Barriers to optimal management of syphilis in pregnancy and congenital syphilis in south-east Queensland: a qualitative investigation
James A. Fowler
A * , Sarah Warzywoda A , Clare Nourse B C , Mandy Wu B D , Sumudu Britton B E , Diane Rowling F , Paul Griffin B G , Mattea Lazarou A D , Zoe Hamilton A and Judith A. Dean A
+ Author Affiliations
- Author Affiliations
A The University of Queensland, Faculty of Medicine, School of Public Health, 288 Herston Road, Herston, Qld, 4006, Australia.
B The University of Queensland, Faculty of Medicine, School of Medicine, 288 Herston Road, Herston, Qld 4006, Australia.
C Infection Management and Prevention Service, Queensland Children’s Hospital, Children’s Health Queensland Hospital and Health Service, 501 Stanley Street, South Brisbane, Qld 4101, Australia.
D Queensland Children’s Hospital, Children’s Health Queensland Hospital and Health Service, 501 Stanley Street, South Brisbane, Qld 4101, Australia.
E Department of Infectious Diseases, Royal Brisbane and Women’s Hospital, Metro North Hospital and Health Service, 7 Butterfield Street, Herston, Qld 4029, Australia.
F Metro North Public Health Unit, Metro North Hospital and Health Service, Bryden Street, Windsor, Qld 4030, Australia
G Mater Health Brisbane, Raymond Terrace, South Brisbane, Qld 4101, Australia.
Sexual Health - https://doi.org/10.1071/SH23119
Submitted: 29 June 2023 Accepted: 3 August 2023 Published online: 21 August 2023
© 2023 The Author(s) (or their employer(s)). Published by CSIRO Publishing. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)
Abstract
Background: Australia, like many high-income countries, is experiencing a resurgence of infectious syphilis in pregnancy and congenital syphilis. Evaluations of public health notifications and clinical records suggest that healthcare systems may not be providing optimal care to women and their neonates. This study aims to explore the barriers to optimal management of syphilis in pregnancy and congenital syphilis to identify key areas for improvement.
Methods: Between 2021 and 2022, 34 healthcare workers (HCW) practicing in south-east Queensland (SEQ) Australia were recruited to complete semi-structured interviews regarding their perceptions towards management of syphilis in pregnancy and congenital syphilis. Interviews were analysed thematically.
Results: Thematic analysis identified four themes related to the management of syphilis in pregnancy. These included poor communication between disciplines, services, and teams from delivery through to management and post-delivery, lack of formal internal and external referral pathways, unclear and often complex maternal and congenital syphilis management procedures, and limited HCW knowledge of infectious syphilis in pregnancy and congenital syphilis.
Conclusion: As congenital syphilis numbers continue to rise in SEQ, it is imperative that healthcare systems and HCWs identify and address gaps in the provision of health care.
Keywords: congenital syphilis, health personnel, healthcare provider, management, pregnancy, qualitative, syphilis, treatment.
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