Temporal evolution and characterization of congenital syphilis cases in Minas Gerais, Brazil, 2007-2015

Incomplete recording of race/colour in health information systems in Brazil: time trend, 2009-2018

This ecological study of time trends and multiple groups evaluated incompleteness in the race/colour field of Brazilian health information system records and the related time trend, 2009-2018, for the diseases and disorders most prevalent in the black population. The Romero and Cunha (2006) classification was applied in order to examine incompleteness using secondary data from Brazil's National Notifiable Diseases System, Hospital Information System and Mortality Information System, by administrative regions of Brazil, while percentage underreporting and time trend were calculated using simple linear regression models with Prais-Winsten correction (p-value<0.05). All records scored poorly except those for mortality from external causes (excellent), tuberculosis (good) and infant mortality (fair). An overall downward trend was observed in percentage incompleteness. Analysis by region found highest mean incompleteness in the North (30.5%), Northeast (33.3%) and Midwest (33.0%) regions. The Southeast and Northeast regions showed the strongest downward trends. The findings intended to increase visibility on the implications of the race/color field for health equity.

Temporal trend of congenital syphilis in the most populous municipality of metropolitan region II of Rio de Janeiro state

OBJECTIVE

This study aimed to explore the temporal trend in congenital syphilis, according to sociodemographic and prenatal care in the city of São Gonçalo - Rio de Janeiro, from 2007 to 2018.

METHODS

Ecological time series study, with data from SINAN (Information System for Notifiable Diseases) and SINASC (Information System on Live Births databases). We calculated annual incidence (per 1,000 live births) according to sociodemographic and prenatal variables. For the same variables, we calculated trends by logarithmic regression (Joinpoint Regression), estimating the annual percentage change.

RESULTS

A total of 2,420 cases were reported from 2007 to 2018, with an increasing trend: 64.9% per year (2010-2013) and 24.9% (2013-2018). In 2018, the highest rates were in adolescents (90.6/1,000 live births), black women (87.6/1,000 live births), low-educated women (122.8/1,000 live births), and those without prenatal care (677.4/1,000 live births). The annual percentage change of these categories was, respectively, 37.3% (2010-2018), 33.5% (2012-2018), 39.9% (2014-2018), and 85.0% (2011-2015), but all categories showed a crescent trend.

CONCLUSIONS

We identified high congenital syphilis incidences and crescent trends, especially in more vulnerable groups, pointing to social and healthcare inequalities. Prenatal care needs to be more comprehensive and qualified, primarily for young, low-educated, and black women.

Completeness and characterization of gestational syphilis and congenital syphilis records in Bahia, Brazil, 2007-2017

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.

Trend in cases of gestational and congenital syphilis in Minas Gerais, Brazil, 2009-2019: an ecological study

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.