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1.
BMC Infect Dis ; 21(1): 64, 2021 Jan 13.
Artículo en Inglés | MEDLINE | ID: mdl-33435889

RESUMEN

BACKGROUND: Congenital syphilis is completely preventable through screening and treatment, but rates have been rising in the United States. Certain areas are at particularly high risk. We aimed to assess attitudes, knowledge, and barriers around effective prevention of congenital syphilis among health care providers and community women potentially at risk. METHODS: Two parallel studies were conducted: in-depth interviews with health care providers and focus groups with community women in the area of Baton Rouge, Louisiana. Each group was questioned about their experience in providing or seeking prenatal care, knowledge and attitudes about congenital syphilis, sources of information on testing and treatment, perceptions of risk, standards of and barriers to treatment. Results were transcribed into QSR NVivo V10, codes developed, and common themes identified and organized. RESULTS: Providers identified delays in testing and care, lack of follow-through with partner testing, and need for community connection for prevention, as major contributors to higher rates of congenital syphilis. Women identified difficulties in accessing Medicaid contributing to delayed start of prenatal care, lack of transportation for prenatal care, and lack of knowledge about testing and prevention for congenital syphilis. CONCLUSIONS: Providers and community members were in broad agreement about factors contributing to higher rates of congenital syphilis, although some aspects were emphasized more by one group or another. Evidence-based interventions, likely at multiple levels, need to be tested and implemented to eliminate congenital syphilis.


Asunto(s)
Concienciación , Conocimientos, Actitudes y Práctica en Salud , Personal de Salud/psicología , Complicaciones Infecciosas del Embarazo/psicología , Sífilis Congénita/psicología , Treponema pallidum , Adolescente , Adulto , Femenino , Grupos Focales , Disparidades en Atención de Salud , Humanos , Louisiana/epidemiología , Tamizaje Masivo , Embarazo , Complicaciones Infecciosas del Embarazo/diagnóstico , Complicaciones Infecciosas del Embarazo/epidemiología , Atención Prenatal , Diagnóstico Prenatal , Investigación Cualitativa , Sífilis Congénita/diagnóstico , Sífilis Congénita/epidemiología , Sífilis Congénita/microbiología , Adulto Joven
2.
Rev. enferm. UFPE on line ; 15(1): [1-19], jan. 2021. ilus, mapas, tab
Artículo en Portugués | BDENF - Enfermería | ID: biblio-1145784

RESUMEN

Objetivo: analisar a situação do tratamento inadequado da Sífilis Congênita (SC). Método: trata-se de um estudo misto, descritivo, com dados coletados no Sistema de Informação de Agravos de Notificação, no período de 2014 a 2017. Realizaram-se, adicionalmente, entrevistas semiestruturadas com os profissionais de saúde da Atenção Básica (AB), sendo os dados quantitativos estudados pela estatística descritiva, e os qualitativos, por meio da Análise de Conteúdo. Resultados: identificaram-se 61 recém-nascidos que receberam tratamento inadequado para SC. Entrevistaram-se enfermeiros da AB do município de Macapá atuantes nas áreas de abrangência das residências das crianças. Aponta-se que as análises das entrevistas permitiram a criação de três categorias: o saber do enfermeiro sobre a doença; a experiência do enfermeiro para a detecção de casos de SC na sua área de atuação; e as estratégias do enfermeiro para a busca de crianças com história de sífilis. Conclusão: evidenciou-se a fragilidade no tratamento da SC em Macapá com um alto índice de tratamento inadequado. Avalia-se que os perfis sociodemográficos e clínico das mães e crianças potencializam as vulnerabilidades individual, programática e social.(AU)


Objective: to analyze the situation of inadequate treatment of Congenital Syphilis (CS). Method: it is a mixed, descriptive study with data collected in the System of Information on Disease Notification (SINAN), within the period from 2014 to 2017. In addition, semi-structured interviews were carried out with health professionals from Basic Care (BC), with the quantitative data studied through descriptive statistics, and the qualitative data by means of Content Analysis. Results: 61 newborns who received inadequate treatment for CS were identified. Nurses from the BC of Macapá who work in the areas of the children's residences were interviewed. It is pointed out that the analysis of the interviews allowed the creation of three categories: the nurse's knowledge on the disease; the nurse's experience for the detection of cases of CS in his/her area of operation; and the nurse's strategies for the search of children with history of syphilis. Conclusion: the fragility in the treatment of CS in Macapá was evidenced with a high rate of inadequate treatment. The sociodemographic and clinical profiles of mothers and children are estimated to have enhanced individual, programmatic and social vulnerabilities.(AU)


Objetivo: analizar la situación de tratamiento inadecuado de la Sífilis Congénita (CS). Método: se trata de un estudio descriptivo mixto, con datos recogidos en el Sistema de Información de Enfermedades de Notificación, en el período de 2014 a 2017. Además, se realizaron entrevistas semiestructuradas con profesionales de la salud de atención primaria (AB) , datos cuantitativos que se estudian mediante estadística descriptiva, y datos cualitativos, a través del análisis de contenido. Resultados: se identificaron 61 recién nacidos que recibieron tratamiento inadecuado por CE. Se entrevistó a enfermeras de AB en la ciudad de Macapá que trabajan en las áreas cubiertas por los hogares de los niños. Se señala que el análisis de las entrevistas permitió la creación de tres categorías: el conocimiento de la enfermera sobre la enfermedad; la experiencia del enfermero en la detección de casos de CS en su área de especialización; y las estrategias de la enfermera para encontrar niños con antecedentes de sífilis. Conclusión: se evidenció debilidad en el tratamiento del CS en Macapá con una alta tasa de tratamiento inadecuado. Se evalúa que los perfiles sociodemográficos y clínicos de madres e hijos potencian las vulnerabilidades individuales, programáticas y sociales.(AU)


Asunto(s)
Humanos , Masculino , Femenino , Sífilis Congénita , Sífilis Congénita/tratamiento farmacológico , Sífilis Congénita/transmisión , Sífilis Congénita/epidemiología , Perfil de Salud , Niño , Salud Materno-Infantil , Transmisión Vertical de Enfermedad Infecciosa , Atención de Enfermería , Epidemiología Descriptiva , Enfermería Maternoinfantil , Sistemas de Información en Salud
3.
Rev. enferm. UERJ ; 28: e50487, jan.-dez. 2020.
Artículo en Inglés, Portugués | LILACS, BDENF - Enfermería | ID: biblio-1145487

RESUMEN

Objetivo: analisar a ocorrência de sífilis gestacional e congênita à luz da vulnerabilidade, no período de 2008 a 2018, no Mato Grosso do Sul. Método: estudo transversal, retrospectivo, de caráter analítico e abordagem quantitativa, com base em dados secundários coletados no Sistema de Informações e Agravos de Notificação. Resultados: houve aumento progressivo de sífilis gestacional e congênita ao longo dos 11 anos, com predomínio em populações vulneráveis e associação (p< 0.05) da ocorrência de sífilis congênita com as variáveis "escolaridade", "faixa etária" e "cor da pele". Verificou-se a influência de fatores comportamentais e relacionados aos serviços de saúde, dentre eles o diagnóstico tardio da sífilis e a baixa adesão do tratamento entre estas gestantes e seus parceiros sexuais. Conclusão: a sífilis gestacional e congênita tiveram causas multifatoriais e podem ser combatidas com ações em saúde que considerem os aspectos que potencializam a vulnerabilidade social, individual e programática da população.


