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BACKGROUND: Between 2014 and 2016, Brazil experienced a severe shortage in penicillin supply, resulting in a lack of treatment among some pregnant women and newborns with syphilis and the use of non-evidence-based regimens. This study evaluated all live births in Fortaleza reported with CS in 2015 in order to identify the different therapeutic regimens used in newborns during this period of penicillin shortage. METHODS: A retrospective cross-sectional study design was conducted using manually extracted data from medical chart review of maternal and infant cases delivered in 2015 from all public maternity hospitals in the city of Fortaleza. Data collection occurred from June 2017 to July 2018. RESULTS: A total of 575 congenital syphilis cases were reported to the municipality of Fortaleza during 2015 and 469 (81.5%) were analyzed. Of these, only 210 (44.8%) were treated with a nationally-recommended treatment. As alternative therapeutic options, ceftriaxone was used in 65 (13.8%), Cefazolin in 15 (3.2%) and the combination of more than one drug in 179 (38.2%). Newborns with serum VDRL titers ≥1:16 (p = 0.021), who had some clinical manifestation at birth (p = 0.003), who were born premature (p < 0.001), with low birth weight (p = 0.010), with jaundice indicative of the need for phototherapy (p = 0.019) and with hepatomegaly (p = 0.045) were more likely to be treated with penicillin according to national treatment guidelines compared to newborns treated with other regimens. CONCLUSION: During the period of shortage of penicillin in Fortaleza, less than half of the infants reported with CS were treated with a nationally-recommended regimen, the remaining received treatment with medications available in the hospital of birth including drugs that are not part of nationally or internationally-recommended treatment recommendations.
Subject(s)
Pregnancy Complications, Infectious , Syphilis, Congenital , Brazil/epidemiology , Cross-Sectional Studies , Female , Humans , Infant , Infant, Newborn , Penicillins/therapeutic use , Pregnancy , Pregnancy Complications, Infectious/drug therapy , Retrospective Studies , Syphilis, Congenital/drug therapy , Syphilis, Congenital/epidemiologyABSTRACT
BACKGROUND: Although there are public policies for eradicating congenital syphilis, they do not seem to be a routine in most health services. The objective of this study was to evaluate the management of sexual partners of pregnant women with syphilis in primary health care in northeastern Brazil. METHODS: This is a qualitative assessment carried out from February to October 2014 in the city of Fortaleza, Ceará, northeastern region of Brazil, through the observation of six primary health care centers and interviews with 21 professionals, six coordinators, nine women diagnosed with syphilis during antenatal care and four sexual partners. The data were submitted to thematic content analysis. RESULTS: Important flaws were identified at the primary health centers studied regarding the management of syphilis during pregnancy. Accessing testing and treatment is difficult, and there are no standardized strategies to notify the partner. The responsibility for notifying them is transferred to the women, and counseling does not offer proper guidance nor sufficient emotional support to help them. CONCLUSION: The management of pregnant women and their sexual partners in our region does not comply with global recommendations. Professional qualification, sensitization, and standardization of health professionals' conduct are necessary. Offering support to health professionals on their clinical practices by means of a supervision process may contribute to the adoption of the recommended guidelines and to the promotion of care based on privacy, respect, confidentiality of information, and awareness of the problems faced by women as a result of syphilis diagnosis.
Subject(s)
Pregnancy Complications, Infectious/prevention & control , Sexual Partners , Syphilis/prevention & control , Adolescent , Adult , Brazil , Contact Tracing , Delivery of Health Care/standards , Disease Eradication , Female , Health Knowledge, Attitudes, Practice , Health Personnel , Humans , Middle Aged , Pregnancy , Pregnant Women/psychology , Prenatal Care/standards , Qualitative Research , Syphilis, Congenital/prevention & control , Young AdultABSTRACT
OBJECTIVE: To analyze risk factors (maternal, obstetric and demographic) associated with congenital syphilis and the clinical characteristics of the newborns. METHOD: A cross-sectional study carried out in ten public maternity hospitals in Fortaleza, Ceará, Brazil that included cases of live births reported with congenital syphilis in 2015. RESULTS: 469 cases were analyzed; 199 (42.4 %) showed some sign or symptom suggestive of congenital syphilis; of these, 65 (32.7 %) were preterm, 87 (43.7 %) had low birth weight, 116 (58.3 %) had jaundice that required phototherapy, 13 (6.5 %) had hepatomegaly, 10 (5 %) had skin lesions, eight (4.0 %) had splenomegaly and one (0.5 %) had limb pseudoparalysis. Records of other clinical changes were identified in 36 (7.7 %) children. Children whose mothers were not treated or who received a drug other than penicillin and those whose mothers had a VDRL titer ≥ 1:16 at birth were 3.7 and 3.2 times more likely to be born with signs of congenital syphilis (p < 0.001- 95 % CI 2.41-5.58; p < 0.001 - 95 % CI 2.41-5.58) respectively. CONCLUSIONS: The findings of this study draw attention to the importance of improving the quality of prenatal care and the development of studies aimed at finding alternative drugs for the treatment of syphilis in pregnant women and the prevention of congenital syphilis.
