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Laurentino ACN, Ramos BA, Lira CDS, Lessa IF, Taquette SR. Health care of sexual partners of adolescents with gestational syphilis and their children: an integrative review. CIENCIA & SAUDE COLETIVA 2024; 29:e12162023. [PMID: 38747774 DOI: 10.1590/1413-81232024295.12162023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 11/16/2023] [Indexed: 05/25/2024] Open
Abstract
Gestational syphilis (GS) in adolescents is a challenge for Brazilian public health, with high incidence rates. Testing, diagnosis and treatment of sexual partners is essential to interrupt the chain of transmission, but since 2017 it is no longer a criterion for the proper treatment of pregnant women. We sought to analyze and synthesize the knowledge produced about the health care of sexual partners of adolescents with GS in Brazil. We carried out a systematic review in the BVS, SciELO and PubMed databases, selecting articles that addressed GS and/or congenital syphilis (CS) in adolescents aged 15 to 19 years and that included information about sexual partners. Forty-one articles were comprehensively analyzed using the WebQDA software and classified into two categories: a) Approach to sexual partners during prenatal care, and b) The role of sexual partners in the transmission cycle of GS and CS. The studies show that the partner's approach is deficient, with a lack of data on the sociodemographic profile and information on testing and treatment. In the context of Primary Health Care, there are no studies that address factors inherent to the context of vulnerability of sexual partners in relation to coping with syphilis.
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Affiliation(s)
- Arnaldo Cezar Nogueira Laurentino
- Faculdade de Ciências Médicas, Universidade de Estado do Rio de Janeiro. Av. Prof. Manoel de Abreu 444, Maracanã. 20550-170 Rio de Janeiro RJ Brasil.
| | - Beatriz Alves Ramos
- Faculdade de Ciências Médicas, Universidade de Estado do Rio de Janeiro. Av. Prof. Manoel de Abreu 444, Maracanã. 20550-170 Rio de Janeiro RJ Brasil.
| | - Carollyne da Silva Lira
- Faculdade de Ciências Médicas, Universidade de Estado do Rio de Janeiro. Av. Prof. Manoel de Abreu 444, Maracanã. 20550-170 Rio de Janeiro RJ Brasil.
| | - Isadora Fiaux Lessa
- Faculdade de Ciências Médicas, Universidade de Estado do Rio de Janeiro. Av. Prof. Manoel de Abreu 444, Maracanã. 20550-170 Rio de Janeiro RJ Brasil.
| | - Stella Regina Taquette
- Faculdade de Ciências Médicas, Universidade de Estado do Rio de Janeiro. Av. Prof. Manoel de Abreu 444, Maracanã. 20550-170 Rio de Janeiro RJ Brasil.
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Lima MG, Bahia JC, Oliveira FS, Vieira FV, Cavalcante AMR, Matos MA, Guimarães JV. Educational intervention improves knowledge and adherence to treatment amongst puerperal women with syphilis: randomized clinical trial. Int J STD AIDS 2023; 34:969-977. [PMID: 37464586 DOI: 10.1177/09564624231188750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
BACKGROUND Gestational syphilis requires early detection and proper treatment to prevent negative maternal-fetal outcomes. This study aimed to evaluate the effectiveness of an educational intervention on treatment adherence and knowledge about syphilis in postpartum women with positive Treponema pallidum results. METHODS A randomized, parallel, and open clinical trial was conducted with 64 postpartum women who tested positive for T. pallidum, assigned to two groups (1:1 ratio). The Intervention Group (IG) received an educational intervention on syphilis, including an explanatory leaflet and hands-on demonstrations, along with standard guidelines. The Control Group (CG) received standard guidelines alone. Pre-test and post-test assessments were conducted to measure knowledge and treatment adherence. Statistical analyses included descriptive and inferential methods, assessing group homogeneity using the Chi-square or Fishers exact test. The interventions effectiveness was determined using relative risk, and pre- and post-test scores were compared using the independent t test. RESULTS The post-test revealed improvements in knowledge scores for general knowledge, treatment, and prevention domains (p < .05). The IG demonstrated an increase in post-test knowledge scores (p = .001), with association between post-test scores and treatment adherence (p = .001). CONCLUSION The educational intervention on syphilis improved knowledge and treatment adherence in postpartum women with syphilis.
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Affiliation(s)
- Maira Gr Lima
- Master in Nursing, Faculdade de Enfermagem da Universidade Federal de Goiás (FEN - UFG), Goiânia/Goiás, Brazil
| | - Julyana C Bahia
- Master in Nursing, Faculdade de Enfermagem da Universidade Federal de Goiás (FEN - UFG), Goiânia/Goiás, Brazil
| | - Flávia S Oliveira
- Master in Nursing, Faculdade de Enfermagem da Universidade Federal de Goiás (FEN - UFG), Goiânia/Goiás, Brazil
| | - Flaviana Vm Vieira
- PhD in nursing, professor at Faculdade de Enfermagem da Universidade Federal de Goiás (FEN - UFG), Goiânia/Goiás, Brazil
| | - Agueda Maria Rz Cavalcante
- PhD in nursing, professor at Faculdade de Enfermagem da Universidade Federal de Goiás (FEN - UFG), Goiânia/Goiás, Brazil
| | - Marcos André Matos
- PhD in nursing, professor at Faculdade de Enfermagem da Universidade Federal de Goiás (FEN - UFG), Goiânia/Goiás, Brazil
| | - Janaína V Guimarães
- PhD in nursing, professor at Faculdade de Enfermagem da Universidade Federal de Goiás (FEN - UFG), Goiânia/Goiás, Brazil
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de Oliveira GL, Ferreira AJF, Santana JG, Lana RM, Cardoso AM, Teles C, Fiaccone RL, Aquino R, Soares MAS, Paixao ES, Santos IO, Salvi L, Barreto ML, Ichihara MY. A completeness indicator of gestational and congenital syphilis information in Brazil. Rev Saude Publica 2023; 57:42. [PMID: 37556664 PMCID: PMC10355315 DOI: 10.11606/s1518-8787.2023057004789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 08/08/2022] [Indexed: 08/11/2023] Open
Abstract
OBJECTIVE To evaluate the quality of information on gestational syphilis (GS) and congenital syphilis (CS) on the Sistema de Informação de Agravos de Notificação (SINAN-Syphilis Brazil - Notifiable Diseases Information System) by compiling and validating completeness indicators between 2007 and 2018. METHODS Overall, care, and socioeconomic completeness scores were compiled based on selected variables, by using ad hoc weights assigned by experts. The completeness scores were analysed, considering the region and area of residence, the pregnant woman's race/colour, and the year of case notification. Pearson's correlation coefficients were used to validate the scores obtained by the weighted average method, compared with the values obtained by principal component analysis (PCA). RESULTS Most selected variables presented a good or excellent degree of completeness for GS and CS, except for clinical classification, pregnant woman's level of education, partner's treatment, and child's race/colour, which were classified as poor or very poor. The overall (89.93% versus 89.69%) and socioeconomic (88.71% versus 88.24%) completeness scores for GS and CS, respectively, were classified as regular, whereas the care score (GS-90.88%, and CS-90.72%) was good, despite improvements over time. Differences in the overall, care and socioeconomic completeness scores according to region, area of residence, and ethnic-racial groups were reported for syphilis notifications. The completeness scores estimated by the weighted average method and PCA showed a strong linear correlation (> 0.90). CONCLUSION The completeness of GS and CS notifications has been improving in recent years, highlighting the variables that form the care score, compared with the socioeconomic scores, despite differences between regions, area of residence, and ethnic-racial groups. The weighted average was a viable methodological alternative easily operationalised to estimate data completeness scores, allowing routine monitoring of the completeness of gestational and congenital syphilis records.