Objective: to examine the occurrence of gestational and congenital syphilis in the light of vulnerability in Mato Grosso do Sul, from 2008 to 2018. Method: this retrospective, analytical, quantitative, cross-sectional study was based on secondary data collected from Brazil's Notifiable Disease Information System. Results: gestational and congenital syphilis increased steadily over the eleven years, predominantly in vulnerable groups. The occurrence of congenital syphilis was found to associate (p < 0.05) with the variables "education", "age group" and "skin color". Behavioral and health service-related factors ­ among them, late diagnosis of syphilis and poor treatment adherence by pregnant women and their sexual partners ­ were found to influence the association. Conclusion: gestational and congenital syphilis had multifactorial causes and can be combated with health measures that address aspects that heighten this population's social, individual and programmatic vulnerability.


Objetivo: examinar la ocurrencia de sífilis gestacional y congénita a la luz de la vulnerabilidad en Mato Grosso do Sul, de 2008 a 2018. Método: este estudio retrospectivo, analítico, cuantitativo y transversal se basó en datos secundarios recopilados del Sistema de Información de Enfermedades Notificables de Brasil. Resultados: la sífilis gestacional y congénita aumentó de manera sostenida durante los once años, predominantemente en grupos vulnerables. Se encontró que la ocurrencia de sífilis congénita se asocia (p < 0.05) con las variables "educación", "grupo de edad" y "color de piel". Se encontró que factores relacionados con el comportamiento y los servicios de salud, entre ellos, el diagnóstico tardío de la sífilis y la mala adherencia al tratamiento por parte de las mujeres embarazadas y sus parejas sexuales, influyen en la asociación. Conclusión: la sífilis gestacional y congénita tuvo causas multifactoriales y se puede combatir con medidas de salud que aborden aspectos que aumentan la vulnerabilidad social, individual y programática de esta población.


Asunto(s)
Humanos , Femenino , Embarazo , Niño , Adolescente , Adulto , Adulto Joven , Sífilis Congénita/epidemiología , Transmisión Vertical de Enfermedad Infecciosa/estadística & datos numéricos , Vulnerabilidad en Salud , Atención Prenatal , Sífilis Congénita/prevención & control , Brasil/epidemiología , Incidencia , Prevalencia , Estudios Transversales , Notificación de Enfermedades/estadística & datos numéricos , Salud Materna , Servicios de Salud Materna
4.
Rev Saude Publica ; 54: 109, 2020.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-33146299

RESUMEN

OBJECTIVE: To analyze the shortage of benzathine penicillin G (BPG), characterizing its temporal evolution and spatial distribution in the city of Rio de Janeiro from 2013 to 2017. METHODS: This ecological study used gestational and congenital syphilis notifications, BPG distribution records, and sociodemographic data from the population of Rio de Janeiro. To quantify the shortage, a BPG supply indicator was estimated per quarter for each neighborhood between 2013 and 2017. Thematic maps were created to identify areas and periods with greater BPG shortage, described according to sociodemographic factors, health services network, and epidemiological features in the incidence of syphilis. RESULTS: BPG shortage in Rio de Janeiro from 2013 to 2017 was not homogeneous in space nor in time. The temporal evolution and spatial distribution of BPG scarcity shows that the shortage affected the inhabitants of the municipality in different ways. Shortage was lower in 2013 and 2016 and more severe in 2014, 2015, and 2017, particularly in neighborhoods within the programmatic areas PA3 and PA5, poorer and with higher prevalence rates of gestational and congenital syphilis. CONCLUSIONS: Analyzing BPG shortage and its temporal evolution and spatial distribution in Rio de Janeiro allowed us to realize that the inhabitants are affected in different ways. Understanding this process contributes to the planning of actions to face shortage crises, minimizing possible impacts on the management of syphilis and reducing inequality in access to treatment.


Asunto(s)
Accesibilidad a los Servicios de Salud , Disparidades en el Estado de Salud , Penicilina G Benzatina/provisión & distribución , Sífilis Congénita/epidemiología , Sífilis/epidemiología , Brasil/epidemiología , Femenino , Humanos , Masculino , Penicilina G Benzatina/uso terapéutico , Embarazo , Análisis Espacio-Temporal , Sífilis/tratamiento farmacológico , Sífilis Congénita/tratamiento farmacológico
5.
Rev Soc Bras Med Trop ; 53: e20200316, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33111911

RESUMEN

INTRODUCTION: The increasing incidence of syphilis among pregnant women (PS) and congenital syphilis (CS) has negatively affected maternal-child health in Brazil. The spatial approach to diseases with social indicators improves knowledge of health situations. Herein, we aimed to evaluate the spatiotemporal distribution of incidences, identify the priority areas for infection control actions, and analyze the relationship of PS and CS clusters with social determinants of health in Mato Grosso. METHODS: This is an ecological study with data from different health information systems. After data procedure linkage, we analyzed the Bayesian incidences of triennial infections during specific periods. We performed SATSCAN screenings to identify spatiotemporal clusters. Further, we verified the differences between the clusters and indicators using Pearson's chi-square test. RESULTS: The variations in PS incidence were 0.9-20.5/1,000 live births (LB), 0.6-46.3/1,000 LB, and 2.1-23.2/1,000 LB in the first, second, and last triennium, respectively; for CS, the variations were 0-7.1/1,000 LB, 0-7.5/1,000 LB, and 0.3-10.8/1,000 LB in the first, second, and last triennium, respectively. Three clusters each were identified for PS (RR=2.02; RR=0.30; RR=21.45, p<0.0001) and CS (RR=3.55; RR=0.10; RR=0.26, p<0.0001). The high-risk clusters overlapped in time-space; CS incidence was associated with municipalities with a higher proportion of LB mothers of race/non-white color and with poor sanitary conditions, lower proportion of pregnant teenagers, and under 8 years of schooling. CONCLUSIONS: The increase in the spatiotemporal evolution of PS and CS incidences and the extension of areas with persistent infections indicate the need for monitoring, especially of priority areas in the state.


