WHO Antenatal Care Guideline Implementation Guide
0.3.0 - CI Build
WHO Antenatal Care Guideline Implementation Guide
0.3.0 - CI Build
WHO Antenatal Care Guideline Implementation Guide, published by World Health Organization (WHO). This guide is not an authorized publication; it is the continuous build for version 0.3.0 built by the FHIR (HL7® FHIR® Standard) CI Build. This version is based on the current content of https://github.com/WorldHealthOrganization/smart-anc/ and changes regularly. See the Directory of published versions
| Active as of 2025-06-24 |
<PlanDefinition xmlns="http://hl7.org/fhir">
<id value="ANCDT21"/>
<text>
<status value="extensions"/>
<div xmlns="http://www.w3.org/1999/xhtml">
<div>
<table class="grid dict">
<tr>
<th scope="row"><b>Id: </b></th>
<td style="padding-left: 4px;">ANCDT21</td>
</tr>
<tr>
<th scope="row"><b>Url: </b></th>
<td style="padding-left: 4px;"><a href="PlanDefinition-ANCDT21.html">ANC.DT.21 Syphilis diagnosis</a></td>
</tr>
<tr>
<th scope="row"><b>Version: </b></th>
<td style="padding-left: 4px;">0.3.0</td>
</tr>
<tr>
<th scope="row">
<b>
Official
</b>
</th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<span>ANC.DT.21</span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Title: </b></th>
<td style="padding-left: 4px;">ANC.DT.21 Syphilis diagnosis</td>
</tr>
<tr>
<th scope="row"><b>Type: </b></th>
<td style="padding-left: 4px;">
<p style="margin-bottom: 5px;">
<b>system: </b> <span><a href="http://terminology.hl7.org/6.4.0/CodeSystem-plan-definition-type.html">http://terminology.hl7.org/CodeSystem/plan-definition-type</a></span>
</p>
<p style="margin-bottom: 5px;">
<b>code: </b> <span>eca-rule</span>
</p>
</td>
</tr>
<tr>
<th scope="row"><b>Date: </b></th>
<td style="padding-left: 4px;">2025-06-24 13:58:48-0600</td>
</tr>
<tr>
<th scope="row"><b>Publisher: </b></th>
<td style="padding-left: 4px;">World Health Organization (WHO)</td>
</tr>
<tr>
<th scope="row"><b>Description: </b></th>
<td style="padding-left: 4px;"><div><p>If the woman tests positive for syphilis, provide counselling and treatment as needed</p>
</div></td>
</tr>
<tr>
<th scope="row"><b>Use Context: </b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<th><b>code</b></th>
<th><b>value</b></th>
</tr>
<tr>
<td>task</td>
<td/>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>Jurisdiction: </b></th>
<td style="padding-left: 4px;">001</td>
</tr>
<tr>
<th scope="row"><b>Libraries: </b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<td><a href="Library-ANCDT21.html">ANC.DT.21 Syphilis diagnosis</a></td>
</tr>
</table>
</td>
</tr>
<tr>
<th scope="row"><b>Actions: </b></th>
<td style="padding-left: 4px;">
<table class="grid-dict">
<tr>
<td>
<b> ANC.DT.21 Syphilis diagnosis:</b>
<br/>
<b>When:</b>
<i>Named Event:</i> ANC.B10.4. Diagnosis and treatment
<br/>
<b>Then:</b>
<table class="grid-dict">
<tr>
<td>
Procedure: Provide first dose of treatment and refer for additional testing
– If primary or secondary stage of syphilis, give single dose of benzathine penicillin 2,400,000 IU
– If late or unknown stage of syphilis, give one dose of benzathine penicillin 2,400,000 IU weekly for 3 consecutive weeks
– Advise on treating partner
– Encourage HIV testing and counselling
– Reinforce use of condoms
– Proceed to further testing with an RPR test
"In high-prevalence settings, provider-initiated testing and counselling (PITC) for HIV should be considered a routine component of the package of care for pregnant women in all antenatal care settings. In low-prevalence settings, PITC can be considered for pregnant women in antenatal care settings as a key component of the effort to eliminate mother-to-child transmission of HIV, and to integrate HIV testing with syphilis, viral or other key tests, as relevant to the setting, and to strengthen the underlying maternal and child health systems" (2)
<br/>
<b>If:</b>
<i>Applicability:</i>
("Population prevalence of syphilis in pregnant women" ≥ 5%)
AND ("Syphilis test type" = "Rapid syphilis test (RST)")
AND (Syphilis test result" = "Syphilis positive")
<i>(Should Conduct syphilis counselling and further testing)</i>
<br/>
</td>
</tr>
<tr>
<td>
