Rising Burden of Congenital Syphilis in South Africa: Trends from 2020–2023: Opportunities to Optimize Implementation of Dual HIV/Syphilis in Pregnant women and their sexual partners
1
HIV and AIDS and STI, National Department of Health, Pretoria, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Congenital syphilis (CS) is a severe but preventable condition caused by vertical transmission of Treponema pallidum during pregnancy. Despite the availability of cost-effective interventions such as antenatal screening and timely treatment, CS continues to pose a major public health challenge globally and in South Africa. The World Health Organization (WHO) has set an elimination target of fewer than 50 cases per 100,000 live births, emphasizing early antenatal care, universal screening, and treatment completion. Understanding recent epidemiological trends is critical for guiding policy and strengthening maternal health programs.
METHODS:
We conducted a retrospective analysis of national surveillance data from the National Institute for Communicable Diseases (NICD) for the period 2020–2023. Data included annual congenital syphilis incidence rates per 100,000 live births, total reported cases, and live birth figures. Trends were assessed to identify changes over time and compare them against WHO elimination targets
RESULTS:
CS incidence increased dramatically over four years, from 37 per 100,000 live births in 2020 to 198 per 100,000 in 2023. Reported cases rose from 382 in 2020 to 1,739 in 2023, while live births declined from 1,035,255 to 876,972. These findings highlight a growing burden of CS despite ongoing elimination strategies and underscore the urgent need for strengthened antenatal screening, timely treatment, and robust surveillance systems. The data suggests that without intensified interventions, South Africa will remain far from achieving the WHO elimination target of fewer than 50 cases per 100,000 live births as it represents a more than a fivefold increase in incidence despite ongoing elimination strategies.
CONCLUSIONS:
Urgent action is required to strengthen maternal health services and achieve elimination targets., It would therefore, be critical for South Africa to implement the Dual HIV/Syphilis modality routinely in ANC clinics in all 9 provinces to reduce the number of CS in the country.
Congenital syphilis (CS) is a severe but preventable condition caused by vertical transmission of Treponema pallidum during pregnancy. Despite the availability of cost-effective interventions such as antenatal screening and timely treatment, CS continues to pose a major public health challenge globally and in South Africa. The World Health Organization (WHO) has set an elimination target of fewer than 50 cases per 100,000 live births, emphasizing early antenatal care, universal screening, and treatment completion. Understanding recent epidemiological trends is critical for guiding policy and strengthening maternal health programs.
METHODS:
We conducted a retrospective analysis of national surveillance data from the National Institute for Communicable Diseases (NICD) for the period 2020–2023. Data included annual congenital syphilis incidence rates per 100,000 live births, total reported cases, and live birth figures. Trends were assessed to identify changes over time and compare them against WHO elimination targets
RESULTS:
CS incidence increased dramatically over four years, from 37 per 100,000 live births in 2020 to 198 per 100,000 in 2023. Reported cases rose from 382 in 2020 to 1,739 in 2023, while live births declined from 1,035,255 to 876,972. These findings highlight a growing burden of CS despite ongoing elimination strategies and underscore the urgent need for strengthened antenatal screening, timely treatment, and robust surveillance systems. The data suggests that without intensified interventions, South Africa will remain far from achieving the WHO elimination target of fewer than 50 cases per 100,000 live births as it represents a more than a fivefold increase in incidence despite ongoing elimination strategies.
CONCLUSIONS:
Urgent action is required to strengthen maternal health services and achieve elimination targets., It would therefore, be critical for South Africa to implement the Dual HIV/Syphilis modality routinely in ANC clinics in all 9 provinces to reduce the number of CS in the country.
| eISSN: | 2654-1459 |
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