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OBJECTIVE: To analyze the follow-up, in specialized outpatient clinics, of infants reported with congenital syphilis during the penicillin shortage. METHOD: A cross-sectional study was carried out in ten public maternity hospitals affiliated with the Brazilian Unified Health System in the city of Fortaleza, state of Ceará. Clinical records of infants reported with congenital syphilis who were born alive in 2015 were used to describe correlates of attendance at recommended clinical follow-up appointments. RESULTS: A total of 469 infants reported with CS from January 1/2015 to December 31/2015 were included in the analysis. The results show that most infants did not attend the follow-up visits (368/469, 78.5%) and the main associated factors are that the follow-up clinic is located in a different hospital from that where the infant was born (OR: 3.7; CI: 2.20-6.22; p < 0.001) and the use of illicit drugs by the mother (OR: 3.2; CI: 1.57-6.87; p = 0.002). Only 33.7% (34/101) were followed until discharge. CONCLUSION: The majority of infants with reported congenital syphilis during this period did not attend the follow-up visits. Public health efforts aimed at reaching the parents of infants with CS should be a priority to ensure appropriate clinical identification and management of the associated outcomes of this vertically transmitted infection.
Subject(s)
Pregnancy Complications, Infectious , Syphilis, Congenital , Infant , Pregnancy , Humans , Female , Penicillins/therapeutic use , Follow-Up Studies , Cross-Sectional StudiesABSTRACT
OBJECTIVE: To analyze the factors associated with prematurity in reported cases of congenital syphilis in the city of Fortaleza, Ceará, Brazil. METHODS: Cross-sectional study conducted in ten public maternity hospitals in Fortaleza, Ceará, Brazil. A total of 478 reported cases of congenital syphilis were included in 2015, and data were collected from notification forms, from mothers' and babies' medical records and from prenatal cards. For the bivariate analysis, Pearson's chi-squared and Fisher's exact tests were used, considering p < 0.05. Multiple logistic regression was conducted, presenting odds ratio (OR) with a 95% confidence interval. RESULTS: We found 15.3% prematurity in pregnant women with syphilis. The titration of the VDRL test > 1:8 at delivery (OR 2.46; 95%CI: 1.33-4.53; p = 0.004) and the non-treatment of the pregnant women or treatment with drugs other than penicillin during prenatal care (OR 3.52; 95%CI: 1.74-7.13; p< 0.001) were associated with higher chances of prematurity. CONCLUSION: The prematurity due to congenital syphilis is a preventable condition, provided that pregnant women with syphilis are treated appropriately. Weaknesses in prenatal care are associated with this outcome, which highlights the importance of public policies oriented to improve the quality of prenatal care.
Subject(s)
Pregnancy Complications, Infectious , Syphilis, Congenital , Syphilis , Brazil/epidemiology , Cross-Sectional Studies , Female , Humans , Pregnancy , Pregnancy Complications, Infectious/epidemiology , Prenatal Care , Syphilis/complications , Syphilis/epidemiology , Syphilis, Congenital/epidemiologyABSTRACT
OBJECTIVES: to identify the scientific evidence about the clinical complications and manifestations of congenital syphilis and aspects related to its prevention. METHODS: integrative review after a search in the databases LILACS and MEDLINE, carried out in March 2018, using the descriptors "syphilis, congenital", "complications", and "signs and symptoms", leading to the selection of 27 researches. RESULTS: the publications found were published from 1966 to 2017, and most of them were from Latin America and Africa. Negative outcomes, laboratory changes, and the clinical manifestations in congenital syphilis, whether early or delayed, were, respectively: low weight at birth, anemia, hepatosplenomegaly, and dental alterations. The lack of treatment of the pregnant women in the prenatal was the most common occasion in which the opportunity to prevent the complications of congenital syphilis was lost. CONCLUSIONS: the scientific evidences analyzed showed serious complications of congenital syphilis that could be avoided if early opportunities of diagnosing and treating the pregnant women are not lost during the prenatal.
