How well is South Africa detecting and reporting congenital syphilis in young children?
Congenital syphilis (CS) remains a serious but preventable public health concern, occurring when syphilis is transmitted from a pregnant woman to her unborn baby. Without timely screening and treatment during pregnancy, infection can result in miscarriage, stillbirth, prematurity, severe illness and death. Despite the availability of effective screening and treatment, CS continues to contribute to preventable neonatal and perinatal deaths globally.
In South Africa, progress towards eliminating CS is monitored through the District Health Information System (DHIS) and the Notifiable Medical Conditions Surveillance System (NMCSS). The surveillance system captures both clinical notifications of CS and rapid plasma reagin (RPR)-positive results among children under two years of age. Together, these data provide insight into disease trends, case detection, testing and reporting across provinces, districts and health facilities.
The following report examines CS notifications and RPR-positive results among children under two years of age in South Africa during 2024, compared with 2023. By analysing trends across different levels of the health system, the study identifies patterns in reported cases and testing, providing evidence to strengthen screening, surveillance and case reporting as South Africa works towards the elimination of CS.
Materials and Methods
This was a cross-sectional analysis of children who met the case definition for CS and were notified as CS cases (clinical notifications) from both public and private healthcare facilities, and RPR-positive children from the public sector reported through the NMCSS platform and included in the line list from calendar Q1 to calendar Q4 of 2024, compared with similar data from 2023.
The line list of clinical notifications and RPR positive children <2 years-of-age was extracted from the NMCSS for the period 01 January to 31 December 2024, and CS case data from Q1–4 of 2023 were provided for comparison with the 2024 findings.
Results
This was a cross-sectional analysis of children who met the case definition for CS and were notified as CS cases (clinical notifications) from both public and private healthcare facilities, and RPR-positive children from the public sector reported through the NMCSS platform and included in the line list from calendar Q1 to calendar Q4 of 2024, compared with similar data from 2023.
The line list of clinical notifications and RPR-positive children <2 years of age was extracted from the NMCSS for the period 01 January to 31 December 2024, and CS case data from Q1–4 of 2023 were provided for comparison with the 2024 findings.
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