Prevalência da sífilis gestacional e congênita no Brasil nos últimos 15 anos: uma revisão sistemática.

Abstract

Syphilis is a sexually transmitted disease with a great impact in public health which can also occur in maternal and congenital forms. The vertical transmission of syphilis, when not early prevented, can bring repercussions to the fetus, with transmission rates reflecting the quality of prenatal care. OBJECTIVE: Demonstrate maternal and congenital syphilis prevalence and/or incidence in Brazil in the last 15 years. METHODS: A Sistematic Review Study, for which were searched cross-sectional and cohort complete scientific articles about maternal and congenital syphilis prevalence in Brazil in the last 15 years, using the descriptors: “prevalence”, “syphilis in pregnant women”, “congenital syphilis”, “Brazil” in portuguese and its english correspondents in virtual databases: LILACS, MEDLINE, Pubmed and Scielo in Portuguese, English and Spanish languages. RESULTS: The prevalence of maternal syphilis ranged between 1,02% and 1,9% in the women evaluated. The prevalence by Brazilian regions presented discreet variation between 2006 and 2014, being the same in all regions and above the established value as goal by the Ministry of Health to be reached in Brazil until 2015. Most of studies showed higher prevalence among non-white women (72,9%), in the age group older than 20 years (81,6%), with low schooling (74,1%) and the ones who performed adequate prenatal care (68,2%). In two studies that demonstrated the prevalence by Brazilian regions, it was observed a variation between 0,6% in South Region and 1,5% in North Region in 2007, and from 0,76% in North Region to 1,1% in South Region in 2014. Congenital syphilis had its incidence, in number of live birth, ranging from 2/1000 to 39,4/1000. National vertical transmission rate was high, an average of 34,3%, which its highest percentage was verified in Brazil’s Northeast (37,9%). CONCLUSION: Patients epidemiologic profile are brown women, older than 20 years, with low schooling and who performed adequate prenatal care. Although the discrete decrease in the last few years, maternal and congenital syphilis are still prevalent in all regions of Brazil. There was little variation in maternal syphilis considering the Brazilian regions, with estimated values above the goals that Ministry of Health has established. Higher prevalences were observed in North and Northeast of Brazil. Due to the presence of a social component, it turns to be necessary to implement health and education public policies, to achieve the established goals for this pathology. As for congenital syphilis, the vertical transmission was high in all Brazilian regions. The referral of infected concept to be treated in adequate services was infrequent, perharps due to the absence of symptoms in neonatal period or the lack of registration of the symptoms. These data point to failures in health care of pregnant women, in prenatal care, and to the concept, in neonatal period referring to those patients who present the profile of the studied population.