Grant: Master's Award: Canada Graduate Scholarships

Recent rising rates of infectious syphilis, a common sexually transmitted infection, have become a cause of concern in Canada. Infection rates have increased by over 700% in women in the past 5 years, with the largest number of cases being seen in women between 15 and 39 years of age. A rise in cases in this group has been followed by an increase in congenital syphilis, a preventable disease, which occurs when a baby receives syphilis from its mother before or during birth. Congenital syphilis can have serious health effects, such as abnormal development or stillbirth. Fortunately, effective prenatal screening can identify syphilis and timely treatment can reduce the risk of transmission. Recommendations on the number and timing of prenatal syphilis testing varies across Canada; 1 test is standard of care, 2 tests are recommended and 3 tests are encouraged for at-risk women. In response to high infection rates and an increase in congenital syphilis, in December 2022, Kingston, Frontenac and Lennox Addington Public Health recommended that prenatal syphilis screening be increased from 2 to 3 tests during pregnancy. Given urgency to slow infection rates, a need exists to determine how many stakeholders implemented the change and if it was effective in identifying additional cases. To do this, the number of prenatal tests, and the syphilis test positivity rate, before and after the change will be compared. Since not all regional health authorities implemented this change, differences can be compared between regions to determine if observed changes may be explained by the recommendation or be due to external factors. This research has the potential to inform future prenatal screening implementation efforts to improve case detection and reduce cases of congenital syphilis.