Persistence of syphilis as a challenge for the Brazilian public health: the solution is to strengthen SUS in defense of democracy and life

Ramos, Alberto Novaes

doi:10.1590/0102-311xen069022

Cited by 6 publications

(6 citation statements)

References 7 publications

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“…The HIV/AIDS epidemic in Brazil has a prevalence of approximately 0.6% in the general population, and its geographic variation has shown a decrease in the southeast and an increase in the northern and northeastern regions [35], which is in line with data from our study.…”

Section: Plos Neglected Tropical Diseasessupporting

confidence: 92%

“…Regarding the incidence of syphilis, viral hepatitis and HIV, a higher concentration was observed in the southern region, although some studies suggest that areas with a lower human development index have higher incidence rates of HIV, syphilis, and viral hepatitis [30][31][32][33][34][35]. Some hypotheses that help explain this scenario might be related to the need for regular STI tests for patients using PrEP, which could lead to a higher detection rate in the population with more access to prophylaxis [10,33].…”

Section: Discussionmentioning

confidence: 99%

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HIV pre-exposure prophylaxis and incidence of sexually transmitted infections in Brazil, 2018 to 2022: An ecological study of PrEP administration, syphilis, and socioeconomic indicators

Mendonça Gil,

Conrado,

Nascimento

et al. 2023

PLoS Negl Trop Dis

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Background Human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP) is one of the pillars of a combination prevention strategy for reducing the risk of new infections caused by HIV. The daily use of antiretroviral drugs by individuals who are not infected with HIV is required to prevent infection. Although its efficacy has been well established in the literature, in recent years, the decreased supply of antiretroviral drugs has been associated with an increase in the incidence of sexually transmitted infections (STI) and changes in the social determinants of health. An ecological study was conducted covering a five-year period (2018–2022), starting from the year of initiation of PrEP administration in Brazilian state capitals. Principal findings Descriptive analysis was performed, and the spatial distribution of study data was taken into account. Correlation analysis was used to assess the association between PrEP administration, the incidence and detection rate of STI, and socioeconomic data. The southern region showed the highest incidence rates of STI, but the northern and northeastern regions demonstrated the worst socioeconomic indicators, especially those related to illiteracy and basic sanitation. PrEP administration was significantly correlated with illiteracy (ρ = -0.658), per capita income (ρ = 0.622), public garbage collection (ρ = 0.612), syphilis (ρ = 0.628) and viral hepatitis (ρ = 0.419) incidences. Further, all STI were significantly associated with illiteracy and per capita income. Significance Our findings highlight the need to continue exploring PrEP use and rising syphilis rates. In terms of policy, PrEP administration appears to be inversely associated with regions of greater social vulnerability. Further efforts should focus on the social determinants and health needs of this population to improve access to PrEP and reduce social disparities.

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Section: Plos Neglected Tropical Diseasessupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

HIV pre-exposure prophylaxis and incidence of sexually transmitted infections in Brazil, 2018 to 2022: An ecological study of PrEP administration, syphilis, and socioeconomic indicators

Mendonça Gil,

Conrado,

Nascimento

et al. 2023

PLoS Negl Trop Dis

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“…In the past, patients were subjected to prolonged treatment regimens involving arsenic and toxic compounds. However, these treatments often resulted in treatment failure, accompanied by periodic and sporadic outbreaks [20,69].…”

Section: Pharmacological Interventionsmentioning

confidence: 99%

“…The pivotal moment in the treatment of syphilis came with the discovery of T. pallidum's susceptibility to penicillin in 1943. This breakthrough redefined the approach to syphilis treatment, shifting from toxic compounds to antibiotics [69]. The widespread use of penicillin led to a substantial decrease in syphilis cases, marking a significant improvement in syphilis control over the past five decades, especially when compared to the pre-penicillin era [70].…”

Section: Pharmacological Interventionsmentioning

confidence: 99%

Advancing Syphilis Research: Exploring New Frontiers in Immunology and Pharmacological Interventions

