Prevalence and risk factors associated with syphilis infection among pregnant women attending antenatal care at Kyayi Health Centre.

Abstract

Background: Syphilis remains a significant public health threat globally, particularly among pregnant women in low-resource settings where antenatal screening and treatment services may be limited. In Uganda, rural areas often report a higher disease burden due to gaps in healthcare access, contributing to adverse pregnancy outcomes such as miscarriage, stillbirth and congenital syphilis. Objective: To determine the prevalence and identify risk factors associated with syphilis infection among pregnant women attending antenatal care (ANC) at Kyayi Health Centre III in Gomba District, Uganda. Methods: A retrospective cross-sectional study was conducted using ANC register data from January 2020 to December 2024. A total of 279 records of pregnant women were reviewed. Data on socio-demographic characteristics, obstetric history, and infections (HIV, syphilis, UTIs, hepatitis B) were extracted and analysed using SPSS v20. Bivariate and multivariate logistic regression analyses were used to determine associations, with a significance level set at p<0.05. Results: The prevalence of syphilis among pregnant women was 5.7%. At bivariate analysis, younger age (<25 years) and HIV positivity were significantly associated with syphilis infection. In the multivariate model, HIV-positive women were significantly more likely to have syphilis (aOR = 17.408, 95% CI [12.587–24.078], p<0.0001). Additionally, women not classified as at risk for mother-to-child transmission were unexpectedly more likely to be infected (aOR = 23.895, 95% CI [1.478–386.321], p=0.025). Conclusion: The syphilis prevalence of 5.7% in this rural Ugandan setting is slightly higher and poses a threat to maternal and neonatal health. HIV co-infection remains a strong predictor of syphilis among pregnant women. These findings highlight the urgent need for enhanced routine screening, integrated STI-HIV services and targeted health education campaigns to reduce the burden of syphilis in rural ANC settings. Keywords: Syphilis, Pregnancy, Antenatal care, HIV, Rural Uganda, Risk factors, Maternal health, Gomba District x