Subject(s)
Pregnancy Complications, Infectious , Syphilis, Congenital , Syphilis , Female , Humans , Infant, Newborn , Parturition , Pregnancy , Pregnancy Complications, Infectious/prevention & control , Syphilis/complications , Syphilis/diagnosis , Syphilis/prevention & control , Syphilis, Congenital/complications , Syphilis, Congenital/prevention & controlABSTRACT
Abstract Objective To analyze the follow-up, in specialized outpatient clinics, of infants reported with congenital syphilis during the penicillin shortage. Method A cross-sectional study was carried out in ten public maternity hospitals affiliated with the Brazilian Unified Health System in the city of Fortaleza, state of Ceará. Clinical records of infants reported with congenital syphilis who were born alive in 2015 were used to describe correlates of attendance at recommended clinical follow-up appointments. Results A total of 469 infants reported with CS from January 1/2015 to December 31/2015 were included in the analysis. The results show that most infants did not attend the follow-up visits (368/469, 78.5%) and the main associated factors are that the follow-up clinic is located in a different hospital from that where the infant was born (OR: 3.7; CI: 2.20-6.22; p< 0.001) and the use of illicit drugs by the mother (OR: 3.2; CI: 1.57-6.87; p= 0.002). Only 33.7% (34/101) were followed until discharge. Conclusion The majority of infants with reported congenital syphilis during this period did not attend the follow-up visits. Public health efforts aimed at reaching the parents of infants with CS should be a priority to ensure appropriate clinical identification and management of the associated outcomes of this vertically transmitted infection.
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RESUMO Objetivo: Analisar a tendência na taxa de detecção de sífilis em gestantes (SG) e na taxa de incidência de sífilis congênita (SC) no estado do Ceará. Métodos: Estudo ecológico que utilizou a técnica da série temporal interrompida para analisar os dados mensais de casos de SG e SC obtidos no Departamento de Informática do Sistema Único de Saúde (DATASUS) no período de janeiro de 2015 a julho de 2021. Utilizaram-se o teste de Kernel e a estimativa de Lincoln-Petersen para analisar a significância estatística. Resultados: Em 2015, estimou-se uma taxa de detecção mensal de SG de 5,4 e de incidência de SC de 8,2 por 1 mil nascidos vivos (NV). A implantação da portaria que alterou os critérios de definição de caso de SG e de SC implicou no aumento de 4,9 na taxa de detecção de SG (p<0,0001; IC95% 3,33; 6,61) e na queda de 0,1 na taxa de incidência de SC (p<0,001; IC95% -0,2; -0,1). A pandemia de COVID-19 não impactou na taxa de detecção mensal de SG (p=0,558; IC95% 5,92; 3,22), nem na sua tendência (p=0,7397; IC95% 0,28; 0,3), mas houve aumento de 0,19 na de SC (p<0,001; IC95% 0,1; -0,31). Conclusões: Entre os anos de 2015 e junho de 2021, a tendência na taxa de detecção de SG e na taxa de incidência da SC sofreu impacto das mudanças nos critérios de definição de caso desses agravos propostas pelo Ministério da Saúde e da pandemia de COVID-19.
