{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T16:29:33Z","timestamp":1790958573133,"version":"4.1.0"},"reference-count":15,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2020,1,9]],"date-time":"2020-01-09T00:00:00Z","timestamp":1578528000000},"content-version":"unspecified","delay-in-days":8,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2019,8,16]]},"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Syphilis morbidity is high among pregnant women in lower income countries with limited laboratory capacity. We evaluated a long-standing global Syphilis Serology Proficiency Programme (SSPP) that supports testing quality in national reference laboratories to determine if participation affects congenital syphilis elimination strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>In this observational cross-sectional study, we calculated coverage on type, frequency and quality of syphilis testing reported by laboratories enrolled in the SSPP from 2008 to 2015. We used country-reported data to WHO on four congenital syphilis (CS) indicators and World Bank country economic data to compare coverage and completeness of reporting of indicators in lower income countries with and without an SSPP-enrolled laboratory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>\n                      From 2008\u20132015, 78 laboratories from 51 countries participated in\n                      <jats:underline>&gt;<\/jats:underline>\n                      1\u2009SSPP evaluation; 56% were national reference laboratories, of which most (93%) participated for\n                      <jats:underline>&gt;<\/jats:underline>\n                      3 years and 11 (22%) in all 24 cycles.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Median proficiency performance score was &gt;95% regardless of test conducted. Of the 51 countries with an SSPP-enrolled laboratory, 22 (43%) were lower-income countries, of which 21 reported CS data during 2008\u20132015. Comparing CS data from 87 (90% of total) lower income countries with and without an SSPP-enrolled laboratory, countries with an SSPP-laboratory had stronger reporting on antenatal syphilis testing (p=0.04). For 2015, an estimated 74% of prenatal syphilis tests and 63% of positive tests reported to WHO from countries with an SSPP-enrolled laboratory.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The SSPP has focused well on national reference laboratories, but has been only partially successful in recruiting laboratories from lower income countries. The finding that over half of syphilis infections in pregnant women living in countries with SSPP-enrolled laboratories suggests wide reach of the current quality assurance programme. However, reach could expand with focussed recruitment of laboratories from lower income countries.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2019-029434","type":"journal-article","created":{"date-parts":[[2020,1,10]],"date-time":"2020-01-10T04:16:55Z","timestamp":1578629815000},"page":"e029434","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Evaluation of the WHO\/CDC Syphilis Serology Proficiency Programme to support the global elimination of mother-to-child transmission of syphilis: an observational cross-sectional study, 2008\u20132015"],"prefix":"10.1136","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8336-2140","authenticated-orcid":false,"given":"Andr\u00e9 O","family":"Hopkins","sequence":"first","affiliation":[{"name":"NCEZID\/ DFWED, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thuy","family":"Trinh","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yetunde F","family":"Fakile","sequence":"additional","affiliation":[{"name":"Laboratory Reference Research Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allan","family":"Pillay","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie M","family":"Taylor","sequence":"additional","affiliation":[{"name":"Organisation mondiale de la Sante, Geneve, Switzerland"},{"name":"Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ellen","family":"Kersh","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Kamb","sequence":"additional","affiliation":[{"name":"Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,1,9]]},"reference":[{"key":"2025121602421924000_10.1.e029434.1","doi-asserted-by":"crossref","unstructured":"Gomez GB , Kamb ML , Newman LM , et al . Untreated maternal syphilis and adverse outcomes of pregnancy: a systematic review and meta-analysis. Bulletin of the World Health Organization: World Health Organization, 2013: 217\u201326.","DOI":"10.2471\/BLT.12.107623"},{"key":"2025121602421924000_10.1.e029434.2","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0211720","article-title":"Global burden of maternal and congenital syphilis and associated adverse birth outcomes-Estimates for 2016 and progress since 2012","volume":"14","author":"Korenromp","year":"2019","journal-title":"PLoS One"},{"key":"2025121602421924000_10.1.e029434.3","unstructured":"Meredith S , Hawkes S , Schmid G , et al . The global elimination of congenital syphilis: rationale and strategy for action. Geneva: WHO, 2007."},{"key":"2025121602421924000_10.1.e029434.4","unstructured":"World Health Organization HRP . WHO\/CDC syphilis proficiency programme, 2017. Available: http:\/\/www.who.int\/reproductivehealth\/congenital-syphilis\/spt-program\/en\/"},{"key":"2025121602421924000_10.1.e029434.5","unstructured":"WHO\/UNICEF . Global AIDS response progress reporting 2016."},{"key":"2025121602421924000_10.1.e029434.6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2010\/312798","article-title":"A road map for the global elimination of congenital syphilis","volume":"2010","author":"Kamb","year":"2010","journal-title":"Obstet Gynecol Int"},{"key":"2025121602421924000_10.1.e029434.7","first-page":"1376","article-title":"Defibrination of blood plasma for use in serological tests for syphilis","volume":"9","author":"Castro","year":"2002","journal-title":"Clin Diagn Lab Immunol"},{"key":"2025121602421924000_10.1.e029434.8","unstructured":"USPS. . Publication 52, hazardous, restricted, and Perishable mail: United States postal service, 2016. Available: http:\/\/pe.usps.com\/text\/pub52\/welcome.htm"},{"key":"2025121602421924000_10.1.e029434.9","unstructured":"Syphilis TML . Immunology and serology in laboratory medicine. Elseiver, 2014."},{"key":"2025121602421924000_10.1.e029434.10","unstructured":"WHO . Who regional offices, 2017. Available: http:\/\/www.who.int\/about\/regions\/en\/"},{"key":"2025121602421924000_10.1.e029434.11","unstructured":"Fantom N , Serajuddin U . The World Bank\u2019s Classification of Countries by Income: World Bank Group, 2018. http:\/\/documents.worldbank.org\/curated\/en\/408581467988942234\/pdf\/WPS7528.pdf"},{"key":"2025121602421924000_10.1.e029434.12","unstructured":"WHO . World Bank GNI Per Capita Operational Guidelines & Analytical Classifications, 2017. Available: http:\/\/siteresources.worldbank.org\/DATASTATISTICS\/Resources\/OGHIST.xls"},{"key":"2025121602421924000_10.1.e029434.13","unstructured":"WHO . Antenatal care (ANC) attendees tested for syphilis at first ANC visit, 2014. Available: http:\/\/apps.who.int\/gho\/data\/node.main.A1358STI?lang=en"},{"key":"2025121602421924000_10.1.e029434.14","unstructured":"WHO . The use of rapid syphilis tests 2006."},{"key":"2025121602421924000_10.1.e029434.15","unstructured":"WHO . Global guidance on criteria and processes for validation: elimination of mother-to-child transmission of HIV and syphilis 2017."}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2019-029434","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,16]],"date-time":"2025-12-16T10:42:29Z","timestamp":1765881749000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2019-029434"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1]]},"references-count":15,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2020,1,9]]},"published-print":{"date-parts":[[2020,1]]}},"alternative-id":["10.1136\/bmjopen-2019-029434"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2019-029434","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1]]}}}