Collective Health Program, University of Fortaleza - UNIFOR, Av, Washington Soares, 1321, Edson Queiróz, Fortaleza, Ceará, CEP 60,811-905, Brazil.
BMC Public Health. 2013 Mar 7;13:206. doi: 10.1186/1471-2458-13-206.
Congenital syphilis is a major public health concern, even after the implementation of intervention protocols in several countries. This study aimed to analyze the prevalence and socio-demographic, behavioral and institutional factors associated with syphilis in parturient women attending public maternity hospitals in Northeast, Brazil.
A cross-sectional study was conducted from June to September 2010 with a proportionate stratified sampling of 222 parturient women using a structured questionnaire. The study analyzed socio-demographic, behavioral and institutional variables. The structured questionnaire was conducted with parturient women and complementary information was obtained through hospitals records, admission forms and prenatal cards. Data were stored using the Statistical Package SPSS version 18. A descriptive statistical analysis was performed using frequency distribution, central tendency and measures of spread for the variables. A bivariate analysis was done using chi square test and Fisher's exact test, with a significance level of 5% and a 95% confidence interval, in order to analyze the relation between the variables and risk factors for syphilis. The multivariate logistic regression analysis was done in the statistical package STATA, version 11.0.
The prevalence of syphilis in parturient women was 7.7%. The bivariate analyses showed that the rate was higher among women who: were from Fortaleza (p = 0.019), studied for less than nine years (p = 0.044), had more than one sexual partner in life (p = 0.021), did not live with partner (p = 0.022), used illegal drugs (p < 0.0001), whose partner used illegal drugs and had diagnosis of syphilis (p = 0.001 and p < 0.0001 respectively). The non-adjusted analysis found significant positive association between syphilis and the following variable: being from Fortaleza (OR = 7.26; CI 95% = 1.49-100.20), having studied for less than nine years (OR = 7.97; CI 95% = 0.87-12.89), having more than one sexual partner in life (OR = 3.75; CI 95% = 1.59-107.11), not living with partner (OR = 3.75; CI95% = 1.03-12.15), and parturient women and partner used illegal drugs (OR = 7.34; CI95% = 1.69-27.57; OR = 4.93; CI95% = 1.58-16.05), respectively. The adjusted multiple logistic regression analysis showed that none of the variables remained significant.
This study enabled to identify a high prevalence of syphilis in parturient women and that this situation is associated with socio-demographic, behavioral and institutional variables.
先天性梅毒仍然是一个重大的公共卫生问题，即使在一些国家实施了干预措施后也是如此。本研究旨在分析在巴西东北部，公立妇产医院就诊的产妇中梅毒的流行情况及其与社会人口学、行为和机构因素的相关性。
这是一项于 2010 年 6 月至 9 月进行的横断面研究，采用比例分层抽样方法，对 222 名产妇进行了调查，使用了结构化问卷。研究分析了社会人口学、行为和机构变量。结构化问卷是在产妇中进行的，通过医院记录、入院表和产前卡获得了补充信息。数据使用 SPSS 统计软件包 18 版进行存储。采用频数分布、集中趋势和离散度等描述性统计方法对变量进行分析。采用卡方检验和 Fisher 确切概率法进行了单变量分析，显著性水平为 5%，置信区间为 95%，以分析变量之间以及梅毒的风险因素之间的关系。采用 STATA 统计软件包 11.0 进行了多变量逻辑回归分析。
产妇梅毒的患病率为 7.7%。单变量分析显示，以下情况的梅毒患病率更高：来自福塔莱萨（p=0.019），受教育年限不足 9 年（p=0.044），有一个以上性伴侣（p=0.021），与伴侣不生活在一起（p=0.022），使用非法药物（p<0.0001），其伴侣使用非法药物且患有梅毒（p=0.001 和 p<0.0001）。非调整分析发现梅毒与以下变量之间存在显著的正相关：来自福塔莱萨（OR=7.26；95%CI 1.49-100.20），受教育年限不足 9 年（OR=7.97；95%CI 0.87-12.89），有一个以上性伴侣（OR=3.75；95%CI 1.59-107.11），与伴侣不生活在一起（OR=3.75；95%CI 1.03-12.15），产妇和伴侣使用非法药物（OR=7.34；95%CI 1.69-27.57；OR=4.93；95%CI 1.58-16.05）。多变量逻辑回归分析调整后，没有一个变量仍然具有统计学意义。
本研究表明，产妇中梅毒的患病率较高，且这种情况与社会人口学、行为和机构因素有关。
