Trends of syphilis in Brazil: A growth portrait of the treponemic epidemic

Abstract

Syphilis is a chronic infectious disease with its prevalence being described since the 15 th century. Although its etiological agent and also the treatment measures are widely known, syphilis is still a great public health problem worldwide, mainly in countries with limited resources associated to low investments in health primary care. The aim of the present study was to analyze the trend and regional distribution of syphilis in Brazil between 2007 and 2017. This is an ecological study using secondary data from the Brazilian notification system. The Ministry of Health selected 100 municipalities which presented the worse outcomes related to syphilis from the 5,570 Brazilian municipalities as a target for a comprehensive project in order to tackle the prevalence of syphilis, called the "No Syphilis Project". These priority municipalities represent 57.7% of syphilis cases and about one third of the Brazilian population. They were compared with other 189 non-priority municipalities with more than 100 thousand inhabitants among the Brazilian regions (North, Northeast, Southeast, South and Center-West). Polynomial regression methods and Joinpoint analyses were used to analyze the trend, from which the Annual Average Percent Change (AACP) for each time period was calculated. There was a significant growth trend in all regions for the main three forms of syphilis (in pregnancy, congenital and acquired), especially in the South. The ratio between syphilis in pregnancy and congenital syphilis increased in both priority (AAPC: 8.54%; p<0.001) and non-priority municipalities (AAPC: 2.61%; p = 0.005), as well as in the regions, except the Center-West. High growth trends in syphilis prevalence were found in all municipalities, as well as all five regions between 2007 and 2017, showing that the challenge to reduce or even eliminate syphilis in Brazil is still difficult.

Oral manifestations of syphilis: an epidemiological study in southern Brazil

“…Considering the significant growth of syphilis cases in recent years, 14,15 this epidemiological survey was important to trace the profile of patients affected by the disease and the clinical characteristics of oral lesions in the population studied. It is extremely important that dentists and other health professionals recognize the signs and symptoms of patients with mouth lesions of syphilis, which allows early diagnosis and treatment, minimizing the risks of transmission and complications resulting from this infectious disease.…”

“…According to the Brazilian Ministry of Health, an increase in registered syphilis cases has been observed in recent years. In 2017, 119 800 cases of acquired syphilis were notified, meaning a rate of 58.1 cases per 100 thousand inhabitants 15 . Syphilis can be identified through its frequent and distinct oral manifestations and, often, the dentist is the first professional that the patient seeks for the correct diagnosis.…”

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

“…Foi possível observar que em alguns estudos não foram identificados dados de localidade em que foi feita a pesquisa e nem o intervalo de tempo analisado. Segundo a análise dos dados incluídos neste estudo, no tocante ao Brasil, observou-se, na última década, um significativo aumento de sífilis gestacional e congênita em todas as regiões brasileiras (Norte, Nordeste, Sudeste, Sul e Centro-Oeste); sendo a região Sudeste a que apresentou maior incidência 3,16 .…”

Spatial analysis, temporal trend, and local risk of congenital syphilis new cases in Sergipe, Brazil

“…Meanwhile, congenital syphilis had increased from a rate of 2.00 / 1,000 live births in 2007 to 8.8 2017 (gross growth rate of 338%). Numbers considered too high for national parameters [30].…”