Completude e caracterização dos registros de sífilis gestacional e congênita na Bahia, 2007-2017

Abstract

Objetivo: Descrever a completude e as características das notificações de sífilis gestacional e congênita no estado da Bahia, Brasil, no período 2007-2017. Métodos: Estudo ecológico, com dados do Sistema de Informação de Agravos de Notificação (Sinan). Foram calculadas as taxas de incidência para a Bahia e suas macrorregiões de saúde, e o percentual da completude dos dados. Resultados: Foram identificados 15.050 casos de sífilis gestacional e 7.812 de sífilis congênita, no período analisado. A taxa de incidência variou de 1,3 para 15,1 casos em gestantes/1 mil nascidos vivos, e de 0,5 para 6,7 casos em menores de 1 ano/1 mil nascidos vivos. A completude da 'classificação clínica' dos casos de sífilis gestacional apresentou preenchimento variável, entre 58,2% e 67,2%, entre 2007 e 2017. Conclusão: Evidenciou-se aumento nas taxas de incidência, falha no preenchimento das notificações e necessidade de implementação de uma rotina de avaliação da qualidade das informações.

A completeness indicator of gestational and congenital syphilis information in Brazil

“…GS and CS notifications have increased more than 9 and 5 times, respectively, in recent years, possibly due to the expansion of primary health care coverage, in particular the Family Health Strategy, and the Bolsa Familia Program, which conditions the receipt of the benefit to the attendance of pregnant women to prenatal care and children to medical appointments to monitor growth and development 14,20 . Improvement in case detection has not been followed by an increase in the completeness of information, with significant regional differences across Brazilian regions, which corroborate previous results described in the literature for other infectious diseases 12,14,21 . Problems with information completeness of SG and SC records may be related to differences in the level of commitment of health professionals with regards to the adequate registration of case notification records, the reduced number of health professionals in health services to complete a significant number of records, as well as the non-prioritisation of syphilis by health managers 7,12 .…”

“…Improvement in case detection has not been followed by an increase in the completeness of information, with significant regional differences across Brazilian regions, which corroborate previous results described in the literature for other infectious diseases 12,14,21 . Problems with information completeness of SG and SC records may be related to differences in the level of commitment of health professionals with regards to the adequate registration of case notification records, the reduced number of health professionals in health services to complete a significant number of records, as well as the non-prioritisation of syphilis by health managers 7,12 . Considering that, often, notification is seen as a bureaucratic activity of secondary importance, it is essential to train health professionals on the need to generate quality information for epidemiological surveillance, ensuring the integrated flow of information between the responsible sectors, which can reduce differences at the area of residence and regional level in the quality of the information available in syphilis notification records 5,7,22 .…”

“…Therefore, this variable has become a complementary and non-mandatory filling field in INR 24 . Insufficient completeness of the field “concomitant treatment of the partner”, influenced by the non-mandatory registration of the information, harms the monitoring of syphilis cases, mainly CS, which reduces the possibility to assess the real transmission scenario of syphilis and the quality of prenatal care 12,25,26 . Studies indicate that the incompleteness of SINAN information, particularly for CS, and the high underreporting of cases, limit the use of this system in studies of incidence and factors related to the growth of syphilis in Brazil 7,27,28 .…”

“…Few national studies have evaluated the completeness of SINAN-Syphilis information 7,12,13 and the factors that influence its variation, such as region, year of notification, area of residence, and race/colour of the individual, as has been evidenced in other studies with HIS in Brazil 2,7,14 . There is also a lack of valuable indicators which are easily operationalised, which enable health managers and professionals to monitor the completeness of the information registered on HIS.…”

Sífilis em gestantes residentes em Vilhena e Rondônia: perfil epidemiológico e taxa de detecção (2010-2020)

“…Os resultados deste estudo mostraram que os casos de sífilis em gestantes no município de Vilhena e no estado de Rondônia aumentou de forma significativa no decorrer dos anos. Estudos corroboram que em outros municípios e unidades federativas do Brasil também houveram aumento significativo nas taxas de detecção de sífilis em mulheres no período gestacional, como em Uberlândia-MG, passando de 4,8 em 2011 para 19,2/1000 por mil nascidos vivos no ano de 2019, no estado da Bahia entre 2007 e 2017, aumento de 1,3 para 15,1 casos a cada 1000 nascidos vivos e no Rio Grande do Sul, em que a taxa subiu de 2,8 para 24/1000 nascidos vivos em um período de 10 anos (Mozzatto et al, 2021;Soares & Aquino, 2021;Sousa et al, 2022a). Observa-se que as taxas de detecção estão muito aquém da meta pactuada pela OPAS/OMS de 0,5/1000 nascidos vivos (OPAS, 2017), e acredita-se que o aumento esteja relacionado a possíveis falhas na implementação das medidas de controle desse problema de saúde pública.…”