ABSTRACT Objective: To analyze the trend in the detection rate of Syphilis in Pregnant Women (SP) and in the incidence rate of Congenital Syphilis (CS) in the state of Ceará. Methods: This is an ecological study that used the technique of interrupted time series to analyze monthly data on cases of SP and CS obtained from the Department of Informatics of the Brazilian Unified Health System (DATASUS) from January 2015 to July 2021. The Kernel test and the Lincoln-Petersen estimate were used to analyze the statistical significance. Results: In 2015, a monthly detection rate of SP was estimated at 5.4 and a CS incidence rate of 8.2 per one thousand live births (LB). The implementation of the ordinance that changed the criteria for defining cases of SP and CS resulted in an increase of 4.9 (p<0.0001; 95%CI; 3.33; 6.61) in the detection rate of SP and a decrease of 0.1 on the incidence of CS (p<0.001; 95%CI -0.2; -0.1). The COVID-19 pandemic did not impact the monthly detection rate of SP (p=0.558; 95%CI 5.92; 3.22), nor its trend (p=0.7397; 95%CI 0.28; 0.3), but there was an increase of 0.19 in CS (p<0.001; 95%CI 0.1; -0.31). Conclusion: Between 2015 and June 2021, the trend in the detection rate of SP and in the incidence rate of CS was impacted by changes in the criteria for defining cases of these diseases proposed by the Brazilian Ministry of Health and the COVID-19 pandemic.
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ABSTRACT OBJECTIVE: To analyze the factors associated with prematurity in reported cases of congenital syphilis in the city of Fortaleza, Ceará, Brazil. METHODS: Cross-sectional study conducted in ten public maternity hospitals in Fortaleza, Ceará, Brazil. A total of 478 reported cases of congenital syphilis were included in 2015, and data were collected from notification forms, from mothers' and babies' medical records and from prenatal cards. For the bivariate analysis, Pearson's chi-squared and Fisher's exact tests were used, considering p < 0.05. Multiple logistic regression was conducted, presenting odds ratio (OR) with a 95% confidence interval. RESULTS: We found 15.3% prematurity in pregnant women with syphilis. The titration of the VDRL test > 1:8 at delivery (OR 2.46; 95%CI: 1.33-4.53; p = 0.004) and the non-treatment of the pregnant women or treatment with drugs other than penicillin during prenatal care (OR 3.52; 95%CI: 1.74-7.13; p< 0.001) were associated with higher chances of prematurity. CONCLUSION: The prematurity due to congenital syphilis is a preventable condition, provided that pregnant women with syphilis are treated appropriately. Weaknesses in prenatal care are associated with this outcome, which highlights the importance of public policies oriented to improve the quality of prenatal care.
RESUMO OBJETIVO: Analisar os fatores associados à prematuridade em casos notificados de sífilis congênita no município de Fortaleza, Ceará, Brasil. MÉTODOS: Estudo transversal realizado em dez maternidades públicas de Fortaleza, Ceará, Brasil. Foram incluídos 478 casos notificados de sífilis congênita em 2015, e os dados foram coletados das fichas de notificação, dos prontuários das mães e dos bebês e do cartão de pré-natal. Para a análise bivariada, foram utilizados os testes do qui-quadrado de Pearson e exato de Fisher, considerando p < 0,05. Realizou-se regressão logística múltipla, apresentando razão de chances (OR) com intervalo de confiança de 95%. RESULTADOS: Encontrou-se 15,3% de prematuridade em gestantes com sífilis. A titulação do teste VDRL > 1:8 no parto (OR 2,46; IC95%: 1,33-4,53; p = 0,004), o não tratamento da gestante ou tratamento realizado com drogas diferentes da penicilina durante o pré-natal (OR 3,52; IC95%: 1,74-7,13; p < 0,001) estiveram associados a maiores chances de prematuridade. CONCLUSÃO: A prematuridade decorrente da sífilis congênita é um agravo evitável, desde que as gestantes com sífilis sejam tratadas adequadamente. As fragilidades na assistência pré-natal estão associadas a este desfecho, o que ressalta a importância de implementar políticas públicas voltadas a melhorar a qualidade do pré-natal.
Subject(s)
Humans , Female , Pregnancy , Pregnancy Complications, Infectious/epidemiology , Syphilis, Congenital/epidemiology , Syphilis/complications , Syphilis/epidemiology , Prenatal Care , Brazil/epidemiology , Cross-Sectional StudiesABSTRACT
ABSTRACT Objectives: to identify the scientific evidence about the clinical complications and manifestations of congenital syphilis and aspects related to its prevention. Methods: integrative review after a search in the databases LILACS and MEDLINE, carried out in March 2018, using the descriptors "syphilis, congenital", "complications", and "signs and symptoms", leading to the selection of 27 researches. Results: the publications found were published from 1966 to 2017, and most of them were from Latin America and Africa. Negative outcomes, laboratory changes, and the clinical manifestations in congenital syphilis, whether early or delayed, were, respectively: low weight at birth, anemia, hepatosplenomegaly, and dental alterations. The lack of treatment of the pregnant women in the prenatal was the most common occasion in which the opportunity to prevent the complications of congenital syphilis was lost. Conclusions: the scientific evidences analyzed showed serious complications of congenital syphilis that could be avoided if early opportunities of diagnosing and treating the pregnant women are not lost during the prenatal.
