Fetal and infant mortality of congenital syphilis reported to the Health Information System

Abstract

BackgroundCongenital syphilis (CS) is a major cause of mortality in several countries, especially in Latin America and the Caribbean. This study aimed to analyze fetal and infant mortality of CS reported to the Health Information System in a State in Northeastern Brazil.Methods and resultsThis was a cross-sectional study that analyzed the deaths of CS from 2010 to 2014 through the linkage of the Mortality Information System (SIM) and the Notifiable Diseases Information System (Sinan). The Statistical Package for the Social Sciences (SPSS) version 23.0 was used to calculate the rates of Fetal, Perinatal, Neonatal (early and late), and Postneonatal Mortality. Simple linear regression was performed. Fisher's exact test or Pearson's chi-square test were used for comparison of proportions and Student's t-test was used for comparison of means.Of the 414 cases reported to the SIM as deaths possibly caused by CS, 44 (10.6%) presented CS as the underlying cause. From 2010 to 2014 the Infant Mortality Rate of CS was 16.3 per 100,000 live births (y = 0.65x + 14.33, R2 = 0.2338, p = 0.003). There was an 89.4% underreporting of deaths. Perinatal deaths and fetal deaths of CS accounted for 87.7% and 73.9% of total deaths, respectively.ConclusionsThe results of the study revealed a significant Fetal and Infant Mortality rate of CS and demonstrated the importance of using the linkage method in studies that involve the analysis of secondary data obtained from mortality and disease reporting systems. The underreporting of CS as a cause of fetal and infant mortality leads to unawareness of the reality of deaths from this disease, hindering the development of public policies aimed at its prevention.

Increase of Incidence of Congenital Syphilis in Santa Catarina State Between 2007-2017: Temporal Trend Analysis

“…For the analysis of deaths, only the SINAN records were used, with no consultation to the Mortality Information System (Sistema de Informação de Mortalidade -SIM) -SINAN may present flaws regarding the registration of deaths related to congenital syphilis. 28 As study limitations, we highlight the lack of information in the notification forms regarding the clinical data of pregnant women and newborns, as well as many variables registered as "ignored", which affects the analysis and interpretation of the reported cases. In addition, there is no follow-up of these newborns, because the notification form only corresponds to the period immediately after birth.…”

Rollet’s mixed chancre in Brazilian pregnant women: An unusual case report

“…Rollet's mixed chancre is the association of syphilis and soft chancre in the same patient. When this occurs in the pregnant woman, it represents a challenge for adequate diagnosis and treatment (Canto et al, 2019;Lewis, 2014). Patients attending health units who have a history of current or previous sexual activity should be offered screening examinations for STIs, as well as methods of prevention and counseling.…”

“…These two diseases are STIs that have quite distinct incubation periods: 10-90 days for syphilis and 3-5 days for soft chancre (Kahn et al, 2014). The coexistence of ulcerated lesions caused by multiple agents represents a higher risk for HIV infection (MS, 2014;Canto et al, 2019).…”

Overview of syphilis in a northern Brazilian city from 2013 to 2017

“…15 Além disso, a faixa etária aponta que o número de mulheres com mais de 20 anos estão vulneráveis a infecção pelo o T. pallidum em seu período de gestação devido da suas praticas sexuais desprotegidas com seus parceiros, problema enfrentado pelos os profissionais da saúde. 3,16 A idade gestacional mais indicada neste estudo foi o 2º trimestre com 37,9%, no teste treponêmico. Não sendo diferente em Belo Horizonte -MG, houve um total de 56,6% das gestantes com sífilis no segundo trimestre de gestação.…”

“…2 Esta última afeta um milhão de mulheres grávidas por ano em todo o mundo, levando a morte de crianças e a sífilis congênita. 3 No Brasil, nos últimos anos, ocorreu um aumento bastante significativo em relação à infecção pelo o Treponema pallidum. No ano de 2010 a sua incidência correspondia 2,0% (para 100 mil habitantes) para sífilis adquirida, 3,5% para sífilis em gestantes e 2,4% para sífilis congênita, isso para cada 1 mil nascidos vivos.…”