Maternal syphilis and accomplishing sexual partner treatment: still a huge gap

2016 ◽  
Vol 28 (9) ◽  
pp. 876-880 ◽  
Author(s):  
Jessica Dallé ◽  
Vanessa Z Baumgarten ◽  
Mauro C Ramos ◽  
Mirela F Jimenez ◽  
Lisiane Acosta ◽  
...  
Keyword(s):  
Congenital Syphilis ◽  
Linear Trend ◽  
Secondary Data ◽  
Cross Sectional Study ◽  
Obstetric Outcomes ◽  
Epidemic Disease ◽  
Cross Sectional ◽  
Adequate Treatment ◽  
Maternal Syphilis ◽  
Child Hospital

Congenital syphilis (CS) is a preventable epidemic disease for which control is hindered by socioeconomic and health system issues. Inadequately treated maternal syphilis (MaS) commonly has serious adverse obstetric outcomes. This study – which is a cross-sectional study in a Brazilian large urban public Mother and Child hospital, making use of secondary data – evaluated the occurrence of treatment of sexual partners (SP) among women with MaS. The results showed that 771 MaS cases were identified from 2007 to 2014. No information on SP treatment was available in 570 (73.9%) cases. Of the 201 cases presenting information, 25 (12.4%) SP were treated. Out of 164 women having six or more prenatal visits, 25 (15.2%) SP received treatment. Data analyzed biennially have shown a growing trend of cases without collected information, ranging from 27.2% in 2007–2008 to 87.5% in 2013–2014. No linear trend in proportions of treated SP (maximum 7.4% SP treated) was found. Thus, in this study, it has been concluded that the proportion of SP adequately treated was consistently low, and the quality of information deteriorated during the studied period. Prenatal care per se, as provided, was not effective in delivering adequate treatment of SP. Creative integrated services with SP active participation are greatly needed if CS is to be controlled.

scholarly journals Gestational and congenital syphilis: maternal, neonatal characteristics and outcome of cases

2017 ◽  
Vol 17 (4) ◽  
pp. 781-789 ◽  
Author(s):  
Larissa Gramazio Soares ◽  
Bruna Zarpellon ◽  
Leticia Gramazio Soares ◽  
Tatiane Baratieri ◽  
Maicon Henrique Lentsck ◽  
...  
Keyword(s):  
Pregnant Woman ◽  
Congenital Syphilis ◽  
Secondary Data ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Adequate Treatment ◽  
Prophylactic Measure ◽  
Basic Care ◽  
Compulsory Notification

Abstract Objectives: to describe the occurrence of gestational and congenital syphilis in Guarapuava-PR, according to maternal, neonatal characteristics and outcome of cases. Methods: cross-sectional study, retrospective, held in Guarapuava/PR, with secondary data collected in the laboratory of clinical analyses and information system of Compulsory Notification, collected between October 2015 and August/2016, the variables were described through absolute and relative frequencies. Results: of the 40 newborn (NB) children ofpregnant women with syphilis, 30.0% had congenital syphilis. The variables that were associated with were: gestational quarter of positive examination (p=0.008), number of antenatal consultations (p=0.041), gestational risk stratification (p= 0.041) and treatment of partner (p<0.001). The variables that were associated with the occurrence of congenital syphilis were: risk classification at birth (p=0.004) and examination VDRL in the peripheral blood of the NB (p=0.004). Conclusions: reinforcing prenatal, with the early capture of the pregnant woman by basic care, expansion of the diagnostic coverage and timely and adequate treatment of the pregnant woman and partner, as a prophylactic measure of a possible reinfection.

scholarly journals Treatment Administered to Newborns With Congenital Syphilis During the Period of Penicillin Shortage in Brazil

2020 ◽  
Author(s):  
Ana Fatima Braga Rocha ◽  
Maria Alix Leite Araújo ◽  
Melanie M. Taylor ◽  
Edna O. Kara ◽  
Nathalie Jeanne Nicole Broutet
Keyword(s):  
Treatment Guidelines ◽  
Congenital Syphilis ◽  
Cross Sectional Study ◽  
National Treatment ◽  
Cross Sectional ◽  
Recommended Treatment ◽  
Maternity Hospitals ◽  
Maternal Syphilis ◽  
The City ◽  
Severe Shortage

