilis elimination within existing systems (WHO, 2011)
Global guidance on criteria and processes for validation: elimination of mother-to-child transmission of HIV, syphilis and hepatitis B virus
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