scholarly journals EPIDEMIOLOGICAL PROFILE OF THE NOTIFIED CASES OF CONGENITAL SYPHILIS BY HEALTH REGION IN TOCANTINS

2018 ◽  
Vol 5 (4) ◽  
pp. 55-65
Author(s):  
Jayanne Silva De Alcantara ◽  
Guilherme Pansani Silva ◽  
Kleidir Hernâny Moreira Oliveira ◽  
Michelle de Jesus Pantoja Filgueira
Keyword(s):  
Health Care ◽  
Prenatal Care ◽  
Urban Areas ◽  
Congenital Syphilis ◽  
Cross Sectional ◽  
Notification System ◽  
Maternal Schooling ◽  
Performance Area ◽  
The One ◽  
Epidemiological Profile

ABSTRACT This is a descriptive, retrospective cross-sectional epidemiological study, on cases of Congenital Syphilis (CS) reported on the Information System for Notifiable Diseases (SINAN) from 2013 to 2017. This study aims to describe the epidemiological profile of CS cases reported in the eight health regions of the state of Tocantins. The health care regions were related to the variables maternal schooling, prenatal performance, area of residence, moment of diagnosis and treatment of the partner. Of the 1192 cases reported,the majority were in the Capim Dourado region. It was verified that in most cases the mothers studied until elementary or secondary school, performed prenatal care and resided in urban areas, and  that the diagnosis occurred during prenatal care, however, the partner was not treated. Only Amor Perfeito region showed a predominance of diagnosis performed at the time of delivery and Ilha do Bananal region was the one with the highest percentage of diagnosis carried out after birth. The increase in SC cases may reflect increase in it’s incidence and improvement in the notification system. The percentage of untreated partners and late diagnoses may suggest a qualitative and an access deficit  in prenatal care. Descriptors: congenital syphilis; epidemiology; health care regions.

scholarly journals Perfil epidemiológico da sífilis congênita em uma microrregião no interior do estado da Bahia (2007-2017)

2019 ◽  
Vol 18 (4) ◽  
pp. 198-229
Author(s):  
Kaic Trindade Almeida ◽  
Álisson Neves Santos ◽  
Ana Karla Araújo Nascimento Costa ◽  
Myllena Rodrigues dos Santos ◽  
Ana Maria Fernandes Menezes ◽  
...  
Keyword(s):  
Public Health ◽  
Prenatal Care ◽  
Quantitative Study ◽  
Health Problem ◽  
Congenital Syphilis ◽  
Public Health Problem ◽  
Cross Sectional ◽  
Notification System ◽  
El Sistema ◽  
Epidemiological Profile

