Send to

Choose Destination
Infect Dis Model. 2018 Mar 9;3:13-22. doi: 10.1016/j.idm.2018.03.003. eCollection 2018.

Adult female syphilis prevalence, congenital syphilis case incidence and adverse birth outcomes, Mongolia 2000-2016: Estimates using the Spectrum STI tool.

Author information

Mongolia National Centre for Communicable Disease, AIDS/STI Surveillance and Research Department, Ulaanbaatar, 210648, Bayanzurkh District, Nam-Yan-Ju Street, Mongolia.
Avenir Health, Geneva, Switzerland, 1 route de Morillons / 150 Route de Ferney (WCC, Office 164), PO Box 2100, CH-1211 Geneva 2, Switzerland.
World Health Organization, Post Box 663, Ulaanbaatar-13, Mongolia.
Mongolia Global Fund Supported Project on AIDS and TB, Peace Avenue 13/3, Sukhbaatar District, Ulaanbaatar, Mongolia.
Mongolia Center for Health Development, Enkhtaivan Street - 13b, Sukhbaatar District, Ulaanbaatar, Mongolia.
Avenir Health, 655 Winding Brook Drive, Glastonbury, CT, CT-06033, USA.
World Health Organization, Western Pacific Regional Office, PO Box 2932 (United Nations Avenue), 1000 Manila, Philippines.
World Health Organization, Department of Reproductive Health and Research, 8 Avenue Appia (L152), 1211 Geneva, Switzerland.
Centers for Disease Control and Prevention, Atlanta GA, USA.



Mongolia's health ministry prioritizes control of Sexually Transmitted Infections, including syphilis screening and treatment in antenatal care (ANC).


Adult syphilis prevalence trends were fitted using the Spectrum-STI estimation tool, using data from ANC surveys and routine screening over 1997-2016. Estimates were combined with programmatic data to estimate numbers of treated and untreated pregnant women with syphilis and associated incidence congenital syphilis (CS) and CS-attributable adverse birth outcomes (ABO), which we compared with CS case reports.


Syphilis prevalence in pregnant women was estimated at 1.7% in 2000 and 3.0% in 2016. We estimated 652 CS cases, of which 410 ABO, in 2016. Far larger, annually increasing numbers of CS cases and ABO were estimated to have been prevented: 1654 cases, of which 789 ABO in 2016 - thanks to increasing coverages of ANC (99% in 2016), ANC-based screening (97% in 2016) and treatment of women diagnosed (81% in 2016). The 42 CS cases reported nationally over 2016 (liveborn infants only) represented 27% of liveborn infants with clinical CS, but only 7% of estimated CS cases among women found syphilis-infected in ANC, and 6% of all estimated CS cases including those born to women with undiagnosed syphilis.


Mongolia's ANC-based syphilis screening program is reducing CS, but maternal prevalence remains high. To eliminate CS (target: <50 cases per 100,000 live births), Mongolia should strengthen ANC services, limiting losses during referral for treatment, and under-diagnosis of CS including still-births and neonatal deaths, and expand syphilis screening and prevention programs.


ABO, Adverse Birth Outcome; ANC, antenatal care; ANC-1, attendance of antenatal care at least once during a pregnancy; Antenatal care; CI, confidence interval; CS, Congenital Syphilis; Congenital syphilis; Epidemiological modelling; F, women; N, sample size tested; NCCD, Mongolia National Center for Communicable Diseases; RPR, Rapid Plasma Reagin test; STI, sexually transmitted infection; Screening; Surveillance; Syphilis; TP, Treponema pallidum; WHO, World Health Organization

Supplemental Content

Full text links

Icon for Elsevier Science Icon for PubMed Central
Loading ...
Support Center