Asunto(s)
Complicaciones Infecciosas del Embarazo , Sífilis Congénita , Adolescente , Teorema de Bayes , Brasil/epidemiología , Femenino , Humanos , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Determinantes Sociales de la Salud , Sífilis Congénita/epidemiología
6.
Public Health ; 185: 386-393, 2020 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-32758762

RESUMEN

OBJECTIVES: Even when new cases of syphilis are notifiable since 1944, the Mexican National Epidemiological Surveillance System lacks information on the changes of the rate of case reports considering the geographic and demographic variables. Therefore, it is necessary to have evidence, with particular attention to the study of the epidemiological behavior by the identification of risk factors and groups. The objective of this study was to analyze the epidemiology, geographical distribution, and forecast of syphilis in Mexico. STUDY DESIGN: The design of the study was a secondary research of epidemiological databases. METHODS: A retrospective analysis of the national surveillance data (2007-2017) of acquired and congenital syphilis (CS) issued by the General Directorate of Epidemiology was performed. RESULTS: Of all cases, 34,998 and 1030 cases were reported for acquired syphilis (AS) and CS , respectively, reflecting an increasing trend in the whole country for both diseases. Cases and incidence of AS per year showed that, male gender presented an increase in reproductive age. Distribution of the rate of case reports is mostly commanded by the states in the extreme north (Gulf of California and northern Gulf of Mexico) and south (Gulf of southern Mexico and the Caribbean Sea). Likewise, the Seasonal Autoregressive Integrated Moving Average model was selected as the best-fit model for the forecast analysis. This model was used to forecast AS cases during 2018-2019. AS may have a slight fluctuation (on the rise) during the following 24 months. CONCLUSIONS: These findings underscore the importance of intensifying, as well as expanding screening and treatment in adult population, including men, who are not routinely benefiting from maternal and reproductive service-based syphilis screening and treatment.


Asunto(s)
Sífilis/epidemiología , Adulto , Femenino , Predicción , Humanos , Incidencia , Masculino , Tamizaje Masivo , México/epidemiología , Persona de Mediana Edad , Vigilancia de la Población , Estudios Retrospectivos , Factores de Riesgo , Factores Sexuales , Sífilis Congénita/epidemiología , Temperatura , Factores de Tiempo , Adulto Joven
7.
Bol. méd. postgrado ; 36(1): 19-25, jul.2020. tab
Artículo en Español | LILACS, LIVECS | ID: biblio-1119376

RESUMEN

Se realizó una estudio descriptivo transversal de recolección retrospectiva de datos de 102 historias clinicas con el objetivo de describir las características clínicas y epidemiológicas de la sífilis congénita en neonatos registrados en el Servicio Desconcentrado Hospital Pediátrico Dr. Agustín Zubillaga durante el período enero 2014 a junio 2017. Los resultados evidencian que el 52% de los neonatos eran del sexo masculino, el peso y longitud del neonato osciló entre 2501 a 4000 gramos y 46 a 55 cms, respectivamente; los neonatos pretérmino y a término tenían un tamaño adecuado; el APGAR fue normal al minuto, cinco y diez minutos. Las manifestaciones clínicas y paraclínicas más frecuentes fueron ictericia (41,2%), leucocitosis (16,7%) y periostitis (12,8%). El 78,4% de los casos presentaron VDRL no reactivo en LCR mientras que 72,5% mostraron VDRL reactivo en sangre. En conclusión, es importante aumentar el control prenatal e indicar de forma rutinaria el VDRL en sangre con la finalidad de detectar tempranamente los casos de sífilis materna y de esta manera prevenir la sífilis congénita(AU)


A descriptive, cross-sectional study, of retrospective review of data from 102 medical charts was carried out in order to describe clinical and epidemiological characteristics of congenital syphilis in neonates registered at the Servicio Desconcentrado Hospital Pediátrico Dr. Agustín Zubillaga during the period January 2014 to June 2017. Male sex was predominant 52%, weight and height of newborns were between 2.501 to 4.000 grams and 46 to 55 cms, respectively; preterm and term neonates were of adequate size; APGAR score was normal at one, five and ten minutes. Most common clinical and paraclinical manifestations of congenital syphilis of the neonate at birth were jaundice (41,2%), leucocitosis (16,7%) and periostitis (12,8%). 78,4% had non-reactive VDRL in cerebrospinal fluid while 72,5% had reactive VDRL in blood. In conclusion, it is important to increase prenatal control and screen for maternal syphilis in order to detect early cases and prevent congenital syphilis(AU)


Asunto(s)
Humanos , Masculino , Femenino , Recién Nacido , Sífilis Congénita/etiología , Sífilis Congénita/epidemiología , Recién Nacido , Enfermedades Transmisibles , Circulación Placentaria , Relaciones Materno-Fetales
8.
MMWR Morb Mortal Wkly Rep ; 69(22): 661-665, 2020 Jun 05.
Artículo en Inglés | MEDLINE | ID: mdl-32497029

RESUMEN

Congenital syphilis is an infection with Treponema pallidum in an infant or fetus, acquired during pregnancy from a mother with untreated or inadequately treated syphilis. Congenital syphilis can cause miscarriage, stillbirth, or early infant death, and infected infants can experience lifelong physical and neurologic problems. Although timely identification and treatment of maternal syphilis during pregnancy can prevent congenital syphilis (1,2), the number of reported congenital syphilis cases in the United States increased 261% during 2013-2018, from 362 to 1,306. Among reported congenital syphilis cases during 2018, a total of 94 resulted in stillbirths or early infant deaths (3). Using 2018 national congenital syphilis surveillance data and a previously developed framework (4), CDC identified missed opportunities for congenital syphilis prevention. Nationally, the most commonly missed prevention opportunities were a lack of adequate maternal treatment despite the timely diagnosis of syphilis (30.7%) and a lack of timely prenatal care (28.2%), with variation by geographic region. Congenital syphilis prevention involves syphilis prevention for women and their partners and timely identification and treatment of pregnant women with syphilis. Preventing continued increases in congenital syphilis requires reducing barriers to family planning and prenatal care, ensuring syphilis screening at the first prenatal visit with rescreening at 28 weeks' gestation and at delivery, as indicated, and adequately treating pregnant women with syphilis (2). Congenital syphilis prevention strategies that implement tailored public health and health care interventions to address missed opportunities can have substantial public health impact.


Asunto(s)
Servicios de Salud Materna/organización & administración , Complicaciones Infecciosas del Embarazo/diagnóstico , Complicaciones Infecciosas del Embarazo/terapia , Sífilis Congénita/prevención & control , Sífilis/diagnóstico , Sífilis/terapia , Diagnóstico Precoz , Femenino , Investigación sobre Servicios de Salud , Humanos , Recién Nacido , Embarazo , Sífilis Congénita/epidemiología , Tiempo de Tratamiento , Estados Unidos/epidemiología
9.
Obstet Gynecol ; 135(5): 1121-1135, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32282589

RESUMEN

Despite a national plan to eliminate syphilis by 2005, recent trends have reversed previously achieved progress in the United States. After a nadir between 2000 and 2013, rates of primary and secondary syphilis among women and congenital syphilis rose by 172% and 185% between 2014 and 2018, respectively. Screening early in pregnancy, repeat screening in the third trimester and at delivery among women at high risk, adherence to recommended treatment regimens, and prompt reporting of newly diagnosed syphilis cases to local public health authorities are strategies that obstetrician-gynecologists can employ to fight the current epidemic. In this report, clinical manifestations and management of syphilis in pregnancy are reviewed, and both traditional and reverse sequence screening algorithms are reviewed in detail in the context of clinical obstetrics.