RESUMEN Objetivos: identificar evidencias científicas sobre las complicaciones y manifestaciones clínicas de la sífilis congénita y aspectos relacionados a prevención. Métodos: revisión integrativa, mediante búsqueda en bases de datos LILACS y MEDLINE, realizada en marzo de 2018, utilizando los descriptores "syphilis, congenital", "complications", "signs and symptoms", resultando en 27 investigaciones seleccionadas. Resultados: encontraron publicaciones entre 1966 y 2017, la mayoría oriundas de Latinoamérica y África. Desfecho desfavorable, la alteración laboratorial y manifestaciones clínicas de la sífilis congénita precoz y tardía más evidenciados fueron, respectivamente, bajo peso al nacer, anemia, hepatoesplenomegalia y alteraciones odontológicas. Observó que la falta de tratamiento de la embarazada en el prenatal fue la principal oportunidad perdida de prevención de las complicaciones de la sífilis congénita. Conclusiones: las evidencias científicas analizadas presentan graves complicaciones de la sífilis congénita que serían evitadas desde que oportunidades precoces de diagnóstico y tratamiento de la embarazada no fueran perdidas durante el prenatal.
RESUMO Objetivos: identificar as evidências científicas acerca das complicações e manifestações clínicas da sífilis congênita e aspectos relacionados à prevenção. Métodos: revisão integrativa, mediante busca nas bases de dados LILACS e MEDLINE, realizada em março de 2018, utilizando os descritores "syphilis, congenital", "complications", "signs and symptoms", resultando em 27 pesquisas selecionadas. Resultados: encontraram-se publicações entre os anos de 1966 e 2017, na maioria oriundas da América Latina e África. O desfecho desfavorável, a alteração laboratorial e as manifestações clínicas da sífilis congênita precoce e tardia mais evidenciados foram, respectivamente, baixo peso ao nascer, anemia, hepatoesplenomegalia e alterações odontológicas. Observou-se que a falta de tratamento da gestante no pré-natal foi a principal oportunidade perdida de prevenção das complicações da sífilis congênita. Conclusões: as evidências científicas analisadas apresentam graves complicações da sífilis congênita que seriam evitadas desde que oportunidades precoces de diagnóstico e tratamento da gestante não fossem perdidas durante o pré-natal.
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Introduction: The low percentage of sexual partners of pregnant women with treated syphilis is one of the main obstacles to the control of congenitalsyphilis. Objective: To analyze the notification of the syphilis diagnosis to the sexual partner of the pregnant woman, its implications and the suggested summoning strategies. Methods: This is a qualitative research conducted in Fortaleza, State of Ceará, from April to October, 2014. A total of 14 women reported with syphilis during prenatal care and nine sexual partners were interviewed. The thematic content analysis and the idea association tree were used to analyze and reveal the results. Results: Pregnant women prefer to communicate the diagnosis to their partner, but they say they need help from the professional for this moment. Among the partners there was no consensus about this strategy, as it generates conflicts for the couple. They therefore indicated other means of communication considered more appropriate. It was found that there is no ideal model of notification of sexual partner of pregnant woman with syphilis. Conclusion: According to the interviewees' reports, we can conclude that the best way is the one that considers the relationship context and the singularities informed by the patients.
