Syphilis in pregnancy and congenital syphilis and their relationship with Family Health Strategy coverage, Goiás, Brazil, 2007-2014: an ecological study

Nunes, Patrícia Silva; Zara, Ana Laura de Sene Amâncio; Rocha, Déborah Ferreira Noronha de Castro; Marinho, Tamíris Augusto; Mandacarú, Polyana Maria Pimenta; Turchi, Marília Dalva

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Epidemiologia e Serviços de Saúde

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ORIGINAL ARTICLE • Epidemiol. Serv. Saúde 27 (4) • 2018 • https://doi.org/10.5123/S1679-49742018000400008 copy

Syphilis in pregnancy and congenital syphilis and their relationship with Family Health Strategy coverage, Goiás, Brazil, 2007-2014: an ecological study^* * Article based on the Master’s Degree dissertation of the lead author, Patrícia Silva Nunes, entitled ‘Congenital syphilis in the State of Goiás, 2007-2014’, defended at the Federal University of Goiás Public Health Postgraduate Program on December 11th 2015.

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Objective:

to analyze the incidence of syphilis in pregnant women (SPW) and congenital syphilis (CS) and the correlation of these indicators with Family Health Strategy (FHS) coverage in Goiás, Brazil, from 2007 to 2014.

Methods:

this was an ecological study using Notifiable Diseases Information System (SINAN) data and data from the Health Ministry’s Department of Primary Care; Spearman's correlation was used to evaluate the relationship between FHS coverage and syphilis incidence.

Results:

SPW incidence increased from 2.8 to 9.5/1,000 live births, while CS incidence increased from 0.3 to 2.5/1,000 live births (p<0.05) in the period 2007-2014; there was a significant increase in CS cases in municipalities with percentage FHS coverage below 75% (p<0.001).

Conclusion:

the concomitant increase in SPW and CS incidence suggests failures in the prevention of vertical transmission of syphilis, especially in regions with lower FHS coverage.

Keywords:
Syphilis; Syphilis, Congenital; Pregnant Women; Family Health Strategy; Ecological Studies

Health Macroregion	Congenital syphilis incidence coefficient (per 1,000 live births)				Syphilis detection coefficient for pregnant (per 1,000 live births)				Family Health Strategy coverage (%)
Health Macroregion	2007	2014	RR^a	p-value^b	2007	2014	RR^a	p-value^b	2007	2014	RR^a	p-value^b
West Central	0.2	2.9	14.5	<0.001	2.6	9.8	3.8	<0.001	60.0	70.0	1.7	<0.001
Northeast	0.8	0.5	0.6	0.262	3.3	5.7	1.7	<0.001	52.0	66.0	1.3	<0.001
North Central	0.3	2.4	8.0	<0.001	3.7	8.3	2.2	<0.001	71.0	82.0	1.5	<0.001
Southeast	0.1	2.6	26.0	<0.001	4.1	11.4	2.8	<0.001	58.0	59.0	1.0	<0.001
Southeast Central	0.2	3.2	16.0	<0.001	1.4	11.1	7.9	<0.001	61.0	70.0	1.1	<0.001
Goiás	0.3	2.5	8.3	<0.001	2.8	9.5	3.4	<0.001	55.9	64.6	1.5	<0.001

Family Health Strategy coverage (%)	Municipalities		Congenital syphilis incidence coefficient (per 1,000 live births)		RR^a	p-value^b
Family Health Strategy coverage (%)	2007 (n=15)	2014 (n=54)	2007	2014		2007
≤25	3	4	0.6	3.5	5.8	<0.001
>25 and <50	3	3	0.4	3.0	7.5	<0.001
≥50 and <75	2	9	2.8	4.5	1.6	<0.001
≥75	7	38	5.7	5.1	0.9	0.602

Secretaria de Vigilância em Saúde e Ambiente - Ministério da Saúde do Brasil SRTVN Quadra 701, Via W5 Norte, Lote D, Edifício P0700, CEP: 70719-040, +55 61 3315-3464, Fax: +55 61 3315-3464 - Brasília - DF - Brazil
E-mail: ress.svs@gmail.com

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[1] Correspondence: Patrícia Silva Nunes - Rua 226, c/ 227, Residencial Bucareste, Torre F, apto. 301, Setor Leste Universitário, Goiânia, GO, Brazil. CEP: 74610-130. E-mail: patnunesufg@gmail.com