Abstract 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. The aim of this study is to describe the different therapeutic regimens used in newborns with congenital syphilis during the period of penicillin shortage using a retrospective cross-sectional study design conducted in Fortaleza, Northeast Brazil. Methods Hospital medical records and case reporting forms of live births reported with congenital syphilis in 2015 and the associated maternal syphilis cases were reviewed during June 2017 to July 2018 from all public maternity hospitals in the city of Fortaleza. 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 VDRL titers > 1:8 (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 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.

scholarly journals Syphilis Notifications and the Triggering Processes for Vertical Transmission: A Cross-Sectional Study

2020 ◽  
Vol 17 (3) ◽  
pp. 984 ◽  
Author(s):  
Samara Isabela Maia de Oliveira ◽  
Cecília Olívia Paraguai de Oliveira Saraiva ◽  
Débora Feitosa de França ◽  
Marcos Antônio Ferreira Júnior ◽  
Libna Helen de Melo Lima ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Vertical Transmission ◽  
Professional Training ◽  
Congenital Syphilis ◽  
Cross Sectional Study ◽  
Epidemiological Surveillance ◽  
Concomitant Treatment ◽  
Sectional Study ◽  
Cross Sectional ◽  
Adequate Treatment

Syphilis is a disease that is found all over the world that causes damaging effects to the fetus through vertical transmission. This study aimed to analyze the processes that trigger the vertical transmission of syphilis through gestational and congenital syphilis notifications. It is a cross-sectional study. The sample totaled 129 notifications of syphilis in pregnant women and 132 notifications of congenital syphilis in the city of Natal, from 2011 to 2015. Data were obtained from the Information System for Disease Notification. The Chi-square, Student’s and Fisher’s tests were used to verify associations of interest. Diagnosis of maternal syphilis was predominant in the third trimester of pregnancy. Only 1.6% of the pregnant women were registered with an adequate treatment regimen, of these 16.3% had the concomitant treatment with their partners. Of the affected children, 78.8% were registered as asymptomatic. The factors that trigger vertical transmission are related to the late diagnosis of the pregnant woman and sexual partner(s) and the deficiencies in clinical/therapeutic management in relation to the phase of the disease. Strategies of professional training should be adopted to notify and expand the provision of information for epidemiological surveillance, aiming to strengthen care, reduce vertical transmission and enable the continuous analysis of this problem.

scholarly journals Sífilis congênita no estado de Pernambuco: uma análise de tendência e das respostas governamentais 2008-2017

2021 ◽  
Vol 1 (54) ◽  
pp. 104
Author(s):  
Laryssa Cristina Alves da Silva ◽  
Bruno Batista Pereira da Paz ◽  
Matheus Santos Duarte ◽  
Carlos Dornels Freire de Souza ◽  
Túlio Romério Lopes Quirino ◽  
...  
Keyword(s):  
Prenatal Care ◽  
Maternal Education ◽  
Congenital Syphilis ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Time Line ◽  
Sexually Transmitted ◽  
Increasing Trend ◽  
And Performance ◽  
Maternal Syphilis

<p><span class="fontstyle0">This article sought to describe the profile of congenital syphilis (CS) cases in Pernambuco and to evaluate government responses from 2008 to 2017. This is a cross-sectional study, with data obtained from the Department of Chronic Conditions and Sexually Transmitted Infections / MS. A trend analysis was conducted with the Joinpoint program and the following variables were adopted: maternal age group, maternal race / color, maternal education, moment of diagnosis of maternal syphilis, maternal treatment scheme, treatment of the mother’s partner and performance of prenatal. From 2008 to 2017, 9866 cases of congenital syphilis were registered in the state of Pernambuco, the numbers of cases showed an increasing trend over the time line. Out of the total, 75% (n = 7405) of women with a notified outcome of CS performed prenatal care. But only 36.9% (n = 3642) of cases of syphilis during pregnancy were diagnosed. As for the treatment performed, 57% (n = 6551) were done inappropriately. The data reflect the need for adjustments in prenatal care in Pernambuco, as well as the strengthening of actions aimed at controlling this indicator</span> <br /><br /></p>