Fajemiroye,

Moreira,

Ito

et al. 2023

Venereology

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In recent years, the global resurgence of syphilis has posed significant challenges to public health. This sexually transmitted infection, caused by the bacterium Treponema pallidum, can have severe consequences if left untreated, including neurological and cardiovascular complications. Diagnosing syphilis is complex due to its diverse clinical presentations, necessitating a multifaceted approach, including serological, molecular, and direct techniques such as dark-field microscopy. Penicillin remains the primary and effective treatment, but emerging macrolide-resistant strains have spurred investigations into alternative antibiotics. Syphilis vaccine development faces unique hurdles, yet promising strategies are under investigation. Targeted prevention strategies focus on high-risk populations such as men who have sex with men, pregnant women, and individuals with multiple sexual partners. The integration of syphilis services into primary healthcare enhances accessibility, early detection, and treatment. Innovative point-of-care diagnostics offer rapid, sensitive testing, while ongoing vaccine research holds the potential for long-term prevention. Addressing the global burden of syphilis requires a multifaceted approach, encompassing immunological advancements, innovative diagnostics, targeted prevention, and primary healthcare integration. Collaborative efforts between governments, healthcare systems, researchers, and communities are essential to effectively combat syphilis, striving toward a syphilis-free future that promotes better sexual health and overall well-being.

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“…Intelligent notification platforms are needed, with management tools that have interoperability between government systems at all levels of care, agility in sending data, and control in a clear, fast, and transparent manner [ 30 ]. This is one of the biggest challenges for the control of syphilis cases: the insertion and implementation of tools that articulate the three levels of health care with epidemiological surveillance, guaranteeing easy access to diagnosis, treatment, and follow-up of diseases [ 12 , 31 , 32 ].…”

Section: Introductionmentioning

confidence: 99%

Salus Platform: A Digital Health Solution Tool for Managing Syphilis Cases in Brazil—A Comparative Analysis

Pinto

Lima

Cunha-Oliveira

et al. 2023

IJERPH

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(1) Introduction: Syphilis is a sexually transmitted infection (STI) that constitutes a serious public health problem in Brazil and worldwide; (2) Methods: This was a descriptive and exploratory study that sought to analyze and compare the characteristics of Brazilian health systems with a new platform (Salus) developed by the Laboratory of Technological Innovation in Health in the scope of notification and management of disease data, including syphilis. In addition, this analysis aimed to assess whether Salus fully meets the necessary data management fields and can be indicated as a tool to improve health management in the context of syphilis in Brazil. (3) Results: In this study, the Salus functionalities were demonstrated and compared with the current Brazilian systems by discovering the existing gaps in the evaluated systems. The gaps found may explain the delay in meeting demands, the difficulty of making routine therapeutic follow-ups, in addition to interference with the vital purpose of follow-up in the epidemiological surveillance of diseases. As a result, Salus demonstrates functionalities that surpass all others and meet case management demands in a superior way to the systems currently used in the country. (4) Conclusions: The Brazilian health information systems related to the response to syphilis do not fulfill the purpose for which they were developed. Instead, they contribute to the fragmentation of health data and information, delays in diagnosis, incomplete case management, and loss of data due to inconsistencies and inadequate reporting. In addition, they are systems without interconnection, which do not articulate epidemiological surveillance actions with primary health care. All these factors may be obscuring accurate data on syphilis in Brazil, resulting in high and unnecessary public spending and late care for users of the Unified Health System (SUS).

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Persistence of syphilis as a challenge for the Brazilian public health: the solution is to strengthen SUS in defense of democracy and life

Cited by 6 publications

References 7 publications

HIV pre-exposure prophylaxis and incidence of sexually transmitted infections in Brazil, 2018 to 2022: An ecological study of PrEP administration, syphilis, and socioeconomic indicators

HIV pre-exposure prophylaxis and incidence of sexually transmitted infections in Brazil, 2018 to 2022: An ecological study of PrEP administration, syphilis, and socioeconomic indicators

Advancing Syphilis Research: Exploring New Frontiers in Immunology and Pharmacological Interventions

Salus Platform: A Digital Health Solution Tool for Managing Syphilis Cases in Brazil—A Comparative Analysis

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