Asunto(s)
Obstetricia/normas , Complicaciones Infecciosas del Embarazo/diagnóstico , Diagnóstico Prenatal/normas , Sífilis Congénita/epidemiología , Sífilis/epidemiología , Adulto , Femenino , Humanos , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/microbiología , Tercer Trimestre del Embarazo , Sífilis/diagnóstico , Sífilis Congénita/diagnóstico , Treponema pallidum , Estados Unidos/epidemiología
10.
J Glob Health ; 10(1): 010504, 2020 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32280458

RESUMEN

Background: Countdown to 2030 (CD2030) tracks progress in the 81 countries that account for more than 90% of under-five child deaths and 95% of maternal deaths in the world. In 2017, CD2030 identified syphilis screening and treatment during antenatal care (ANC) as priority indicators for monitoring. Methods: Country-reported data in the UNAIDS Global AIDS Monitoring System (GAM) system were used to evaluate four key syphilis indicators from CD2030 countries: (1) maternal syphilis screening and (2) treatment coverage during ANC, (3) syphilis seroprevalence among ANC attendees, and (4) national congenital syphilis (CS) case rates. A cascade analysis for CD2030 countries with coverage data for the number of women attending at least 4 antenatal care visits (ANC4), syphilis testing, seroprevalence and treatment was performed to estimate the number of CS cases that were attributable to missed opportunities for syphilis screening and treatment during antenatal care. Results: Of 81 countries, 52 (64%) reported one or more values for CS indicators into the GAM system during 2016-2017; only 53 (65%) had maternal syphilis testing coverage, 41 (51%) had screening positivity, and 40 (49%) had treatment coverage. CS case rates were reported by 13 (16%) countries. During 2016-2017, four countries reported syphilis screening and treatment coverage of ≥95% consistent with World Health Organization (WHO) targets. Sufficient data were available for 40 (49%) of countries to construct a cascade for data years 2016 and 2017. Syphilis screening and treatment service gaps within ANC4 resulted in an estimated total of 103 648 adverse birth outcomes with 41 858 of these occurring as stillbirths among women attending ANC4 (n = 31 914 408). Women not in ANC4 (n = 25 619 784) contributed an additional 67 348 estimated adverse birth outcomes with 27 198 of these occurring as stillbirths for a total of 69 056 preventable stillbirths attributable to syphilis in these 40 countries. Conclusion: These data and findings can serve as an initial baseline evaluation of antenatal syphilis surveillance and service coverage and can be used to guide improvement of delivery and monitoring of syphilis screening and treatment in ANC for these priority countries.


Asunto(s)
Complicaciones Infecciosas del Embarazo/diagnóstico , Sífilis/diagnóstico , Femenino , Humanos , Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Tamizaje Masivo , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Atención Prenatal , Sífilis/epidemiología , Sífilis/prevención & control , Sífilis Congénita/diagnóstico , Sífilis Congénita/epidemiología , Sífilis Congénita/prevención & control , Organización Mundial de la Salud
11.
PLoS One ; 15(4): e0231029, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-32271807

RESUMEN

Syphilis is a chronic infectious disease with its prevalence being described since the 15th century. Although its etiological agent and also the treatment measures are widely known, syphilis is still a great public health problem worldwide, mainly in countries with limited resources associated to low investments in health primary care. The aim of the present study was to analyze the trend and regional distribution of syphilis in Brazil between 2007 and 2017. This is an ecological study using secondary data from the Brazilian notification system. The Ministry of Health selected 100 municipalities which presented the worse outcomes related to syphilis from the 5,570 Brazilian municipalities as a target for a comprehensive project in order to tackle the prevalence of syphilis, called the "No Syphilis Project". These priority municipalities represent 57.7% of syphilis cases and about one third of the Brazilian population. They were compared with other 189 non-priority municipalities with more than 100 thousand inhabitants among the Brazilian regions (North, Northeast, Southeast, South and Center-West). Polynomial regression methods and Joinpoint analyses were used to analyze the trend, from which the Annual Average Percent Change (AACP) for each time period was calculated. There was a significant growth trend in all regions for the main three forms of syphilis (in pregnancy, congenital and acquired), especially in the South. The ratio between syphilis in pregnancy and congenital syphilis increased in both priority (AAPC: 8.54%; p<0.001) and non-priority municipalities (AAPC: 2.61%; p = 0.005), as well as in the regions, except the Center-West. High growth trends in syphilis prevalence were found in all municipalities, as well as all five regions between 2007 and 2017, showing that the challenge to reduce or even eliminate syphilis in Brazil is still difficult.


Asunto(s)
Epidemias/estadística & datos numéricos , Sífilis/epidemiología , Brasil/epidemiología , Femenino , Humanos , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Prevalencia , Análisis de Regresión , Sífilis Congénita/epidemiología
12.
Enferm. glob ; 19(57): 107-121, ene. 2020. tab, graf
Artículo en Español | IBECS | ID: ibc-193648

RESUMEN

OBJETIVO: Describir el perfil epidemiológico a través de las características sociodemográficas, obstétricas y del compañero, de casos notificados de sífilis en gestantes y de sífilis congénita, en el período de 2012 a 2016. MÉTODOS: Se trata de un estudio transversal y descriptivo realizado en la 16ª Regional de Salud de Apucarana, en el estado de Paraná, a través de las fichas de notificación compulsoria de sífilis en gestante y sífilis congénita, que constaban en el Sistema de Notificación de Perjuicios y Enfermedades (SINAN). RESULTADOS: Fueron notificados 257 casos de sífilis en gestantes y 119 casos de sífilis congénita. La tasa de prevalencia de sífilis gestacional fue de 0,97% y la tasa de incidencia de sífilis congénita de 4,73%. Las mujeres notificadas como "sífilis en gestante" (SG) y con recién nacido (RN) con "sífilis congénita" (SC), eran en su mayoría, blancas, jóvenes, con baja escolaridad y residían en zona urbana. Los compañeros no tratados totalizaron 40,8%; las madres consideradas con tratamiento inadecuado fueron 47,05%. Entre los nacidos vivos (NV) con SC, 69,7% no realizaron el test treponémico (TT) a los 18 meses y 81,5% no hicieron el test no treponémico (TNT) en el líquido cefalorraquídeo. CONCLUSIÓN: El sistema de salud debe ser reorganizado garantizando el seguimiento y acompañamiento tanto de la gestante como del recién nacido


