Syphilis notifications among pregnant women in Campo Grande, state of Mato Grosso do Sul, Brazil, 2011 to 2017

Abstract

Introduction: Syphilis is a sexually transmitted infection caused by Treponema pallidum. Considering the high rates of syphilis in pregnancy and congenital syphilis reported in Brazil in the past, and their serious consequences, this study described the epidemiological and clinical profile of pregnant women with a confirmed diagnosis of syphilis in Campo Grande, in the state of Mato Grosso do Sul, Brazil, from 2011 to 2017. Methods: This is a descriptive study, based on syphilis notifications among pregnant women reported to the Sistema de Informação de Agravos de Notificação (National System of Disease Notification of Brazil). Results: Over the study period, 2,056 confirmed cases of syphilis in pregnancy were reported, resulting in a crude cumulative incidence of 144.76 cases per 1,000 liveborn babies. The incidence increased from 9.97 cases per 1,000 live-born babies in 2011 to 36.10 cases per 1,000 live-born babies in 2017. It was more prevalent in women who were young, of mixed race, with low educational attainment. Over one third of women were diagnosed in the first trimester of pregnancy; therefore, they were at risk of reinfection if they or their sexual partners were inadequately treated. Furthermore, syphilis was not well classified according to its clinical stage, which led to inappropriate treatments. Conclusions: Despite efforts to reduce the incidence of syphilis, syphilis during pregnancy remains a public health problem, reflecting possible inadequacies in antenatal care, especially in vulnerable populations. It is important to include sexual partners in syphilis treatment during pregnancy to prevent reinfection.

Fatores associados à transmissão vertical de sífilis em um município do Estado de São Paulo

“…In this study, sociodemographic variables (age group, education, and skin color) were not statistically associated with the occurrence of CS. Even so, the predominant age group was similar to that found in other Brazilian studies; [13][14][15] this may reflect vulnerability related to "age and emotional immaturity" (especially with 20-24 years old), influence of social groups, early onset of sexual life, and not using condoms during sexual intercourse. 16 As for education, the lack of association with the outcome may be a consequence of the number of forms without information (or with ignored information), as well as the sample size.…”

“…19,23,24 In the present study, 38.8% of the notification forms had the clinical classification field "no information or ignored" (data not shown). This lack of information on the clinical classification was also evidenced in the literature, 13,19,21,22 showing the importance of adequate classification and correct completion of the notification forms, thus contributing not only to the treatment definition but also to research and follow-up of reported cases.…”

“…A high proportion of untreated partners was observed; although the above association was not statistically significant, the adoption of strategies in health services to welcome and monitor partners during the prenatal period is fundamental. Some studies 13,19,20 observed considerable percentages (41, 61, and 83%, respectively) of untreated partners. Although the percentage found in the present study was lower than that found in the literature, our data reinforce that the treatment of sexual partners is an important obstacle to the reduction of CS cases, as there is a risk of reinfection in those who were not treated (or treated inappropriately) even with early diagnosis and treatment of pregnant women.…”

Sífilis Congênita No Brasil: Panorama Atualizado Da Incidência E Fatores De Influência

“…Este último ponto ressalta a importância dos métodos educacionais e campanhas de esclarecimento à população geral acerca da prevenção da contaminação e infecção. Muito embora se acreditava que tais métodos preventivos sejam bem conhecidos, a falha na aplicabilidade e o aumento de casos de sífilis em gestante alertam para possíveis falhas nesta etapa 15,18,19 .…”

“…A sífilis gestacional afeta cerca de 1,5 milhão de gestantes por ano em todo o mundo 4,10 . No Brasil, segundo os dados fornecidos pelo Boletim Epidemiológico da Sífilis (2020), em 2019, houve 61.127 casos de sífilis em gestantes (taxa de detecção de 20,8/1.000 nascidos vivos), 24.130 casos de sífilis congênita (taxa de incidência de 8,2/1.000 nascidos vivos) e 173 óbitos por sífilis congênita (taxa de mortalidade de 5,9/100.000 nascidos vivos) 6 . Ademais, conforme os Indicadores de Sífilis do Departamento Doenças de…”