scholarly journals Vulnerabilidade à sífilis gestacional e congênita: uma análise de 11 anos [Vulnerability to gestational and congenital syphilis: a 11-year analysis] [Vulnerabilidad a la sífilis gestacional y congénita: un análisis de 11 años]

2020 ◽  
Vol 28 ◽  
pp. e50487
Author(s):  
Joice Élica Espindola Paes Ozelame ◽  
Oleci Pereira Frota ◽  
Marcos Antonio Ferreira Júnior ◽  
Elen Ferraz Teston
Keyword(s):  
Skin Color ◽  
Congenital Syphilis ◽  
Secondary Data ◽  
Cross Sectional Study ◽  
Vulnerable Groups ◽  
Related Factors ◽  
Cross Sectional ◽  
Mato Grosso ◽  
Disease Information ◽  
Mato Grosso Do Sul

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.ABSTRACTObjective: 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.RESUMENObjetivo: 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.

scholarly journals US-GUIDED PERCUTANEOUS CORE LIVER BIOPSY: ANALYSIS OF 171 CASES FROM A SINGLE ONCOLOGY SERVICE

2018 ◽  
Vol 55 (3) ◽  
pp. 208-211 ◽  
Author(s):  
Francisco Victor Costa PARENTE ◽  
Eder Alencar MOURA ◽  
José Alexandre de Macêdo dos SANTOS ◽  
Marcos Venício Alves LIMA
Keyword(s):  
Liver Biopsy ◽  
Secondary Data ◽  
Cross Sectional Study ◽  
Focal Lesions ◽  
Cross Sectional ◽  
Adequate Treatment ◽  
Radiology Service ◽  
Oncological Patients ◽  
Treatment Objective ◽  
Histological Confirmation

ABSTRACT BACKGROUND: Though strongly suggestive of metastasis, focal lesions on liver scans of oncological patients require histological confirmation for the prescription of adequate treatment. OBJECTIVE: To evaluate the safety and efficacy of US-guided percutaneous core liver biopsy. METHODS: Descriptive, cross-sectional study based on secondary data from 171 patients submitted to US-guided percutaneous core liver biopsy at the diagnostic radiology service of the Ceará Cancer Institute (ICC, Brazil) between February 2010 and March 2015. Quantitative data were expressed in absolute numbers or percentages, with emphasis on the rate of complications observed within six hours after the procedure. RESULTS: The overall accuracy was 96.4%. The overall rate of complications was 2.3%, three quarters of which was due to hemorrhage. Age over 50 years was positively associated with accuracy. No deaths occurred within the period of observation. CONCLUSION: Our findings support the claim that the use of thick biopsy needles improves diagnostic accuracy. The few complications observed were non-lethal and predominantly hemorrhagic.

scholarly journals Análise temporal dos aspectos clínicos e sociais relacionados a sífilis congênita na Paraíba entre 2008 e 2017

2021 ◽  
Vol 1 (54) ◽  
pp. 44
Author(s):  
Matheus Santos Duarte ◽  
Michael Ferreira Machado ◽  
Carlos Dornels Freire de Souza
Keyword(s):  
Prenatal Care ◽  
Pregnant Women ◽  
Congenital Syphilis ◽  
Treponema Pallidum ◽  
Secondary Data ◽  
Cross Sectional Study ◽  
Social Characteristics ◽  
Cross Sectional ◽  
Time Period ◽  
The Government

