Abstract
Abstract Objectives: to analyze the variation in the incidence rates of congenital syphilis according to the spatial distribution of Life Condition Index (LCI) among neighborhoods in the city of Recife-PE. Methods: an ecological study, developed from 3,234 cases of congenital syphilis notified in the Sistema de Informação de Agravos de Notificação (Severe Disease Notification Information System), between 2007 and 2016. LCI was built from seven variables related to the dimensions of the environment, education and income, aggregated at the neighborhood levels and spatially distributed in four strata: very high, high, low and very low. The correlation between the rates of congenital syphilis in the strata and LCI was investigated by applying the Spearman correlation coefficient and demonstrated by means of scatter graphics. Results: the mean rate on disease incidence was 6.8 cases per thousand live births. There was a higher incidence in the strata of very low and low living conditions, as well as in Districts that presented poor sanitary conditions and low schooling for the head of the family (District VII), higher proportion of illiteracy among 10 and 14 year olds (District II) and low income of the head of the household (Districts I, II and VII). Conclusions: this study showed the persistence of health inequalities in areas with worse living conditions.
Highlights
Congenital syphilis is the result of hematogenous dissemination of Treponema pallidum, from infected pregnant women who are not treated or inadequately treated, transmit to their fetus via the placental route.[1]
To analyze the variation in the incidence rates of congenital syphilis according to the living conditions of the population in Recife, the ICVA was constructed, using the neighborhoods in the city as units of analysis
The 33% increase in the disease detection rate in the second five-year period compared to the first may have been influenced by the shortage of penicillin in the market between 2014 and 2016, which reached practically all the Brazilian States[20] and by the resistance of some professionals to use the drug indicated due to the risk of anaphylactic reaction,[21] which shows difficulties in the manage
Summary
Congenital syphilis is the result of hematogenous dissemination of Treponema pallidum, from infected pregnant women who are not treated or inadequately treated, transmit to their fetus via the placental route.[1]. The occurrence of congenital syphilis is a sentinel event in the quality of prenatal care provided[3] and the adequacy of the treatment of maternal syphilis, as well as the performance of routinely laboratorial tests and compliance with the recommended basic procedures, prescriptions, and guidelines during consultations, are factors that significantly contribute to the incidence of the congenital form of the infection.[4]. In the city of Recife, a survey conducted in the public hospital network revealed that most users had seven or more prenatal consultations, the puerperal women showed dissatisfaction with the care provided,[5] which may reflect the low adherence to practices recommended by health professionals, and, increase the risk of vertical transmission of syphilis during pregnancy. As for the quality of prenatal care, the population's living conditions can be a factor associated with difficult access or non-adherence to prescribed treatments, especially in cases of maternal syphilis in which there is a need for treatment, from the partnership to be considered appropriate
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