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Syphilis tests were done using the RPR card test (Becton Dickinson, Maryland, USA) and
positive samples were confirmed with Treponema pallidum haemagglutination test (TPHA,
Randox Laboratories, UK). Serum HIV-1 antibodies were detected by enzyme-linked
immunosorbent assay (ELISA) (Biochem immuno systems kit, Montreal, Canada) and
positive samples were confirmed using double ELISA test (Biotech, Cambridge, Ireland).
Data analysis was done using SPSS version 7.5. Pearson's Chi-square with Yates' correction
was used to compare proportions and the t-test to compare means. ORs and their 95% CIs
were used to measure strength of association.
The study was approved by the Ethical Committee of the University of Nairobi.
Results
From April 1997 to April 1998, an unselected group of 12,414 women who gave birth in the
Pumwani Maternity Hospital (PMH) were screened for syphilis. Of them, 377 (3%) were RPR
reactive. Of those 377 women, 117 (31%) had already been identified RPR positive earlier
on during pregnancy while 155 (41%) had been RPR negative and 105 (28%) had not been
tested during pregnancy.
Postpartum, partner notification information was provided to 357 of the 377 RPR-positive
women and 127 (36%) of their partners came for treatment. Forty-two (33%) of those
partners had already been treated during pregnancy and of them 12 (29%) were still RPR
positive at the time of delivery. Twenty-two men (17%) declined to be tested for syphilis. Of
the 105 men tested, 33 (31%) were RPR positive. Fourteen men had a positive RPR test but
negative TPHA test, suggesting a new early infection or a false positive RPR test.
Table 1 shows the characteristics of women whose partners came for treatment and those
who did not turn up. There was no difference in education, history of alcohol use, parity, bad
obstetrical history, HIV status or number of sex partners in the past year. Women whose
partners did not come for treatment however were younger (P=0.01), more likely to be
unmarried (P