Space–time risk cluster and time trends of congenital syphilis in Brazil: an ecological study

Abstract

Background Congenital syphilis (CS) is a problem of great concern for public health, especially in Brazil. The aim of this study was to analyse the time trends and the space–time dynamics of morbidity and mortality from CS in Brazil. Methods An ecological and time series study, which included all cases and deaths from CS recorded in a national Brazilian database from 2013 to 2019 was performed. Time trends in CS incidence and mortality were assessed using segmented linear regression. Univariate global and local Moran indices and space–time scan statistics were used in the space and space–time analyses. Results A total of 183 171 cases and 2401 deaths from CS were recorded in Brazil, with the highest number of cases being observed in the Southeast Region (n=82 612 [45.1%]). Only 21.1% of pregnant mothers with syphilis received adequate treatment. There was an upward trend in CS rates among mothers ages 20–29 y (average annual percent change [AAPC] 1.4 [95% confidence interval {CI} 1.0 to 1.7]) and with <8 y of schooling (AAPC 6.6 [95% CI 5.3 to 7.9]). The primary space–time cluster involved 338 municipalities in the Southeast Region (relative risk 3.06, p<0.001) and occurred between 2017 and 2019. Conclusions To reduce the trends in CS rates, it is necessary to develop actions to improve the quality of prenatal care and expand early diagnosis and adequate treatment of syphilis in pregnant women and their sexual partners, especially in groups with upward trends (mothers ages 20–29 y and <8 y of schooling) and living in higher-risk regions (Southeast, North and Northeast).

Exposure to Treponema pallidum Infection among Adolescent and Young Adult Women in Roraima, Amazon Region of Brazil

“…To evaluate the prevalence of syphilis among the study participants, a rapid immunochromatographic test was used as an initial screening method for the detection of anti-treponemal antibodies (Imuno-rapido Sífilis; Wama Diagnóstica) for the qualitative determination of antibodies (IgG and IgM) against Treponema pallidum [13].…”

Syphilis in pregnancy and congenital syphilis: women’s experiences from the perspective of symbolic interactionism

“…Although many studies have been developed with a focus on prenatal care and treatments for both syphilis during pregnancy and CS, the evidence is based on epidemiological data ( 1 - 4 , 21 - 23 ) . There is a gap in the literature about the symbolic representations and meanings involved in actions and practices of women before the child’s birth to avoid vertical transmission and, after birth, when following up the health of the child with CS.…”

Sífilis gestacional e congênita: experiência de mulheres na ótica do Interacionismo Simbólico

“…Embora existam muitas pesquisas com foco no pré-natal e nos tratamentos tanto da sífilis durante a gestação quanto da SC, as evidências concentram-se em dados epidemiológicos (1)(2)(3)(4)(21)(22)(23) . Há uma lacuna na literatura sobre as representações simbólicas e significados que perpassam as ações e as práticas das mulheres, anteriores ao nascimento da criança, para evitar a transmissão vertical e, posteriores a ele, no acompanhamento da saúde do filho com SC.…”