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. 2024 Jun 10:33:e2024188.
doi: 10.1590/S2237-96222024V33E2024188.en. eCollection 2024.

Detection of gestational and congenital syphilis in Paraná state, Brazil, 2007-2021: a time series analysis

[Article in English, Portuguese]
Giovana Gomes de Oliveira  1 , Isadora Gabriella Silva Palmieri  2 , Lucas Vinícius de Lima  2 , Gabriel Pavinati  2 , Vitória Maytana Alves Dos Santos  2 , Kelly Cristina Suzue Iamaguchi Luz  1 , Gabriela Tavares Magnabosco  2
Affiliations

Detection of gestational and congenital syphilis in Paraná state, Brazil, 2007-2021: a time series analysis

[Article in English, Portuguese]
Giovana Gomes de Oliveira et al. Epidemiol Serv Saude. .

Abstract
in English, Spanish, Portuguese

Objective: To describe temporal trends in the detection rates of gestational and congenital syphilis, by maternal age and health macro-region of the state of Paraná, Brazil, 2007-2021.

Methods: This was a time-series study using surveillance data; the trend analysis was performed by means of joinpoint regression, and average annual percent change (AAPC) and 95% confidence intervals (95%CI) were estimated.

Results: An increase in statewide detection of gestational syphilis (AAPC = 21.7; 95%CI 17.7; 32.8) and congenital syphilis (AAPC = 14.8; 95%CI 13.0; 19.7) was found; an increase was also found in the health macro-regions, with the Northwest (gestational, AAPC = 26.1; 95%CI 23.4; 31.6) and North (congenital, AAPC = 23.8; 95%CI 18.8; 48.9) macro-regions standing out; statewide rising trends were observed for young women [gestational, AAPC = 26.2 (95%CI 22.4; 40.6); congenital, AAPC = 19.4 (95%CI 17.6; 21.8)] and adult women [gestational, AAPC = 21.3 (95%CI 16.9; 31.9); congenital, AAPC = 13.7 (95%CI 11.9; 19.3)].

Conclusion: Maternal and child syphilis detection rates increased in the state, regardless of maternal age and health macro-region.

Main results: Increasing trends were found for the detection rates of gestational and congenital syphilis in Paraná state and its health macro-regions, including in the analysis stratified by maternal age group; however, there was a decline during the COVID-19 period.

Implications for services: There is a need for strategic and immediate action by the state health services, focusing on expanding access and linkage to care, in order to ensure maternal and child well-being and reverse the rising trends observed.

Perspectives: Prevention and control actions towards the elimination of syphilis are needed to overcome these obstacles, directing efforts towards strengthening health education, early detection and appropriate treatment for pregnant women and their partners.

Objetivo:: Describir las tendencias temporales en las tasas de detección de sífilis gestacional y congénita, por grupo de edad materna y macrorregión de salud de Paraná, 2007-2021.

Métodos:: Estudio de series temporales utilizando datos de vigilancia; se realizó análisis de tendencia mediante regresión segmentada, estimando cambios porcentuales anuales promedio (CPAP) e intervalos de confianza del 95% (IC95%).

Resultados:: Se identificaron aumentos en la detección estatal de sífilis gestacional (CPAP = 21,7; IC95% 17,7;32,8) y congénita (CPAP = 14,8; IC95% 13,0;19,7); las macrorregiones mostraron incrementos, destacándose la Noroeste (gestacional, CPAP = 26,1; IC95% 23,4;31,6) y la Norte (congénita, CPAP = 23,8; IC95% 18,8;48,9); las tendencias estatales fueron crecientes para mujeres jóvenes [gestacional, CPAP = 26,2 (IC95% 22,4;40,6); congénita, CPAP = 19,4 (IC95% 17,6;21,8)] y adultas [gestacional, CPAP = 21,3 (IC95% 16,9;31,9); congénita, CPAP = 13,7 (IC95% 11,9;19,3)].

Conclusión:: Las tasas de detección de sífilis materno-infantil estuvieron en aumento en el estado, independientemente de la edad materna y la macrorregión de salud.

Objetivo:: Descrever as tendências temporais nas taxas de detecção de sífilis gestacional e congênita, por faixa etária materna e macrorregião de saúde do Paraná, Brasil, 2007-2021.

Métodos:: Estudo de séries temporais, utilizando-se dados de vigilância; realizou-se análise de tendência por regressão segmentada, sendo estimadas variações percentuais anuais médias (VPAM) e intervalos de confiança de 95% (IC95%).

Resultados:: Foram identificados acréscimos na detecção estadual de sífilis gestacional (VPAM = 21,7; IC95% 17,7;32,8) e congênita (VPAM = 14,8; IC95% 13,0;19,7); as macrorregiões de saúde registraram incrementos, destacando-se as macrorregiões Noroeste (gestacional, VPAM = 26,1; IC95% 23,4;31,6) e Norte (congênita, VPAM = 23,8; IC95% 18,8;48,9); as tendências estaduais foram crescentes para mulheres jovens [gestacional, VPAM = 26,2 (IC95% 22,4;40,6); congênita, VPAM = 19,4 (IC95% 17,6;21,8)] e mulheres adultas [gestacional, VPAM = 21,3 (IC95% 16,9;31,9); congênita, VPAM = 13,7 (IC95% 11,9;19,3)].

Conclusão:: As taxas de detecção de sífilis materno-infantil foram ascendentes no estado, independentemente da idade materna e da macrorregião de saúde.

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Conflict of interest statement

CONFLICTS OF INTEREST: The authors declare they have no conflicts of interest.

Figures

Figure 1
Figure 1. Detection rates of (A) gestational syphilis and (B) congenital syphilis per 1,000 live births, according to health macro-regions, Paraná state, Brazil, 2007-2021
See this image and copyright information in PMC

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