On weekdays, state health worker Kenneth Nash could spend hours driving across the Rapids Parish to find a woman in an apartment building, under I-49, Burger King, or the Salvation Army. there is.
Nash is trying to turn to a name that has been flagged as positive for syphilis during pregnancy every time he stops. If left untreated, syphilis can transfer to the fetus, leading to blood abnormalities, organ damage, bone deformities, blindness, stillbirth, or death shortly after birth.
He is part of a field team that tracks all known cases of pregnancy syphilis. In 2016, Louisiana had the highest proportion of babies born with syphilis in the country. The Centers for Disease Control and Prevention has provided the state with a temporary supplementary fund of $ 550,000 to help fight the epidemic. Cash helped lower interest rates, raising the state’s ranking from worst to seventh in 2020, according to a CDC report released earlier this month.
But lately, despite funding and new efforts, Louisiana’s prices are higher than ever.
According to a preliminary study by the Louisiana Department of Health, the number of neonatal syphilis cases in 2021 increased by 67% year-on-year, from 63 in 2020 to 105 in 2021.
This is in stark contrast to 2009, when there were only 11 babies born of syphilis in Louisiana. Louisiana Health Department Report..
All diagnoses of congenital syphilis are considered “sentinel events” and are avoidable illnesses that suggest that the public health system is not functioning. But as a pregnant woman suffering from lifelong poverty, mental illness, addiction, and the homeless, Nash often awaits more than the budget surge can be repaired after a pandemic. As a result, many years of progress have been lost.
“When the COVID hit, we started seeing a surge in the case of congenital syphilis,” Nash said.
This increase began to solve problems through targeted efforts such as field visits, extensive educational efforts, carry-on treatments, keeping antibiotic treatment inventories, and even providing shots where patients want. It represents a major setback for the state. ..
According to the latest data, the syphilis rate in infants in Louisiana in 2021 is more than 20 times the national average.
In the Rapids Parish, where Dr. David Holcomb is the director of health, the number of babies born with syphilis increased from 9 to 23 between 2020 and 2021. Almost everything has something in common.
“Most of the time there is poverty,” Holcomb said. “Poverty is just there, it’s always there.”
Overdose also surged in the parish, rising 35% in one year in Louisiana. Nationally, overdose has increased by about 12%, According to the CDC..
“This was a complete storm of the situation,” said Dr. David Holcomb, Health Director of the Alexandria region. “The number of deaths from drug use and overdose is skyrocketing … also due to medical problems, clinical confusion, and problems related to substance abuse.”
If someone like Nash can meet the woman at least 30 days before her due date, three weekly shots of penicillin could prevent many complications that the baby may face. I have. If not, a disturbing fate awaits: Some pregnant women with active infections The risk of stillbirth is 25%, the risk of newborn death is 14%, the risk of giving birth to a living but infected baby is 41%, and the chance of giving birth to a healthy, uninfected baby is only 20%...
Women often face challenges that are difficult to overcome.
A study of women and health care providers in Baton Rouge, published last year by researchers at the University of Tulane and the LSU Health Science Center, showed that doctors are familiar with screening protocols and identification of syphilis. However, identified as high risk based on factors such as imprisonment, poverty, substance abuse, and homelessness, recently pregnant women have presented many challenges when trying to pursue medical care.
Women will go for months without Medicaid, even if they are applying and are already pregnant for several months. Others have said that doctors will not accept them as patients if they are past the first semester.
According to the researchers, all women (42 in total) had some knowledge of syphilis. However, few understood how it could endanger a baby.
“I know if you’re not pregnant, it can make you infertile, or you won’t get pregnant because of the medicines they give you,” said a woman in the focus group. Told. “When it comes to pregnancy, doctors have never talked to me about sexually transmitted diseases.”
Louisiana does not require sex education, and when it is taught, state law requires an emphasis on abstinence. Also, there are fewer family planning clinics and public health clinics than before. This is a large result. Governor Bobby Jindal’s Administration Reduces Public Health FundsGloria Jaratano, a research author and professor of nursing practice at LSU Health, who ran the focus group, said.
Many women interviewed shortly before the pandemic said their partners were not able to undergo the same sexually transmitted disease test because they were offered only to pregnant women. That was a problem because people can be re-infected after treatment.
“It was hard to believe that I was in Louisiana and heard that I knew what the environment was like, and that it would take a long time for my partner to be tested and treated. Is something wrong? “Jaratano said.
Although the overall number of cases last year (105 babies) may sound small, congenital syphilis is like a “coal mine canary,” Giarratano said. This means that sexually transmitted diseases are lurking and have a spillover effect on the entire population.
“It shouldn’t be,” Giarratano said. “It’s a preventable disease.”
National requirements stipulate three initiatives for women who test positive for syphilis during pregnancy: letters, phone calls, and home visits. That’s not enough to find most people in Louisiana, said Nash, a disease intervention expert.
He visited four different addresses he found for a new incident last Tuesday. In the final speech he pulled in at 7:30 pm the night before the big storm struck, the patient’s mother told him she was in jail. Nash estimates that he spent thousands of hours tracking people.
“In that case, we need to work in the best possible way,” says Nash. “We are scheduled from 8:00 to 4:30, but if that means making a field visit at 7:30, we’re just trying to catch this patient, so do that. is needed.”