Provide treatment according to the clinical phase of syphilis:
– If primary or secondary stage of syphilis, give single dose of benzathine penicillin 2,400,000 IU
– If late or unknown stage of syphilis, give one dose of benzathine penicillin 2,400,000 IU weekly for 3 consecutive weeks
– Advise on treating partner
– Encourage HIV testing and counselling
– Reinforce use of condoms
– Proceed to further testing with an RPR test
"In high-prevalence settings, provider-initiated testing and counselling (PITC) for HIV should be considered a routine component of the package of care for pregnant women in all antenatal care settings. In low-prevalence settings, PITC can be considered for pregnant women in antenatal care settings as a key component of the effort to eliminate mother-to-child transmission of HIV, and to integrate HIV testing with syphilis, viral or other key tests, as relevant to the setting, and to strengthen the underlying maternal and child health systems" (2)
<br/>
<b>If:</b>
<i>Applicability:</i>
("Population prevalence of syphilis in pregnant women" ≥ 5%)
AND ("Syphilis test type" = "Rapid plasma reagin (RPR) test")
AND (Syphilis test result" = "Syphilis positive")
<i>(Should Conduct syphilis counselling and further testing 2)</i>
<br/>
</td>
</tr>
<tr>
<td>
Procedure:
– If primary or secondary stage of syphilis, give single dose of benzathine penicillin 2,400,000 IU
– If late or unknown stage of syphilis, give one dose of benzathine penicillin 2,400,000 IU weekly for 3 consecutive weeks
– Advise on treating partner
– Encourage HIV testing and counselling
– Reinforce use of condoms
"In high-prevalence settings, provider-initiated testing and counselling (PITC) for HIV should be considered a routine component of the package of care for pregnant women in all antenatal care settings. In low-prevalence settings, PITC can be considered for pregnant women in antenatal care settings as a key component of the effort to eliminate mother-to-child transmission of HIV, and to integrate HIV testing with syphilis, viral or other key tests, as relevant to the setting, and to strengthen the underlying maternal and child health systems" (2)
<br/>
<b>If:</b>
<i>Applicability:</i>
("Population prevalence of syphilis in pregnant women" < 5%)
AND ("Syphilis test result" = "Syphilis positive")
<i>(Should Conduct syphilis counselling and further testing 3)</i>
<br/>
</td>
</tr>
</table>
</td>
</tr>
</table>
</td>
</tr>
</table>
</div>
</div>
</text>
<contained>
<Library>
<id value="effective-data-requirements"/>
<name value="EffectiveDataRequirements"/>
<status value="active"/>
<type>
<coding>
<system value="http://terminology.hl7.org/CodeSystem/library-type"/>
<code value="module-definition"/>
</coding>
</type>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library Config"/>
<resource value="http://smart.who.int/anc/Library/ANCConfig"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library FHIRHelpers"/>
<resource value="http://smart.who.int/anc/Library/FHIRHelpers|4.0.1"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library ContactData"/>
<resource
value="http://smart.who.int/anc/Library/ANCContactDataElements"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library WC"/>
<resource value="http://smart.who.int/anc/Library/WHOCommon"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Library Cx"/>
<resource value="http://smart.who.int/anc/Library/ANCConcepts"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Syphilis test result"/>
<resource value="http://smart.who.int/anc/ValueSet/anc-b9-de107"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Syphilis test result - Positive Choices"/>
<resource value="http://smart.who.int/anc/ValueSet/anc-b9-de108"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display value="Value set Syphilis test type"/>
<resource value="http://smart.who.int/anc/ValueSet/anc-b9-de98"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Syphilis test type - Rapidd plasma reagin (RPR) test Choices"/>
<resource value="http://smart.who.int/anc/ValueSet/anc-b9-de100"/>
</relatedArtifact>
<relatedArtifact>
<type value="depends-on"/>
<display
value="Value set Syphilis test type - Rapid syphilis test (RST) Choices"/>
