• 1.

    World Health Organization, 2007. The Global Elimination of Congenital syphilis: Rationale and Strategy for Action. Geneva, Switzerland: WHO.

    • Search Google Scholar
    • Export Citation
  • 2.

    Avelleira JCR, Bottino G, 2006. Sífilis: diagnóstico, tratamento e controle. An Bras Dermatol 81: 111126.

  • 3.

    World Health Organization, Dept. of Reproductive Health and Research, 2003. Guidelines for the Management of Sexually Transmitted Infections. Geneva, Switzerland: WHO.

    • Search Google Scholar
    • Export Citation
  • 4.

    World Health Organization, Centers for Disease Control and Prevention, 2012. Investment Case for Eliminating mother-to-Child transmission of syphilis: Promoting Better Maternal and Child Health and Stronger Health Systems. Geneva, Switzerland: WHO.

    • Search Google Scholar
    • Export Citation
  • 5.

    World Health Organization, 2014. Global Guidance on Criteria and Processes for Validation: Elimination of Mother-to-Child Transmission (EMTCT) of HIV and Syphilis. Geneva, Switzerland: WHO.

    • Search Google Scholar
    • Export Citation
  • 6.

    Wolff T, Shelton E, Sessions C, Miller T, 2009. Screening for syphilis infection in pregnant women: evidence for the U.S. preventive services task force reaffirmation recommendation statement. Ann Intern Med 150: 710716.

    • Search Google Scholar
    • Export Citation
  • 7.

    Newman L, Kamb M, Hawkes S, Gomez G, Say L, Seuc A, Broutet N, 2013. Global estimates of syphilis in pregnancy and associated adverse outcomes: analysis of multinational antenatal surveillance data. PLoS Med 10: e1001396.

    • Search Google Scholar
    • Export Citation
  • 8.

    Qin J, Yang T, Xiao S, Tan H, Feng T, Fu H, 2014. Reported estimates of adverse pregnancy outcomes among women with and without syphilis: a systematic review and meta-analysis. PLoS One 9: e102203.

    • Search Google Scholar
    • Export Citation
  • 9.

    Milanez H, 2016. Syphilis in pregnancy and congenital syphilis: why can we not yet face this problem? Rev Bras Ginecol Obstet 38: 425427.

    • Search Google Scholar
    • Export Citation
  • 10.

    González MA, 2010. Regional initiative for the Elimination of Mother-to-Child Transmission of HIV and Congenital Syphilis in Latin America and the Caribbean: Regional Monitoring Strategy. Washington, DC: Pan American Health Organization.

    • Search Google Scholar
    • Export Citation
  • 11.

    Ministério da Saúde, 2014. Estratégias para eliminação da Transmissão Vertical do HIV e da Sífilis. Brazil.

  • 12.

    Ministério da Saúde, 2016. Boletim Epidemiológico de Sífilis. Saúde Sdve, ed. Brasília, Brasil: Ministério da Saúde.

  • 13.

    Lafetá KRG, Martelli Júnior H, Paranaíba LMR, Silveira MF, 2016. Maternal and congenital syphilis, underreported and difficult to control. Rev Bras Epidemiol 19: 6374.

    • Search Google Scholar
    • Export Citation
  • 14.

    Ministério da Saúde, 2015. DATASUS. Brazil.

  • 15.

    Szwarcwald CL, Junior AB, Miranda AE, Paz LC, 2007. Resultados do estudo sentinela-parturiente, 2006: desafios para o controle da sífilis congênita no Brazil. DST J Bras Doenças Sex Transm 19: 128133.

    • Search Google Scholar
    • Export Citation
  • 16.

    Ministério da Saúde, 2016. Diretrizes Para Controle da Sífilis Congênita: Manual de olso. Saúde Md, ed. Brasília, Brazil: Secretaria de Vigilância em Saúde, 72.

    • Search Google Scholar
    • Export Citation
  • 17.

    Kennedy EJ, Creighton ET, 1998. Venereal Disease Research Laboratory (VDRL) Slide Test. Atlanta, GA: CDC, ed. Manual of Syphilis Tests.