Introdução: O baixo percentual de parceiros sexuais de gestantes com sífilis tratados representa um dos principais entraves para o controle da sífilis congênita. Objetivo: Analisar a notificação do diagnóstico de sífilis ao parceiro sexual da gestante, suas implicações e as estratégias de convocação sugeridas. Métodos: Trata-se de uma pesquisa qualitativa realizada em Fortaleza, Ceará, de abril a outubro de 2014. Foram entrevistadas 14 mulheres notificadas com sífilis durante o pré-natal e nove parceiros sexuais. Utilizou-se da análise de conteúdo temática e a árvore de associação de ideias para análise e apresentação dos resultados. Resultados: As gestantes preferem comunicar o diagnóstico ao parceiro, mas referem necessitar de ajuda do profissional para esse momento. Entre os parceiros, não houve consenso acerca dessa estratégia, por gerar conflitos para o casal. Assim, indicaram outros meios de comunicação que consideram mais adequados. Constatou-se que não há um modelo ideal de convocação de parceiro sexual da gestante com sífilis. Conclusão: Com base no exposto pelos entrevistados, acredita-se que o melhor modelo é aquele que considera o contexto do relacionamento e as singularidades trazidas pela paciente.
Subject(s)
Humans , Syphilis , Qualitative Research , Pregnant Women , Prenatal Care , Sexual Partners , DiagnosisABSTRACT
Objetivo: analisar os casos de sorologia positiva para o HIV em uma unidade de saúde de referência. Método:estudo transversal de série história. A coleta de dados ocorreu de junho a julho de 2010 nas fichas deatendimento de pessoas que procuraram realizar o teste anti-HIV no período de 1996 a 2009, em Fortaleza(CE), Brasil. Os dados foram analisados pelo teste qui-quadrado de Pearson com nível de significância de 5% eintervalo de confiança de 95%. Resultados: foram encontrados 165 registros de casos de HIV. Quandoanalisados por sexo, encontrou-se diferença estatisticamente significativa entre ser homem homo/bissexual(p<0,001), ter tido dois ou mais parceiros sexuais nos últimos três meses (p=0,002), ter parceria fixa eocasional (p<0,001) e ter o resultado de VDRL e FTA-Abs reagente (p<0,001 e p=0,013, respectivamente).Conclusão: houve maior proporção de casos HIV positivo entre homens com orientaçãohomossexual/bissexual, com parcerias sexuais fixas e ocasionais.
Subject(s)
Male , Female , Humans , Adolescent , Adult , Middle Aged , Aged , Sexually Transmitted Diseases , AIDS Serodiagnosis , HIV Seropositivity , Acquired Immunodeficiency Syndrome , Contact Tracing , Cross-Sectional Studies , Acquired Immunodeficiency Syndrome/prevention & controlABSTRACT
Resumo Objetivou-se analisar os casos de doenças sexualmente transmissíveis (DST) atendidos em uma unidade primária de saúde em Fortaleza, Ceará, estudo retrospectivo que analisou 5.590 prontuários de casos de DST atendidos nos anos de 1999 a 2009. Os dados foram coletados de março a junho de 2010 e analisados pelo SPSS 18.0. Pessoas jovens com boa escolaridade e que tiveram múltiplos parceiros sexuais nos últimos três meses apresentaram mais úlcera e verruga. Encontrou-se associação entre apresentar verruga e ter resultado reagente para o HIV e apresentar úlcera e ter resultado reagente de VDRL. Quando analisados por sexo, as mulheres apresentaram mais úlcera, verruga, mais de uma síndrome genital no momento da consulta e aceitaram mais realizar os exames de VDRL e HIV. Já os homens tiveram mais resultado reagente para o HIV. Homens e mulheres com DST apresentaram especificidades comportamentais que os tornam mais vulneráveis ao HIV e sífilis.
Abstract This study aimed to assess cases of sexually transmitted diseases (STDs) in a primary healthcare unit in the city of Fortaleza, Ceará. A retrospective study that analyzed 5,590 medical records of STD cases treated between 1999 and 2009. Data were collected from March to June 2010 and analyzed using SPSS 18.0. Young people with high education levels and those with multiple sex partners in the past three months presented with more ulcers and warts. The presence of warts was associated to reactive HIV result, and the presence of ulcers was associated to reactive VDRL result. As for gender, women presented more ulcers, warts, and more than one genital syndrome at physical examination and were more willing to perform VDRL and HIV testing. Men and women with STDs presented behavioral specificities that make them more vulnerable to HIV and syphilis.