Objective: To analyze the epidemiological profile of Congenital Syphilis in 18 municipalities in the state of Bahia between 2007 and 2017.Method: A descriptive, cross-sectional and quantitative study of the confirmed cases of Congenital Syphilis in the micro-region registered in the Aggravation and Notification Information System.Results: In the study period, 39 cases were confirmed, with 30.8% of the mothers being between 20 and 24 years of age, 59% were brown, 46.2% had incomplete primary education, 33.3% were housewives, 74.4% 94.9% underwent prenatal care, 53.8% were diagnosed at the time of delivery / curettage, 41% received inadequate treatment and 38.5% of the partners were not treated. With regard to newborns, 69.2% were diagnosed with 0 day of life, 74.4% with recent Congenital Syphilis and 46.2% asymptomatic.Conclusion: The data reveal a serious public health problem in the micro-region analyzed, also pointing out failures in the notification system, observed in the high ignored index in the studied variables. Objetivo: Analizar el perfil epidemiológico de Sífilis Congénita en 18 municipios en el interior del estado de Bahía entre 2007 y 2017.Método: Estudio descriptivo, transversal y cuantitativo de los casos confirmados de Sífilis Congénita en la microrregión registrados en el Sistema de Información de Agravios y Notificación.Resultados: En el período estudiado se confirmaron 39 casos, donde el 30,8% de las madres tiene entre 20 a 24 años, el 59% son pardas, el 46,2% tienen enseñanza fundamental incompleta, el 33,3% amas de casa, el 74,4% en el momento del parto / curetaje, el 41% recibió tratamiento inadecuado y el 38,5% de los socios no fueron tratados. Con respecto a los recién nacidos, el 69,2% fue diagnosticado con 0 días de vida, 74,4% con Sífilis Congénita reciente y 46,2% asintomáticos.Conclusión: Los datos revelan un serio problema de salud pública en la microrregión analizada apuntando también fallas en el sistema de notificación, observadas en el elevado índice de ignorados en las variables estudiadas. Objetivo: Analisar o perfil epidemiológico de Sífilis Congênita em 18 municípios no interior do estado da Bahia entre 2007 e 2017. Método: Estudo descritivo, transversal e quantitativo dos casos confirmados de Sífilis Congênita na microrregião registrados no Sistema de Informação de Agravos e Notificação. Resultados: No período estudado foram confirmados 39 casos, onde 30,8% das mães tem entre 20 a 24 anos, 59% são pardas, 46,2% possuem ensino fundamental incompleto, 33,3% donas de casa, 74,4% residentes na zona urbana, 94,9% realizou o pré-natal, 53,8% foram diagnosticadas no momento do parto/curetagem, 41% receberam tratamento inadequado e 38,5% dos parceiros não foram tratados. Com relação aos recém-nascidos, 69,2% foram diagnosticados com 0 dia de vida, 74,4% com Sífilis Congênita recente e 46,2% assintomáticos. Conclusão: Os dados revelam um sério problema de saúde pública na microrregião analisada apontando também falhas no sistema de notificação, observadas no elevado índice de ignorados nas variáveis estudadas.

scholarly journals Sífilis na gestante e congênita: perfil epidemiológico e prevalencia

2019 ◽  
Vol 19 (1) ◽  
pp. 107-150
Author(s):  
Giordana Maronezzi ◽  
Giovanna Brichi Pesce ◽  
Débora Cristina Martins ◽  
Cacilda Maria Do Prado ◽  
Carlos Alexandre Molena Fernandes
Keyword(s):  
Pregnant Women ◽  
Urban Areas ◽  
Congenital Syphilis ◽  
Cross Sectional ◽  
Notification System ◽  
El Sistema ◽  
Partner Characteristics ◽  
Las Mujeres ◽  
Epidemiological Profile

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. 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. 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.

scholarly journals Access to prenatal care: inequalities in a region with high maternal mortality in southeastern Brazil

2016 ◽  
Vol 21 (5) ◽  
pp. 1647-1658 ◽  
Author(s):  
Katrini Guidolini Martinelli ◽  
Edson Theodoro dos Santos Neto ◽  
Silvana Granado Nogueira da Gama ◽  
Adauto Emmerich Oliveira
Keyword(s):  
Health Care ◽  
Prenatal Care ◽  
Health Services ◽  
Pregnant Women ◽  
Minimum Wage ◽  
Urban Areas ◽  
Access To Health Care ◽  
Universal Access ◽  
Southeastern Brazil ◽  
Cross Sectional

Abstract Aim This article aims to evaluate access to prenatal care according to the dimensions of availability, affordability and acceptability in the SUS microregion of southeastern Brazil. Methods A cross-sectional study conducted in 2012-2013 that selected 742 postpartum women in seven hospitals in the region chosen for the research. The information was collected, processed and submitted to the chi-square test and the nonparametric Spearman’s test, with p-values less than 5% (p < 0.05). Results Although the SUS constitutionally guarantees universal access to health care, there are still inequalities between pregnant women from rural and urban areas in terms of the availability of health care and among families earning up to minimum wage and more than one minimum wage per month in terms of affordability; however, the acceptability of health care was equal, regardless of the modality of the health services. Conclusion The location, transport resources and financing of health services should be reorganised, and the training of health professionals should be enhanced to provide more equitable health care access to pregnant women.

scholarly journals Study of Working Experience in Remote Rural Areas after Medical Graduation

