The magnitude of syphilis: from prevalence to vertical transmission

Authors

  • Luciane Rodrigues Pedreira de Cerqueira Universidade do Estado do Rio de Janeiro; Hospital Universitário Pedro Ernesto, Núcleo Perinatal
  • Denise L. M. Monteiro Centro Universitário Serra dos Órgãos
  • Stella R. Taquette Universidade do Estado do Rio de Janeiro; Faculdade de Ciências Médicas
  • Nádia C. P. Rodrigues Escola Nacional de Saúde Pública Sergio Arouca
  • Alexandre J. B. Trajano Universidade do Grande Rio
  • Flavio Monteiro de Souza Universidade do Estado do Rio de Janeiro; Faculdade de Ciências Médicas
  • Bianca De Melo Araújo Universidade do Estado do Rio de Janeiro; Faculdade de Ciências Médicas

Keywords:

Syphilis, Gestation, Congenital syphilis, Prevalence, VDRL, Treponemal tests, Treponema pallidum

Abstract

Introduction: In 2013, the World Health Organization (WHO) reported that 1.9 million pregnant women were infected with syphilis worldwide, of which 66.5% had adverse fetal effects in cases of untreated syphilis. Congenital syphilis contributes significantly to infant mortality, accounting for 305,000 perinatal deaths worldwide annually. Aim: To estimate the prevalence of syphilis in parturients, the incidence of congenital syphilis and the vertical transmission rate. Material and methods: a cross-sectional study with data collected from 2041 parturients who had undergone treatment between 2012 and 2014 in the maternity section of the Pedro Ernesto Hospital of the State University of Rio de Janeiro, in the metropolitan area of Rio de Janeiro. The inclusion criterion was positive VDRL and treponemal test in a hospital environment. Results: the prevalence of syphilis in pregnant women was 4.1% in 2012, 3.1% in 2013 and 5% in 2014, with official reporting of 15.6%, 25.0% and 48.1%, respectively. The incidence of congenital syphilis (CS) was 22/1,000 in live births (LB) in 2012; 17/1,000 LB in 2013 and 44.8/1,000 LB in 2014. CS underreporting during the period was 6.7%. Vertical transmission occurred in 65.8% of infants from infected mothers. It was concluded that, in 34.6% of the CS cases, maternal VDRL titers were = 1/4. Conclusion: Results demonstrate the magnitude of the disease, fragility of the reporting system in the assessment of the actual prevalence, impact on perinatal outcomes, and they are a warning about the real situation of syphilis, which is still underestimated in the State.

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Published

2017-01-01

Issue

Section

Original Articles

How to Cite

The magnitude of syphilis: from prevalence to vertical transmission. (2017). Revista Do Instituto De Medicina Tropical De São Paulo, 59, e78. https://www.revistas.usp.br/rimtsp/article/view/143751