Diagnosis, treatment, and notification of syphilis during pregnancy in the state of Goiás, Brazil, between 2007 and 2017

Authors

DOI:

https://doi.org/10.11606/s1518-8787.2021055003122

Keywords:

Pregnant women, Syphilis, pharmacologic treatment, Serodiagnosis of Syphilis, trends, Disease Notification, Health care Quality, Access, and Evaluation, Maternal and Infant Health care

Abstract

OBJECTIVE To analyze the evolution of syphilis during pregnancy notification regarding clinical classification, diagnosis and treatment in the state of Goiás, Brazil, between 2007 and 2017. METHODS This is a time-series study, analyzing data provided by the Health Secretariat of the state of Goiás. The variables related to the diagnosis and treatment of pregnant women and their partners were analyzed, and their evolution trend during the years. Descriptive statistics and percentage calculation were used. Cochran-Armitage test with a significance level α = 0.05 was used to determine increase and decrease trends. RESULTS During the period, 7,774 cases were notified. The highest percentage of notifications occurred in the second trimester of pregnancy (39.8%) and corresponded to primary syphilis (34.1%). The most frequent treatment prescribed was benzathine benzylpenicillin with a dosage of 7.2 million (43.8%). Between 2007 and 2017, there was an increasing trend in the notification percentage of latent (14.1% to 30.7%), secondary (5.2% to 19%), and tertiary syphilis (4.4% to 11.4%). The treatment with benzathine benzylpenicillin with a dosage of 7.2 million also increased (19.3% to 59.6%). The percentages of primary syphilis decreased (43.4% to 22.1%), as well as other treatments’ percentages. CONCLUSIONS Latent syphilis notification of pregnant women and treatment with penicillin at the dosage of 7,200,000 IU increased. Notification forms’ data completeness also increased for the variables clinical classification and treatment, suggesting improvements in the notification process.

References

Rowley J, Vander Hoorn S, Korenromp E, Low N, Unemo M, Abu-Raddad LJ, et al. Chlamydia, gonorrhoea, trichomoniasis and syphilis: global prevalence and incidence estimates. Bull World Health Organ. 2019;97(8):548-62. https://doi.org/10.2471/BLT.18.228486 [ Links ]

Gomez GB, Kamb ML, Newman LM, Mark J, Broutet N, Hawkes SJ. Untreated maternal syphilis and adverse outcomes of pregnancy: a systematic review and meta-analysis. Bull World Health Organ. 2013;91(3):217-26. https://doi.org/10.2471/BLT.12.107623 [ Links ]

Qin J, Yang T, Xiao S, Tan H, Feng T, Fu H. Reported estimates of adverse pregnancy outcomes among women with and without syphilis: a systematic review and meta-analysis. PLoS One. 2014;9(7):e102203. https://doi.org/10.1371/journal.pone.0102203 [ Links ]

Kidd S, Bowen VB, Torrone EA, Bolan G. Use of National Syphilis Surveillance Data to develop a congenital syphilis prevention cascade and estimate the number of potential congenital syphilis cases averted. Sex Transm Dis. 2018;45(9S Suppl 1)):S23-8. https://doi.org/10.1097/OLQ.0000000000000838 [ Links ]

Ministério da Saúde (BR). Procolo clínico e diretrizes terapêuticas para prevenção da transmissão vertical de HIV, sífilis e hepatites virais. Brasília, DF; 2019 [cited 2020 Jan 10]. Available from: http://www.aids.gov.br/pt-br/pub/2015/protocolo-clinico-e-diretrizes-terapeuticas-para-prevencao-da-transmissao-vertical-de-hiv [ Links ]

Lafetá KRG, Martelli Júnior H, Silveira MF, Paranaiba LMR. Sífilis materna e congênita, subnotificação e difícil controle. Rev Bras Epidemiol. 2016;19(1):63-74. https://doi.org/10.1590/1980-5497201600010006 [ Links ]

Padovani C, Oliveira RR, Pelloso SM. Syphilis in during pregnancy: association of maternal and perinatal characteristics in a region of southern Brazil. Rev Latino Am Enfermagem. 2018;26:e3019. https://doi.org/10.1590/1518-8345.2305.3019 [ Links ]

Federação Brasileira de Ginecologia e Obstetrícia. Sífilis na gravidez. São Paulo: Febrasgo; 2018 [cited 2020 Jan 10]. Available from: https://www.febrasgo.org.br/pt/noticias/item/700-sifilis-na-gravidez [ Links ]

Saraceni V, Pereira GFM, Silveira MF, Araujo MAL, Miranda AE. Vigilância epidemiológica da transmissão vertical da sífilis: dados de seis unidades federativas no Brasil. Rev Panam Salud Publica. 2017;41:e44. https://doi.org/10.26633/RPSP.2017.44 [ Links ]

Amâncio VC, Graciano AR, Cozer AM, Assis LPF, Dias DCS. Epidemiologia da sífilis congênita no estado de Goiás. Rev Educ Saude. 2016 [cited 2020 Jan 10];4(2):58-63. Available from: http://periodicos.unievangelica.edu.br/index.php/educacaoemsaude/article/view/2017/1799 [ Links ]

Ministério da Saúde (BR). Portaria Nº 542 de 22 dezembro de 1986. Dispõe sobre a inclusão da Síndrome da Imunodeficiência Adquirida – SIDA/AIDS e da Sífilis Congênita como agravos de notificação compulsória. Brasília, DF; 1986 [cited 2020 Jan 10]. Available from: https://pesquisa.bvsalud.org/ses/resource/pt/crt-3619 [ Links ]