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Affiliation(s)
- Guilherme Lopes de Oliveira
- Fundação Oswaldo CruzCentro de Integração de Dados e Conhecimentos para SaúdeSalvadorBABrasilFundação Oswaldo Cruz. Centro de Integração de Dados e Conhecimentos para Saúde, Salvador, BA, Brasil
- Centro Federal de Educação Tecnológica de Minas GeraisDepartamento de ComputaçãoBelo HorizonteMGBrasilCentro Federal de Educação Tecnológica de Minas Gerais. Departamento de Computação. Belo Horizonte, MG, Brasil
| | - Andrêa JF Ferreira
- Fundação Oswaldo CruzCentro de Integração de Dados e Conhecimentos para SaúdeSalvadorBABrasilFundação Oswaldo Cruz. Centro de Integração de Dados e Conhecimentos para Saúde, Salvador, BA, Brasil
- Drexel UniversityDornsife School of Public HealthThe Ubuntu Center on Racism, Global Movements & Population Health EquityPhiladelphiaUSADrexel University. Dornsife School of Public Health. The Ubuntu Center on Racism, Global Movements & Population Health Equity. Philadelphia, USA
| | - José Guilherme Santana
- Fundação Oswaldo CruzCentro de Integração de Dados e Conhecimentos para SaúdeSalvadorBABrasilFundação Oswaldo Cruz. Centro de Integração de Dados e Conhecimentos para Saúde, Salvador, BA, Brasil
- Drexel UniversityDornsife School of Public HealthThe Ubuntu Center on Racism, Global Movements & Population Health EquityPhiladelphiaUSADrexel University. Dornsife School of Public Health. The Ubuntu Center on Racism, Global Movements & Population Health Equity. Philadelphia, USA
| | - Raquel Martins Lana
- Fundação Oswaldo CruzCentro de Integração de Dados e Conhecimentos para SaúdeSalvadorBABrasilFundação Oswaldo Cruz. Centro de Integração de Dados e Conhecimentos para Saúde, Salvador, BA, Brasil
- Centro Nacional de SupercomputaciónBarcelonaEspañaCentro Nacional de Supercomputación. Barcelona, España
- Fundação Oswaldo CruzEscola Nacional de Saúde Pública Sérgio AroucaDepartment of Endemic Diseases Samuel PessoaRio de JaneiroRJBrasilFundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sérgio Arouca, Department of Endemic Diseases Samuel Pessoa. Rio de Janeiro, RJ, Brasil
| | - Andrey Moreira Cardoso
- Fundação Oswaldo CruzEscola Nacional de Saúde Pública Sérgio AroucaDepartment of Endemic Diseases Samuel PessoaRio de JaneiroRJBrasilFundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sérgio Arouca, Department of Endemic Diseases Samuel Pessoa. Rio de Janeiro, RJ, Brasil
| | - Carlos Teles
- Fundação Oswaldo CruzCentro de Integração de Dados e Conhecimentos para SaúdeSalvadorBABrasilFundação Oswaldo Cruz. Centro de Integração de Dados e Conhecimentos para Saúde, Salvador, BA, Brasil
- Universidade Estadual de Feira de SantanaDepartamento de Ciências ExatasFeira de SantanaBABrasilUniversidade Estadual de Feira de Santana, Departamento de Ciências Exatas. Feira de Santana, BA, Brasil
| | - Rosemeire L. Fiaccone
- Fundação Oswaldo CruzCentro de Integração de Dados e Conhecimentos para SaúdeSalvadorBABrasilFundação Oswaldo Cruz. Centro de Integração de Dados e Conhecimentos para Saúde, Salvador, BA, Brasil
- Universidade Federal da BahiaInstituto de Matemática e EstatísticaSalvadorBABrasilUniversidade Federal da Bahia. Instituto de Matemática e Estatística, Salvador, BA, Brasil
| | - Rosana Aquino
- Fundação Oswaldo CruzCentro de Integração de Dados e Conhecimentos para SaúdeSalvadorBABrasilFundação Oswaldo Cruz. Centro de Integração de Dados e Conhecimentos para Saúde, Salvador, BA, Brasil
- Universidade Federal da BahiaInstituto de Saúde ColetivaSalvadorBABrasilUniversidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil.
| | - Maria Auxiliadora Santos Soares
- Fundação Oswaldo CruzCentro de Integração de Dados e Conhecimentos para SaúdeSalvadorBABrasilFundação Oswaldo Cruz. Centro de Integração de Dados e Conhecimentos para Saúde, Salvador, BA, Brasil
- Universidade Federal da BahiaInstituto de Saúde ColetivaSalvadorBABrasilUniversidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil.
| | - Enny S. Paixao
- Fundação Oswaldo CruzCentro de Integração de Dados e Conhecimentos para SaúdeSalvadorBABrasilFundação Oswaldo Cruz. Centro de Integração de Dados e Conhecimentos para Saúde, Salvador, BA, Brasil
- London School of Hygiene and Tropical MedicineLondonUnited KingdomLondon School of Hygiene and Tropical Medicine. London, United Kingdom
| | - Idália Oliveira Santos
- Fundação Oswaldo CruzCentro de Integração de Dados e Conhecimentos para SaúdeSalvadorBABrasilFundação Oswaldo Cruz. Centro de Integração de Dados e Conhecimentos para Saúde, Salvador, BA, Brasil
- Universidade Federal da BahiaInstituto de Saúde ColetivaSalvadorBABrasilUniversidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil.
