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Paula MAD, Simões LA, Mendes JC, Vieira EW, Matozinhos FP, Silva TMRD. Diagnosis and treatment of syphilis in pregnant women at the services of Primary Care. CIENCIA & SAUDE COLETIVA 2022. [DOI: 10.1590/1413-81232022278.05022022en] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract The aim of this article is to evaluate the conditions of Primary Care (PC) services in Brazil as regards the availability of quick tests (QTs) for early diagnoses and of Benzylpenicillin (BZP) for the treatment of pregnant women with syphilis. This was a cross-sectional study, conducted with data from PC services that participated in the National Program for Access and Quality Improvement in Primary Care (PMAQ-AB, in Portuguese). The services where QTs were not readily available or where BZP was not available in a sufficient quantity were categorized as “inadequate”, while those where the QTs were readily available and BZP was found in sufficient quantities were categorized as “adequate”. A bivariate analysis and Odds Ratio (OR) estimates, together with their respective 95% confidence intervals (CI), were performed. The sample included 20,286 PC services from regions throughout the country. The prevalence of services with inadequate conditions for the diagnosis and treatment of syphilis was 47.7%. The Midwest region and non-capital cities presented the highest prevalence rates for PC services with inadequate conditions for the diagnosis and treatment of syphilis in pregnant women (p<0.05). Differences in the regions and locations of the PC services impact the availability of QTs and BZP.
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Paula MAD, Simões LA, Mendes JC, Vieira EW, Matozinhos FP, Silva TMRD. Diagnosis and treatment of syphilis in pregnant women at the services of Primary Care. CIENCIA & SAUDE COLETIVA 2022; 27:3331-3340. [PMID: 35894342 DOI: 10.1590/1413-81232022278.05022022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 04/05/2022] [Indexed: 11/22/2022] Open
Abstract
The aim of this article is to evaluate the conditions of Primary Care (PC) services in Brazil as regards the availability of quick tests (QTs) for early diagnoses and of Benzylpenicillin (BZP) for the treatment of pregnant women with syphilis. This was a cross-sectional study, conducted with data from PC services that participated in the National Program for Access and Quality Improvement in Primary Care (PMAQ-AB, in Portuguese). The services where QTs were not readily available or where BZP was not available in a sufficient quantity were categorized as "inadequate", while those where the QTs were readily available and BZP was found in sufficient quantities were categorized as "adequate". A bivariate analysis and Odds Ratio (OR) estimates, together with their respective 95% confidence intervals (CI), were performed. The sample included 20,286 PC services from regions throughout the country. The prevalence of services with inadequate conditions for the diagnosis and treatment of syphilis was 47.7%. The Midwest region and non-capital cities presented the highest prevalence rates for PC services with inadequate conditions for the diagnosis and treatment of syphilis in pregnant women (p<0.05). Differences in the regions and locations of the PC services impact the availability of QTs and BZP.
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Affiliation(s)
- Mariane Andreza de Paula
- Departamento de Enfermagem Materno Infantil e Saúde Pública, Escola de Enfermagem, Universidade Federal de Minas Gerais (UFMG). Av. Alfredo Balena 190, Santa Efigênia. 30130-000 Belo Horizonte MG Brasil.
| | - Luana Andrade Simões
- Programa de Pós-Graduação em Medicamentos e Assistência Farmacêutica, Faculdade de Farmácia, UFMG. Belo Horizonte MG Brasil
| | - Jullye Campos Mendes
- Programa de Pós-Graduação em Medicamentos e Assistência Farmacêutica, Faculdade de Farmácia, UFMG. Belo Horizonte MG Brasil
| | - Ed Wilson Vieira
- Departamento de Enfermagem Materno Infantil e Saúde Pública, Escola de Enfermagem, Universidade Federal de Minas Gerais (UFMG). Av. Alfredo Balena 190, Santa Efigênia. 30130-000 Belo Horizonte MG Brasil.
| | - Fernanda Penido Matozinhos
- Departamento de Enfermagem Materno Infantil e Saúde Pública, Escola de Enfermagem, Universidade Federal de Minas Gerais (UFMG). Av. Alfredo Balena 190, Santa Efigênia. 30130-000 Belo Horizonte MG Brasil.
| | - Tércia Moreira Ribeiro da Silva
- Departamento de Enfermagem Materno Infantil e Saúde Pública, Escola de Enfermagem, Universidade Federal de Minas Gerais (UFMG). Av. Alfredo Balena 190, Santa Efigênia. 30130-000 Belo Horizonte MG Brasil.