2015 ◽  
Vol 12 (2) ◽  
pp. 121-125
Author(s):  
KR Thapa ◽  
BK Shrestha ◽  
MD Bhattarai
Keyword(s):  
Health Care ◽  
Rural Areas ◽  
Urban Areas ◽  
Sampling Method ◽  
Postgraduate Training ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Remote Areas ◽  
Convenience Sampling ◽  
A Priority

Background Posting of doctors in remote rural areas has always been a priority for Government; however data are scarce in the country about experience of doctors of working in remote areas after medical graduation.Objective A questionnaire survey of doctors was planned to analyze their experience of working after graduation in remote rural areas in various parts of the country.Method The cross-sectional survey was done by convenience sampling method. A one-page questionnaire with one partially closed-end and five open-end type questions was distributed to the doctors who had worked in remote rural areas after graduation under various governments’ postings.Result Two-third of participants had their home in urban areas and 89.8% had stayed for 1 to 5 years. About half of the participants had difficulty in getting the posting in the remote areas of their choice. Most participants indicated provision of opportunities for Residential (postgraduate) Training as their reasons of going to remote areas as well as their suggestions to encourage young graduates to go there. Similarly most also suggested appropriate career, salary and incentives to encourage doctors to go to work in remote areas. About 85% of participants pointed out the major problem faced while posted in remote areas as difficulty in handling varied situations with no guidance or seniors available around.Conclusion The notable points indicated by the participants are centered on the opportunity for Residential Training and difficulties faced without such training. Residential Training is a priority to be considered while planning the health policy for optimum health care of people.Kathmandu University Medical Journal Vol.12(2) 2014: 121-125

scholarly journals Clinical and epidemiological profile of hypertensive patients at the primary health care level in the state of Alagoas

2018 ◽  
Vol 50 (6) ◽  
pp. 349-357
Author(s):  
Raphaela Costa Ferreira ◽  
Bruna Merten Padilha ◽  
Yasmin Eugênia Santos e Silva Pedrosa ◽  
Rosielle Batista Ferreira ◽  
Poliana Coelho Cabral ◽  
...  
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Public Health Problem ◽  
Population Based ◽  
Important Public Health Problem ◽  
Cross Sectional ◽  
Study Objective ◽  
Hypertensive Patients ◽  
Primary Health ◽  
Epidemiological Profile

Study design: This was a cross-sectional, population-based and descriptive study. Study objective: To describe the clinical and epidemiological profile of hypertensive patients at the primary health care of Alagoas state. Methods: This study was carried out in the Basic Health Units of 12 cities of Alagoas, between 2014 and 2015, with hypertensive individuals between 20 and 60 years, of both gender. Socioeconomic, demographic, clinical, lifestyle, anthropometric and biochemical data were collected. Data were analyzed using descriptive statistics by Epi-Info version 7. Results: We evaluated 645 individuals. Of these, 86.2% were women, 62.3% had uncontrolled blood pressure, 41.9% had low educational level, 11.1% were smokers, 26.3% were alcohol users, 64.7% were sedentary, 48.4% were obese, 73.6% had high cardiovascular risk, according to waist circumference; 54.4% and 47.2% had elevated total cholesterol and triglycerides, respectively. Conclusion: Since hypertension is an important public health problem that has serious consequences, the knowledge of the hypertensive population profile of Alagoas will facilitate the treatment for the health of patients with this condition.

scholarly journals Prenatal evaluation in primary care in Northeast Brazil

2019 ◽  
Vol 53 ◽  
pp. 43 ◽  
Author(s):  
Esther Pereira da Silva ◽  
Antônio Flaudiano Bem Leite ◽  
Roberto Teixeira Lima ◽  
Mônica Maria Osório
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Prenatal Care ◽  
Health Care Professionals ◽  
Cross Sectional Study ◽  
Educational Strategies ◽  
Cross Sectional ◽  
Factors Associated ◽  
Primary Health ◽  
Logistic Regression Method