| | - Leonardo Salvi
- Fundação Oswaldo CruzCentro de Integração de Dados e Conhecimentos para SaúdeSalvadorBABrasilFundação Oswaldo Cruz. Centro de Integração de Dados e Conhecimentos para Saúde, Salvador, BA, Brasil
| | - Maurício L. Barreto
- Fundação Oswaldo CruzCentro de Integração de Dados e Conhecimentos para SaúdeSalvadorBABrasilFundação Oswaldo Cruz. Centro de Integração de Dados e Conhecimentos para Saúde, Salvador, BA, Brasil
- Universidade Federal da BahiaInstituto de Saúde ColetivaSalvadorBABrasilUniversidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil.
| | - Maria Yury Ichihara
- Fundação Oswaldo CruzCentro de Integração de Dados e Conhecimentos para SaúdeSalvadorBABrasilFundação Oswaldo Cruz. Centro de Integração de Dados e Conhecimentos para Saúde, Salvador, BA, Brasil
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Uchôa TLDA, Araújo EDC, da Silva RAR, Valois R, de Azevedo Junior WS, Nascimento VGC, Aben-Athar CYUP, Parente AT, Botelho EP, Ferreira GRON. Determinants of gestational syphilis among women attending prenatal care programs in the Brazilian Amazon. Front Public Health 2022; 10:930150. [PMID: 36438302 PMCID: PMC9683036 DOI: 10.3389/fpubh.2022.930150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 10/04/2022] [Indexed: 11/11/2022] Open
Abstract
Background There was a high proportion of pregnant women who were attending prenatal care who were not tested for syphilis or tested but not treated, among priority countries. The coverage for prenatal care visits, syphilis screening, and treatment are priority indicators for monitoring of the elimination of syphilis. The aim was to determine the factors associated with gestational syphilis among postpartum women who were in a prenatal care program in the Brazilian Amazon. Methods An unmatched case-control study was conducted at the hospital in Brazil. Data collection was carried out from November 2020 to July 2021 during hospitalization using a pretested structured questionnaire. The criteria for selection of cases and control followed the guidelines established by the Ministry of Health of Brazil; postpartum women with a laboratory diagnosis based on treponemal and/or nontreponemal tests, symptoms of syphilis or asymptomatic, treatment or not treated, and in a prenatal care program. Gestational syphilis cases were identified as women who tested positive for syphilis, and those who tested negative were controls, at minimally one prenatal care visit, childbirth, and/or the puerperium. The sample size encompassed 59 cases and 118 controls (1: 2 ratio of cases to controls). Data were analyzed using Minitab 20® and BioEstat 5.3® software. The odds ratio was calculated by multiple logistic regression. Results One hundred and seventy-seven postpartum women were included in the study, 59 cases and 118 controls. Among all participants, 95.5% (169) were tested for syphilis in any trimester during pregnancy and at the delivery and 4.5% (8) were tested in the maternity only, at the time childbirth and/or puerperium. The final multiple logistic regression model evidenced that cases had higher odds compared to controls if they had past history of sexually transmitted infections (AOR: 55.4; p: 0.00), difficulty talking about condom use with their sexual partner (AOR: 4.92; p: 0.01), one to six prenatal care visits (AOR: 4.93; p: 0.01), had not received a sexually transmitted infections test result in the maternity hospital (AOR: 4.09; p: 0.04), lower monthly income (AOR: 4.32; p: 0.04), or one to three miscarriages (AOR: 4.34; p: 0.01). Conclusion The sociodemographic, programmatic, obstetric, and sexual factors are associated with gestational syphilis among postpartum women.
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Affiliation(s)
| | | | | | - Rubenilson Valois
- Program of Post-Graduation in Nursing, State University of Pará, Belém, Brazil
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Fernandes LPMR, Oliveira CNT, de Brito BB, Freire de Melo F, Souza CL, Oliveira MV. Prevalence and factors associated with non-adherence to therapy among partners of pregnant women with syphilis in a city of northeastern Brazil. World J Obstet Gynecol 2022; 11:20-32. [DOI: 10.5317/wjog.v11.i3.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/30/2022] [Accepted: 06/03/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND One of the main difficulties faced in the prevention of the vertical transmission of syphilis is the inadequate treatment of pregnant women and their partners. The disease causes serious repercussions in infected newborns.
AIM To evaluate the prevalence and factors associated with the therapeutic adhesion among partners of pregnant women with syphilis in a county in Northeastern Brazil.
METHODS This is a descriptive, analytic, quantitative, cross-sectional study that was carried out through interviews with 46 pregnant women diagnosed with syphilis between 2017 and 2018 as well as with their partners. The interviews aimed at collecting data regarding sociodemographic characteristics, obstetric variables and information about syphilis, and partners’ related variables.
RESULTS Our results showed that 73.91% of the partners did not undergo appropriate treatments, and obtaining negative results in syphilis tests was the main reason for the absence of therapies. The following factors were significantly associated with the lack of treatment among partners: Being a partner that is not the current mate of the pregnant woman, having a level of schooling inferior to 8 years [odds ratio (OR) = 10.28], and the pregnant woman undergoing up to two syphilis tests during the prenatal care (OR = 8.6). The study found a higher odds of absent treatment among partners if the pregnant woman is not white (OR = 13.88) or if the partner has less than 8 years of schooling (OR = 21.00) or has a monthly income of less than half the minimum wage (OR = 13.93).
CONCLUSION The findings of this study show a high prevalence of partners that are not adequately treated for syphilis, a phenomenon that is strongly associated with socioeconomic factors.
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Affiliation(s)
| | | | - Breno Bittencourt de Brito
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Fabrício Freire de Melo
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Cláudio Lima Souza
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
| | - Márcio Vasconcelos Oliveira
- Instituto Multidisciplinar em Saúde, Universidade Federal da Bahia, Vitória da Conquista 45029-094, Bahia, Brazil
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Spatiotemporal dynamics of syphilis in pregnant women and congenital syphilis in the state of São Paulo, Brazil. Sci Rep 2022; 12:585. [PMID: 35022472 PMCID: PMC8755837 DOI: 10.1038/s41598-021-04530-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 12/17/2021] [Indexed: 11/17/2022] Open
Abstract
We aimed to estimate the occurrence of syphilis in pregnant women (SPW) and congenital syphilis (CS) in the municipalities of the state of São Paulo (SP) and evaluate their relationship with socioeconomic, demographic, and health care variables. We developed an ecological study based on secondary data of SPW and CS with spatiotemporal components from 645 municipalities in SP including data from 2007 to 2018. We modeled the data in a Bayesian context, considered spatial and temporal random effects, and used binomial negative probability distributions. We found a continuous increase in the relative temporal risk of SPW, from 2007 to 2018, and CS, from 2007 to 2017, when their incidences increased by 8.6 and 6.6 times, respectively. This increase occurred en bloc in practically all municipalities of SP. The increase in SPW was associated with teenage pregnancy, municipalities with a large number of inhabitants, and acquired immunodeficiency syndrome (AIDS) incidence. The increase in CS was associated with municipalities with a large number of inhabitants, incomplete antenatal care, and AIDS incidence. Although actions to control these diseases are required in all municipalities of SP, the identification of high-risk areas points to priority regions for development.