<p class="Normal1"><span class="fontstyle0">Congenital syphilis is a disease resulting from vertical transmission of the Treponema pallidum bacterium from the infected mother to her child, which can result in several sequelae for the newborn. This study aimed to analyze the clinical and social characteristics of mothers whose children were affected by this disease in Paraíba between 2008 and 2017. It is a descriptive and cross-sectional study developed from secondary data from the Ministry of Health. The trends were analyzed through a segmented regression model using Joinpoint software. The statistical results were compared with the government actions implemented in the analyzed time period, in the scope of the fight against syphilis. A higher proportion of cases of this disease was observed in women with brown skin and low schooling. This proportion was higher than the national average. A high percentage of inadequate treatment was also observed. Although this ratio has decreased lately, the proportion of those who did not undergo treatment has increased. Prenatal care has been increasingly performed by these pregnant women. In this sense, the influence of the Rede Cegonha on this process can be highlighted, providing greater reach and quality of prenatal care, in addition to the expansion of the capacity of testing and treatment of pregnant women with syphilis.</span><strong> <br /><br /> </strong></p>

scholarly journals Perfil epidemiológico da sífilis gestacional e congênita no Brasil – período de 2007 a 2016 / Epidemiological profile of gestational and congenital syphilis in Brazil – from 2007 to 2016

2019 ◽  
Vol 64 (2) ◽  
pp. 69 ◽  
Author(s):  
Beatriz Raia Bottura ◽  
Laís Matuda ◽  
Priscila Simão Serrano Rodrigues ◽  
Cássia Maria Carvalho Abrantes do Amaral ◽  
Lene Garcia Barbosa
Keyword(s):  
Neonatal Period ◽  
Congenital Syphilis ◽  
Epidemiological Studies ◽  
Cross Sectional Study ◽  
Correct Treatment ◽  
Cross Sectional ◽  
Sexually Transmitted ◽  
Treatment And Prevention ◽  
Maternal Syphilis ◽  
Epidemiological Profile

Objetivo: Descrever a ocorrência dos casos notificados de sífilis congênita e materna nas regiões do Brasil, considerando o perfil epidemiológico das mães. Métodos: Estudo transversal constituído pelos casos notificados de sífilis gestacional e congênita no Brasil, no período de 2007 a 2016. Os dados foram coletados no SINAN (Sistema de Informação de Agravos de Notificação). Resultados: Houve um aumento dos casos de sífilis gestacional e congênita, no período analisado. O perfil das gestantes com sífilis foi semelhante em todas as regiões do país, com idade 20 a 29 anos e ensino fundamental incompleto. O diagnóstico de sífilis gestacional foi predominantemente realizado durante o pré-natal e o de sífilis congênita no período neonatal. O pré-natal foi realizado em 80% dos casos. O tratamento inadequado da sífilis materna obteve valores extremamente baixos, devido ao não tratamento dos parceiros. Conclusão: Ao longo dos anos houve aumento do número de casos de sífilis gestacional e congênita evidenciando a necessidade de ações efetivas para tratamento correto e prevenção.Descritores: Sífilis congênita, Sífilis, Perfil de saúde, Prevalência, Doenças sexualmente transmissíveis, Estudos epidemiológicosABSTRACTObjective: To describe the occurrence of reported cases of congenital and maternal syphilis in Brazilian regions, considering the epidemiological profile of the mothers. Methods: A cross-sectional study of reported cases of gestational and congenital syphilis in Brazil, from 2007 to 2016. Data were collected at SINAN (Notification of Injury Information System). Results: There was an increase in gestational and congenital syphilis in the analyzed period. The profile of pregnant women with syphilis was similar in all regions of the country, aged 20 to 29 years and incomplete elementary school. The diagnosis of gestational syphilis was predominantly performed during prenatal and congenital syphilis in the neonatal period. Prenatal care was performed in 80% of the cases. The inadequate treatment of maternal syphilis obtained extremely low values due to the non-treatment of the partners. Conclusion: Over the years there was an increase in the number of cases of congenital and gestational syphilis evidencing the need for effective actions for correct treatment and prevention. Keywords: Syphilis, congenital; Syphilis, Health profile, Prevalence, Sexually transmitted diseases, Epidemiological studies

scholarly journals Empty shelves: selected essential medicines stockouts in South Africa

