Prevalence of syphilis in pregnancy and prenatal syphilis testing in Brazil: Birth in Brazil study

Authors

  • Rosa Maria Soares Madeira Domingues Fundação Oswaldo Cruz; Instituto Nacional de Infectologia Evandro Chagas; Laboratório de Pesquisa Clínica em DST e Aids
  • Celia Landmann Szwarcwald Fundação Oswaldo Cruz; Instituto de Comunicação e Informação Científica e Tecnológica em Saúde
  • Paulo Roberto Borges Souza Junior Fundação Oswaldo Cruz; Instituto de Comunicação e Informação Científica e Tecnológica em Saúde
  • Maria do Carmo Leal Fundação Oswaldo Cruz; Escola Nacional de Saúde Pública Sérgio Arouca; Departamento de Epidemiologia e Métodos Quantitativos em Saúde

DOI:

https://doi.org/10.1590/S0034-8910.2014048005114

Abstract

OBJECTIVE Determine the coverage rate of syphilis testing during prenatal care and the prevalence of syphilis in pregnant women in Brazil. METHODS This is a national hospital-based cohort study conducted in Brazil with 23,894 postpartum women between 2011 and 2012. Data were obtained using interviews with postpartum women, hospital records, and prenatal care cards. All postpartum women with a reactive serological test result recorded in the prenatal care card or syphilis diagnosis during hospitalization for childbirth were considered cases of syphilis in pregnancy. The Chi-square test was used for determining the disease prevalence and testing coverage rate by region of residence, self-reported skin color, maternal age, and type of prenatal and child delivery care units. RESULTS Prenatal care covered 98.7% postpartum women. Syphilis testing coverage rate was 89.1% (one test) and 41.2% (two tests), and syphilis prevalence in pregnancy was 1.02% (95%CI 0.84;1.25). A lower prenatal coverage rate was observed among women in the North region, indigenous women, those with less education, and those who received prenatal care in public health care units. A lower testing coverage rate was observed among residents in the North, Northeast, and Midwest regions, among younger and non-white skin-color women, among those with lower education, and those who received prenatal care in public health care units. An increased prevalence of syphilis was observed among women with < 8 years of education (1.74%), who self-reported as black (1.8%) or mixed (1.2%), those who did not receive prenatal care (2.5%), and those attending public (1.37%) or mixed (0.93%) health care units. CONCLUSIONS The estimated prevalence of syphilis in pregnancy was similar to that reported in the last sentinel surveillance study conducted in 2006. There was an improvement in prenatal care and testing coverage rate, and the goals suggested by the World Health Organization were achieved in two regions. Regional and social inequalities in access to health care units, coupled with other gaps in health assistance, have led to the persistence of congenital syphilis as a major public health problem in Brazil.

Published

2014-10-01

How to Cite

Domingues, R. M. S. M., Szwarcwald, C. L., Souza Junior, P. R. B., & Leal, M. do C. (2014). Prevalence of syphilis in pregnancy and prenatal syphilis testing in Brazil: Birth in Brazil study . Revista De Saúde Pública, 48(5), 766-774. https://doi.org/10.1590/S0034-8910.2014048005114

Issue

Section

Original Articles