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Reis ARDP, Duarte G, Menegueti MG, Reis RK, Silva ACRE, Gir E. Reactive treponemal and non-treponemal tests in pregnant women and associated factors. Rev Esc Enferm USP 2022; 56:e20220146. [PMID: 36427270 PMCID: PMC10081588 DOI: 10.1590/1980-220x-reeusp-2022-0146en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 09/27/2022] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT Objective: to identify the rate of reactive treponemal and non-treponemal tests in pregnant women during childbirth and to analyze the factors associated with this seroreactivity. Method: this is a cross-sectional, quantitative study with secondary sources of sociodemographic and clinical data on 2,626 pregnant women treated at a public maternity hospital in the interior of São Paulo, in 2020. For statistical analysis, Fisher’s exact test, Mann-Whitney test and the logistic regression model were used. A difference of p < 0.05 was considered statistically significant. Results: the rate of seropositivity for syphilis among pregnant women in this series was 2.74%. Among the groups with positive and non-reactive tests, marital status, occupation, place of residence and use of licit drugs indicated significant differences, but, in the final model, only unmarried marital status was associated with reactive tests (Odds Ratio: 0.169; Confidence Interval: 0.04–0.72; and p: 0.016). Conclusion: in this study, unmarried marital status was the only independent factor associated with seroreactivity for syphilis. Therefore, it is necessary to create strategies aimed at women in this condition, potentially reducing the rate of congenital syphilis.
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Reis ARDP, Duarte G, Menegueti MG, Reis RK, Silva ACRE, Gir E. Testes treponêmicos e não treponêmicos reagentes em gestantes e fatores associados. Rev Esc Enferm USP 2022. [DOI: 10.1590/1980-220x-reeusp-2022-0146pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
RESUMO Objetivo: identificar a taxa de testes treponêmicos e não treponêmicos reagentes em gestantes no período do parto e analisar os fatores associados a essa sororreatividade. Método: estudo transversal, quantitativo, com fontes secundárias de dados sociodemográficos e clínicos de 2.626 gestantes atendidas em uma maternidade pública do interior paulista, em 2020. Para a análise estatística, foram utilizados os Testes Exato de Fisher, de Mann-Whitney e o modelo de regressão logística. Considerou-se diferença com significância estatística valores de p < 0,05. Resultados: a taxa de soropositividade para sífilis entre gestantes nesta casuística foi de 2,74%. Entre os grupos com testes reagentes e não reagentes à situação maritária, ocupação, local da residência e uso de drogas lícitas indicaram diferenças significantes, mas, no modelo final, apenas a situação marital não casada apresentou associação com os testes reagentes (Odds Ratio: 0,169; Intervalo de Confiança: 0,04–0,72; e p: 0,016). Conclusão neste estudo, a situação maritária não casada foi o único fator independente associado à sororreatividade para a sífilis. Por isso, faz-se necessária a criação de estratégias voltadas para mulheres nessa condição, potencialmente reduzindo a taxa de sífilis congênita.
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Soares MAS, Aquino R. Completeness and characterization of gestational syphilis and congenital syphilis records in Bahia, Brazil, 2007-2017. EPIDEMIOLOGIA E SERVIÇOS DE SAÚDE 2021; 30:e20201148. [PMID: 34816889 DOI: 10.1590/s1679-49742021000400018] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Accepted: 07/14/2021] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE To describe the completeness and characteristics of reported gestational syphilis and congenital syphilis cases in the state of Bahia, Brazil, between 2007 and 2017. METHODS This was an ecological study using data retrieved from the Notifiable Health Conditions Information System (SINAN). Incidence rates at the macro-regional and state levels and percentage completeness were calculated. RESULTS 15,050 gestational syphilis cases and 7,812 congenital syphilis cases were identified. The incidence rate varied from 1.3 to 15.1 cases in pregnant women/1,000 live births and from 0.5 to 6.7 cases in infants under 1 year old/1,000 live births. Completeness of 'clinical classification' of gestational syphilis varied from 58.2% to 67.2% in the periods studied. CONCLUSION The study showed an increase in incidence rates, flaws in report form completion and the need to implement routine information quality evaluation.
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Affiliation(s)
| | - Rosana Aquino
- Universidade Federal da Bahia, Instituto de Saúde Coletiva, Salvador, BA, Brasil
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Oliveira IMD, Oliveira RPB, Alves RRF. Diagnosis, treatment, and notification of syphilis during pregnancy in the state of Goiás, Brazil, between 2007 and 2017. Rev Saude Publica 2021; 55:68. [PMID: 34730749 PMCID: PMC8522754 DOI: 10.11606/s1518-8787.2021055003122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 11/17/2020] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To analyze the evolution of syphilis during pregnancy notification regarding clinical classification, diagnosis and treatment in the state of Goiás, Brazil, between 2007 and 2017. METHODS This is a time-series study, analyzing data provided by the Health Secretariat of the state of Goiás. The variables related to the diagnosis and treatment of pregnant women and their partners were analyzed, and their evolution trend during the years. Descriptive statistics and percentage calculation were used. Cochran-Armitage test with a significance level α = 0.05 was used to determine increase and decrease trends. RESULTS During the period, 7,774 cases were notified. The highest percentage of notifications occurred in the second trimester of pregnancy (39.8%) and corresponded to primary syphilis (34.1%). The most frequent treatment prescribed was benzathine benzylpenicillin with a dosage of 7.2 million (43.8%). Between 2007 and 2017, there was an increasing trend in the notification percentage of latent (14.1% to 30.7%), secondary (5.2% to 19%), and tertiary syphilis (4.4% to 11.4%). The treatment with benzathine benzylpenicillin with a dosage of 7.2 million also increased (19.3% to 59.6%). The percentages of primary syphilis decreased (43.4% to 22.1%), as well as other treatments’ percentages. CONCLUSIONS Latent syphilis notification of pregnant women and treatment with penicillin at the dosage of 7,200,000 IU increased. Notification forms’ data completeness also increased for the variables clinical classification and treatment, suggesting improvements in the notification process.