OBJECTIVE: To characterize prenatal care and verify possible factors associated with its adequacy. METHODS: This is a cross-sectional study based on interviews with health care professionals and consultations on official documents of women attending prenatal of the primary health care in the city of João Pessoa, capital of Paraíba, in the Northeast region of Brazil. Prenatal care was evaluated by an index with criteria referring to aspects of structure, process and outcome, denominated IPR/Prenatal. The multivariate logistic regression method revealed that demographic, socioeconomic, reproductive and maternal morbidity variables were possible determinants for prenatal adequacy. RESULTS: The survey involved 130 services and 1,625 primary health care patients. Prenatal care was adequate in approximately 23% of the cases. Low prevalence of referral to maternity, educational strategies and examinations were observed. The analysis showed that nonadolescent women (OR = 1,390), with a longer period of schooling (OR = 1.750), higher per capita income (OR = 1,870) and primiparous women (OR = 1,230) were more likely to have an adequate prenatal. CONCLUSIONS: Prenatal care, when evaluated by broader criteria, showed a low percentage of adequacy. Strategies should be developed to ensure the referral to the maternity where the birth will take place and health education activities and examinations to provide adequate prenatal care in the municipality under study. In addition, factors associated with adequacy must be considered by managers and health professionals.

scholarly journals Epidemiological profile of cases of congenital syphilis in Belém City, Pará State, from 2009 to 2018

2020 ◽  
Vol 32 ◽  
Author(s):  
Aline do Socorro Lima Kzam ◽  
Fernando Maia Coutinho ◽  
Márcio César Ribeiro Marvão ◽  
Yuri Fadi Geha ◽  
Talles Levi Pereira Nogueira ◽  
...  
Keyword(s):  
Incidence Rate ◽  
Social Inequalities ◽  
Congenital Syphilis ◽  
Treponema Pallidum ◽  
Notification System ◽  
Maternal Characteristics ◽  
Lack Of Information ◽  
Appropriate Treatment ◽  
Epidemiological Profile ◽  
Low Prevalence

Introduction: Congenital Syphilis (CS) is a systemic infectious disease caused by the bacterium spirochete Treponema pallidum, of vertical transmission, trans placentally, resulting from the non-treatment or inadequate treatment of infected mothers, thus determining alarming numbers in the national territory, as in Belém City (Pará State). Objective: To analyze the epidemiological profile and incidence rate of CS in Belém, Pará. Methods: Quantitative, ecological, and descriptive study, conducted based on data available on DATASUS/TABNET from 2009 to 2018. Results: A total of 1,109 cases of CS were reported in Belém City. The mean incidence rate in this period was 5.4/1000 live births. As for newborns, 1,031 (92.97%) were diagnosed in the first week of life, 499 (45.00%) were male, 742 (66.91%) were pardo, and 860 (77.55%) classified as CS. Regarding maternal characteristics, the age group was inadequately filled in 100% of notifications, 476 (42.92%) had their level of education ignored at the time of filling out the forms, 768 (69.25%) underwent prenatal care, 490 (44.19%) were diagnosed with congenital syphilis at the time of delivery/curettage, and 636 (53.35%) reported no partner treatment. Conclusion: The profile studied showed an incidence rate above the parameters established for control, reflecting the increase in social inequalities, the lack of information about the disease, failure to register health organs, especially on the maternal age analyzed, low prevalence in the appropriate treatment of pregnant women’s partners, resonating the need for improvements in the notification system.

scholarly journals Perfil epidemiológico da sífilis congênita

2019 ◽  
Vol 13 (3) ◽  
pp. 604
Author(s):  
Isadora Maria Delmiro Silva ◽  
Eliane Maria Medeiros Leal ◽  
Helder Freire Pacheco ◽  
José Gilmar de Souza Junior ◽  
Filipe Santana da Silva
Keyword(s):  
Congenital Syphilis ◽  
Cross Sectional Study ◽  
Health Profile ◽  
Sectional Study ◽  
Annual Incidence Rate ◽  
Cross Sectional ◽  
Live Births ◽  
El Sistema ◽  
Epidemiological Profile