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Ribeiro ADDC, Dan CDS, Santos ADS, Croda J, Simionatto S. Neurosyphilis in Brazilian newborns: a health problem that could be avoided. Rev Inst Med Trop Sao Paulo 2020; 62:e82. [PMID: 33174978 PMCID: PMC7653815 DOI: 10.1590/s1678-9946202062082] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 09/03/2020] [Indexed: 11/22/2022] Open
Abstract
Syphilis is a public health problem, especially in pregnant women, due to the risk of transmission to the fetus and the involvement of the central nervous system, causing neurosyphilis. A case-control study was carried out to analyze the variables associated with neurosyphilis in Brazilian newborns of pregnant women with syphilis admitted for childbirth. Newborns were submitted to treponemal and non-treponemal tests, cerebrospinal fluid analysis, and long bone radiography. Newborns diagnosed with neurosyphilis and congenital syphilis were defined as cases and controls, respectively. The length of hospitalization and mean cost of neurosyphilis treatment were also evaluated. Twenty-one cases of newborns with neurosyphilis and 42 controls with congenital syphilis were included in the study. Out of 63 pregnant women with syphilis, 95.2% (60/63) received prenatal care, 74.6% (47/63) were diagnosed with syphilis during this period, 31.9% (15/47) underwent treponemic tests, 80.8% (38/47) were treated with penicillin and only 46.8% (22/47) of the partners received the treatment. Clinical complications such as low birth weight were observed in 12.7% (8/63) of the newborns. About 50.8% (32/63) of the newborns were hospitalized due to syphilis complications and each case of neurosyphilis spent at least US$ 881.48 on treatment and hospitalization. The results showed that the prenatal coverage is not sufficient to prevent neurosyphilis. The late diagnosis of syphilis in pregnant women and inadequate follow-up of sexual partners may favor the vertical transmission of T. pallidum in pregnant Brazilian women. Thus, improving the quality of health services is important for a more effective control of neurosyphilis.
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Affiliation(s)
- Anny Danyelly da Costa Ribeiro
- Universidade Federal da Grande Dourados , Laboratório de Pesquisa em Ciências da Saúde Dourados , Mato Grosso do Sul , Brazil.,Universidade Federal da Grande Dourados , Hospital Universitário de Dourados , Dourados , Mato Grosso do Sul , Brazil
| | - Cristiane de Sá Dan
- Universidade Federal da Grande Dourados , Laboratório de Pesquisa em Ciências da Saúde Dourados , Mato Grosso do Sul , Brazil.,Universidade Federal da Grande Dourados , Hospital Universitário de Dourados , Dourados , Mato Grosso do Sul , Brazil
| | - Andrea da Silva Santos
- Universidade Federal da Grande Dourados , Laboratório de Pesquisa em Ciências da Saúde Dourados , Mato Grosso do Sul , Brazil
| | - Júlio Croda
- Fundação Oswaldo Cruz , Campo Grande , Mato Grosso do Sul , Brazil.,Universidade Federal de Mato Grosso do Sul , Faculdade de Medicina , Campo Grande , Mato Grosso do Sul , Brazil
| | - Simone Simionatto
- Universidade Federal da Grande Dourados , Laboratório de Pesquisa em Ciências da Saúde Dourados , Mato Grosso do Sul , Brazil
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Oliveira VDS, Rodrigues RL, Chaves VB, Dos Santos TS, de Assis FM, Ternes YMF, de Aquino ÉC. [High-risk clusters and temporal trends in congenital syphilis infection in Brazil]. Rev Panam Salud Publica 2020; 44:e75. [PMID: 32818032 PMCID: PMC7425818 DOI: 10.26633/rpsp.2020.75] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 03/05/2020] [Indexed: 11/30/2022] Open