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Amorim EKR, Matozinhos FP, Araújo LA, Silva TPRD. Trend in cases of gestational and congenital syphilis in Minas Gerais, Brazil, 2009-2019: an ecological study. ACTA ACUST UNITED AC 2021; 30:e2021128. [PMID: 34644777 DOI: 10.1590/s1679-49742021000400006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 05/24/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To analyze the trend of notifications of gestational and congenital syphilis in Minas Gerais, Brazil, from 2009 to 2019. METHODS This was an ecological time series study which took the state of Minas Gerais as its unit of analysis, based on data reported on the Notifiable Health Conditions Information System (SINAN). The Prais-Winsten autoregressive model was used to verify trends. RESULTS 20,348 cases of gestational syphilis and 11,173 cases of congenital syphilis were reported. Average percentage annual increase was 36.7% (95%CI 32.5;41.0), for gestational syphilis incidence rates, and 32.8% (95%CI 28.0;37.8) for congenital syphilis incidence rates (p<0.001). CONCLUSION The temporal trend analysis showed that gestational and congenital syphilis incidence rates had significant increasing trends, which may be related to inadequate treatment or failure to treat syphilis during pregnancy.
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Affiliation(s)
| | - Fernanda Penido Matozinhos
- Universidade Federal de Minas Gerais, Departamento de Enfermagem Materno-Infantil e Saúde Pública, Belo Horizonte, MG, Brasil
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Soares MAS, Aquino R. [Association between the incidence rates for gestational syphilis and congenital syphilis and prenatal care coverage in the State of Bahia, Brazil]. CAD SAUDE PUBLICA 2021; 37:e00209520. [PMID: 34259750 DOI: 10.1590/0102-311x00209520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 11/23/2020] [Indexed: 11/22/2022] Open
Abstract
This study aimed to analyze the association between incidence rates for gestational and congenital syphilis and coverage of prenatal care from 2007 to 2017 in the State of Bahia, Brazil. This was an ecological and longitudinal study in which the units of analysis were the municipalities (counties) of the State of Bahia. Secondary data were used, obtained from the databases of the Health Information Systems. Analysis of the association between the incidence rates and prenatal coverage was performed with panel datal, using the fixed model with negative binomial response, controlled for socioeconomic, demographic, and temporal variables. In the multivariate analyses, prenatal coverage showed a statistically significant positive association with gestational syphilis incidence rate, but no association was found with congenital syphilis the incidence rate. Using municipalities with prenatal coverage < 45% as the reference group, the gestational syphilis incidence rate increased by 22% and 25%, respectively, in municipalities with prenatal coverage of 45%-64.9% (RR = 1.22; 95%CI: 1.11-1.33) and ≥ 65% (RR = 1.25; 95%CI: 1.10-1.43). The findings indicate that although the expansion of prenatal coverage in municipalities in Bahia has helped improve the detection of gestational syphilis, it did not impact the congenital syphilis incidence rate. Prenatal care as provided suffers limitations that should be the target of interventions to prevent and block vertical syphilis transmission.
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Affiliation(s)
- Maria Auxiliadora Santos Soares
- Secretaria de Saúde de Salvador, Salvador, Brasil.,Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brasil
| | - Rosana Aquino
- Instituto de Saúde Coletiva, Universidade Federal da Bahia, Salvador, Brasil
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Fernandes LPMR, Souza CL, Oliveira MV. Missed opportunities in treating pregnant women’s sexual partners with syphilis: a systematic review. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2021. [DOI: 10.1590/1806-93042021000200002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Abstract Objectives: to compile studies in the literature that deal with missed opportunities related in treating pregnant women’s partners with syphilis Methods: this is a systematic review from SciELO, PUBMED, Lilacs and BVS databases, using articles published between 2008 and 2018. The research was carried out between April and August 2019 and followed PRISMA guideline recommendation Results: 56,686 titles were identified and 53 were extracted in which addressed aspects related intreating pregnant women’s partners with syphilis. Most studies were National, representing 60.7% of the researched articles. 51% of them used the Sistemas de Informação de Agravos Notificados (SINAN) (Notified Diseases Information System) as a database, followed by the use of Questionnaires / Interviews (33.9%) and consulted patients’ files (15.1%). The factors most associated with the non-treatment of the pregnant women’s partners with syphilis were: structuring /quality in the services from the aspect related to failures in prenatal care, characteristics of pregnant women that interfere in their treatment and aspects related to the cultural particularities that involvemen's healthcare. Conclusion: in all continents, the main aspect related to failures in the treatment of the partners/pregnant women with syphilis is associated with low quality in prenatal care.
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Araújo MAL, Esteves ABB, Rocha AFB, Silva Junior GBD, Miranda AE. Factors associated with prematurity in reported cases of congenital syphilis. Rev Saude Publica 2021; 55:28. [PMID: 34008782 PMCID: PMC8102023 DOI: 10.11606/s1518-8787.2021055002400] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Accepted: 09/02/2020] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE: To analyze the factors associated with prematurity in reported cases of congenital syphilis in the city of Fortaleza, Ceará, Brazil. METHODS: Cross-sectional study conducted in ten public maternity hospitals in Fortaleza, Ceará, Brazil. A total of 478 reported cases of congenital syphilis were included in 2015, and data were collected from notification forms, from mothers’ and babies’ medical records and from prenatal cards. For the bivariate analysis, Pearson’s chi-squared and Fisher’s exact tests were used, considering p < 0.05. Multiple logistic regression was conducted, presenting odds ratio (OR) with a 95% confidence interval. RESULTS: We found 15.3% prematurity in pregnant women with syphilis. The titration of the VDRL test > 1:8 at delivery (OR 2.46; 95%CI: 1.33–4.53; p = 0.004) and the non-treatment of the pregnant women or treatment with drugs other than penicillin during prenatal care (OR 3.52; 95%CI: 1.74–7.13; p< 0.001) were associated with higher chances of prematurity. CONCLUSION: The prematurity due to congenital syphilis is a preventable condition, provided that pregnant women with syphilis are treated appropriately. Weaknesses in prenatal care are associated with this outcome, which highlights the importance of public policies oriented to improve the quality of prenatal care.
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Affiliation(s)
- Maria Alix Leite Araújo
- Universidade de Fortaleza. Programa de Pós-Graduação em Saúde Coletiva. Fortaleza, CE, Brasil
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Pitilin ÉDB, Gasparin VA, de Resende e Silva DT, Souza JBD, Haag FB. Hospitalizations due to Congenital Syphilis in Neonates: Associated Factors from the Prenatal Care Process. AQUICHAN 2020. [DOI: 10.5294/aqui.2020.20.4.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Objective: To identify the factors associated with hospitalizations due to congenital syphilis in neonates, based on the characteristics of prenatal care.
Materials and method: A quantitative case-control study, conducted by applying a questionnaire to 65 puerperal women with their babies hospitalized from July to November 2017. The data were analyzed using logistic regression, according to the plan proposed in the hierarchical approach.