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
L Wolvaardt ◽  
R Nemuntandani ◽  
I Kamungoma-Dada
Keyword(s):  
South Africa ◽  
Urban Areas ◽  
Descriptive Analysis ◽  
Secondary Data ◽  
Treatment Interruption ◽  
Cross Sectional Study ◽  
Essential Medicines ◽  
Chi Square ◽  
Cross Sectional ◽  
Antiretroviral Medication

Abstract Background Access to essential medicines in South Africa has been compromised by stockouts in health facilities. This study describes the occurrence of stockouts for a selection of essential medicines. Methods This cross-sectional study used secondary data retrieved from the Stop Stock Outs Project (SSP). A descriptive analysis was conducted on data from the 2013-2015 SSP case management database of routinely reported stockouts. Chi square tests of independence was conducted on data from the SSP 2015 annual telephonic survey to investigate associations between the occurrence of stockouts, the level of health facility and the type of health professional. Results 231 facilities reported 609 stockouts. Antiretroviral medication had the most stockout reports (78%; n = 475/609), followed by anti-infectives (17.1%; n = 104/609) and tuberculosis medication (4.9%; n = 30/609). The highest number of stockout reports were received from Gauteng province and the majority (71.09%; n = 150/211) of facilities reporting stockouts were in urban areas. There were more stockouts at ambulatory, rather than inpatient care, facilities however, this was not statistically significant. Conclusions This study confirms that South Africa experiences medicine stockouts for many of the essential medicines, with antiretroviral medication being the category most affected. The stockouts vary between provinces and the urban-rural divide but are an equal threat to both ambulatory and inpatient facilities. Key messages The pattern of stockouts experienced over a three-year period suggest that stockouts are ‘normal’ despite the substantive effects of treatment interruption – especially patients with HIV and/or TB. Antiretroviral therapy is at risk as a result of stockouts.

scholarly journals Effect of number of medications and use of potentially inappropriate medications on frailty among early-stage older outpatients

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Yuya Uragami ◽  
Kazuhiro Takikawa ◽  
Hajime Kareki ◽  
Koji Kimura ◽  
Kazuyuki Yamamoto ◽  
...  
Keyword(s):  
Early Stage ◽  
Linear Trend ◽  
Cross Sectional Study ◽  
Potentially Inappropriate Medications ◽  
Sectional Study ◽  
Antithrombotic Drugs ◽  
Cross Sectional ◽  
The Relationship ◽  
Inappropriate Medications ◽  
Frailty Score

Abstract Background Frailty is an urgent concern among an aging population worldwide. However, the relationship between frailty and number and types of medications has not been studied in detail among early-stage older patients, and it is unclear what prescriptions may have a role in preventing frailty. This study aimed to clarify the effects of number of medications and use of potentially inappropriate medications (PIMs) on frailty among early-stage older outpatients in Japan. Methods A cross-sectional study was undertaken. Frailty scores and medications of outpatients aged 65–74 years who regularly visited community pharmacies were investigated. Frailty scores were classified as 0 (non-frailty), 1–2 (pre-frailty), and ≥ 3 (frailty). The association between frailty and number of medications was analyzed by age and compared between PIM use and non-use groups. The proportion of patients who used PIMs was also analyzed by frailty score. Results Of 923 older outpatients, 49 (5.3%) and 318 (34.5%) patients had frailty and pre-frailty scores, respectively. The numbers of medications among patients with pre-frailty and frailty were significantly higher than among those with non-frailty (p <  0.001 for both). A similar increase was shown for PIM use groups aged 69–71 and 72–74 years, but not for the PIM use group aged 65–68 years and all groups without PIM use. An increasing linear trend was observed for the relationship between the proportion of patients who used any PIM, as well as some subcategories of PIMs (such as NSAIDs, benzodiazepines, loop diuretics and antithrombotic drugs) and frailty score. Conclusions Unnecessary medication use among early-stage older outpatients, especially patients aged ≥69 years who use PIMs and many medications, seems to be associated with frailty, but further research is needed to confirm these findings.

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