<resource value="http://smart.who.int/anc/ValueSet/anc-b9-de99"/>
</relatedArtifact>
<parameter>
<name value="encounter"/>
<use value="in"/>
<min value="0"/>
<max value="1"/>
<type value="string"/>
</parameter>
<parameter>
<name
value="Should Conduct syphilis counselling and further testing 3"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name
value="Should Conduct syphilis counselling and further testing 2"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<parameter>
<name
value="Should Conduct syphilis counselling and further testing"/>
<use value="out"/>
<min value="0"/>
<max value="1"/>
<type value="boolean"/>
</parameter>
<dataRequirement>
<type value="Observation"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Observation"/>
<mustSupport value="code"/>
<mustSupport value="status"/>
<mustSupport value="encounter"/>
<mustSupport value="encounter.reference"/>
<codeFilter>
<path value="code"/>
<valueSet value="http://smart.who.int/anc/ValueSet/anc-b9-de107"/>
</codeFilter>
</dataRequirement>
<dataRequirement>
<type value="Observation"/>
<profile value="http://hl7.org/fhir/StructureDefinition/Observation"/>
<mustSupport value="code"/>
<mustSupport value="status"/>
<mustSupport value="encounter"/>
<mustSupport value="encounter.reference"/>
<codeFilter>
<path value="code"/>
<valueSet value="http://smart.who.int/anc/ValueSet/anc-b9-de98"/>
</codeFilter>
</dataRequirement>
</Library>
</contained>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="ANCConfig"/>
</extension>
<extension url="name">
<valueString
value="Population prevalence of syphilis in pregnant women"/>
</extension>
<extension url="statement">
<valueString
value="/*
Description: The proportion of pregnant women in the population with syphilis
*/
define "Population prevalence of syphilis in pregnant women":
6 '%'"/>
</extension>
<extension url="displaySequence">
<valueInteger value="0"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="ANCContactDataElements"/>
</extension>
<extension url="name">
<valueString value="Syphilis test result"/>
</extension>
<extension url="statement">
<valueString
value="/*
@dataElement: ANC.B9.DE107 Syphilis test result
@activity: ANC.B9 Lab tests & imaging
@description: Syphilis test result
*/
define "Syphilis test result":
WC.Only(
[Observation: Cx."Syphilis test result"] O
where O.status in { 'final', 'amended', 'corrected' }
and Coalesce(WC.ModifierExtension(O, 'who-notDone').value, false) is false
and Last(Split(O.encounter.reference, '/')) = Last(Split(encounter, '/'))
).value as FHIR.CodeableConcept"/>
</extension>
<extension url="displaySequence">
<valueInteger value="1"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="ANCDT21"/>
</extension>
<extension url="name">
<valueString
value="Should Conduct syphilis counselling and further testing 3"/>
</extension>
<extension url="statement">
<valueString
value="/*
("Population prevalence of syphilis in pregnant women" < 5%)
AND ("Syphilis test result" = "Syphilis positive")
*/
define "Should Conduct syphilis counselling and further testing 3":
Config."Population prevalence of syphilis in pregnant women" < 5 '%'
and ContactData."Syphilis test result" in Cx."Syphilis test result - Positive Choices""/>
</extension>
<extension url="displaySequence">
<valueInteger value="2"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="ANCContactDataElements"/>
</extension>
<extension url="name">
<valueString value="Syphilis test type"/>
</extension>
<extension url="statement">
<valueString
value="/*
@dataElement: ANC.B9.DE98 Syphilis test type
@activity: ANC.B9 Lab tests & imaging
@description: Select the type of syphilis test that was done
*/
define "Syphilis test type":
WC.Only(
[Observation: Cx."Syphilis test type"] O
where O.status in { 'final', 'amended', 'corrected' }
and Coalesce(WC.ModifierExtension(O, 'who-notDone').value, false) is false
and Last(Split(O.encounter.reference, '/')) = Last(Split(encounter, '/'))
).value as FHIR.CodeableConcept"/>
</extension>
<extension url="displaySequence">
<valueInteger value="3"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="ANCDT21"/>
</extension>
