Spatial scenery of congenital syphilis in Brazil between 2007 and 2018: an ecological study

Abstract

ObjectiveTo analysis the epidemiological scenery of the congenital syphilis (CS) in Brazil employing spatial analysis techniques.DesignEcological study.SettingsThis study was conducted in BrazilSampleA total of 151 601 CS cases notified to the Diseases and Notification Information System from 2007 to 2018 from children aged 0–23 months and born from mothers living in Brazil were included in this study.Primary outcome measuresThe CS incidence rates were calculated by triad (2007–2010, 2011–2014 and 2015–2018) for all Brazilian municipalities following the Boxcox transformation to remove the discrepant values. The transformed rates were analysed through the spatial autocorrelation of Moran, Kernel density estimative and spatial scan.ResultsFrom 2007 to 2018, the CS incidence rates increased in all Brazilian regions. The CS spread towards the interior of Brazil, and a higher expansion was noticed between 2015 and 2018. The municipalities that were greatly affected by the CS were those having a high migration of people, such as the ones bordering other countries and the touristic cities. Recife, Campo Grande, Rio de Janeiro, Porto Alegre and Manaus were the capitals with the greatest spatial and spatiotemporal risk.ConclusionThis study provides assistance to health authorities to fight CS in Brazil. More investment is necessary in prenatal care quality focusing on pregnant women and their partners to guarantee their full access to preventive resources against sexually transmitted infections.

The Use of Spatial Analysis in Syphilis-Related Research: Protocol for a Scoping Review

“…Previous research has used spatial analysis to map disease distribution (eg, for multiple sclerosis [ 7 ], HIV [ 8 ], and COVID-19 [ 9 ]), and spatial analysis could also guide health strategies against syphilis [ 10 ], which has a high incidence and represents a problem for public health worldwide, especially in Latin America, Africa, and Asia [ 11 , 12 ].…”

“…A previous study used spatial analysis to assess the epidemiological status of congenital syphilis in Brazil and found that the most affected municipalities were those with a large migratory flow, those bordering other countries, and those with many tourists [ 10 ]. Clusters of congenital syphilis were even identified in municipalities with prenatal care [ 14 ].…”

“…New strategies are needed to reduce syphilis transmission, such as spatial analysis, which has previously been applied in syphilis-related research [ 10 , 14 , 15 , 19 ]. However, due to a lack of studies, how and to what extent this tool is being used is unclear.…”

Prevalência E Associação De Sífilis Congênita Em Capital Do Nordeste Do Brasil

“…de SC por quadriênio para cada região brasileira, observa-se que na Região Nordeste, houve aumento na taxa de incidência nos estados do Rio Grande Norte e Ceará em todo período analisado, bem como nos munícipios do interior de Sergipe, Piauí, Alagoas e Bahia. 9 Diante dessa elevada prevalência, é notória a dificuldade de enfrentamento da sífilis gestacional no Brasil e no mundo. A baixa adesão ao tratamento da gestante, a não adesão ao tratamento pelo parceiro e a vulnerabilidade social elavam o risco de transmissão vertical em cerca de 70% a 100% dos casos notificados.…”

Aspectos epidemiológicos e da dinâmica temporal da sífilis congênita na região do Médio Paraíba - RJ

“…É fato que o pré-natal é capaz de fazer o reconhecimento precoce da sífilis em gestantes e é um meio que viabiliza uma progressão mais favorável dos casos de SC (SOARES; AQUINO, 2021;e congênita continuam crescendo continuamente a cada ano, o que nos leva a concluir que "apesar do aumento das coberturas de pré-natal, ainda se observa uma baixa efetividade dessas ações para a prevenção da SC"(ARAÚJO et al, 2020, p. 479-486). Em outras palavras, apesar da grande cobertura do pré-natal em território nacional, a qualidade desse serviço no Brasil ainda é baixa(SEABRA et al, 2022).É necessário que esteja bem claro que a falha na assistência pré-natalseja por realização inadequada, tardia ou incompletairá interferir tanto na execução de um diagnóstico correto e precoce da sífilis, como em um tratamento conveniente e em tempo propício. Há forte associação entre casos de sífilis congênita e assistência pré-natal inadequada(VALENTIM et al, 2022; DOMINGUES et al, 2021).…”