Abstract
Objetivo. Determinar a existência de aglomerados de municípios (clusters) com alto risco para sífilis congênita (SC) no Brasil e descrever a tendência temporal da doença no país, comparando a população de crianças cujas mães realizaram o pré-natal com aquelas cujas mães não realizaram esse controle. Métodos. Este estudo ecológico utilizou dados do Sistema de Informação de Agravos de Notificação (SINAN) e do Sistema de Informações sobre Nascidos Vivos (SINASC). Para a análise de aglomerados, a estatística de varredura Kulldorff foi aplicada à população de risco. A significância estatística foi determinada pelo logaritmo da razão de verossimilhança utilizando a distribuição discreta de Poisson. Para a análise das tendências das taxas de detecção do agravo, utilizou-se a regressão de Prais-Winsten. A análise foi realizada com os programas SatScan 9.4 e Stata 14.0. Resultados. Clusters com taxas de detecção de 41,3, 44,4 e 188,1 casos/10 000 nascidos vivos foram identificados em 2001, 2009 e 2017, respectivamente. Em 2001, as taxas foram 8 vezes maiores nos clusters do que no restante do país; em 2009, foram 3,3 vezes maiores; e, em 2017, 2,5. Detectou-se uma tendência crescente na infecção por SC em todas as regiões e unidades da federação. As taxas foram 8,53 vezes maiores nos neonatos cujas mães não realizaram pré-natal (243,3 casos/1 000 nascidos vivos vs. 28,4 casos/1 000 nascidos vivos em mães com pré-natal). Conclusões. A identificação de aglomerados de municípios com alto risco para SC e de tendências crescentes de infecção por SC em todo o país, mesmo na presença de pré-natal, indicam a necessidade de melhoria nas ações de saúde pública para o combate dessa doença.
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Affiliation(s)
- Vinícius da Silva Oliveira
- Universidade Federal de Goiás (FM-UFG) Faculdade de Medicina Goiânia (GO) Brasil Universidade Federal de Goiás (FM-UFG), Faculdade de Medicina, Goiânia (GO), Brasil
| | - Roberta Luiza Rodrigues
- Universidade Federal de Goiás (FM-UFG) Faculdade de Medicina Goiânia (GO) Brasil Universidade Federal de Goiás (FM-UFG), Faculdade de Medicina, Goiânia (GO), Brasil
| | - Vinícius Barros Chaves
- Universidade Federal de Goiás (FM-UFG) Faculdade de Medicina Goiânia (GO) Brasil Universidade Federal de Goiás (FM-UFG), Faculdade de Medicina, Goiânia (GO), Brasil
| | - Thiago Soares Dos Santos
- Universidade Federal de Goiás (FM-UFG) Faculdade de Medicina Goiânia (GO) Brasil Universidade Federal de Goiás (FM-UFG), Faculdade de Medicina, Goiânia (GO), Brasil
| | - Flaviane Marques de Assis
- Universidade Federal de Goiás (FM-UFG) Faculdade de Medicina Goiânia (GO) Brasil Universidade Federal de Goiás (FM-UFG), Faculdade de Medicina, Goiânia (GO), Brasil
| | - Yves Mauro Fernandes Ternes
- Universidade Federal de Goiás (IPTSP-UFG) Instituto de Patologia Tropical e Saúde Pública Goiânia (GO) Brasil Universidade Federal de Goiás (IPTSP-UFG), Instituto de Patologia Tropical e Saúde Pública, Goiânia (GO), Brasil
| | - Érika Carvalho de Aquino
- Universidade Federal de Goiás (IPTSP-UFG) Instituto de Patologia Tropical e Saúde Pública Goiânia (GO) Brasil Universidade Federal de Goiás (IPTSP-UFG), Instituto de Patologia Tropical e Saúde Pública, Goiânia (GO), Brasil