<extension url="name">
<valueString
value="Should Conduct syphilis counselling and further testing 2"/>
</extension>
<extension url="statement">
<valueString
value="/*
("Population prevalence of syphilis in pregnant women" ≥ 5%)
AND ("Syphilis test type" = "Rapid plasma reagin (RPR) test")
AND (Syphilis test result" = "Syphilis positive")
*/
define "Should Conduct syphilis counselling and further testing 2":
Config."Population prevalence of syphilis in pregnant women" >= 5 '%'
and ContactData."Syphilis test type" in Cx."Syphilis test type - Rapidd plasma reagin (RPR) test Choices"
and ContactData."Syphilis test result" in Cx."Syphilis test result - Positive Choices""/>
</extension>
<extension url="displaySequence">
<valueInteger value="4"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="ANCDT21"/>
</extension>
<extension url="name">
<valueString
value="Should Conduct syphilis counselling and further testing"/>
</extension>
<extension url="statement">
<valueString
value="/*
("Population prevalence of syphilis in pregnant women" ≥ 5%)
AND ("Syphilis test type" = "Rapid syphilis test (RST)")
AND (Syphilis test result" = "Syphilis positive")
*/
define "Should Conduct syphilis counselling and further testing":
Config."Population prevalence of syphilis in pregnant women" >= 5 '%'
and ContactData."Syphilis test type" in Cx."Syphilis test type - Rapid syphilis test (RST) Choices"
and ContactData."Syphilis test result" in Cx."Syphilis test result - Positive Choices""/>
</extension>
<extension url="displaySequence">
<valueInteger value="5"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToConcept"/>
</extension>
<extension url="statement">
<valueString
value="define function ToConcept(concept FHIR.CodeableConcept):
if concept is null then
null
else
System.Concept {
codes: concept.coding C return ToCode(C),
display: concept.text.value
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="6"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToCode"/>
</extension>
<extension url="statement">
<valueString
value="define function ToCode(coding FHIR.Coding):
if coding is null then
null
else
System.Code {
code: coding.code.value,
system: coding.system.value,
version: coding.version.value,
display: coding.display.value
}"/>
</extension>
<extension url="displaySequence">
<valueInteger value="7"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="WHOCommon"/>
</extension>
<extension url="name">
<valueString value="Only"/>
</extension>
<extension url="statement">
<valueString
value="define function Only(observations List<Observation>):
singleton from observations"/>
</extension>
<extension url="displaySequence">
<valueInteger value="8"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToString"/>
</extension>
<extension url="statement">
<valueString
value="define function ToString(value ObservationStatus): value.value"/>
</extension>
<extension url="displaySequence">
<valueInteger value="9"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToBoolean"/>
</extension>
<extension url="statement">
<valueString
value="define function ToBoolean(value boolean): value.value"/>
</extension>
<extension url="displaySequence">
<valueInteger value="10"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="WHOCommon"/>
</extension>
<extension url="name">
<valueString value="ModifierExtension"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Returns the single WHO core modifier extension (if present) on the given resource with the specified id.
@comment: This function uses singleton from to ensure that a run-time exception is thrown if there
is more than one extension on the given resource with the specified url.
*/
define function ModifierExtension(domainResource DomainResource, id String):
singleton from ModifierExtensions(domainResource, id)"/>
</extension>
<extension url="displaySequence">
<valueInteger value="11"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="WHOCommon"/>
</extension>
<extension url="name">
<valueString value="ModifierExtensions"/>
</extension>
<extension url="statement">
<valueString
value="/*
@description: Returns any WHO core modifier extensions defined on the given resource with the specified id.
