---
title: "Performance of a Pilot EMTCT Programme for Syphilis in Baoan District, Shenzhen: Implementation an"
id: "bmj-open-21-implementation-and-performance-of-a-national-pilot-programme-for-eliminating"
canonical_url: "https://medichelpline.com/clinical-feed/bmj-open-21-implementation-and-performance-of-a-national-pilot-programme-for-eliminating"
content_type: "clinical_feed_article"
specialty: "Infectious Disease"
source_name: "BMJ Open"
source_url: "http://bmjopen.bmj.com/cgi/content/short/16/9/e122320?rss=1"
published_at: "2026-09-22T17:11:09.000Z"
evidence_level: "Journal Feed"
license: "CC-BY-NC-4.0 / Informational Use"
---
# Performance of a Pilot EMTCT Programme for Syphilis in Baoan District, Shenzhen: Implementation an
## Provenance & Clinical Metadata
- **Canonical URL:** https://medichelpline.com/clinical-feed/bmj-open-21-implementation-and-performance-of-a-national-pilot-programme-for-eliminating
- **Specialty:** [Infectious Disease](https://medichelpline.com/clinical-feed/infectious-disease.md)
- **Primary Source:** BMJ Open
- **Source URL:** [Original Journal Publication](http://bmjopen.bmj.com/cgi/content/short/16/9/e122320?rss=1)
- **Published At:** 2026-09-22T17:11:09.000Z
- **Evidence Rating:** Journal Feed
## Executive GIST (TL;DR)
- This retrospective cross-sectional analysis evaluated the integrated elimination of mother-to-child transmission (**EMTCT**) programme for syphilis in Baoan District, Shenzhen, using data from 2017–2024. - The dataset included 752 pregnant women with syphilis and 769 liveborn infants exposed to maternal syphilis. - Indicators were compared between a pre-practice period (2017–2018) and a post-practice period (2019–2024); statistical methods included Pearson's χ2 test, joinpoint regression to estimate annual percentage change (APC), and logistic regression to identify risk factors. - During the post-practice period, most process indicators showed significant upward trends; first-trimester screening coverage increased substantially (APC = 6.79, p = 0.01). - Overall testing coverage and several other process indicators improved (reported as significant upward trends), though the precise APC values for each indicator were not all reported in the source. - Coverage of **adequate treatment** plateaued during 2019–2024 (APC = 0.41, p = 0.67) and reached 87.74% in 2024, below the 90% target. - Multivariable analysis identified four independent risk factors for inadequate treatment: ethnic minority status (aOR 2.41, 95% CI 1.09–5.35), first antenatal visit at ≥13 weeks (aOR 2.30, 95% CI 1.09–4.84), partner not tested for syphilis (aOR 2.07, 95% CI 1.07–4.01), and a fourth factor with reported effect size (aOR 3.14, 95% CI 1.55–6.33) for which the source did not specify the variable label. - The authors conclude that integrated EMTCT implementation produced favorable trends but highlighted persistent bottlenecks in achieving treatment adequacy, pointing to the need for targeted interventions for ethnic minorities, women with late antenatal care, and those whose partners were not tested. - Specific programmatic recommendations, long-term outcome data beyond 2024, and the exact identity of one reported risk factor were not provided in the source article text.
## Clinical Analysis & Structured Key Points
Background Syphilis remains a significant global health burden, with congenital syphilis (CS) posing a major threat to child health. China has implemented the elimination of mother-to-child transmission (EMTCT) programme for syphilis through integrated strategies. However, few studies have analysed granular data along the entire cascade of care to identify specific bottlenecks. Objective We aimed to characterise the implementation status of integrated interventions in Baoan District, Shenzhen, and to identify risk factors associated with suboptimal indicators. Methods This retrospective cross-sectional study used data from the information system for the prevention of mother-to-child transmission of syphilis in Baoan District (2017 - 2024). Indicators were compared between the pre-practice (2017 - 2018) and post-practice (2019 - 2024) periods using Pearson's ² test. Joinpoint regression models were used to estimate annual percentage change ( APC ) during the post-practice period. Univariate and multivariable logistic regression analyses were used to identify factors associated with indicators failing to meet predefined targets. Results A total of 752 pregnant women with syphilis and 769 exposed liveborn infants were finally included. Compared with the pre-practice period, significant upward trends were observed in the post-practice period across all process indicators (all p APC =0.23, p=0.01) and first-trimester screening coverage ( APC =6.79, p=0.01) showed significant upward trends. However, adequate treatment coverage plateaued ( APC =0.41, p=0.67), with the 2024 rate of 87.74% (below the 90% target). Multivariable analysis identified four independent risk factors for inadequate treatment: ethnic minority background ( aOR =2.41, 95% CI 1.09 to 5.35), first antenatal visit at ≥13 weeks ( aOR =2.30, 95% CI 1.09 to 4.84), aOR =3.14, 95% CI 1.55 to 6.33) and partner not tested for syphilis ( aOR =2.07, 95% CI 1.07 to 4.01). Conclusions EMTCT process indicators showed favourable trends during the integrated implementation period in Baoan District. However, gaps in achieving the treatment adequacy target highlight critical bottlenecks. Targeted interventions for high-risk populations, including ethnic minorities, women with late or insufficient antenatal care and those with untested partners, are essential to further achieve EMTCT goals.
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