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Heringer ALDS, Kawa H, Fonseca SC, Brignol SMS, Zarpellon LA, Reis AC. [Inequalities in congenital syphilis trends in the city of Niterói, Brazil, 2007-2016Desigualdades en la tendencia de sífilis congénita en la ciudad de Niterói, Brasil, 2007-2016]. Rev Panam Salud Publica 2020; 44:e3. [PMID: 32038724 PMCID: PMC7001125 DOI: 10.26633/rpsp.2020.8] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 10/07/2019] [Indexed: 12/15/2022] Open
Abstract
Objetivo. Descrever a distribuição temporal e as características epidemiológicas da sífilis congênita (SC) em Niterói, Sudeste do Brasil, de 2007 a 2016. Métodos. Este estudo descritivo de série temporal da incidência de SC utilizou os dados do Sistema de Informação de Agravos de Notificação (SINAN) e do Sistema de Informações sobre Nascidos Vivos (SINASC). A amostra incluiu todos os casos notificados. Além disso, foi realizado um relacionamento probabilístico entre SINAN e SINASC para recuperar informações ignoradas. A série temporal foi estimada por regressão logarítmica, de acordo com variáveis sociodemográficas e de pré-natal. Resultados. Identificaram-se 754 casos de SC no período estudado (incidência média de 11,9 casos/1 000 nascidos vivos). A incidência foi mais elevada em jovens (10 a 19 anos; 20 a 24 anos), participantes de cor preta e naquelas com baixa escolaridade e sem pré-natal. Do total de mulheres, apenas 57,6% obtiveram o diagnóstico de sífilis durante o pré-natal. O tratamento foi inadequado em 87,7% das mulheres. Apenas 12,2% dos parceiros foram tratados. Houve tendência crescente do agravo (16%/ano), que atingiu 23,2 casos/1 000 nascidos vivos em 2016. O crescimento foi mais acentuado em adolescentes do sexo feminino (25,2%/ano), raça/cor parda (16,8%/ano), indivíduos com baixa escolaridade (57,1%/ano) e mulheres que realizaram pré-natal (17,3%/ano); e, no período de 2012 a 2016, em mulheres com informação ignorada para a cor da pele. Conclusões. As iniquidades sociais se destacaram na ocorrência de SC, com incidência crescente em jovens. É necessária a capacitação dos profissionais de saúde para o manejo da sífilis gestacional e uma atuação efetiva das políticas públicas sobre os determinantes sociais da sífilis.
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Affiliation(s)
- Andressa Lohan Dos Santos Heringer
- Universidade Federal Fluminense (UFF), Instituto de Saúde Coletiva Departamento de Epidemiología e Bioestatística Niterói (RJ) Brasil Universidade Federal Fluminense (UFF), Instituto de Saúde Coletiva, Departamento de Epidemiología e Bioestatística, Niterói (RJ), Brasil
| | - Helia Kawa
- Universidade Federal Fluminense (UFF), Instituto de Saúde Coletiva Departamento de Epidemiología e Bioestatística Niterói (RJ) Brasil Universidade Federal Fluminense (UFF), Instituto de Saúde Coletiva, Departamento de Epidemiología e Bioestatística, Niterói (RJ), Brasil
| | - Sandra Costa Fonseca
- Universidade Federal Fluminense (UFF), Instituto de Saúde Coletiva Departamento de Epidemiología e Bioestatística Niterói (RJ) Brasil Universidade Federal Fluminense (UFF), Instituto de Saúde Coletiva, Departamento de Epidemiología e Bioestatística, Niterói (RJ), Brasil
| | - Sandra Mara Silva Brignol
- Universidade Federal Fluminense (UFF), Instituto de Saúde Coletiva Departamento de Epidemiología e Bioestatística Niterói (RJ) Brasil Universidade Federal Fluminense (UFF), Instituto de Saúde Coletiva, Departamento de Epidemiología e Bioestatística, Niterói (RJ), Brasil