@comment: NOTE: Extensions are not the preferred approach, but are used as a way to access
content that is defined by extensions but not yet surfaced in the
CQL model info.
*/
define function ModifierExtensions(domainResource DomainResource, id String):
domainResource.modifierExtension E
where E.url = ('http://fhir.org/guides/who/core/StructureDefinition/' + id)
return E"/>
</extension>
<extension url="displaySequence">
<valueInteger value="12"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToString"/>
</extension>
<extension url="statement">
<valueString value="define function ToString(value uri): value.value"/>
</extension>
<extension url="displaySequence">
<valueInteger value="13"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/StructureDefinition/cqf-logicDefinition">
<extension url="libraryName">
<valueString value="FHIRHelpers"/>
</extension>
<extension url="name">
<valueString value="ToString"/>
</extension>
<extension url="statement">
<valueString
value="define function ToString(value string): value.value"/>
</extension>
<extension url="displaySequence">
<valueInteger value="14"/>
</extension>
</extension>
<extension
url="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-effectiveDataRequirements" id="effective-data-requirements">
<valueCanonical value="#effective-data-requirements"/>
</extension>
<extension
url="http://hl7.org/fhir/uv/crmi/StructureDefinition/crmi-softwaresystem">
<valueReference>🔗
<reference value="Device/cqf-tooling"/>
</valueReference>
</extension>
<url value="http://smart.who.int/anc/PlanDefinition/ANCDT21"/>
<identifier>
<use value="official"/>
<value value="ANC.DT.21"/>
</identifier>
<version value="0.3.0"/>
<name value="ANCDT21"/>
<title value="ANC.DT.21 Syphilis diagnosis"/>
<type>
<coding>
<system
value="http://terminology.hl7.org/CodeSystem/plan-definition-type"/>
<code value="eca-rule"/>
</coding>
</type>
<status value="active"/>
<experimental value="false"/>
<date value="2025-06-24T13:58:48-06:00"/>
<publisher value="World Health Organization (WHO)"/>
<contact>
<telecom>
<system value="url"/>
<value value="https://www.who.int"/>
</telecom>
</contact>
<description
value="If the woman tests positive for syphilis, provide counselling and treatment as needed"/>
<useContext>
<code>
<system
value="http://terminology.hl7.org/CodeSystem/usage-context-type"/>
<code value="task"/>
<display value="Workflow Task"/>
</code>
<valueCodeableConcept>
<coding>
<system value="http://smart.who.int/anc/CodeSystem/activity-codes"/>
<code value="ANC.B10.4."/>
<display value="Diagnosis and treatment"/>
</coding>
</valueCodeableConcept>
</useContext>
<jurisdiction>
<coding>
<system value="http://unstats.un.org/unsd/methods/m49/m49.htm"/>
<code value="001"/>
</coding>
</jurisdiction>
<library value="http://smart.who.int/anc/Library/ANCDT21"/>
<action>
<title value="ANC.DT.21 Syphilis diagnosis"/>
<trigger>
<type value="named-event"/>
<name value="ANC.B10.4. Diagnosis and treatment"/>
</trigger>
<action id="1">
<title value="Conduct syphilis counselling and further testing"/>
<description value="Conduct syphilis counselling and further testing"/>
<textEquivalent
value="Procedure: Provide first dose of treatment and refer for additional testing
– If primary or secondary stage of syphilis, give single dose of benzathine penicillin 2,400,000 IU
– If late or unknown stage of syphilis, give one dose of benzathine penicillin 2,400,000 IU weekly for 3 consecutive weeks
– Advise on treating partner
– Encourage HIV testing and counselling
– Reinforce use of condoms
– Proceed to further testing with an RPR test
"In high-prevalence settings, provider-initiated testing and counselling (PITC) for HIV should be considered a routine component of the package of care for pregnant women in all antenatal care settings. In low-prevalence settings, PITC can be considered for pregnant women in antenatal care settings as a key component of the effort to eliminate mother-to-child transmission of HIV, and to integrate HIV testing with syphilis, viral or other key tests, as relevant to the setting, and to strengthen the underlying maternal and child health systems" (2)"/>