Boletim Epidemiológico de Sífilis 2017. Brasília, DF: Ministério da Saúde; 2017 [cited 2020 Jan 10]. Available from: http://www.aids.gov.br/pt-br/pub/2017/boletim-epidemiologico-de-sifilis-2017 [ Links ]

Ministério da Saúde (BR), Secretaria de Vigilância em Saúde. Portaria Nº 33 de 14 de julho de 2005. Inclui doenças à relação de notificação compulsória, define agravos de notificação imediata e a relação dos resultados laboratoriais que devem ser notificados pelos Laboratórios de Referência Nacional ou Regional. Brasília, DF; 2005 [cited 2020 Jan 5]. Available from: https://bvsms.saude.gov.br/bvs/saudelegis/svs/2005/prt0033_14_07_2005.html#:~:text=Inclui%20doen%C3%A7as%20%C3%A0%20rela%C3%A7%C3%A3o%20de,de%20Refer%C3%AAncia%20Nacional%20ou%20Regional [ Links ]

Cavalcante PAM, Pereira RBL, Castro JGD. Sífilis gestacional e congênita em Palmas, Tocantins, 2007-2014. Epidemiol Serv Saude. 2017;26(2):255-64. https://doi.org/10.5123/s1679-49742017000200003 [ Links ]

Souza BSO, Rodrigues RM, Gomes RML. Análise epidemiológica de casos notificados de sífilis. Rev Soc Bras Clin Med. 2018 [9 fev 2020];16(2):94-8. Available from: http://docs.bvsalud.org/biblioref/2018/09/913366/16294-98.pdf [ Links ]

Marques JVS, Alves BM, Marques MVS, Arcanjo FPN, Parente CC, Vasconcelos RL. Perfil epidemiológico da sífilis gestacional: clínica e evolução de 2012 a 2017. SANARE. 2018;17(2):13-20. https://doi.org/10.36925/sanare.v17i2.1257 [ Links ]

Cabello A, Górgolas M. Syphilis. Status of a current epidemic. Med Clin (Barc). 2017;149(12):540-1. https://doi.org/10.1016/j.medcli.2017.07.008 [ Links ]

Magalhães M, Basto L, Areia AL, Franco S, Malheiro ME, Afonso ME, et al. Sífilis na gravidez e sífilis congênita: realidade de um hospital universitário central português. Rev Bras Ginecol Obstet. 2017;39(6):265-72. https://doi.org/10.1055/s-0037-1603646 [ Links ]

Stafford IA, Berra A, Minard CG, Kopkin RH, Rodrigue E, Roitsch CM, et al. Challenges in the contemporary management of syphilis among pregnant women in New Orleans, LA. Infect Dis Obstet Gynecol. 2019;2019:2613962. https://doi.org/10.1155/2019/2613962 [ Links ]

Torres RG, Mendonça ALN, Montes GC, Manzan JJ, Ribeiro JU, Paschoini MC. Sífilis na gestação: a realidade em um hospital público. Rev Bras Ginecol Obstet. 2019;41(2):90-6. https://doi.org/10.1055/s-0038-1676569 [ Links ]

Comissão Nacional de Incorporação de Tecnologia do SUS. Penicilina benzatina para prevenção da sífilis congênita durante a gravidez. Brasília, DF: Ministério da Saúde; 2015 [cited 2020 Feb 8]. (Relatório de Recomendação; nº 150). Available from: http://conitec.gov.br/images/Consultas/Relatorios/2015/Relatorio_Penicilina_SifilisCongenita_CP.pdf [ Links ]

Pan American Health Organization. Elimination of mother-to-child transmission of HIV and syphilis in the Americas. Update 2016. Washington, DC: PAHO; 2017 [cited 2020 Feb 9]. Available from: https://iris.paho.org/bitstream/handle/10665.2/34072/9789275119556-eng.pdf [ Links ]

Cardoso ARP, Araújo MAL, Cavalcante MS, Frota MA, Melo SP. Análise dos casos de sífilis gestacional e congênita nos anos de 2008 a 2010 em Fortaleza, Ceará, Brasil. Cienc Saude Coletiva. 2018;23(2):563-74. https://doi.org/10.1590/1413-81232018232.01772016 [ Links ]

Dou L, Wang X, Wang F, Wang Q, Qiao Y, Su M, et al. Epidemic profile of maternal syphilis in China in 2013. Biomed Res Int. 2016;2016:9194805. https://doi.org/10.1155/2016/9194805 [ Links ]

Nonato SM, Melo APS, Guimarães MDC. Sífilis na gestação e fatores associados à sífilis congênita em Belo Horizonte-MG, 2010-2013. Epidemiol Serv Saude. 2015;24(4):681-94. https://doi.org/10.5123/S1679-49742015000400010 [ Links ]

Tiago ZS, Picoli RP, Graeff SVB, Cunha RV, Arantes R. Subnotificação de sífilis em gestantes, congênita e adquirida entre povos indígenas em Mato Grosso do Sul, 2011-2014. Epidemiol Serv Saude. 2017;26(3):503-12. https://doi.org/10.5123/s1679-49742017000300008 [ Links ]

Published

2021-10-29

Issue

Section

Original Articles

How to Cite

Oliveira, I. M. de ., Oliveira, R. P. B., & Alves, R. R. F. (2021). Diagnosis, treatment, and notification of syphilis during pregnancy in the state of Goiás, Brazil, between 2007 and 2017. Revista De Saúde Pública, 55, 68. https://doi.org/10.11606/s1518-8787.2021055003122