Trial reportThe Lancet. Global health2019
A multifaceted intervention to improve syphilis screening and treatment in pregnant women in Kinshasa, Democratic Republic of the Congo and in Lusaka, Zambia: a cluster randomised controlled trial.
Trial report in The Lancet. Global health, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02353117 (Preventing Congenital Syphilis), which is not on this map. Cited by 26 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Preventing Congenital Syphilis
Who cites it
26 citing papers in PubMed, 4 syntheses or guidelines pooled it, 34 citations in OpenAlex.
- Factors influencing implementation of point-of-care tests for maternal and newborn screening and diagnosis in low-resource settings: a systematic review.BMC global and public health · 2026Pooled it
- Tailored interventions to address determinants of practice.The Cochrane database of systematic reviews · 2026Pooled it
- Audit and feedback: effects on professional practice.The Cochrane database of systematic reviews · 2025Pooled it
- Exploring the content and delivery of feedback facilitation co-interventions: a systematic review.Implementation science : IS · 2024Pooled it
- Re-emerging syphilis among women of reproductive age: temporal dynamics, demographic drivers, inequalities and projections to 2046.New microbes and new infections · 2026Article
- State-of-the-Art Review: Congenital Syphilis in the Modern Era: Current Strategies and Future Directions.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2026Review
- Characteristics and effectiveness of maternal health interventions to prevent mother-to-child transmission (PMTCT) of syphilis in a global setting: a scoping review using Intervention Mapping as a framework.BMC pregnancy and childbirth · 2026Article
- Adoption of universal prenatal syphilis rescreening recommendations across Ontario, Canada: a difference-in-differences analysis.BMJ public health · 2026Article
- HCV screening among surgical patients in a tertiary hospital of Northern China.BMC gastroenterology · 2025Article
- Factors related to adverse pregnancy outcomes of maternal syphilis in Nanning, Guangxi, China 2016-2020.Scientific reports · 2025Article
- Opportunities to Optimize Outcomes of Diagnosis and Treatment of HIV and Syphilis in Pregnancy: the Quest to Eliminate Maternal and Vertical Transmission.Current HIV/AIDS reports · 2025Review
- Benzathine penicillin G stockouts and other barriers to documented syphilis treatment in pregnancy in Zambia.PloS one · 2024Article
- Implementing maternal and newborn health quality of care standards in healthcare facilities to improve the adoption of respectful maternity care in Bangladesh, Ghana and Tanzania: a controlled before and after study.BMJ global health · 2023Article
- Simplifying screening for Trypanosoma cruzi in pregnant persons and their infants.PLoS neglected tropical diseases · 2023Article
- Eliminating congenital syphilis and congenital Chagas disease.Lancet regional health. Americas · 2022Article
- Facilitators and barriers to point-of-care testing for sexually transmitted infections in low- and middle-income countries: a scoping review.BMC infectious diseases · 2022Article
- Data flow within global clinical trials: a scoping review.BMJ global health · 2022Article
- Clinical presentation of congenital syphilis in a rotavirus vaccine cohort study in Lusaka: a case series.Journal of medical case reports · 2021Article
- Improvement of quality of care for gestational syphilis in the municipality of Rio de Janeiro.Revista de saude publica · 2021Article
- Health facility readiness and provider knowledge as correlates of adequate diagnosis and management of pre-eclampsia in Kinshasa, Democratic Republic of Congo.BMC health services research · 2020Article
Corrections and comments
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Authors and funding
29 authors at 7 institutions in 5 countries.
Funding
Abstract
backgroundDespite international recommendations, coverage of syphilis testing in pregnant women and treatment of those found seropositive remains limited in sub-Saharan Africa. We assessed whether combining the provision of supplies with a behavioural intervention was more effective than providing supplies only, to improve syphilis screening and treatment during antenatal care.
methodsIn this 18-month, cluster randomised controlled trial, we randomly assigned (1:1) 26 urban antenatal care clinics in Kinshasa, Democratic Republic of the Congo, and Lusaka, Zambia, to receive a behavioural intervention (opinion leader selection, academic detailing visits, reminders, audits and feedback, and supportive supervision) plus supplies for syphilis testing and treatment (intervention group) or to receive supplies only (control group). The primary outcomes were proportion of pregnant women who had syphilis screening out of the total who attended the clinic; and the proportion of women who had treatment with benzathine benzylpenicillin out of those who tested positive for syphilis at their first antenatal care visit. This trial is registered at ClinicalTrials.gov, number NCT02353117.
findingsThe 18-month study period was Feb 1, 2016, to July 14, 2017. 18 357 women were enrolled at the 13 intervention clinics and 17 679 women were enrolled at the 13 control clinics at their first antenatal care visit. Syphilis screening was done in a median of 99·9% (IQR 99·0-100·0) of women in the intervention clinics and 93·8% (85·0-98·9) in the control clinics (absolute difference 6·1% [95% CI 1·1-14·1]; p=0·00092). Syphilis treatment at the first visit was done in a median of 100% (IQR 99·7-100·0) of seropositive women in intervention clinics and 43·2% (2·6-83·2) of seropositive women in control clinics (absolute difference 56·8% [12·8-99·0]; p=0·0028).
interpretationA behavioural intervention, together with the provision of supplies, can lead to more than 95% of women being screened and treated for syphilis. The sole provision of supplies is sufficient to reach such levels of screening coverage but is not sufficient to ensure high levels of treatment.
fundingBill & Melinda Gates Foundation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.