Prevalence of syphilis and associated factors among pregnant people attending antenatal care at public hospitals in Eastern Tigray, Ethiopia, an institutional based cross-sectional study.

BackgroundSyphilis remains a significant global public health challenge, particularly in Sub-Saharan Africa. As part of the sustainable development goals, Ethiopia has aimed to eliminate vertical transmission of syphilis by 2030. Thus, this study aimed to assess the prevalence and factors associated with syphilis infection among pregnant people attending antenatal care (ANC).MethodsAn institution-based cross-sectional study was conducted and public hospitals were selected using simple random sampling, and 488 study participants were recruited via systematic random sampling. Data were collected using interviewer-administered questionnaires and patient chart reviews through the Kobo Collect mobile application. Data analysis was performed using SPSS version 23. Bivariate and multivariable logistic regression models were used to identify factors associated with syphilis infection. Statistical significance was declared at a p-value <0.05.ResultThe prevalence of syphilis among the 488 pregnant people was 4.9% (95% CI: 3.3-7.0%). Additionally, 9 (1.8%) participants had syphilis-HIV co-infection. Multivariable analysis identified three factors significantly associated with syphilis: A history of current or previous sexually transmitted infection (STI) symptoms (AOR = 7.67, 95% CI (2.7-21.6), having a partner with known or suspected extra-marital sexual contacts (AOR = 6.3, 95% CI (2.29-17.2) and history of abortion (AOR = 3.8, 95% CI (1.25-11.4).ConclusionThe prevalence of syphilis among pregnant people in the study area is high relative to the national elimination targets. It is essential to strengthen routine antenatal screening and move beyond individual treatment and should be includes partner notification and management. Targeted interventions should prioritize women with a history of STIs or prior pregnancy losses to reduce the burden of syphilis in pregnancy and prevent the devastating consequences of congenital syphilis.