Risk factors for syphilis in women: case-control study

Abstract

OBJECTIVE To determine the sociodemographic, behavioral, and health care factors related to the occurrence of syphilis in women treated at public maternity hospitals.METHODS This is a case-control study (239 cases and 322 controls) with women admitted to seven maternity hospitals in the municipality of Recife, Brazil, from July 2013 to July 2014. Eligible women were recruited after the result of the VDRL (Venereal Disease Research Laboratory) under any titration. The selection of cases and controls was based on the result of the serology for syphilis using ELISA (enzyme-linked immunosorbent assay). The independent variables were grouped into: sociodemographic, behavioral, clinical and obstetric history, and health care in prenatal care and maternity hospital. Information was obtained by interview, during hospitalization, with the application of a questionnaire. Odds ratios and 95% confidence intervals were estimated using logistic regression to identify the predicting factors of the variable to be explained.RESULTS The logistic regression analysis identified as determinant factors for gestational syphilis: education level of incomplete basic education or illiterate (OR = 2.02), lack of access to telephone (OR = 2.4), catholic religion (OR = 1.70 ), four or more pregnancies (OR = 2.2), three or more sexual partners in the last year (OR = 3.1), use of illicit drugs before the age of 18 (OR = 3.0), and use of illicit drugs by the current partner (OR = 1.7). Only one to three prenatal appointments (OR = 3.5) and a previous history of sexually transmitted infection (OR = 9.7) were also identified as determinant factors.CONCLUSIONS Sociodemographic, behavioral, and health care factors are associated with the occurrence of syphilis in women and should be taken into account in the elaboration of universal strategies aimed at the prevention and control of syphilis, but with a focus on situations of greater vulnerability.

Determinantes sociais da saúde de gestantes acompanhadas no pré-natal de alto risco

“…Ademais, sugere-se que quanto maior o número de filhos, maior a chance de preocupações financeiras e desgaste físico, o que implica em uma pior qualidade de vida. O elevado número de gestações apresenta associação com a ocorrência de sífilis gestacional, ratificando a necessidade de fortalecer as estratégias de planejamento reprodutivo (14) , no intuito de melhorar as condições de saúde dessa população.…”

Syphilis in women coming out of the prison system: prevalence and associated factors

“…Studies indicate that the level of schooling is a powerful predictor of a risk factor for Sexually Transmitted Infections. People with more schooling tend to assimilate information better, adopt prevention and health promotion actions, besides having greater access to health services and to purchase of condoms (5,13) .…”

“…The data were entered and stored in a Microsoft Office Excel 2003 spreadsheet and later analyzed through descriptive statistics (measures of central tendency and dispersion, relative and absolute frequency), bivariate analysis and prevalence. The Pearson's Chi-square test (χ2) was used to test the association between the dependent variable (serological condition for syphilis) and the independent variables (sociodemographic, sexual practices and use of illicit drugs) and the Fisher's exact test was used in the cases in which the expected frequency was less than 5 , which was necessary for most variables. The significance level adopted was p<0.05.…”

“…Studies show a higher occurrence of infection among individuals exposed to risk situations such multiplicity of partners, unprotected sex, and use of injectable drugs (2)(3) . Other factors can still be highlighted, such as poor access to health services, low levels of education, lack of information and barriers related to gender inequality and social stigmas (4)(5) .…”

Infant mortality: surveillance, epidemiological characteristics and spatial distribution pattern in Recife, Brazil

“…Post-neonatal whooping cough and external causes were highlighted in the postneonatal period. The whooping cough vaccine, in addition to integrating the basic immunization schedule of the child, was introduced in the pregnant woman schedule as an indirect prevention to the baby because it remains a cause of infant morbidity and mortality, even in municipalities with high vaccination coverage (Mançaneira, Benedetti, & Zhang, 2016).Unacceptable remains the situation of congenital syphilis in the municipality as an expression of the low effectiveness in the care for pregnant women, especially the most vulnerable women (Macêdo et al, 2017).…”