OBJETIVO: Descrever o perfil epidemiológico através das características sociodemograficas, obstétricas e do parceiro dos casos notificados de sífilis em gestantes e de sífilis congênita no período de 2012 a 2016. MÉTODOS: Trata-se de um estudo transversal e descritivo realizado na 16ª Regional de Saúde de Apucarana do estado do Paraná através das fichas de notificação compulsória de sífilis em gestante e sífilis congênita inseridas no Sistema de Notificação de Agravos e Doenças (SINAN). RESULTADOS: Foram notificados 257 casos de sífilis em gestante e 119 casos de sífilis congênita. A taxa de prevalência de sífilis gestacional foi de 0.97% e a taxa de incidência de sífilis congênita de 4.73%. As mulheres notificadas com sífilis em gestante (SG) e com recém nascido (RN) portador de sífilis congênita (SC) eram em sua maioria, brancas, jovens, com baixa escolaridade e residiam em zona urbana. Parceiros não tratados totalizaram 40,8% e 47.05% das mães foram consideradas com tratamento inadequado. Entre os nascidos vivos (NV) com SC, 69,7% não realizaram o TT aos 18 meses e 81.5% não fizeram o TNT no líquor. CONCLUSÃO: O sistema de saúde deve ser reorganizado garantindo o seguimento e acompanhamento tanto da gestante quanto do recém-nascido


OBJECTIVE: To describe the epidemiological profile through sociodemographic, obstetric and partner characteristics of the notified cases of syphilis in pregnant women in the period of 2012 to 2016. METHODS: This is a cross-sectional and descriptive study conducted at the 16th Apucarana Health Region of the State of Paraná through the compulsory notification sheets for syphilis in pregnant women and congenital syphilis inserted in the Notification System of Diseases and Diseases (SINAN). RESULTS: It was recorded 257 cases of syphilis in pregnant women and 119 cases of congenital syphilis. The prevalent rate of syphilis was 0,97% and the incidence rate of congenital syphilis was 4,73%. Women with congenital syphilis (SG) and congenital syphilis (SC) were mostly white, young, with low schooling and living in urban areas. Untreated partners accounted for 40,8% and 47.05% of the mothers were considered with inadequate treatment. Among live births (NS) with SC, 69.7% did not undergo TT at 18 months and 81.5% did not do TNT in CSF. CONCLUSION: The health system must be reorganized ensuring the follow-up and follow-up of both the pregnant and the newborn


Asunto(s)
Humanos , Femenino , Embarazo , Niño , Adolescente , Adulto Joven , Adulto , Persona de Mediana Edad , Sífilis Congénita/epidemiología , Sífilis/epidemiología , Complicaciones Infecciosas del Embarazo/epidemiología , Treponema pallidum/aislamiento & purificación , Estudios Transversales , Transmisión Vertical de Enfermedad Infecciosa/estadística & datos numéricos , Tamizaje Neonatal/tendencias , Treponema pallidum/patogenicidad , Infecciones por Treponema/enfermería , Enfermedades de Transmisión Sexual/epidemiología
13.
Pediatr Int ; 62(3): 330-336, 2020 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-31886919

RESUMEN

BACKGROUND: The World Health Organization has set a goal to eliminate mother-to-child transmission of syphilis to a target of <50 cases per 100 000 live births. This study aimed to determine the rate of congenital syphilis and identify gaps in prevention. METHODS: A retrospective chart review was conducted in a tertiary care center in Bangkok, Thailand. The study included all pregnant women with positive syphilis serology and their infants. All congenital syphilis cases were categorized according to Centers for Disease Control criteria. RESULTS: From 2013 to 2017, 69 syphilis-infected pregnant women were included, with 30 congenital syphilis cases. The rate of congenital syphilis was 115 cases (95% CI 78-164) per 100 000 live births. The median (interquartile range) maternal age was 21 (18-32) years and 12 (17%) women had human immunodeficiency virus co-infection. Regarding maternal treatment, 28 (41%) women had inadequate treatment due to 13 cases (19%) of late or no antenatal care, six cases (8%) of recent infection near delivery, five cases (7%) of failure of treatment provision, and four (6%) others. There were three syphilitic stillbirths who were prematurely born to untreated pregnant women and 67 live births (one set of twins) of which 27 met definitions of probable congenital syphilis. They received complete treatment with penicillin and had non-reactive rapid plasma reagin within the first 6 months of life, with the exception of one who had non-reactive rapid plasma reagin at the age of 7 months. CONCLUSIONS: Congenital syphilis remains a problem in our setting. Nearly half of pregnant women who had syphilis had inadequate treatment. There is an urgent need to strengthen diagnosis and the treatment cascade of syphilis during antenatal care.


Asunto(s)
Transmisión Vertical de Enfermedad Infecciosa/prevención & control , Sífilis Congénita/epidemiología , Sífilis Congénita/prevención & control , Centros de Atención Terciaria , Adolescente , Adulto , Antibacterianos/uso terapéutico , Femenino , Humanos , Recién Nacido , Penicilinas/uso terapéutico , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/terapia , Resultado del Embarazo , Atención Prenatal , Estudios Retrospectivos , Sífilis/epidemiología , Sífilis/terapia , Sífilis Congénita/tratamiento farmacológico , Tailandia/epidemiología , Adulto Joven
14.
Rev. eletrônica enferm ; 22: 1-9, 2020. graf, tab
Artículo en Inglés, Portugués | LILACS | ID: biblio-1145227

RESUMEN

Objetivo: Analisar a tendência temporal e distribuição espacial da sífilis congênita em uma região da Amazônia brasileira. Metodologia: Estudo ecológico realizado com casos de sífilis congênita em crianças menores de um ano de idade no Pará empregando dados do Sistema de Informação de Agravo de Notificação e do Sistema de Informações sobre Nascidos Vivos, 2007 a 2017. Aplicou-se análise de autocorrelação espacial de Moran e análise temporal pelo método joinpoint. Resultados: A taxa de incidência bruta e média de sífilis congênita para o período do estudo foi de 3,8 e 0,345 (x1.000 nascidos vivos), respectivamente. A incidência de sífilis congênita apresentou tendência crescente com variação percentual anual de 12,0% (IC 9,8­14,8; p=0,000). A sífilis congênita apresentou expansão territorial, com as maiores taxas nos municípios do nordeste, sudeste e sudoeste paraense. Conclusão: A sífilis congênita apresentou tendência crescente contínua no Pará e expansão territorial. Nossos resultados sugerem ineficácia do acompanhamento de pré-natal.


