Abstract
To analyze, in the light of the social-ecological theory, the temporal progression of gestational syphilis and its relationship with the implementation of the rede cegonha in Ceará. This is a retrospective documental study, based on the information system of notifiable diseases about gestational syphilis in the perspective of the social-ecological theory. The sample consisted of all notifications from the state of Ceará in the period from 2007 to 2017. Data collection was carried out in October 2019. A total of 229,558 cases of gestational syphilis was reported in Brazil; of these, 7,040 were from the state of Ceará (3.1%), with a growing increase in cases over the years. Regarding the distribution of syphilis cases between the period before and after the implementation of the rede cegonha, there was an association with education (p < 0.0001), clinical classification (p < 0.0001), and gestational age (p = 0.0005). Despite the implementation of public policies and improvement of the epidemiological surveillance system, there is still a long way to go to control syphilis during pregnancy.
Highlights
Syphilis is a Sexually Transmitted Infection (STI) that has persisted for thousands of years even with wide application of preventive measures and efficient treatments
Data are only available for the period 2014 to 2016, with 7.4% of cases not being treated with penicillin, and the year 2015 being highlighted for showing the lowest number of pregnant women treated with penicillin (86.5%) (Table 1)
According to the results presented, syphilis is still a problem among pregnant women, with its detection rate increasing over the years
Summary
Syphilis is a Sexually Transmitted Infection (STI) that has persisted for thousands of years even with wide application of preventive measures and efficient treatments. In addition to being associated with serious complications in untreated people, Gestational Syphilis (GS) is related to perinatal complications such as Congenital Syphilis (CS), fetal deaths/stillbirths, neonatal deaths, premature babies/low birth weight, and infected children[3]. Syphilis causes more than 300,000 fetal and neonatal deaths per year worldwide, in addition to increasing the risk of premature death in another 215,000 children[4]. In 2017, the number of cases of SG notified in Brazil was 49,013 (28.4% higher than in 2016). Of these cases, 9,084 (18.5%) lived in the Northeast Region, with 1,297 cases in the state of Ceará alone (2.65%). In 2017, the Brazilian Public Health System (SUS) spent approximately 2.8 million dollars on medium- and high-cost procedures, such as hospitalizations, of which a significant amount was directly related to syphilis and CS[5]
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