| | - Loren Angelica Zarpellon
- Universidade Federal Fluminense (UFF), Instituto de Saúde Coletiva Departamento de Epidemiología e Bioestatística Niterói (RJ) Brasil Universidade Federal Fluminense (UFF), Instituto de Saúde Coletiva, Departamento de Epidemiología e Bioestatística, Niterói (RJ), Brasil
| | - Ana Cristina Reis
- Escola Politécnica de Saúde Joaquim Venâncio (EPSJV/FIOCRUZ) Laboratório de Educação Profissional em Informações e Registros em Saúde Rio de Janeiro (RJ) Brasil Escola Politécnica de Saúde Joaquim Venâncio (EPSJV/FIOCRUZ), Laboratório de Educação Profissional em Informações e Registros em Saúde, Rio de Janeiro (RJ), Brasil
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Differences in maternal characteristics and pregnancy outcomes between syphilitic women with and without partner coinfection. BMC Pregnancy Childbirth 2019; 19:439. [PMID: 31771540 PMCID: PMC6880551 DOI: 10.1186/s12884-019-2569-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 10/22/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Partner infection is a significant factor in preventing mother-to-child syphilis transmission. We compared pregnancy outcomes between syphilis discordant and syphilis concordant couples. METHODS We conducted a retrospective study among 3076 syphilis-positive women who received syphilis screening together with their partners during pregnancy. Multivariate analysis was used to explore risks for abnormal outcomes in objects correcting for the major covariate factors. Adjusted odds ratios (OR) and 95% confidence intervals (CI) were estimated to compare pregnancy outcomes between syphilis concordant and syphilis discordant couples. RESULTS Overall, 657 of the 3076 women were diagnosed with gestational syphilis and had a syphilis-positive partner, giving a partner concordance prevalence of 21.36%. Women in concordant couples were more likely to have higher parity, more children, late antenatal care and syphilis screening, a lower proportion of latent syphilis, and elevated serologic titers than women in discordant couples (P < 0.01 for all). Totally, 10.08% of women had adverse pregnancy outcomes. Multivariate analysis showed partners' syphilis infection (ORadj = 1.44, 95% CI: 1.10-1.89), untreated pregnancy syphilis (ORadj = 1.67, 95% CI: 1.15-2.43), and higher maternal serum titers (> 1:8) (ORadj = 1.53, 95% CI: 1.17-2.00) increased the risks of adverse pregnancy outcomes. Concordance was associated with increased risk for stillbirth (ORadj = 2.86, 95%CI:1.36-6.00), preterm birth (PTB) (ORadj = 1.38,95%CI:1.02-1.87) and low birth weight (LBW) (ORadj = 1.55, 95%CI:1.13-2.11) compared with discordance. Even among treated women, concordance was associated with increased risk for stillbirth (ORadj = 3.26, 95%CI:1.45-7.31) and LBW (ORadj = 1.52, 95%CI:1.08-2.14). Among women with one treatment course, the risks for PTB(ORadj = 1.81, 95%CI:1.14-2.88) and LBW(ORadj = 2.08, 95%CI:1.28-3.38)were also higher among concordant couples than discordant couples. Nevertheless, there were no significant differences between concordant and discordant couples in risks of stillbirth (ORadj = 2.64, 95% CI: 0.98-7.05),PTB (ORadj = 1.15, 95% CI: 0.76-1.74), and LBW(ORadj = 1.21, 95% CI: 0.78-2.02) among women with two treatment courses. CONCLUSION Male partner coinfection increased the risks for stillbirth, PTB and LBW, particularly when gestational syphilis treatment was suboptimal. However, this risk could be reduced by adequate treatment.