  • 18.

    Ministério da Saúde, 2015. Boletim Epidemiológico de Sífilis. Brazil: Ministério da Saúde 4.

  • 19.

    Lawi JD, Mirambo MM, Magoma M, Mushi MF, Jaka HM, Gumodoka B, Mshana SE, 2015. Sero-conversion rate of Syphilis and HIV among pregnant women attending antenatal clinic in Tanzania: a need for re-screening at delivery. BMC Pregnancy Childbirth 15: 3.

    • Search Google Scholar
    • Export Citation
  • 20.

    Endris M, Deressa T, Belyhun Y, Moges F, 2015. Seroprevalence of syphilis and human immunodeficiency virus infections among pregnant women who attend the University of Gondar teaching hospital, northwest Ethiopia: a cross sectional study. BMC Infect Dis 15: 111.

    • Search Google Scholar
    • Export Citation
  • 21.

    Volker F, Cooper P, Bader O, Uy A, Zimmermann O, Lugert R, Gross U, 2017. Prevalence of pregnancy-relevant infections in a rural setting of Ghana. BMC Pregnancy Childbirth 17: 172.

    • Search Google Scholar
    • Export Citation
  • 22.

    Ministério da Saúde, 2017. Indicadores e Dados Básicos da Sífilis nos Municípios Brasileiros. Departamento de DST, AIDS e Hepatites Virais, Secretaria de Vigilância em Saúde, Brazil.

    • Search Google Scholar
    • Export Citation
  • 23.

    Viellas EF, Domingues RM, Dias MA, Gama SG, Theme Filha MM, Costa JV, Bastos MH, Leal Mdo C, 2014. Prenatal care in Brazil. Cad Saude Publica 30 (Suppl 1): S1S15.

    • Search Google Scholar
    • Export Citation
  • 24.

    Berman SM, 2004. Maternal syphilis: pathophysiology and treatment. Bull World Health Organ 82: 433438.

  • 25.

    Lago EG, 2016. Current perspectives on prevention of mother-to-child transmission of syphilis. Cureus 8: e525.

  • 26.

    Gust DA, Levine WC, St Louis ME, Braxton J, Berman SM, 2002. Mortality associated with congenital syphilis in the United States, 1992–1998. Pediatrics 109: E799.

    • Search Google Scholar
    • Export Citation
  • 27.

    Ministério da Saúde, 1998. Assistência Pré-Natal: Normas e Manuais Técnicos. Brasília, Brazil: Ministério da Saúde, 62.

  • 28.

    Santos Neto ET, Oliveira AE, Zandonade E, Gama SG, Leal Mdo C, 2012. Prenatal patient cards and quality of prenatal care in public health services in Greater Metropolitan Vitoria, Espirito Santo State, Brazil [article in Portuguese]. Cad Saude Publica 28: 16501662.

    • Search Google Scholar
    • Export Citation
  • 29.

    Hwang LY, Ross MW, Zack C, Bull L, Rickman K, Holleman M, 2000. Prevalence of sexually transmitted infections and associated risk factors among populations of drug abusers. Clin Infect Dis 31: 920926.

    • Search Google Scholar
    • Export Citation
  • 30.

    Khan MR, Berger A, Hemberg J, O'Neill A, Dyer TP, Smyrk K, 2013. Non-injection and injection drug use and STI/HIV risk in the United States: the degree to which sexual risk behaviors versus sex with an STI-infected partner account for infection transmission among drug users. AIDS Behav 17: 11851194.

    • Search Google Scholar
    • Export Citation
  • 31.

    DeHovitz JA, Kelly P, Feldman J, Sierra MF, Clarke L, Bromberg J, Wan JY, Vermund SH, Landesman S, 1994. Sexually transmitted diseases, sexual behavior, and cocaine use in inner-city women. Am J Epidemiol 140: 11251134.