RESUMOObjetivo: descrever o perfil epidemiológico dos casos de Sífilis Congênita (SC) notificados em um município nordestino. Método: trata-se de um estudo do tipo seccional, de caráter descritivo, de todos os casos de sífilis congênita notificados pelo Sistema de Informação de Agravos de Notificação (SINAN) e pelo Sistema de Informações sobre Nascidos Vivos (SINASC). Apresentam-se os resultados em forma de tabelas. Resultados: identificaram-se 57 casos, com taxa anual média de incidência de SC de 6,72 casos por mil nascidos vivos (NV), entre 2011-2015, variando de 11,20/1000 NV em 2012 a 3,77/1000 NV em 2015. Registrou-se no período uma diminuição de 7,4% nos casos, porém, ainda ultrapassando a meta do Ministério da Saúde de incidência menor ou igual a 1/1000 NV. Conclusão: aponta-se, pelo estudo, a necessidade de melhorias na qualidade da assistência pré-natal, pois, mesmo havendo a diminuição na incidência da SC, os indicadores mostram valores distantes da meta. Descritores: Sífilis Congênita; Nascimento Vivo; Nascimento; Gravidez; Perfil de Saúde; Vigilância; Epidemiologia.ABSTRACT Objective: to describe the epidemiological profile of Congenital Syphilis (CS) cases reported in a Northeastern municipality. Method: this is a cross-sectional study of all cases of congenital syphilis reported by the SINAN and the SINASC. The results are presented in the form of tables. Results: 57 cases were identified, with a mean annual incidence rate of SC of 6.72 cases per thousand live births (LB), between 2011-2015, ranging from 11.20 / 1000 LB in 2012 to 3.77 / 1000 LB in 2015. A reduction of 7.4% in cases was recorded in the period, however, still exceeding the target of the Ministry of Health of incidence less than or equal to 1/1000 LB. Conclusion: the study points to the need for improvements in the quality of prenatal care, since even though there is a decrease in the incidence of CS, the indicators show values that are distant from the goal. Descriptors: Congenital syphilis; Live Birth; Birth; Pregnancy; Health Profile; Surveillance; Epidemiology.RESUMENObjetivo: describir el perfil epidemiológico de los casos de Sífilis Congénita (SC) notificados en un municipio nordestino. Método: se trata de un estudio del tipo seccional, de carácter descriptivo, de todos los casos de sífilis congénita notificados por el Sistema de Información de Agravios de Notificación (SINAN) y por el Sistema de Información sobre Nacidos Vivos (SINASC). Se presentan los resultados en forma de tablas. Resultados: se identificaron 57 casos, con una tasa anual media de incidencia de SC de 6,72 casos por mil nacidos vivos (NV), entre 2011-2015, variando de 11,20 / 1000 NV en 2012 a 3,77 / 1000 NV en el año En el período se redujo un 7,4% en los casos, pero superando la meta del Ministerio de Salud de incidencia menor o igual a 1/1000 NV. Conclusión: se señala, por el estudio, la necesidad de mejoras en la calidad de la asistencia prenatal, pues, aun habiendo la disminución en la incidencia de la SC, los indicadores muestran valores distantes de la meta. Descriptores: Sífilis Congénita; Nacimiento Vivo; Nacimiento; Embarazo; Perfil de Salud; Vigilancia; Epidemiología.

scholarly journals COVID-19 in socially vulnerable quilombola populations in Salvaterra, Pará, Eastern Amazon, Brazil

2021 ◽  
Vol 15 (08) ◽  
pp. 1066-1073
Author(s):  
Nelson Veiga Gonçalves ◽  
João Simão De Melo Neto ◽  
Selma Kazumi da Trindade Noguchi ◽  
Andrey Silva Machado ◽  
Alcindo Da Silva Martins Junior ◽  
...  
Keyword(s):  
Spatial Distribution ◽  
Epidemiological Survey ◽  
Incidence Rates ◽  
National Registry ◽  
Disease Notification ◽  
Cross Sectional ◽  
Notification System ◽  
Family Farmers ◽  
Use Of Data ◽  
Epidemiological Profile