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Marinho de Souza J, Giuffrida R, Ramos APM, Morceli G, Coelho CH, Pimenta Rodrigues MV. Mother-to-child transmission and gestational syphilis: Spatial-temporal epidemiology and demographics in a Brazilian region. PLoS Negl Trop Dis 2019; 13:e0007122. [PMID: 30789909 PMCID: PMC6383870 DOI: 10.1371/journal.pntd.0007122] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Accepted: 01/03/2019] [Indexed: 11/29/2022] Open
Abstract
Syphilis is a Sexually Transmitted Infection (IST) with significant importance to public health, due to its impact during pregnancy (Gestational Syphilis-GS); especially because syphilis can affect fetus and neonates' development (mother-to-child transmission-MTCT of syphilis), by increasing susceptibility to abortion, premature birth, skeletal malformations, meningitis and pneumonia. Measures to control and eliminate MTCT of syphilis have failed on the last few years in Brazil and this research aimed to identify the seasonality of notified cases of syphilis in a region of São Paulo state. The studied region, Pontal do Paranapanema, comprises 32 cities located in the West of São Paulo state, in Brazil. Data collected from the National System of Aggravations and Notification (SINAN) website was used to calculate the incidence rate of GS and MTCT. The incidence rate of GS was acquired dividing number of cases by number of women in each municipality and MTCT using number of live births in each year (from 2007 to 2013) in each municipality. This result was then, standardized multiplying incidence rate by 10,000 and expressed as incidence/10,000 women or live births, for GS and MTCT, respectively. To identify possible endemic/epidemic periods, a control diagram was performed using the standard deviation (SD) of incidence rate. Thematic maps representing the spatial distribution of incidence rates were constructed using a Geographic Information System software (GIS, based on cartographic vector available on the Brazilian Institute of Geography and Statistics (IBGE) website. Eighty cases of GS and 61 cases of MTCT were notified in the studied region. An increase of GS notification was detected in the Pontal do Paranapanema in 2011 followed by an increase in number of MTCT cases in the subsequent year, suggesting inefficacy in the treatment during gestational period. Most of those cases were reported on February and November which suggested seasonality for this IST in the region. The control diagram, based on the inputs collected from SINAN, showed no endemic period; however, the most susceptible month to happen an endemic event of GS and MTCT was February. Our study provided a new methodology to understand the syphilis dynamics as a potential tool to improve the success of future measures to control and possibly eliminate MTCT of syphilis.
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Affiliation(s)
- Joyce Marinho de Souza
- Faculdade de Ciências da Saúde, Biomedicina, Universidade do Oeste Paulista, Presidente Prudente, SP, Brazil
- Laboratório de Biologia Molecular de Microrganismos, Universidade Estadual Paulista, Londrina, PR, Brazil
| | - Rogério Giuffrida
- Programa de pós-graduação em Meio Ambiente e Desenvolvimento Regional, Universidade do Oeste Paulista, Presidente Prudente, SP, Brazil
- Programa de pós-graduação em Ciência Animal, Universidade do Oeste Paulista, Presidente Prudente, SP, Brazil
| | - Ana Paula Marques Ramos
- Programa de pós-graduação em Meio Ambiente e Desenvolvimento Regional, Universidade do Oeste Paulista, Presidente Prudente, SP, Brazil
| | - Glilciane Morceli
- Faculdade de Ciências da Saúde, Biomedicina, Universidade do Oeste Paulista, Presidente Prudente, SP, Brazil
- Mestrado em Ciências da Saúde, Universidade do Oeste Paulista, Presidente Prudente, SP, Brazil
| | - Camila H. Coelho
- Laboratory of Malaria Immunology and Vaccinology, DIR, NIAID, NIH, Bethesda, MD, United States of America
| | - Marcus Vinícius Pimenta Rodrigues
- Faculdade de Ciências da Saúde, Biomedicina, Universidade do Oeste Paulista, Presidente Prudente, SP, Brazil
- Programa de pós-graduação em Meio Ambiente e Desenvolvimento Regional, Universidade do Oeste Paulista, Presidente Prudente, SP, Brazil
- Mestrado em Ciências da Saúde, Universidade do Oeste Paulista, Presidente Prudente, SP, Brazil
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Furegato M, Fifer H, Mohammed H, Simms I, Vanta P, Webb S, Foster K, Kingston M, Charlett A, Vishram B, Reynolds C, Gill N, Hughes G. Factors associated with four atypical cases of congenital syphilis in England, 2016 to 2017: an ecological analysis. ACTA ACUST UNITED AC 2018; 22. [PMID: 29233254 PMCID: PMC5727590 DOI: 10.2807/1560-7917.es.2017.22.49.17-00750] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Four isolated cases of congenital syphilis born to mothers who screened syphilis negative in the first trimester were identified between March 2016 and January 2017 compared with three cases between 2010 and 2015. The mothers were United Kingdom-born and had no syphilis risk factors. Cases occurred in areas with recent increases in sexually-transmitted syphilis among women and men who have sex with men, some behaviourally bisexual, which may have facilitated bridging between sexual networks.