    • Search Google Scholar
    • Export Citation
 
 
 
 

 

 
 

 

 

 

 

 

 

High Prevalence of Syphilis and Inadequate Prenatal Care in Brazilian Pregnant Women: A Cross-Sectional Study

View More View Less
  • 1 Laboratório de Pesquisa Em Ciências da Saúde, Universidade Federal da Grande Dourados–UFGD, Dourados, Brazil;
  • | 2 Hospital Universitário de Dourados, Universidade Federal da Grande Dourados–UFGD, Dourados, Brazil;
  • | 3 Fundação Oswaldo Cruz (FIOCRUZ), Campo Grande, Brazil;
  • | 4 Faculdade de Medicina (FAMED), Universidade Federal de Mato Grosso do Sul, Campo Grande, Brazil

In Brazil, the reported number of syphilis cases among pregnant women has markedly increased. We conducted a cross-sectional study to determine the prevalence of Treponema pallidum infection and associated factors in pregnant women in Dourados, Mato Grosso do Sul, Brazil. Participants voluntarily completed a risk-factor questionnaire and provided blood specimens for unlinked anonymous testing for the presence of antibodies against T. pallidum, the causative agent of syphilis. Data of newborns were obtained from medical records. We performed univariate and multivariate regression analyses to assess associations with syphilis. The seroprevalence of syphilis in pregnant women was 4.4% (n = 29/661). Twenty-five newborns were seropositive for T. pallidum, and complications due to syphilis were observed in 28% (n = 7/25). Although 96.5% (n = 28/29) of women with syphilis received antenatal care, Venereal Disease Research Laboratory tests were performed in the first trimester for 47.6% (n = 10/21) of women. Women who received treatment in the third trimester (28.6%; n = 6/21) were considered successfully treated at the time of delivery. The use of illicit drugs during pregnancy (odds ratio [OR]: 13.3, 95% CI: 1.9–91.2) and a history of abortion (OR: 3.7, 95% CI: 1.7–8) were associated with syphilis. Our findings highlight that the poor quality of antenatal care services contributes to the high prevalence of syphilis. In addition, there are social and behavioral risk factors associated with syphilis in pregnant women. Future studies are needed to determine limitations of clinical management and control services available to pregnant women with syphilis.

Author Notes

Address correspondence to Simone Simionatto, Laboratório de Pesquisa Em Ciências da Saúde, Universidade Federal da Grande Dourados–UFGD, Rodovia Itahum km 12, Cidade Universitária, Dourados 79804970, Brazil. E-mail: simonesimionatto@ufgd.edu.br

Financial support: This work was partially supported by the National Council for Scientific and Technological Development (CNPq grant 440245/2018-4), Fundação de Apoio ao Desenvolvimento do Ensino, Ciência e Tecnologia do Estado de Mato Grosso do Sul (FUNDECT grants 092/2015 and 041/2017), Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES, grant 001), and Universidade Federal da Grande Dourados (UFGD). J. H. F. S. Q. and K. E. S. received a scholarship from CAPES.

Authors’ addresses: Kelle Cristhiane Soria Vieira Benedetti, Anny Danyelly da Costa Ribeiro, Julio Henrique Ferreira de Sá Queiroz, Amanda Barbosa Dias Melo, Roque Beltrão Batista, Flavia Maria Delgado, Kesia Esther da Silva, and Simone Simionatto, Laboratório de Pesquisa em Ciências da Saúde, Universidade Federal da Grande Dourados–UFGD, Dourados, Brazil, E-mails: kelle_cristhiane@msn.com, annydcribeiro@gmail.com, juliohenriquefsq@hotmail.com, amanda_melo5@hotmail.com, roquebeltrao@hotmail.com.Flavia, flavinha_fmd@hotmail.com, kesia.eds@gmail.com, and simonesimionatto@ufgd.edu.br. Julio Croda, Laboratório de Pesquisa em Ciências da Saúde, Universidade Federal da Grande Dourados–UFGD, and Fundação Oswaldo Cruz (FIOCRUZ), Campo Grande, Brazil, E-mail: juliocroda@gmail.com.

Save