Epidemiología de la sífilis con enfoque territorial: caso del Hospital de La Serena, años 2015-2017

Abstract

Epidemiological features of syphilis diagnosed at a clinic of sexually transmitted diseases Background: Syphilis continues to be a common sexually transmitted disease. Aim: To describe the epidemiologic features of patients with syphilis consulting in a Chilean sexually transmitted diseases clinic. Material and Methods: Review of medical records of patients with positive serology for syphilis, who attended a unit of sexually transmitted diseases between 2015 and 2017. Results: Of 266 cases, 61% were male and 74% were aged between 20 and 49 years. The highest incidence was observed in males aged between 20 and 30 years. Eighty five percent of cases were diagnosed in latent phases, 10% of the cases had a co-infection with HIV and 18%, a history of other sexually transmitted disease. The rate of coinfection was significantly higher in men than in women (78 and 28%, respectively; p < 0.01). Only 6.4% reported always using a condom. Men used it with higher frequency than women (72 and 28% respectively; p < 0.01). A low adherence to treatment and faulty follow-up and treatment of sexual contacts was observed. Twenty five percent of women diagnosed with syphilis were pregnant and 27% of them had a premature birth, with one neonatal death. Conclusions: A high incidence of syphilis was observed, especially in men of younger ages. The diagnosis is delayed, the treatment of sexual contacts and the use of condoms are uncommon. Although the treatment of pregnant women is appropriated, some perinatal complications are observed.

"Como será minha vida com sífilis?" Desafios do diagnóstico em homens à luz de Leininger ["How will my life with syphilis be?" Diagnosis challenges in men in the light of Leininger] [¿Cómo será mi vida con sífilis? Desafíos diagnósticos en los hombres a la luz de Leininger]

“…Sabe-se que a sífilis pode se apresentar de diversas formas clínicas. Contudo, muitos pacientes infectados não apresentam sintomas, sendo diagnosticados apenas com testes sorológicos 19,20 . A possibilidade de infecção assintomática deve ser informada aos homens, com o intuito de encorajá-los a realizarem a testagem voluntária.…”

“…Por isso, a capacitação contínua de gestores e profissionais é fundamental para o diagnóstico e manejo da sífilis 28 , assim como a escuta atenta durante a anamnese e o olhar apurado no momento do exame físico. Uma vez que a sífilis continua tendo alta morbidade, com aumento de incidência preocupante, o sistema de saúde deve melhorar suas estratégias preventivas às IST, com a promoção do uso do preservativo, oportunizando o diagnóstico e o tratamento das pessoas infectadas 20 .…”