* Since the last assessment in 2024, updated information became available that required a change in the baseline.
EOB 2024-2025
IMPACT INDICATOR
Incidence rate of congenital syphilis (including stillbirths)
Baseline
2017
2.13 cases per 1000 live births
Target
2025
0.5 cases per 1000 live births
Status
2024
2.67 cases per 1000 live births
Rating
Wrong track
% annual change required to achieve target
-18.12%
% annual change recorded as of last year available
3.23%
This indicator measures the number of reported cases of syphilis in infants (live births) and fetal deaths (stillbirths) per 1000 live births over a 12-month period. It is used to monitor progress toward the elimination of congenital syphilis in the Region, supported through PAHO’s Disease Elimination Initiative.
Since 2010, when the incidence rate was 0.8 cases per 1000 live births, the incidence of congenital syphilis has increased at an average annual rate of 6%. In 2024, the regional rate was 2.7 cases per 1000 live births, higher than the 2017 baseline of 2.1 and far exceeding the 2025 target of 0.5 cases per 1000 live births. In general, the highest prevalence of syphilis among pregnant women, and consequently the highest incidence of congenital syphilis, is observed along the eastern coast of South America. Progress has been made in the 11 countries and territories in the Caribbean that have validated or revalidated elimination of mother-to-child transmission for syphilis. Nevertheless, at the regional level, this indicator is considered to be on the wrong track.
Congenital syphilis is preventable through primary care strategies, including the prevention of syphilis infection among women of reproductive age, high coverage of quality antenatal care that includes syphilis screening, and treatment for women who test positive. These key approaches should guide interventions as the indicator continues to be monitored under the PAHO Strategic Plan 2026–2031.
Recommendations
Strengthen antenatal care through person-centered prevention, education, information, and screening measures and extend these actions to the sexual partners of pregnant women.
Integrate and expand access to syphilis screening, treatment, confirmation, and notification across all services, with particular emphasis on primary care, HIV and sexually transmitted infection services, emergency departments, gynecology units, among others.
Adopt regulations that allow trained non-laboratory personnel to perform rapid syphilis and dual syphilis/HIV tests outside laboratory settings.
Eliminate barriers to timely testing and treatment, including through simplified algorithms and increased availability of commodities, leveraging the Regional Revolving Funds where appropriate.
Strengthen interoperable surveillance systems to support individual-level reporting of syphilis cases, using more sensitive case definitions for pregnant women and congenital syphilis, while strengthening notification systems and integrating surveillance with primary care and other health services to identify hotspots, outbreaks, and populations in situations of vulnerability.