消除梅毒母婴传播：中国在COVID-19大流行前和流行期间的实践经验

doi:10.24920/003903

摘要/Abstract

摘要：

在许多发展中国家,梅毒的母婴传播（mother-to-child transmission,MTCT）仍然是新生儿死产和死亡的主要原因。2007年,世界卫生组织启动了全球消除梅毒MTCT的计划。鉴于先天性梅毒的高疾病负担,中国随后发布了国家梅毒EMTCT政策和方案,以减少梅毒的MTCT。中国的先天性梅毒报告发病率由2013年的69.9例/10万活产下降到2019年的12.0例/10万活产。当前在新型冠状病毒肺炎（COVID-19）全球大流行期间,消除梅毒MTCT领域的工作进展受到拖延,使消除和终止梅毒MTCT的计划面临巨大挑战。本文总结了近20年来中国在消除梅毒MTCT的策略和措施,指出在国家卫生政策的支持和政府的坚强领导下,中国消除梅毒MTCT取得了显著的成就。在COVID-19大流行期间,加强对区域性暴发的COVID-19疫情的应急响应,采用安全、快速、早期和高质量的临床护理,确保100%的孕妇获得产前梅毒检测服务,确保治疗用苄星青霉素的药物供给,加强对感染梅毒孕妇和新生儿的闭环管理,是决定梅毒MTCT效果的关键措施。中国的经验教训可能对其他正在计划消除梅毒MTCT的国家有借鉴价值。

关键词: 母婴阻断, 梅毒, 新型冠状病毒肺炎, 中国

Abstract:

Mother-to-child transmission (MTCT) of syphilis remains a leading cause of stillbirth and death among neonates in many developing countries. In 2007, World Health Orgernization launched the global elimination of MTCT (EMTCT) of syphilis. Given the high burden of congenital syphilis, China subsequently released the specific national EMTCT policies and programs to reduce MTCT of syphilis. The congenital syphilis incidence rate per 100,000 live births in China has markedly decreased from 69.9 in 2013 to 11.9 in 2019. However, due to the global pandemic of COVID-19, the current measures for eliminating MTCT of syphilis are greatly challenged. In this article, we summarize the strategies and measures for the EMTCT of syphilis in China in the past 20 years, the remarkable achievements by the policy support under the leadership of the government. In the context of COVID-19 pandemics, strengthening emergency response to the regional outbreaks of COVID-19, adopting safe, rapid, early and high-quality clinical care for 100% of pregnant women to receive prenatal syphilis testing services, ensuring the availability of Benzathine penicillin for the treatment, and strengthening the closed-loop management of pregnant women and newborns infected with syphilis are the key measures to determine the effectiveness of MTCT for syphilis. Lessons from China may be valuable for other countries that are planning to eliminate MTCT of syphilis.

Key words: mother-to-child transmission, syphilis, COVID-19, China

基金资助: 中国医学科学院联合创新团队项目(2016-I2M-3021);国家自然科学基金项目(81772209);国家自然科学基金项目(81601804);南京市国家级临床医学中心培育计划项目(2019060001)

Fangzhi Du, Ruili Zhang, Qianqiu Wang. Eliminating Mother-to-Child Transmission of Syphilis: Chinese Practice before and during COVID-19 Pandemics[J].Chinese Medical Sciences Journal, 2022, 37(1): 67-72.

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