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O estudo teve como objetivo analisar os óbitos maternos e apresentar a Razão de Mortalidade Materna no município de Fortaleza, Nordeste do Brasil, nos anos de 2008 a 2010. Estudo descritivo. Os dados foram colhidos do Sistema de Informação de Mortalidade e das fichas de investigação de óbito materno da Secretaria de Saúde do município. Foram analisados 56 óbitos maternos, com uma Razão de Mortalidade de 39,75/100.000 nascidos vivos. A faixa etária predominante foi de 20 a 29 anos de idade (50,0%). Dentre os óbitos maternos obstétricos diretos, os transtornos hipertensivos foram as causas mais prevalentes (50,0%). Nos obstétricos indiretos, foram as doenças infecciosas e parasitárias (28,1%). Quase a totalidade dos óbitos eram evitáveis ou provavelmente evitáveis (91,1%). Pode-se inferir que a maioria dos óbitos poderia ter sido evitada por meio da garantia da qualidade da atenção pré-natal...
This study aimed to analyze maternal deaths and present the Maternal Mortality Ratio in the city of Fortaleza, in the Northeastregion of Brazil, from 2008-2010. This is a descriptive study. Data collection occurred in the Mortality Information Systemand in the maternal death investigation files of the Local Health Department. Fifty-six maternal deaths were investigated witha Maternal Mortality Ratio of 39.75/100,000 live births. The prevalent age group was 20-29 years (50.0%). Hypertensivedisorders (50.0%) were the most prevalent causes of direct obstetric deaths. As for indirect obstetric deaths, infectious andparasitic diseases (28.1%) prevailed. Nearly all deaths were considered preventable or possibly preventable (91.1%). Thus,it can be assumed that most deaths could have been avoided by ensuring the quality of prenatal care...
El objetivo del estudio fue analizar las muertes maternas y presentar la Razón de Mortalidad Materna en Fortaleza, norestedel Brasil, en los años 2008-2010. Estudio descriptivo. Los datos fueron recogidos del Sistema de Información sobreMortalidad y de las fichas de investigación de muerte materna de la Secretaria de Salud del municipio. Se analizaron 56muertes maternas, con Razón de Mortalidad de 39,75/100.000 nacidos vivos. El grupo de edad predominante fue de 20 a 29años (50,0%). Entre las muertes maternas obstétricas directas, los trastornos hipertensivos fueron las causas más frecuente(50,0%). En los obstétricos indirectos, fueron las enfermedades infecciosas y parasitarias (28,1%). Casi totalidad de lasmuertes se consideraron prevenibles o probablemente evitables (91,1%). Se puede inferir que la mayoría de las muertes sepodrían haber evitado, a través de la seguridad de la calidad de la atención prenatal...
Subject(s)
Humans , Female , Pregnancy , Maternal Mortality , Women's Health , Epidemiological MonitoringABSTRACT
Objetivo: Avaliar a estrutura e o processo de trabalho dos profissionais de saúde para desenvolver as ações de prevenção e controle da sífilis congênita em Fortaleza, Ceará. Métodos: Pesquisa avaliativa desenvolvida de julho a outubro de 2011 em 89 unidades primárias. Foram avaliados os componentes de estrutura física, materiais e insumos, recursos humanos e estrutura organizacional e as unidades foram classificadas como satisfatórias e insatisfatórias. Resultados: Na classificação geral, descobriu-se que somente 47,2% das unidades foram consideradas insatisfatórias. A sala de coleta de sangue estava presente em 68,5%, profissional capacitado para atender casos de sífilis em 21,3% e apenas 16,9% das unidades aplicavam a penicilina benzatina em gestantes. Conclusão: No geral, as unidades primárias de saúde não se encontravam em condições estruturais e processuais para contribuir para o controle da sífilis congênita.
Objective: To evaluate the work structure and process of healthcare professionals in order to develop actions for the prevention and control of congenital syphilis in Fortaleza, Ceará. Methods: This is an evaluation research conducted in 89 primary healthcare units between July and October, 2011. The components of physical structure, materials and inputs, human resources, and organizational structure were evaluated; then, the units were classified as satisfactory or unsatisfactory. Results: The general classification showed that only 47.2% of the units were found to be unsatisfactory. In all, 68.5% of the units had a blood-sampling room, 21.3% had professionals qualified to attend syphilis cases, and only 16.9% of the units administered benza-thine penicillin to pregnant women. Conclusion: In general, primary healthcare units did not present structural and procedural conditions to help control congenital syphilis.