Congenital syphilis: epidemiological analysis and sentinel event of the quality of care for the mother/newborn binomium
Keywords:congenital syphilis, vertical transmission of infectious disease, epidemiological monitoring, health assessment
Introduction: congenital syphilis remains a serious public health problem in Brazil and worldwide, being fetal and antenatal infections the main causes of global morbidity and mortality.
Objective: to analyze the cases of congenital syphilis and an outcome indicator of the quality of care for the mother/newborn binomial in Vitória (ES), in the 2016-2019 quadrennium.
Methods: study with a quantitative approach, which evaluated the indicator “congenital syphilis follow-up”. Data were collected in the Notifiable Diseases Information System (SINAN), for the period from January 1, 2016 to December 31, 2019. The information regarding the follow-up of NB occurred by searching an electronic medical record, from August 1, 2020 to March 31, 2021.
Results: in the 2016-2019 quadrennium, the municipality of Vitória had 169 cases of congenital syphilis, according to the year of diagnosis criterion. This indicator decreased over the quadrennium: 64 cases in 2016 (37.9%), 43 in 2017 (25.4%), 37 in 2018 (21.9%) and 25 in 2019 (14.8 %). The nontreponemal test was reactive in 62.7% of cases. In 10.7% there were alterations in the laboratory analysis of the CSF; 3%, alteration in the examination of long bones; 5.3%, non-treponemal CSF reagent test, and 11.8% were symptomatic at birth. The congenital syphilis incidence rate, which was 14.65/1000 live births in 2016, reached 5.58/1000 live births in 2019. The follow-up indicator for congenital syphilis cases that were born alive was 69.8 % in 2016, 79.5% in 2017, 84.4% in 2018 and 85.7% in 2019.
Conclusion: there was a significant reduction in the number of cases of congenital syphilis, in the incidence rate of the disease and progressive improvement in the follow-up of congenital syphilis, having, as a guideline, the Plan to Eliminate Syphilis.
Pan American Health Organization (PAHO). World Health Organization releases estimates about congenital syphilis. [quoted in 2019 Oct. 05]. Brasilia; 2019. Available on: https://www.paho.org/bra/index.php?option=com_content&view=article&id=5879:organizacao-mundial-da-saude-publica-novas-estimativas-sobre-sifilis-congenita&Itemid=812.
Arora N, Sadovsky Y, Dermody TS, Coyne CB. Microbial Vertical Transmission during Human Pregnancy. Cell Host Microbe. 2017 May 10;21(5):561-567. doi: 10.1016/j.chom.2017.04.007.
Brazil. Ministry of Health. Department of Health Surveillance. Department of Chronic Condition Diseases and Sexually Transmitted Infections. Clinical protocol and therapeutic guidelines for comprehensive care for people with sexually transmitted infections (IST). Brasilia: Ministry of Health; 2019.
Pan American Health Organization (PAHO). Plan of prevention and control of HIV and sexually transmitted infections 2016-2021. In 55th Directing Council, 68th Session of the Regional Committee of WHO for the Americas. Washington, D.C.: PAHO; 2016 [quoted on 2020 Jul. 05]. Available on: https://www. paho.org/hq/dmdocuments/ 2016/CD55-14-e.pdf
Pan American Health Organization (PAHO). Elimination of mother-to-child transmission of HIV and syphilis in the Americas. Update 2016. Washington, (D.C.): PAHO; 2017.
Brazil. Ministry of Health. Department of Health Surveillance. Department of Surveillance, Prevention and Control of Sexually Transmitted Infections, HIV/SIDA and Viral Hepatitis (DIAHV). Epidemiologic Bulletin for Syphilis, v. 49, no. 45. Brasilia: Ministry of Health, 2019. Brazil.
Dalfior ET, Lima RCD, Andrade MAC. Reflections on health policy implementation analysis. Saúde em Debate, 2015;39(104):210-25. https://dx.doi.org/10.1590/0103-110420151040201.
Vitoria (ES). City Hall. Municipal Department of Health. Plan of Elimination “Vitoria Against Syphilis”. Vitoria; 2016.
Tanaka OY, Tamaki EM. The role of evaluation for decision-making in the management of health services. Ciênc. saúde coletiva. 2012 Apr;17(4): 821-828. http://dx.doi.org/10.1590/S1413-81232012000400002.
Tanaka OY, Melo C. Reflections on evaluation in health services and the adoption of qualitative and quantitative approaches. In: Bosi MLM, Mercado FJ, organizers. Qualitative Research of Health Services. Petropolis: Vozes; 2004. p. 121-136.
Tanaka OY. Evaluation of primary health care: a new proposal. Saúde soc. 2011; 20(4): 927-934. http://dx.doi.org/10.1590/S0104-12902011000400010.
Tanaka OY. Evaluation of adolescent health programs: a way of doing it. Sao Paulo: Ed. University of Sao Paulo; 2004.
Cardoso ARP, Araújo MAL, Cavalcante MS, Frota MA, Melo SP. Analysis of cases of gestational and congenital syphilis from 2008 to 2010 in Fortaleza, Ceara, Brazil. Ciênc. saúde coletiva. 2018 Feb; 23(2): 563-574. https://doi.org/10.1590/1413-81232018232.01772016.
