Declining syphilis prevalence in pregnant women in Nairobi since 1995: another success story in the STD field?

Untreated maternal syphilis during pregnancy will cause adverse pregnancy o utcomes in more than 60% of the infected women. In Nairobi, Kenya, the prev alence of syphilis in pregnant women of 2.9% in 1989, showed a rise to 6.5% in 1993, parallel to an increase of HIV-1 prevalence rates. Since the earl y 1990s, decentralized STD/HIV prevention and control programmes, including a specific syphilis control programme, were developed in the public health facilities of Nairobi. Since 1992 the prevalence of syphilis in pregnant w omen has been monitored. This paper reports the findings of 81,311 pregnant women between 1994 and 1997. A total of 4244 women (5.3%) tested positive with prevalence rates of 7.2% (95% CT: 6.7-7.7) in 1994, 7.3% (95% CI: 6.9- 7.7) in 1995, 4.5% (95% CI: 4.3-4.8) in 1996 and 3.8% (95% CI: 3.6-4.0) in 1997. Tn conclusion, a marked decline in syphilis seroprevalence in pregnan t women in Nairobi was observed since 1995-96 (P<0.0001, Chi-square test fo r trend) in contrast to upward trends reported between 1990 and 1994-95 in the same population.