IncIdence of congenItal SyphIlIS In a MetropolItan regIon of rIo de JaneIro State: SocIal InequalItIeS

Abstract

Introduction: congenital syphilis remains a public health matter, with no perspective of reaching governmental reduction goals. There are few studies about social inequalities and its relation with this disease in Brazil. Objective: describe occurrence of congenital syphilis in a reference hospital in a Metropolitan Region of Rio de Janeiro State, according to socioeconomic and clinical-laboratorial variables as well. Methods: cross-sectional study, based on interviews, review of medical records and prenatal cards. Population: all women admitted to a maternity ward during a trimester in 2011. Maternal variables: age, schooling, skin color, income, prenatal visits. Fetus/neonate variables: birth weight, gestational age, clinical and laboratory outcomes. Incidence of congenital syphilis (Brazilian Ministry of Health criteria) was calculated for all live births and for each social and economical variable. Results: there were 666 eligible women, comprehending 576 deliveries -558 live births and 18 stillbirths. We identified 22 CS cases: 18 live births, three fetal deaths and 1 abortion. One of the neonates died in the third day of life. The incidence of CS was of 39.4/1,000 live births. Socioeconomic variableslow education, low income and black skin -were related to a greater incidence. Only 13 out of 22 cases were identified in prenatal care. Conclusion: our results pointed to social inequalities in the congenital syphilis incidence. As prenatal care is also related to socioeconomic variables, investments in quality of maternal assistance should be directed to more vulnerable women.

Desigualdades na tendência da sífilis congênita no município de Niterói, Brasil, 2007 a 2016

“…Sendo assim, a explicação para os resultados deste estudo pode ser o aumento de iniquidades sociais. As características das mulheres que foram diagnosticadas com SC foram semelhantes às relatadas em outros estudos no território brasileiro, principalmente a baixa escolaridade (2, 13, 21-26) e a cor da pele parda/preta (2,11,13,(21)(22)(23)(24). Vale ressaltar que a cidade tem um índice de Gini elevado, inferior apenas ao da capital do Rio de Janeiro (16), e uma cobertura da atenção primária elevada, superior a 70% na maior parte do período estudado (17).…”

“…Em Niterói, a incidência de SC e a velocidade de crescimento da incidência superaram as de um estudo nacional no Brasil, de 2003 a 2008 (13); e de outras localidades brasileiras, como Belo Horizonte, de 2001 a 2008 (23); Rio Grande do Sul, de 2001 a 2012 (12); Mato Grosso, de 2001 a 2011 (14); e outras cinco unidades federadas avaliadas de 2007 a 2012 (4). As tendências mais acentuadas se relacionaram a variáveis sociodemográficas já identificadas em outros estudos brasileiros (2,11,13,(21)(22)(23)(24)(25)(26), como cor da pele parda ou preta e baixa escolaridade. Até o momento, este é o único estudo que avaliou a tendência temporal por métodos de regressão, de acordo com características sociodemográficas e assistenciais, revelando que a SC está aumentando em grupos populacionais mais vulneráveis socialmente.…”

Syphilis in pregnancy, congenital syphilis, and factors associated with mother-to-child transmission in Itapeva, São Paulo, 2010 to 2014.

“…In this study, smoking during pregnancy, attending <6 prenatal visits, starting prenatal care after the 13 th week of pregnancy, and high VDRL antibody titers (>1:4) were independently associated with CS. Other Brazilian studies also found an association of CS with a low number of prenatal visits [5][6][11][12][13] . Low number of serological tests 6 and a lack of tests in the first trimester 6 were also associated with higher CS risk.…”

Prevalence of Gestational and Congenital Syphilis in Brazil in the Last 15 Years

“…Already Muricy and Pinto Junior [15] found an incidence of 2/1000 in a population of the Federal District. Figueiró-Filho et al and Fonseca et al [16,17] found some discrepancy in the incidence values of their studies, being 23.4/1000 in the first, in Campo Grande, and 39.4/1000 in the last, in Niterói. This incidence rate evolved with a tendency to fall over the years, as shown in the cited studies; however, it showed an increase in its last measurement, recorded by Domingues and Leal [13].…”