<documentation>
<type value="citation"/>
<label
value="WHO ANC recommendations (2016): B.1.7. Human immunodeficiency virus (HIV) and syphilis (3)"/>
</documentation>
<condition>
<kind value="applicability"/>
<expression>
<description
value="("Population prevalence of syphilis in pregnant women" ≥ 5%)
AND ("Syphilis test type" = "Rapid syphilis test (RST)")
AND (Syphilis test result" = "Syphilis positive")"/>
<language value="text/cql-identifier"/>
<expression
value="Should Conduct syphilis counselling and further testing"/>
</expression>
</condition>
</action>
<action id="2">
<title value="Conduct syphilis counselling and further testing"/>
<description
value="Conduct syphilis counselling and further testing 2"/>
<textEquivalent
value="Provide treatment according to the clinical phase of syphilis:
– If primary or secondary stage of syphilis, give single dose of benzathine penicillin 2,400,000 IU
– If late or unknown stage of syphilis, give one dose of benzathine penicillin 2,400,000 IU weekly for 3 consecutive weeks
– Advise on treating partner
– Encourage HIV testing and counselling
– Reinforce use of condoms
– Proceed to further testing with an RPR test
"In high-prevalence settings, provider-initiated testing and counselling (PITC) for HIV should be considered a routine component of the package of care for pregnant women in all antenatal care settings. In low-prevalence settings, PITC can be considered for pregnant women in antenatal care settings as a key component of the effort to eliminate mother-to-child transmission of HIV, and to integrate HIV testing with syphilis, viral or other key tests, as relevant to the setting, and to strengthen the underlying maternal and child health systems" (2)"/>
<documentation>
<type value="citation"/>
<label
value="WHO ANC recommendations (2016): B.1.7. Human immunodeficiency virus (HIV) and syphilis (3)"/>
</documentation>
<condition>
<kind value="applicability"/>
<expression>
<description
value="("Population prevalence of syphilis in pregnant women" ≥ 5%)
AND ("Syphilis test type" = "Rapid plasma reagin (RPR) test")
AND (Syphilis test result" = "Syphilis positive")"/>
<language value="text/cql-identifier"/>
<expression
value="Should Conduct syphilis counselling and further testing 2"/>
</expression>
</condition>
</action>
<action id="3">
<title value="Conduct syphilis counselling and further testing"/>
<description
value="Conduct syphilis counselling and further testing 3"/>
<textEquivalent
value="Procedure:
– If primary or secondary stage of syphilis, give single dose of benzathine penicillin 2,400,000 IU
– If late or unknown stage of syphilis, give one dose of benzathine penicillin 2,400,000 IU weekly for 3 consecutive weeks
– Advise on treating partner
– Encourage HIV testing and counselling
– Reinforce use of condoms
"In high-prevalence settings, provider-initiated testing and counselling (PITC) for HIV should be considered a routine component of the package of care for pregnant women in all antenatal care settings. In low-prevalence settings, PITC can be considered for pregnant women in antenatal care settings as a key component of the effort to eliminate mother-to-child transmission of HIV, and to integrate HIV testing with syphilis, viral or other key tests, as relevant to the setting, and to strengthen the underlying maternal and child health systems" (2)"/>
<documentation>
<type value="citation"/>
<label
value="WHO ANC recommendations (2016): B.1.7. Human immunodeficiency virus (HIV) and syphilis (3)"/>
</documentation>
<condition>
<kind value="applicability"/>
<expression>
<description
value="("Population prevalence of syphilis in pregnant women" < 5%)
AND ("Syphilis test result" = "Syphilis positive")"/>
<language value="text/cql-identifier"/>
<expression
value="Should Conduct syphilis counselling and further testing 3"/>
</expression>
</condition>
</action>
</action>
</PlanDefinition>