Results: 20% of the hospitalizations were due to syphilis (cases) and 80% to other causes (control). The vulnerability risk (p = 0.036), previous history of sexually transmitted infection (p = 0,006), use of oral contraceptives (p = 0.011) and parity (p = 0.043) variables were statistically significant. The absence of the partner during the consultation (p = 0.028), failure to perform a rapid test for syphilis (p = 0.035) and educational activity for the partner (p = 0.033) were also associated with the occurrence of the outcome, in addition to the variables of the newborn: low birth weight (p = 0.025), not being on exclusive breastfeeding (p = 0.036) and not having had skin-to-skin contact (p = 0.043).
Conclusions: Congenital syphilis has several risk factors for its occurrence. It was possible to observe that the assistance inequalities existing in care during the prenatal consultations directly reflect on the occurrence of this condition.
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Nascimento LFC. CONGENITAL SYPHILIS IN THE PARAÍBA VALLEY USING A SPATIAL APPROACH. REVISTA PAULISTA DE PEDIATRIA 2020; 38:e2018395. [PMID: 32756849 PMCID: PMC7391929 DOI: 10.1590/1984-0462/2020/38/2018395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Accepted: 05/28/2019] [Indexed: 11/22/2022]
Abstract
Objective: To compare spatial patterns of congenital syphilis (CS) with those of
socioeconomic and medical variables in Paraíba Valley, São Paulo, between
2012 and 2016. Methods: Ecological and exploratory study developed using spatial analysis tools,
with information on CS cases obtained from official data reports. Rates were
found for CS cases per 1,000 live births, number of family health teams and
pediatricians available in the health system per 100,000 inhabitants, and
social vulnerability index values. Thematic maps were constructed with these
variables and compared using TerraView 4.2.2 software. Estimated global
Moran (IM) indexes were calculated. In order to detect areas with
priority attention regarding the incidence of CS, BoxMaps were developed.
The Spearman correlation was estimated for the variable values and compared
using the Kruskal-Wallis test. P <0.05 was significant. Results: 144,613 births and 870 CS cases (6.04/1000 live births) occurred during the
study period. The average value of CS rates per municipality was 4.0±4.1,
(0.0-17.6/1000 live births). Higher CS rates occurred in municipalities of
the Upper Vale do Paraíba, contrary to the proportions of pediatricians who
were in the far east of the region. The thematic maps of the variables
presented a mosaic aspect, which characterized the random distribution of
the variables. The IM were not significant. No significant
correlation was found between the variables. The BoxMap identified eight
municipalities with high CS rates. Conclusions: Even though it was not possible to identify a spatial pattern of CS rates,
it was shown that eight municipalities deserve the attention of city
managers.
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Oliveira VDS, Rodrigues RL, Chaves VB, dos Santos TS, de Assis FM, Ternes YMF, de Aquino ÉC. [High-risk clusters and temporal trends in congenital syphilis infection in Brazil]. Rev Panam Salud Publica 2020; 44:e75. [PMID: 32818032 PMCID: PMC7425818 DOI: 10.26633/rpsp.2020.75] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 03/05/2020] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To determine the occurrence of high-risk clusters for congenital syphilis (CS) in Brazil and describe the temporal trends in the CS infection in the country, comparing children whose mothers received vs. those whose mothers did not receive prenatal care. METHOD This ecological study used data from the National Disease Notification System (Sistema de Informação de Agravos de Notificação, SINAN) and the Live Birth Information System (Sistema de Informações sobre Nascidos Vivos, SINASC). For cluster analysis, the Kulldorff scan statistic was applied to the population at risk. Statistical significance was determined by the log-likelihood ratio based on Poisson discrete distribution. To analyze the temporal trends of disease detection rates, Prais-Winsten regression was used. The analysis was performed with SatScan 9.4 and Stata 14.0 software. RESULTS Clusters with detection rates of 41.3, 44.4 and 188.1 CS cases/10 000 live births were identified in 2001, 2009 and 2017 respectively. In 2001, the rates were 8 times higher in the clusters than in the remaining country; in 2009, the rates were 3.3 times higher; and in 2017, 2.5 times higher. An increasing trend in CS infection was detected in all regions and federation units. The rates were 8.53 times higher in the children of mothers without prenatal care (243.3 cases/1 000 live births vs. 28.3 cases/1 000 live births in the children of mothers with prenatal care). CONCLUSIONS The identification of municipality clusters at high risk for CS and of increasing trends in CS infection across the country, even in the presence of prenatal care, suggests the need for improvement of public health actions to fight this disease.
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Affiliation(s)
- Vinícius da Silva Oliveira
- Universidade Federal de Goiás (FM-UFG)Faculdade de MedicinaGoiânia (GO)BrasilUniversidade Federal de Goiás (FM-UFG), Faculdade de Medicina, Goiânia (GO), Brasil.
| | - Roberta Luiza Rodrigues
- Universidade Federal de Goiás (FM-UFG)Faculdade de MedicinaGoiânia (GO)BrasilUniversidade Federal de Goiás (FM-UFG), Faculdade de Medicina, Goiânia (GO), Brasil.
| | - Vinícius Barros Chaves
- Universidade Federal de Goiás (FM-UFG)Faculdade de MedicinaGoiânia (GO)BrasilUniversidade Federal de Goiás (FM-UFG), Faculdade de Medicina, Goiânia (GO), Brasil.
| | - Thiago Soares dos Santos
- Universidade Federal de Goiás (FM-UFG)Faculdade de MedicinaGoiânia (GO)BrasilUniversidade Federal de Goiás (FM-UFG), Faculdade de Medicina, Goiânia (GO), Brasil.
| | - Flaviane Marques de Assis
- Universidade Federal de Goiás (FM-UFG)Faculdade de MedicinaGoiânia (GO)BrasilUniversidade Federal de Goiás (FM-UFG), Faculdade de Medicina, Goiânia (GO), Brasil.
| | - Yves Mauro Fernandes Ternes
- Universidade Federal de Goiás (IPTSP-UFG)Instituto de Patologia Tropical e Saúde PúblicaGoiânia (GO)BrasilUniversidade Federal de Goiás (IPTSP-UFG), Instituto de Patologia Tropical e Saúde Pública, Goiânia (GO), Brasil.
| | - Érika Carvalho de Aquino
- Universidade Federal de Goiás (IPTSP-UFG)Instituto de Patologia Tropical e Saúde PúblicaGoiânia (GO)BrasilUniversidade Federal de Goiás (IPTSP-UFG), Instituto de Patologia Tropical e Saúde Pública, Goiânia (GO), Brasil.