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Affiliation(s)
- Martina Furegato
- HIV & STI Department, Public Health England, Colindale, London, United Kingdom
| | - Helen Fifer
- Bacteriology Reference Department, National Infection Service, Public Health England, Colindale, London, United Kingdom
| | - Hamish Mohammed
- HIV & STI Department, Public Health England, Colindale, London, United Kingdom
| | - Ian Simms
- HIV & STI Department, Public Health England, Colindale, London, United Kingdom
| | - Paul Vanta
- HIV & STI Department, Public Health England, Colindale, London, United Kingdom
| | - Sharon Webb
- NHS Infectious Diseases in Pregnancy Screening Programme, PHE Screening, London, United Kingdom
| | - Kirsty Foster
- HIV & STI Department, Public Health England, Colindale, London, United Kingdom
| | - Margaret Kingston
- The Northern Integrated Contraception, Sexual Health & HIV Service, Manchester University NHS Foundation Trust, Manchester, United Kingdom
| | - André Charlett
- Statistics, Modelling and Economics Department, National Infection Service, Public Health England, Colindale, London, United Kingdom
| | - Bhavita Vishram
- NHS Blood & Transplant/PHE Epidemiology Unit, Public Health England, Colindale, London, United Kingdom
| | - Claire Reynolds
- NHS Blood & Transplant/PHE Epidemiology Unit, Public Health England, Colindale, London, United Kingdom
| | - Noel Gill
- HIV & STI Department, Public Health England, Colindale, London, United Kingdom
| | - Gwenda Hughes
- HIV & STI Department, Public Health England, Colindale, London, United Kingdom
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Howe B, Foster K, Waldram A, Hussey J. Challenges in the management of syphilis in pregnancy: completing a multicentre audit cycle with mixed outcomes. Int J STD AIDS 2018; 29:418-420. [PMID: 29409434 DOI: 10.1177/0956462417750712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Bridie Howe
- 1 5983 Newcastle Upon Tyne Hospitals NHS Foundation Trust , New Croft Centre, Newcastle Upon Tyne, UK
| | - Kirsty Foster
- 2 436303 Public Health England North East , Newcastle Upon Tyne, UK
| | - Alison Waldram
- 3 Field Epidemiology Services, Public Health England, Newcastle Upon Tyne, UK
| | - Jane Hussey
- 4 Genitourinary Medicine, Sunderland Royal Hospital, Sunderland, UK
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Rodrigues DC, Domingues RMSM. Management of syphilis in pregnancy: Knowledge and practices of health care providers and barriers to the control of disease in Teresina, Brazil. Int J Health Plann Manage 2017; 33:329-344. [PMID: 28983958 DOI: 10.1002/hpm.2463] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 08/30/2017] [Indexed: 11/10/2022] Open
Abstract
AIMS The aim of the study is to verify the knowledge and practices of health professionals working in prenatal care (PNC) related with syphilis during pregnancy and to identify the main barriers to the implementation of protocols for the control of this disease. METHODS A cross-sectional study in Teresina, Brazil, from January to May 2015, was conducted with 366 physicians and nurses working in PNC, corresponding to 70% of eligible professionals. We evaluated 20 knowledge and practice criteria related to the diagnosis and treatment of syphilis during pregnancy with a 95% compliance standard. We performed descriptive analysis of the data and used χ2 statistical test to verify differences according to professional category. RESULTS Only 2 criteria, "knowledge about mother to child transmission according to gestational age" and "counselling on infection," reached 95% compliance. Knowledge of the epidemiological profile of congenital syphilis and the goal of elimination of congenital syphilis and knowledge about serological tests had scores below 50%, while practices related with posttest counselling, cure control, and treatment of partners reached 60%. We identified organisational barriers related to the late initiation of PNC, to the delayed return of syphilis test results, to the application of benzathine penicillin in primary care units and to the treatment of partners. CONCLUSIONS Strategies for early initiation of PNC, implementation of rapid tests for syphilis, ensuring treatment of pregnant women with penicillin, adequate partner treatment, and continued education of health professionals on clinical management and counselling in sexually transmitted diseases are necessary to eliminate congenital syphilis.
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