Congenital Syphilis in the Paraíba Valley Using a Spatial Approach

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.