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Costa JC, Maia MFS, Victora CG. Ciência & Saúde Coletiva - 25 years: contributions to pregnancy, delivery, and childhood studies. CIENCIA & SAUDE COLETIVA 2020; 25:4813-4830. [PMID: 33295503 DOI: 10.1590/1413-812320202512.21642020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 06/24/2020] [Indexed: 11/22/2022] Open
Abstract
We reviewed the scientific production on maternal health and the health of children under ten years of age, published in Journal Ciência & Saúde Coletiva during the last 25 years, focusing on quantitative studies. The authors' characteristics, populations under study, thematic areas, and methodology are described. A total of 170 publications were identified and grouped into 12 major themes. Pregnancy, delivery, and puerperium were the subject of 47 studies, followed by child anthropometric assessments (29), breastfeeding (24), and mortality (13). The selected publications represented 3.5% of the total original papers published by the Journal since its creation in 1996 and about 5% of the publications in the 2015-2020 period. The primary data sources were health service records, information systems, and population surveys. The cross-sectional design was used in 113 of the 170 articles, and 70% covered only one municipality. The Southeast and Northeast Regions of Brazil were the target of most studies, and the North Region was the least represented. The publications reflect the complexity of maternal and child health themes, with a particular focus on the importance of the Unified Health System and showing how open access data can contribute to public health research.
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Affiliation(s)
- Janaína Calu Costa
- Centro Internacional de Equidade em Saúde, Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas. R. Marechal Deodoro 1160, Centro. 96020-220 Pelotas RS Brasil.
| | - Maria Fatima Santos Maia
- Centro Internacional de Equidade em Saúde, Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas. R. Marechal Deodoro 1160, Centro. 96020-220 Pelotas RS Brasil.
| | - Cesar Gomes Victora
- Centro Internacional de Equidade em Saúde, Programa de Pós-Graduação em Epidemiologia, Universidade Federal de Pelotas. R. Marechal Deodoro 1160, Centro. 96020-220 Pelotas RS Brasil.
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do Nascimento DDG, de Moraes SHM, Santos CADST, de Souza AS, Bomfim RA, De Carli AD, Kodjaoglanian VL, dos Santos MLDM, Zafalon EJ. Impact of continuing education on maternal and child health indicators. PLoS One 2020; 15:e0235258. [PMID: 32589647 PMCID: PMC7319283 DOI: 10.1371/journal.pone.0235258] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 06/11/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE This study investigated whether the presence of care workers who completed a specialization course on family health was associated with improved care and maternal and child health indicators in municipalities in the state of Mato Grosso do Sul, Brazil. METHODS Negative binomial regression models with fixed effects were used for the 79 municipalities in the state of Mato Grosso do Sul, with repeated observations for the period 2009-2015. For our reference, the parameter "number of professionals who completed the course" calculated the proportion of professionals who completed the course, and was divided by the total number of primary health care professionals in the municipality to create a ratio. The cutoff points used represented tertile distribution: T3: high (0.35-1.00), T2: intermediate (0.02-0.33) and T1: low (0.00-0.01); to avoid biased results, the analysis was also performed for the years prior to the beginning of the course in question (2009 and 2010). RESULTS During the study period, enrollment of pregnant women, exclusive breastfeeding for children under 4 months, and up-to-date vaccinations in children younger than 1 year to 23 months increased (high to intermediate categories) in municipalities where professionals who completed the specialization course worked. Growth in the intermediate ratio was also observed in indicators related to cervical cancer screening and new diagnoses of congenital syphilis in infants under one year of age. CONCLUSIONS The presence of care workers who completed a specialization course on family health was seen to be associated with improved care and indicators for maternal and child health in municipalities in the state of Mato Grosso do Sul, Brazil. These findings reaffirm the importance and effectiveness of policies on training and continuing education for the Brazilian Unified Health System.
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Affiliation(s)
| | | | | | - Albert Schiaveto de Souza
- Biosciences Institute, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | - Rafael Aiello Bomfim
- Post-doctoral Researcher at The School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Alessandro Diogo De Carli
- Faculty of Dentistry, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
| | | | | | - Edilson José Zafalon
- Faculty of Dentistry, Federal University of Mato Grosso do Sul, Campo Grande, Mato Grosso do Sul, Brazil
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de Mélo KC, dos Santos AGG, Brito AB, de Aquino SHS, Alencar ÉTDS, Duarte EMDS, Machado MF, de Araújo MDP, de Paiva JPS, do Carmo RF, Leal TC, da Silva AG, da Silva LF, Correira DS, Santos VS, de Souza CDF. Syphilis among pregnant women in Northeast Brazil from 2008 to 2015: a trend analysis according to sociodemographic and clinical characteristics. Rev Soc Bras Med Trop 2020; 53:e20190199. [PMID: 32187335 PMCID: PMC7094034 DOI: 10.1590/0037-8682-0199-2019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 01/17/2020] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The number of syphilis cases among pregnant women in Brazil has increased. This study aimed to analyze the temporal trend of syphilis indicators among pregnant women in Northeast Brazil. METHODS A time-series study was performed. RESULTS We observed an increase in the detection rate of syphilis among pregnant women, those aged 15-19 years, and those of brown ethnicity. A strong correlation was observed between the detection rate of syphilis and family health strategy coverage. CONCLUSIONS Despite an increase in primary care coverage, The increase in cases of syphilis among pregnant women is still considered a challenge.
