Since 2012, Louisiana has ranked number one in the nation for congenital syphilis (CS). In 2015, Louisiana’s congenital syphilis rate rose to an all-time high of 83.9 cases per 100,000 live births, which was over six times higher than the national rate of 12.6 cases per 100,000 live births. Louisiana reported fewer cases in 2016 and the majority of cases reported were from three public health regions: Baton Rouge, Monroe, and Shreveport. Primary and secondary (P&S) syphilis rates among women in Louisiana also remain high, aiding Louisiana’s consistently high rates of CS. In 2015, Louisiana’s P&S syphilis rate of 7.9 cases per 100,000 females was over five times higher than the national rate of 1.9 cases per 100,000 females. This disease burden disproportionately affects people of color in Louisiana. In 2016, 90% of mothers of reported CS cases in Louisiana were black. Likewise, 85% of females diagnosed with P&S syphilis in Louisiana in 2016 were black.​

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Goal:

SHP received additional grant funding from the CDC for efforts to reduce congenital syphilis in Louisiana. While case numbers will not be settled until the year following the campaign, the immediate goal of SHP-CSP is to inform the public on syphilis signs, symptoms and testing, and to educate providers on how to properly diagnose and treat syphilis, especially during pregnancy.

Approach:
SHP planned a robust statewide CS awareness and case reduction campaign. Patient-facing materials focused on syphilis and other STD awareness and testing. Since many CS cases in Louisiana came from the reinfection of women in the later trimester of their pregnancy, a large portion of the campaign targeted men and partners of women who were diagnosed with syphilis. Social marketing targeted men and women in the high-risk areas by age, race and interests. Billboards were placed strategically around areas with the highest syphilis morbidity in the targeted public health regions.

Additionally, every public health region in Louisiana had an existing STD/HIV-reduction task force composed of various community partners, healthcare providers and universities dedicated to STD/HIV awareness and reduction. SHP capitalized on existing localized community engagement activities and provider education efforts to broaden the message of CS reduction.

SHP also focused on provider education of both public and private healthcare providers on appropriate syphilis screening, testing and treatment practices as an integral part of the successful syphilis reduction campaign. 

Results:

• Louisiana fell from #1 for CS case rates to #3 between 2017 and 2018

• Outdoor component of the campaign had a reach of over 2M people per month, with all ads placed for 3 months (Oct to Dec 2018).

• Two regional CS conferences were held and attended by over 100 healthcare professionals each.

• Over 150 one-on-one provider education sessions were held throughout the state of Louisiana.

• Campaign was recognized by CDC and National Coalition of STD Directors for being innovative, modern, and effective.