Trends of acquired, congenital and in pregnancy syphilis in Brazil: a portrait of the treponema epidemic growth
Syphilis, Congenital; Pregnant Women; Syphilis; Time Series Studies
Objective. To analyze the trends of syphilis acquired between 2011-2017, of syphilis in pregnant women and congenital between 2007-2017 and of the ratio between pregnant syphilis and congenital syphilis, in the municipalities and regions of Brazil. Methods. Ecological study to identify trends in syphilis incidence, using secondary data from the Brazilian system of notifications. The five Brazilian regions participated this study, as well the municipalities from the criteria of the Ministry of Health that listed 100 priority municipalities and 189 non-priority municipalities. At both time intervals, the standard syphilis detection rates were calculated, beside calculating the ratio of pregnant / congenital syphilis. For the analysis of trends, we applied the polynomial and Joinpoint regression methods. A significance level of 5% was used for data analysis. Results. There was a significant growth trend in syphilis rates in pregnant women, congenital and acquired in the municipalities and all regions, especially in the Southern Region. In the evaluation of the syphilis ratio trend in pregnant / congenital, there was growth in the priority municipalities (AAPC: 8,54%; p<0,001) and non-priority municipalities (AAPC: 2.61%, p = 0.005), as well in the North, Northeast, Southeast and South regions. There was a significant reduction trend in the Central West region. Conclusion. There were high growth trends in syphilis rates in the municipalities, as in all regions of the country. The commitment to eliminate syphilis is still a distant reality in Brazil. The measures adopted to reduce it should be evaluated, noting whether it will be enough to modify the growth of the treponemic epidemic.