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Affiliation(s)
| | | | - Alyne Barbosa Brito
- Universidade Federal de Alagoas, Departamento de Medicina, Arapiraca, AL, Brasil
| | | | | | | | - Michael Ferreira Machado
- Universidade Federal de Alagoas, Departamento de Medicina, Arapiraca, AL, Brasil
- Universidade Federal de Alagoas, Núcleo de Estudos em Medicina Social e Preventiva, Arapiraca, AL, Brasil
| | | | - João Paulo Silva de Paiva
- Universidade Federal de Alagoas, Departamento de Medicina, Arapiraca, AL, Brasil
- Universidade Federal de Alagoas, Núcleo de Estudos em Medicina Social e Preventiva, Arapiraca, AL, Brasil
| | - Rodrigo Feliciano do Carmo
- Universidade Federal do Vale do São Francisco, Colegiado de Ciências Farmacêuticas, Petrolina, PE, Brasil
| | - Thiago Cavalcanti Leal
- Universidade Federal de Alagoas, Departamento de Medicina, Arapiraca, AL, Brasil
- Universidade Federal de Alagoas, Núcleo de Estudos em Medicina Social e Preventiva, Arapiraca, AL, Brasil
| | | | - Leonardo Feitosa da Silva
- Universidade Federal de Alagoas, Departamento de Medicina, Arapiraca, AL, Brasil
- Universidade Federal de Alagoas, Núcleo de Estudos em Medicina Social e Preventiva, Arapiraca, AL, Brasil
| | - Divanise Suruagy Correira
- Universidade Federal de Alagoas, Faculdade de Medicina, Maceió, AL, Brasil
- Universidade Federal de Alagoas, Programa de Pós-graduação em Saúde da Família, Maceió, AL, Brasil
| | - Victor Santana Santos
- Universidade Federal de Alagoas, Programa de Pós-graduação em Saúde da Família, Maceió, AL, Brasil
- Universidade Federal de Alagoas, Núcleo de Epidemiologia e Saúde Pública, Arapiraca, AL, Brasil
| | - Carlos Dornels Freire de Souza
- Universidade Federal de Alagoas, Departamento de Medicina, Arapiraca, AL, Brasil
- Universidade Federal de Alagoas, Núcleo de Estudos em Medicina Social e Preventiva, Arapiraca, AL, Brasil
- Universidade Federal de Alagoas, Programa de Pós-graduação em Saúde da Família, Maceió, AL, Brasil
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Cavalcante ANM, Araújo MAL, Nobre MA, Almeida RLFD. Factors associated with inadequate follow-up of children with congenital syphilis. Rev Saude Publica 2019; 53:95. [PMID: 31644773 PMCID: PMC6802946 DOI: 10.11606/s1518-8787.2019053001284] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Accepted: 03/10/2019] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To analyze factors associated with outpatient follow-up of children with congenital syphilis. METHODS A non-concurrent cohort study performed in primary care units and three reference maternity hospitals in Fortaleza (Ceará State). Data were collected from September 2013 to September 2016 in the notification forms and in the medical records of hospitalization and outpatient follow-up, and they were presented considering an adequate and inadequate follow-up. Children who attended the primary care unit or referral outpatient clinic during the period recommended by the Ministry of Health were considered adequately followed up and performed the recommended examinations. Pearson's chi-square and Fisher's exact tests were used in the comparative analysis. The estimated risk of adequate non-follow-up was verified by simple and multiple logistic regression. RESULTS The total of 460 children with congenital syphilis were notified, of which 332 (72.2%) returned for at least one appointment and were part of the study. Exactly 287 (86.4%) children attended the primary health unit; however, there was no reference to congenital syphilis in 236 (71.1%) medical records and no information on the venereal disease research laboratory (VDRL) test was found in 264 (79.5%) children. There was nonadherence to subsequent appointments by 272 (81.9%) individuals. The following variables had a statistically significant association with the non-adequate follow-up of the children: marital status of the mothers, number of prenatal appointments, number of pregnancies, blood count, and radiography of long bones. CONCLUSIONS Most children with congenital syphilis attended primary care for follow-up, but the services do not meet the recommendations of the Brazilian Ministry of Health for adequate follow-up.
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Affiliation(s)
- Ana Nery Melo Cavalcante
- Universidade de Fortaleza. Faculdade de Medicina. Programa de Pós-Graduação em Saúde Coletiva. Fortaleza, CE, Brasil
| | - Maria Alix Leite Araújo
- Universidade de Fortaleza. Centro de Ciências da Saúde. Programa de Pós-Graduação em Saúde Coletiva. Fortaleza, CE, Brasil
| | - Marina Arrais Nobre
- Universidade de Fortaleza. Curso graduação em Medicina. Fortaleza, CE, Brasil
| | - Rosa Lívia Freitas de Almeida
- Universidade de Fortaleza. Centro de Ciências da Saúde. Programa de Pós-Graduação em Saúde Coletiva. Fortaleza, CE, Brasil
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Conceição HND, Câmara JT, Pereira BM. Análise epidemiológica e espacial dos casos de sífilis gestacional e congênita. SAÚDE EM DEBATE 2019. [DOI: 10.1590/0103-1104201912313] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
RESUMO O presente estudo teve como objetivo analisar o perfil epidemiológico e a distribuição espacial dos casos de sífilis gestacional e congênita. Trata-se de uma pesquisa descritiva, exploratória e retrospectiva, com abordagem quantitativa, realizada em Caxias (MA). Utilizaram-se os dados das fichas de investigação dos casos confirmados de sífilis gestacional e congênita do Sistema de Informação de Agravos de Notificação no período de 2013 a 2017. Com a tecnologia Global Positioning System (Sistema de Posicionamento Global), foram coletadas as coordenadas dos casos, e com o programa Quantum GIS, versão 1.7.0, os mapas foram construídos. Foram 149 casos de sífilis gestacional, apresentando crescimento de 73% no período. As maiores prevalências ocorreram em mulheres jovens, pardas, com baixa escolaridade e donas de casa. Evidenciou-se maior frequência do diagnóstico no terceiro trimestre gestacional, com maior prevalência de sífilis primária. Foram 18 casos de sífilis congênita, com redução de 33% na taxa de detecção e prevalência na idade entre 1 e 28 dias de vida. Na análise espacial, as zonas Oeste e Leste, periferia do município, concentraram o maior número de casos. Revelou-se frágil o manejo de investigação, tornando necessária a educação permanente para qualificar os profissionais, com o intuito de instituir a identificação precoce, o tratamento oportuno e o acompanhamento efetivo.
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Garbin AJÍ, Martins RJ, Belila NDM, Exaltação SM, Garbin CAS. Reemerging diseases in Brazil: sociodemographic and epidemiological characteristics of syphilis and its under-reporting. Rev Soc Bras Med Trop 2019; 52:e20180226. [PMID: 30810654 DOI: 10.1590/0037-8682-0226-2018] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Accepted: 07/04/2018] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION This paper analyzed sociodemographic and epidemiological data of individuals with syphilis as well as the compulsory reporting of the disease, for being a reemerging disease in Brazil. METHODS General information and sociodemographic, epidemiological, clinical, and laboratory data were verified in compulsory reporting. RESULTS From 2010 to 2016, 157 reporting forms were explored. Acquired and gestational syphilis occurred predominantly in those 20 to 29 years of age and those who did not complete secondary education. Compulsory reporting forms were not complete. CONCLUSIONS The number of syphilis cases has varied over the years in the city. Incomplete compulsory reporting was noted.
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Affiliation(s)
- Artênio José Ísper Garbin
- Programa de Pós-graduação em Odontologia Preventiva e Social, Faculdade de Odontologia de Araçatuba, Universidade Estadual Paulista, Araçatuba, SP, Brasil
| | - Ronald Jefferson Martins
- Programa de Pós-graduação em Odontologia Preventiva e Social, Faculdade de Odontologia de Araçatuba, Universidade Estadual Paulista, Araçatuba, SP, Brasil
| | - Naiana de Melo Belila
- Programa de Pós-graduação em Odontologia Preventiva e Social, Faculdade de Odontologia de Araçatuba, Universidade Estadual Paulista, Araçatuba, SP, Brasil
| | | | - Cléa Adas Saliba Garbin
- Programa de Pós-graduação em Odontologia Preventiva e Social, Faculdade de Odontologia de Araçatuba, Universidade Estadual Paulista, Araçatuba, SP, Brasil
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