Objective: To analyze the temporal trend and spatial distribution of congenital syphilis in a region of the Brazilian Amazon. Methodology: Ecological study conducted with cases of congenital syphilis in children under one year of age in Pará using data from the Information System of Notifiable Diseases and the Live Birth Information System, 2007 to 2017. Moran's spatial autocorrelation analysis and temporal analysis using the joinpoint model were applied. Results: The crude and mean incidence rates of congenital syphilis for the study period were 3.8 and 0.345 (x1,000 live births), respectively. The incidence of congenital syphilis showed an increasing trend with an annual percentage change of 12.0% (CI 9.8­14.8; p=0.000). Congenital syphilis presented territorial expansion, with highest rates in the municipalities of northeast, southeast and southwest of Pará. Conclusion: Congenital syphilis showed a continuously growing trend in Pará and territorial expansion. The results suggest ineffective prenatal follow-up.


Asunto(s)
Humanos , Femenino , Embarazo , Recién Nacido , Lactante , Niño , Adolescente , Adulto , Adulto Joven , Sífilis Congénita/epidemiología , Atención Prenatal , Sífilis Congénita/prevención & control , Brasil/epidemiología , Incidencia , Distribución Temporal , Análisis Espacial
15.
Rev. panam. salud pública ; 44: e8, 2020. tab
Artículo en Portugués | LILACS | ID: biblio-1101754

RESUMEN

RESUMO Objetivo. Descrever a distribuição temporal e as características epidemiológicas da sífilis congênita (SC) em Niterói, Sudeste do Brasil, de 2007 a 2016. Métodos. Este estudo descritivo de série temporal da incidência de SC utilizou os dados do Sistema de Informação de Agravos de Notificação (SINAN) e do Sistema de Informações sobre Nascidos Vivos (SINASC). A amostra incluiu todos os casos notificados. Além disso, foi realizado um relacionamento probabilístico entre SINAN e SINASC para recuperar informações ignoradas. A série temporal foi estimada por regressão logarítmica, de acordo com variáveis sociodemográficas e de pré-natal. Resultados. Identificaram-se 754 casos de SC no período estudado (incidência média de 11,9 casos/1 000 nascidos vivos). A incidência foi mais elevada em jovens (10 a 19 anos; 20 a 24 anos), participantes de cor preta e naquelas com baixa escolaridade e sem pré-natal. Do total de mulheres, apenas 57,6% obtiveram o diagnóstico de sífilis durante o pré-natal. O tratamento foi inadequado em 87,7% das mulheres. Apenas 12,2% dos parceiros foram tratados. Houve tendência crescente do agravo (16%/ano), que atingiu 23,2 casos/1 000 nascidos vivos em 2016. O crescimento foi mais acentuado em adolescentes do sexo feminino (25,2%/ano), raça/cor parda (16,8%/ano), indivíduos com baixa escolaridade (57,1%/ano) e mulheres que realizaram pré-natal (17,3%/ano); e, no período de 2012 a 2016, em mulheres com informação ignorada para a cor da pele. Conclusões. As iniquidades sociais se destacaram na ocorrência de SC, com incidência crescente em jovens. É necessária a capacitação dos profissionais de saúde para o manejo da sífilis gestacional e uma atuação efetiva das políticas públicas sobre os determinantes sociais da sífilis.(AU)


ABSTRACT Objective. To describe the temporal distribution and epidemiologic characteristics of congenital syphilis (CS) cases in the city of Niterói, southeastern Brazil, from 2007 to 2016. Method. This descriptive time series analysis of the incidence of CS used data from the Notifiable Diseases Information System (SINAN) and the Live Birth Information System (SINASC). The sample included all notified cases. A probabilistic matching was performed between SINAN and SINASC data to recover ignored information. The time series was estimated using logarithmic regression according to sociodemographic and prenatal care variables. Results. There were 754 identified cases of CS in the study period (mean incidence: 11.9 cases/1 000 live births). The incidence was higher in younger women (10 to 19; 20 to 24 years) and in those with black skin, low schooling, and without prenatal care. Of the overall group, only 57.6% received a diagnosis of syphilis during prenatal care. Treatment was not adequate in 87,7%, and only 12.2% of partners were treated. SC incidence presented a growing trend of 16%/year, reaching 23.2 cases/1 000 living births in 2016. This growth was especially marked in female adolescents (25.2%/year), brown race/skin color (16.8%/year), women with low schooling (57.1%/year) and women who received prenatal care (17.3%/year); and, from 2012 to 2016, in women without information on skin color. Conclusions. Social inequalities were linked to CS in the present sample. Also, increasing CS incidence was detected in youth. Health care professionals must be trained to manage gestational syphilis, and public policies must effectively address the social determinants of this condition.(AU)


RESUMEN Objetivo. Describir la distribución temporal y las características epidemiológicas de la sífilis congénita en Niterói, sureste de Brasil, de 2007 a 2016. Métodos. Estudio descriptivo de series temporales sobre la incidencia de la sífilis congénita; se utilizaron datos del Sistema de Información de Enfermedades Notificables (SINAN) y del Sistema de Información de Nacimientos Vivos (SINASC). La muestra incluyó todos los casos reportados. Se realizó además una relación probabilística entre el SINAN y el SINASC para recuperar información ignorada. La serie temporal se estimó mediante regresión logarítmica, según variables sociodemográficas y prenatales. Resultados. En el período estudiado se identificaron 754 casos de sífilis congénita (incidencia media de 11,9 casos/1 000 nacidos vivos). La incidencia fue mayor en las mujeres jóvenes (10-19, 20-24 años), mujeres de raza negra, con baja escolaridad y sin atención prenatal. Del total de mujeres, sólo se realizó el diagnóstico de sífilis durante la atención prenatal en 57,6%. El tratamiento fue inadecuado en 87,7% de las mujeres, solo el 12,2% de las parejas fueron tratadas. La enfermedad presentó una tendencia creciente (16%/año), y alcanzó 23,2 casos/1 000 nacidos vivos en 2016. El aumento fue más pronunciado en las adolescentes (25,2%/año), raza/color de piel morena (16.8%/año), mujeres con baja educación (57,1%/año), mujeres que recibieron atención prenatal (17,3%/año) y, de 2012 a 2016, en mujeres sin información sobre el color de la piel. Conclusiones. En esta muestra se destacaron las desigualdades sociales en la aparición de sífilis congénita, con una incidencia creciente en las jóvenes. Se requiere capacitación de los profesionales de la salud en el manejo de la sífilis gestacional y la acción efectiva de políticas públicas sobre los determinantes sociales de la sífilis.(AU)


Asunto(s)
Humanos , Sífilis Congénita/epidemiología , Inequidad Social/estadística & datos numéricos , Brasil/epidemiología , Estudios de Series Temporales , Epidemiología Descriptiva
16.
Epidemiol. serv. saúde ; 29(1): e2018193, 2020. graf, mapa
Artículo en Portugués | LILACS | ID: biblio-1090252

RESUMEN

Objetivo: analisar a distribuição espacial da sífilis em gestantes e da sífilis congênita no estado do Espírito Santo, Brasil, no período de 2011 a 2018. Métodos: estudo ecológico, com análise espacial dos casos notificados no Sistema de Informação de Agravos de Notificação (Sinan); utilizou-se o software TerraView 4.2.0. Resultados: foram analisados 78 municípios; identificou-se aglomerado significativo para sífilis em gestantes (índice de Moran=0,38; p=0,01) e sífilis congênita (índice de Moran=0,31; p=0,01), compreendendo a região metropolitana de Vitória e municípios litorâneos ao norte; no litoral norte e metropolitano, foram identificados cerca de 30 municípios com maior ocorrência dos desfechos, e cerca de 14 municípios com elevada proporção de sífilis congênita e baixa proporção em gestantes. Conclusão: foram identificados locais para direcionamento de ações e capacitação de profissionais ligados ao atendimento pré-natal, visando ao controle da sífilis em gestantes e congênita.


