Dual elimination refers to the elimination of mother-to-child transmission of HIV and syphilis, sexually transmitted infections that cause substantial global health burden. The use of dual elimination tools, such as dual rapid tests for HIV and syphilis, can significantly reduce maternal and neonatal morbidity and mortality in developing countries.

 

In 2012 an estimated 230,000 children in Sub-Saharan Africa were newly infected with HIV. However, nearly all of these infections can be prevented by comprehensive prevention of mother-to-child transmission (MTCT) services.

 

Syphilis, another sexually transmitted infection (STI), also remains a public health challenge in Sub-Saharan Africa, with recent estimates suggesting that more than 500,000 pregnant women in Sub-Saharan Africa have probable active syphilis. Without treatment, approximately half of these pregnancies will result in adverse birth outcomes, such as early fetal loss and stillbirth, neonatal death, prematurity and low birth weight, and clinical evidence of syphilis in infants. Mother-to-child transmission (MTCT) of syphilis, or congenital syphilis, can be detected and treated inexpensively, but only about one third of antenatal clinic attendees in Sub-Saharan Africa receive syphilis testing.

 

The prevention of mother-to-child transmission (MTCT) of HIV and syphilis infections can be addressed with similar strategies, therefore combining the delivery and implementation of HIV and congenital syphilis services in antenatal care clinics (ANC) can enhance the effectiveness of current programs on elimination of MTCT of HIV and syphilis. However, a recent study suggested that these programs are greatly limited by such factors as delayed testing and long turnaround time of test results. Therefore, provider-initiated provision of dual rapid tests for HIV and syphilis could improve testing and treatment to accelerate elimination of MTCT of HIV and syphilis in Sub-Saharan Africa.

 

Engaging the support of healthcare providers in Sub-Saharan Africa through education in dual elimination strategies, including the use of such tools as dual HIV and syphilis rapid tests, can contribute significantly to reducing maternal and infant morbidity and mortality from both HIV and syphilis.