P3.348 Maternal and Congenital Syphilis Remain a Challenge

Abstract

Conclusion These data suggest a high burden of TV and co-infection with CT. Public health surveillance focusing on CT infection may consider routine screening of other STIs, including TV, in local populations to reduce STI morbidity. Saúde do Distrito Federal, Brasília, Brazil This descriptive study set the profile of pregnant with positive VDRL followed at public maternity hospitals in Federal District, Brazil, of the newborns children of mothers with syphilis that showed clinic signs of congenital disease and verified approach according with the recommendations of the Ministry of Health. The study verified the percentage of pregnant women who had access to prenatal care and were inadequately treated and the percentage of newborns with inadequate clinical management in accordance with the recommendations of the MS. We interviewed 67 pregnant as postpartum women who reported to the National System of Disease Notification, users of five public hospitals of the DF and consulted information from medical records and from prenatal care charts, when available. The information relating to the clinical and laboratory received to the children were supplemented with data from medical records, compulsory notification forms of syphilis, from prenatal care charts and the child health card, when available. Data were collected on sociodemographic, obstetric, information related to diagnosis, treatment of pregnant and puerperal women their partners and treatment of newborns into delivery. Only 41.8% patients were adequately treatment and main reason for inadequacy was the lack of treatment (83.6%) or inadequate treatment of the partner (88.1%). The study demonstrated the need for new treatment of the mother at the hospital for lack of documentation of the treatment in prenatal care. There was disagreement with the recommendations of the MS to follow-up of newborns with congenital syphilis in relation to radiographic study only 48% children carried out and lumbar pucture was required only 42%. It was observed that 36% newborns not received any treatment. Our date demonstrates that the quality of prenatal care received by pregnant women is not sufficient to ensure control of congenital syphilis an reaching the goal of controlling the disease. In the years 1996-2012 all together 4966 pregnant women infected with syphilis were registered in Belarus (8.36% from the general number of the women with syphilis for this period -59426 cases). Primary syphilis was diagnosed in 13.2% of patients, secondary syphilis -30.5%, latent early syphilis -55.9%, latent late syphilis -0.4%. Disease has been revealed in I trimester of pregnancy in 56.7% of patients, II trimester -23.2%, III trimester -17.5%, after delivery -2.6%. 45.1% of women have made abortion after disease revealing. Maternal and Congenital SyPhiliS reMain a ChallengeThere are 127 children with congenital syphilis (CS) registered in 1994-2012 in Belarus in total, but last two years cases of CS have not been registered. Among women which have given birth to children with CS prim...

Incidência de sífilis congênita e fatores associados à transmissão vertical da sífilis: dados do estudo Nascer no Brasil

“…Essa mesma estratégia de testagem, se aplicada aos parceiros, permitiria maior cobertura de tratamento, que é relatada como baixa em vários estudos locais 14,15,18,32,33 , sendo de apenas 11% no Brasil, segundo dados do SINAN para o ano de 2011 9 . Ressalta-se que o tratamento do parceiro é fundamental para evitar a reinfecção da gestante, sendo a não realização deste tratamento, ou a realização de tratamento inadequado, um dos critérios adotados pelo Ministério da Saúde para a definição de caso de sífilis congênita 2 .…”

Adhesion to the monitoring of newborns from VDRL positive mothers

“…Studies of similar shape and objectives conducted in maternity hospitals in different regions of Brazil, reported congenital syphilis rates varying from 1.3% to 14.5%. [17][18][19][20][21][22] Domingues et al, 23 in a national hospital based study in a sample of 450 newly delivered The monitoring of newborns from VDRL Lopes ID 21 Based on the 2012 guidelines of the Scientific Department of Nutrology, 28 86.8% of newborns in this study gained weight daily in their first month of life, greater than 15g per day. Only 14.2% gained less than 15g daily.…”

“…This plan established the right of all pregnant women to carry out the VDRL test in the first prenatal consultation, third trimester of pregnancy and on admission for childbirth. 6 Despite the implementation of these WHO recommended actions, some studies have shown that, in the last decade, the incidence of congenital syphilis has increased globally, even in developed countries. These studies indicate, according to regions or countries, some factors that may or may not have contributed to its occurrence: the difficult access to prenatal care and/or its low quality; early sexual initiation; low income; use of legal and illegal drugs; sex professionals; low education, the non-partner treatment, among others.…”

“…6 Thus, this study was conducted in order to monitor newborns diagnosed with congenital syphilis, to determine the prevalence of the disease, adherence to follow-up and therapeutic management. The study was conducted in the Aracaju (population 570,000, high Human Development Index -0.777), the capital of the northeastern Brazilian state of Sergipe (population, 2,200,000 Average HDI -0.665)…”

Variables associated to anti-HIV, anti-rubella antibodies, syphilis reagins and enteroparasitosis in pregnant women

“…Such situation can be explained by the lower number of pre-natal consultations, insufficiency of resources for transportation to the laboratories and basic health units (UBS), and lack of financial support, and many others. Magalhães et al (2013) also found that 80.6% of the pregnant women studied had family income of up to four minimum salaries, concluding that syphilis, even if not being a disease that is restricted to the least privileged classes, is related to the low social-economic level and therefore, public health policies must be implemented to help pregnant women in this sense.…”