Objetivo: analizar la distribución espacial de casos de sífilis en mujeres embarazadas y sífilis congénita, de 2011 a 2018. Métodos: estudio ecológico, con análisis espacial de casos de sífilis en mujeres embarazadas y congénita en el Sistema de Información de Enfermedades de Notificación; se utilizó el software TerraView 4.2.0. Resultados: fueron analizados 78 municipios; se identificó clúster significativo por el índice de Moran, de 0,38 (p=0,01) para sífilis en mujeres embarazadas y de 0,31 (p=0,01) para sífilis congénita, abarcando la región metropolitana de Vitória y municipios del litoral norte, fueron identificados 30 municipios con mayor incidencia de desenlaces, y 14 municipios con una alta proporción de sífilis congénita y baja para sífilis en embarazadas. Conclusión: a través del estudio fueron identificadas regiones prioritarias para la planificación y capacitación de profesionales de la atención prenatal, priorizando el control de la sífilis congénita y prenatal.


Objective: to analyze the spatial distribution of syphilis cases in pregnancy and congenital syphilis cases, from 2011 to 2018. Methods: this was an ecological study applying spatial analysis of syphilis cases in pregnancy and congenital syphilis reported on the Notifiable Diseases Information System; TerraView 4.2.0 software was used. Results: seventy-eight municipalities were analyzed, and evidence of a significant cluster was found for syphilis in pregnant women (Moran index=0.38; p=0.01) and for congenital syphilis (Moran index=0.31; p=0.01) in the greater Vitória region and north coast municipalities; along the north and metropolitan coastal regions some 30 municipalities were identified as having higher occurrence of the outcomes, as well as some 14 municipalities with a high proportion of congenital syphilis and a low proportion of syphilis in pregnancy. Conclusion: the study identified places where interventions and prenatal care professional training need to be channeled, with the aim of controlling syphilis in pregnancy and congenital syphilis.


Asunto(s)
Humanos , Femenino , Embarazo , Sífilis Congénita/epidemiología , Sífilis/epidemiología , Mujeres Embarazadas , Análisis Espacio-Temporal , Complicaciones Infecciosas del Embarazo/epidemiología , Brasil/epidemiología , Epidemiología Descriptiva , Incidencia , Salud Materna
17.
Rev. Bras. Saúde Mater. Infant. (Online) ; 19(4): 865-872, Sept.-Dec. 2019. tab
Artículo en Inglés | LILACS | ID: biblio-1057121

RESUMEN

Abstract Objectives: to assess the epidemiological profile of congenital and syphilis during pregnancy in residents of São José do Rio Preto in São Paulo State. Methods: ecological study of the epidemiological profile of patients with congenital and gestational syphilis, based on the Sistema de Informação de Agravos de Notificação (Information System for Notifiable Diseases) from 2007 to 2016. Results: there were 396 cases of syphilis reported in pregnant women and 290 of congenital syphilis. In 2016, the rate of detecting syphilis in pregnant women was 13.2 cases/1,000 live births, while congenital syphilis the incidence rate was 6.5 cases/1,000 live births. For gestational syphilis, 54% of the diagnosis was performed in 2nd or 3rd trimester and 85% were reported at the primary care. Adequate treatment for pregnant women occurred in 96% of the notifications with 52% of partners treated. In congenital syphilis, 82% of the mothers underwent prenatal care. However, 94% of the pregnant women were treated inadequately while 82% of the partners did not receive any treatment. Conclusions: there has been an increase in the number of cases of gestational syphilis in pregnant women and a decrease in the cases of congenital syphilis from 2014. These results showed that the goal of 0.5 case/1,000 live births proposed by World Health Organization is still far from being achieved in this city.


Resumo Objetivos: conhecer o perfil epidemiológico da sífilis congênita e em gestantes nos residentes de São José do Rio Preto/SP. Métodos: estudo ecológico do perfil epidemiológico dos pacientes com sífilis congênita e gestacional, a partir de dados coletados no Sistema de Informação de Agravos de Notificação entre 2007 e 2016. Resultados: foram notificados 396 casos de sífilis em gestantes e 290 de sífilis congênita. Em 2016, a taxa de detecção da sífilis em gestantes foi 13,2 casos/1.000 nascidos vivos, enquanto a sífilis congênita, a taxa de incidência foi 6,5 casos/1.000 nascidos vivos. Para sífilis gestacional, 54% do diagnóstico foram realizados no 2° ou 3° trimestre e 85% notificadas na atenção primária. O tratamento adequado das gestantes ocorreu em 97% das notificações, com 52% dos parceiros tratados. Na sífilis congênita, 82% das mães realizaram o pré-natal, entretanto, 94% das gestantes foram tratadas inadequadamente e 82% dos parceiros não realizaram o tratamento. Conclusões: foi observado o aumento no número de casos de sífilis em gestantes e uma queda dos casos de sífilis congênita a partir de 2014. Com esses resultados, é notório que a meta de 0,5 caso/1.000 nascidos vivos proposta pela Organização Mundial da Saúde ainda está distante de ser alcançada no município.