Vitoria (ES). Vitoria Municipal Department of Health (SEMUS), Espirito Santo. Welfare Chain Computerized Management System (SGIRBE). [quoted in 2020 June 24]. Vitoria (ES): SEMUS; 2013. Available on: https://m.vitoria.es.gov.br/noticia/rede-bem-estar-integracao-na-rede-de-saude-e-reducao-de-custos-16836.
Brazil. Ministry of Health. Department of Health Surveillance. General Coordination of Epidemiology in Services Development. Health Surveillance Guide. Brasilia: Ministry of Health; 2016.
Brazil. Ministry of Health. Department of Health Surveillance. Department of Surveillance, Prevention and Control of Sexually Transmitted Infections, of HIV/SIDA and Viral Hepatitis (DIAHV). Information note. (2– SEI/2017); 2017.
Madrid L, Varo R, Sitoe A, Bassat Q. Congenital and perinatally-acquired infections in resource-constrained settings. Expert Rev Anti Infect Ther. 2016 Sep;14(9):845-61. doi: 10.1080/14787210.2016.1215913.
Araújo MAL., Esteves ABB, Rocha AF, Silva Junior GBS, Miranda AE. Factors associated with prematurity in reported cases of congenital syphilis. Saúde Pública [online magazine]. 2021 May; 55 [Acessed on 2021 Jun 17th]:28. Available on: <https://doi.org/10.11606/s1518-8787.2021055002400>. Epub 2021 May 17. ISSN 1518-8787. https://doi.org/10.11606/s1518-8787.2021055002400.
The Lancet. Congenital syphilis in the USA. Lancet. 2018 Oct 6;392(10154):1168. doi: 10.1016/S0140-6736(18)32360-2.
Veiga, Marília Vilela Alencastro e Loyola, Valeska Maria Zanello de. Choosing is Being Chosen: Childhood, Poverty and Child Marriage in Brazil* * Work derived from the first author’s master’s thesis, supervised by the second. Psychology: Theory and Research [online]. 2020, 36 (spe) [Accessed on 2021 August 28th]:e36nspe18. Available on: <https://doi.org/10.1590/0102.3772e36nspe18>. Epub 02 Dec 2020. ISSN 1806-3446. https://doi.org/10.1590/0102.3772e36nspe18.
Slutsker JS, Hennessy RR, Schillinger JA. Factors Contributing to Congenital Syphilis Cases - New York City, 2010-2016. MMWR Morb Mortal Wkly Rep. 2018 Oct 5;67(39):1088-1093. doi: 10.15585/mmwr.mm6739a3.
Macêdo VC, Lira PIC, Frias PG, Romaguera LMD, Caires SFF, Ximenes RAA. Risk factors for syphilis in women: a case-control study. Saúde Pública Magazine, 2017;51:78. https://doi.org/10.11606/s1518-8787.2017051007066.
Cooper JM, Michelow IC, Wozniak PS, Sánchez PJ. In time: the persistence of congenital syphilis in Brazil - More advances are needed! Rev Paul Pediatr ; 2016;34(3): 251-3.
Figueiredo DCM, Figueiredo AM, S TKB, Tavares G, Vianna RPT. Relationship between the provision of diagnosis and treatment of syphilis in primary care on the incidence of gestational and congenital syphilis. Saúde Pública Magazine. 2020; 36(3): e00074519. http://dx.doi.org/10.1590/0102-311x00074519.
Vitoria (ES). The City Hall. Municipal Department of Health. Department of Health Care Department of Health Surveillance. Joint Technical Note.no. 08/2019 SEMUS/GAS and SEMUS/GVS on 2019 December 2nd. Vitoria; 2019.
Werneck J. Institutional racism and the health of the black population. Saúde e Sociedade [online magazine]. 2016 25(3) [Accessed on 2021 July 2nd]:535-549. Available on: <https://doi.org/10.1590/S0104-129020162610>. ISSN 1984-0470. https://doi.org/10.1590/S0104-129020162610
Cardoso AR, Araújo MA, Andrade RF, Saraceni V, Miranda AE, Dourado MI. Underreporting of Congenital Syphilis as a Cause of Fetal and Infant Deaths in Northeastern Brazil. PLoS One. 2016 Dec 12;11(12):e0167255. doi: 10.1371/journal.pone.0167255.
Ghanem KG, Ram S, Rice PA. The Modern Epidemic of Syphilis. N Engl J Med. 2020 Feb 27;382(9):845-854. doi: 10.1056/NEJMra1901593.
Amsalu A, Ferede G, Assegu D. High seroprevalence of syphilis infection among pregnant women in Yiregalem hospital southern Ethiopia. BMC Infect Dis. 2018 Mar 6;18(1):109. doi: 10.1186/s12879-018-2998-8.
Kismödi E, Kiragu K, Sawicki O, Smith S, Brion S, Sharma A, Mworeko L, Iovita A. Where Public Health Meets Human Rights: Integrating Human Rights into the Validation of the Elimination of Mother-to-Child Transmission of HIV and Syphilis. Health Hum Rights. 2017 Dec;19(2):237-247.
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