Introduction: Congenital syphilis is a preventable disease with significant risks. Between 2015 and 2022 Australia syphilis notifications increased in women of reproductive age, giving rise to the potential of congenital syphilis. From 1 January 2016 to 30 September 2022, 54% (n=54) of congenital syphilis cases and 67% (n=12) of deaths were reported in Aboriginal infants, this rate is exaggerated in the Northern Territory (NT) and in 2022 the NT Health reported 2 cases of congenital syphilis.
Aim: This study aimed to assess rates of syphilis serology testing in a cohort of pregnant Aboriginal women in the NT seeking care in the remote Primary Health Care (PHC) sector, and to formulate recommendations.
Methodology: A retrospective audit of syphilis serology testing in Aboriginal women who had antenatal and postnatal episodes of care in four remote PHC clinics, and who gave birth, between 1 May 2019 and 31 March 2021 (n=382) was undertaken.
Results: This study found that 94% of the cohort attended at least one antenatal episode of care and 93% had an antenatal syphilis serology test at their first episode of care.
As gestational age increased, the proportion of women having syphilis serology testing decreased, compared to the proportion of women attending antenatal care. Attendance at antenatal episodes of care exceeded 86% across all gestations. Syphilis serology testing ranged from 93% at first attendance, reducing to 61% at 36 weeks gestation. A postnatal episode of care was attended by 27% of the cohort, with less than one third of attendees having a syphilis test.
Conclusion: Pregnant Aboriginal women in specific remote PHC clinics, in the NT, are not having the recommended syphilis serology testing, despite the overall uptake of antenatal care being high. It is recommended the reasons for this be explored, and the PHC sector implement a routine and prompt system to ensure syphilis serology testing and monitor compliance to guidelines.