Asunto(s)
Humanos , Femenino , Embarazo , Sífilis Congénita/epidemiología , Perfil de Salud , Sífilis/epidemiología , Notificación de Enfermedades , Atención Primaria de Salud , Brasil/epidemiología , Transmisión Vertical de Enfermedad Infecciosa , Mujeres Embarazadas , Estudios Ecológicos , Monitoreo Epidemiológico , Sistemas de Información en Salud/estadística & datos numéricos
18.
S Afr Med J ; 109(9): 652-658, 2019 Aug 28.
Artículo en Inglés | MEDLINE | ID: mdl-31635589

RESUMEN

BACKGROUND: Despite preventive measures and effective treatment, congenital syphilis continues to impact significantly on neonatal morbidity and mortality. There has been no recent South African (SA) published literature reviewing congenital syphilis, particularly in the context of a tertiary neonatal setting. OBJECTIVES: To describe the clinical features of symptomatic neonates with congenital syphilis and to identify modifiable patient, clinical and health facility factors that contributed to syphilis infection. METHODS: All positive serological tests for syphilis performed in neonates at Groote Schuur Hospital (GSH), Cape Town, SA, between 1 January 2011 and 31 December 2013 were obtained. Folders were reviewed, and neonates with clinical signs of congenital syphilis were included. RESULTS: Of 50 symptomatic neonates, 19 (38%) died. Twenty-eight mothers (56%) were unbooked and therefore received no antenatal care. Most mothers (98%) were inadequately treated. Health worker-related failures included poor notification and partner tracing as well as failure to recheck syphilis serology after 32 weeks' gestation in mothers who initially tested negative. Thirty-four neonates required intensive care unit admission. Two significant predictors of mortality were 1-minute and 5-minute Apgar scores <5. Hydrops fetalis was an independent risk factor for mortality, as were moderate to severely abnormal cranial ultrasound scan findings. CONCLUSIONS: Congenital syphilis in neonates admitted to the GSH neonatal unit was associated with substantial morbidity and mortality. The modifiable factors identified represent inadequate antenatal healthcare and health system failures. These factors are longstanding, highlighting the need to establish governance and audit processes and address the continuing socioeconomic and sociocultural barriers that mothers face as a way forward in ultimately eliminating this entirely preventable disease.


Asunto(s)
Complicaciones Infecciosas del Embarazo/diagnóstico , Atención Prenatal/estadística & datos numéricos , Sífilis Congénita/epidemiología , Sífilis/diagnóstico , Adulto , Puntaje de Apgar , Femenino , Humanos , Recién Nacido , Unidades de Cuidado Intensivo Neonatal/estadística & datos numéricos , Masculino , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/microbiología , Estudios Retrospectivos , Sudáfrica/epidemiología , Sífilis/epidemiología , Serodiagnóstico de la Sífilis , Sífilis Congénita/mortalidad , Centros de Atención Terciaria , Adulto Joven
19.
Afr Health Sci ; 19(2): 1858-1865, 2019 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-31656468

RESUMEN

Background: A significant proportion of newborns in the developing countries are born with congenital anomalies. Objective: This study investigated congenital infections due to Rubella virus, Toxoplasma gondii, Treponema pallidum among presumed normal neonates from full term pregnant women in Mwanza, Tanzania. Methods: Sera from mothers were tested for Treponema pallidum and Toxoplasma gondii infection while newborns from mothers with acute infections were tested for T. pallidum and T. gondii, and all newborns were tested for Rubella IgM antibodies. Results: A total of 13/300 (4.3 %) mothers had T. pallidum antibodies with 3 of them having acute infection. Two (0.7 %) of the newborns from mothers with acute infection were confirmed to have congenital syphilis. Regarding toxoplasmosis, 92/300 (30.7 %) mothers were IgG seropositive and 7 had borderline positivity, with only 1/99 (1%) being IgM seropositive who delivered IgM seronegative neonate. Only 1/300 (0.3 %) newborn had rubella IgM antibodies indicating congenital rubella infection. Conclusion: Based on these results, it is estimated that in Mwanza city in every 100,000 live births about 300 and 600 newborns have congenital rubella and syphilis infections, respectively. Rubella virus and T. pallidum are likely to be among common causes of congenital infections in developing countries.


Asunto(s)
Complicaciones Infecciosas del Embarazo/epidemiología , Virus de la Rubéola/inmunología , Rubéola (Sarampión Alemán)/congénito , Rubéola (Sarampión Alemán)/epidemiología , Sífilis Congénita/epidemiología , Toxoplasma/inmunología , Toxoplasmosis Congénita/epidemiología , Treponema pallidum/inmunología , Adolescente , Adulto , Anticuerpos Antivirales/sangre , Estudios Transversales , Femenino , Sangre Fetal/inmunología , Humanos , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Recién Nacido , Embarazo , Complicaciones Infecciosas del Embarazo/inmunología , Atención Prenatal , Prevalencia , Rubéola (Sarampión Alemán)/diagnóstico , Virus de la Rubéola/aislamiento & purificación , Estudios Seroepidemiológicos , Sífilis/complicaciones , Sífilis/epidemiología , Sífilis Congénita/diagnóstico , Tanzanía/epidemiología , Toxoplasma/aislamiento & purificación , Toxoplasmosis/complicaciones , Toxoplasmosis/epidemiología , Toxoplasmosis Congénita/diagnóstico , Treponema pallidum/aislamiento & purificación , Población Urbana
20.
Rev Saude Publica ; 53: 95, 2019.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-31644773

RESUMEN

OBJECTIVE: To analyze factors associated with outpatient follow-up of children with congenital syphilis. METHODS: A non-concurrent cohort study performed in primary care units and three reference maternity hospitals in Fortaleza (Ceará State). Data were collected from September 2013 to September 2016 in the notification forms and in the medical records of hospitalization and outpatient follow-up, and they were presented considering an adequate and inadequate follow-up. Children who attended the primary care unit or referral outpatient clinic during the period recommended by the Ministry of Health were considered adequately followed up and performed the recommended examinations. Pearson's chi-square and Fisher's exact tests were used in the comparative analysis. The estimated risk of adequate non-follow-up was verified by simple and multiple logistic regression. RESULTS: The total of 460 children with congenital syphilis were notified, of which 332 (72.2%) returned for at least one appointment and were part of the study. Exactly 287 (86.4%) children attended the primary health unit; however, there was no reference to congenital syphilis in 236 (71.1%) medical records and no information on the venereal disease research laboratory (VDRL) test was found in 264 (79.5%) children. There was nonadherence to subsequent appointments by 272 (81.9%) individuals. The following variables had a statistically significant association with the non-adequate follow-up of the children: marital status of the mothers, number of prenatal appointments, number of pregnancies, blood count, and radiography of long bones. CONCLUSIONS: Most children with congenital syphilis attended primary care for follow-up, but the services do not meet the recommendations of the Brazilian Ministry of Health for adequate follow-up.


Asunto(s)
Cuidados Posteriores/estadística & datos numéricos , Instituciones de Atención Ambulatoria/estadística & datos numéricos , Madres/estadística & datos numéricos , Pacientes Ambulatorios/estadística & datos numéricos , Atención Primaria de Salud/estadística & datos numéricos , Sífilis Congénita/terapia , Adolescente , Adulto , Brasil/epidemiología , Estudios de Cohortes , Femenino , Estudios de Seguimiento , Edad Gestacional , Humanos , Lactante , Recién Nacido , Modelos Logísticos , Masculino , Embarazo , Complicaciones Infecciosas del Embarazo/epidemiología , Complicaciones Infecciosas del Embarazo/terapia , Factores de Riesgo , Factores Socioeconómicos , Sífilis Congénita/epidemiología , Cumplimiento y Adherencia al Tratamiento/estadística & datos numéricos , Resultado del Tratamiento , Adulto Joven
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