Introduction: COVID-19 is a severe respiratory syndrome caused by the SARS-CoV-2 virus. In Brazil the highest infection rates are associated with socially vulnerable populations. This study therefore sought to analyze the spatial distribution of the disease and its relation with geographic, socioeconomic and public health policy characteristics associated with quilombola communities in Salvaterra municipality, state of Pará, for the period of March to September, 2020. Methodology: This cross-sectional and ecological study used data from the Disease Notification System and the National Registry of Health Establishments of the Ministry of Health, the Income Transfer Registry of the Ministry of Citizenship and the 2010 census of the Brazilian Institute of Geography and Statistics. Statistical and spatial analysis of the data was done through percentages of cases and Flow and Kernel map techniques. Results: Seventy-five notified cases of COVID-19 distributed among 7 quilombola communities in the municipality were analyzed. The epidemiological profile followed a national trend, with a higher percentage of cases among persons who were female, adults with low schooling levels, working as family farmers and with an outcome ending in recovery. The spatial distribution of the disease was not homogenous and showed clusters of cases and high incidence rates, especially in communities close to the municipal seat or to highways. Conclusions: The use of data analysis techniques was satisfactory for providing an understanding of the socioeconomic production of the disease in the areas studied. Accordingly, the need for intensifying epidemiological survey actions in the quilombola communities of the municipality is emphasized.

scholarly journals Lessons about the reliability of congenital syphilis and vertical HIV transmission data learned from case reviews in Uruguay: a cross-sectional study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Susana Cabrera ◽  
Mariangela Freitas Silveira ◽  
Ana Visconti ◽  
Fabian García ◽  
Rafael Aguirre ◽  
...  
Keyword(s):  
Health Care ◽  
Gestational Age ◽  
Congenital Syphilis ◽  
Cross Sectional Study ◽  
Mother To Child Transmission ◽  
Sectional Study ◽  
Child Transmission ◽  
Cross Sectional ◽  
Pregnancy Diagnosis ◽  
Mother To Child

Abstract Background In Uruguay it is mandatory to review all cases of positive HIV or reactive syphilis tests in pregnancy and peripartum. We compared the rates of mother-to-child transmission of syphilis and HIV detected by case reviews to those obtained from the usual surveillance system and described the characteristic of vertical transmission cases. Methods This is a cross-sectional study performed with secondary data obtained from official government sources, for all the country cases of maternal to child transmission of HIV and syphilis from 2012 to 2017, with descriptive analyses. For congenital syphilis analyses, the following pregnancy characteristics were investigated: number of antenatal checks, gestational age at pregnancy diagnosis, gestational age at syphilis test and diagnosis, adequate treatment, and treatment of partners. Sociodemographic characteristics included type of health care (public/private), maternal age, distribution of ethnic minorities, maximum educational attainment, presence of partner, planned pregnancy, drug and alcohol use, domestic violence, previous maternal diagnosis of syphilis, and previous children with congenital syphilis. Results Coverage of syphilis case reviews increased from 82% in 2014 to 97.4% in 2017. For HIV, this coverage reached 100% in 2017 and elimination of mother to child transmission was achieved. A marked decline in congenital syphilis was noted in the public health care sector, especially in the capital Montevideo, whereas the private sector has remained below the elimination target. Variables related with congenital syphilis in exposed children were late pregnancy diagnosis, < 5 antenatal checks, delayed diagnosis of gestational syphilis, lower rate of correct treatment for gestational syphilis, untreated partner, low maternal schooling, unplanned pregnancy, history of syphilis, and having other children with syphilis. Conclusion The use of case reviews provided knowledge regarding the accurate number of mother-to-child transmission cases and the evolution of elimination of mother to child transmission in the country. The results suggest that rates must be adjusted, providing an opportunity to improve the reliability of surveillance data, and point the need to address specific gaps in order to improve the quality of care during pregnancy, delivery, and the neonatal period.

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