One test, two results: How a dual test is tackling HIV and syphilis

Congenital syphilis is easily preventable with a simple treatment of antibiotics but can only be prescribed if we know which women need it.

Testing rates for syphilis are low

Mother-to-child transmission of syphilis, or congenital syphilis, is the second leading cause of stillbirth globally. Babies born with syphilis can have bone damage, severe anaemia, and nerve problems causing blindness or deafness, amongst other serious symptoms.

Access to antenatal care is limited in many low- and middle-income countries (LMICs). Only half of pregnant women attend all four recommended antenatal care visits in sub-Saharan Africa, making every touchpoint with the healthcare system incredibly important to ensure mother and baby are healthy. Healthcare systems with limited resources need products that offer the best level of care and value for money.

One of the easiest ways to identify pregnant women who have syphilis is by using a rapid diagnostic test, which only requires a drop of blood and a few minutes waiting to give a result. Treatment can also be provided right then and there, in a single visit.

However, syphilis testing rates in pregnant women are typically low in LMICs, ranging between 40-60%.

HIV and syphilis testing and treatment signs in Primary Health Centre, Base Uyo Akwa Ibom State, Nigeria

Making testing easy and convenient

Years of global backing and programmes to build awareness of HIV has helped many LMICs reach 70-100% of pregnant women with HIV tests. Taking advantage of these established systems can help find and reach women with testing for syphilis too, bringing testing rates for syphilis up to match those for HIV.

One way of doing this is to use a dual test for HIV and syphilis. This makes it easy and convenient to test pregnant women for syphilis simultaneously.

MedAccess helped bring the price of SD Biosensor’s dual test closer to that of existing HIV single tests by providing a volume guarantee to SD Biosensor. The lower price makes dual tests a more cost-effective option for many countries. With the same diagnostic budget, women can be tested for both HIV and syphilis at the same time, with the same device.

SD Biosensor was the third WHO-prequalified supplier to enter the dual test market in LMICs. This encourages competition and strengthens supply security by providing greater choice to countries looking to procure. We hope these impacts on the wider market will help ensure that changes catalysed by the guarantee are embedded in the health system and provide long-term benefit beyond the boundaries of our agreement.

Other challenges remain, including logistical barriers that affect attendance at antenatal clinics and limited supply of antibiotic treatment, but ensuring that dual tests are available when needed is a crucial step in ensuring healthy mothers and babies.

Abasiama sits in the queue with other expectant mothers as they wait to be attended to by the nurses in the Primary Health Centre Base, Uyo Akwa Ibom State, Nigeria

Creating a sustainable market

Healthcare workers are now being trained on how to administer and read these tests to reach a larger population. More LMIC countries are looking to adopt and roll-out the dual test for HIV and syphilis on a wider scale. Some countries are already making moves to expand testing to other key populations in need, such as the partners of pregnant women.

As demand increases, a healthier market will help ensure more pregnant women are tested for both HIV and syphilis and help reduce the negative impacts of these illnesses on mothers and babies.

Joy Majuako, laboratory technician, trains her colleagues on how to use the HIV and syphilis dual test kit in Obio Cottage Hospital Rumuobiakani, Port Harcourt, Rivers State, Nigeria

In November 2021, MedAccess, SD Biosensor and the Clinton Health Access Initiative (CHAI) announced a partnership to increase access to a dual test for syphilis and HIV.

Dual test for syphilis and HIV