Department of Health Surveillance, Ceará State Secretary of Health, Fortaleza, Ceará, Brazil.
Collective Health Post Graduation Program, University of Fortaleza, Fortaleza, Ceará, Brazil.
PLoS One. 2019 Jan 4;14(1):e0209906. doi: 10.1371/journal.pone.0209906. eCollection 2019.
Congenital syphilis (CS) is a major cause of mortality in several countries, especially in Latin America and the Caribbean. This study aimed to analyze fetal and infant mortality of CS reported to the Health Information System in a State in Northeastern Brazil.
This was a cross-sectional study that analyzed the deaths of CS from 2010 to 2014 through the linkage of the Mortality Information System (SIM) and the Notifiable Diseases Information System (Sinan). The Statistical Package for the Social Sciences (SPSS) version 23.0 was used to calculate the rates of Fetal, Perinatal, Neonatal (early and late), and Postneonatal Mortality. Simple linear regression was performed. Fisher's exact test or Pearson's chi-square test were used for comparison of proportions and Student's t-test was used for comparison of means. Of the 414 cases reported to the SIM as deaths possibly caused by CS, 44 (10.6%) presented CS as the underlying cause. From 2010 to 2014 the Infant Mortality Rate of CS was 16.3 per 100,000 live births (y = 0.65x + 14.33, R2 = 0.2338, p = 0.003). There was an 89.4% underreporting of deaths. Perinatal deaths and fetal deaths of CS accounted for 87.7% and 73.9% of total deaths, respectively.
The results of the study revealed a significant Fetal and Infant Mortality rate of CS and demonstrated the importance of using the linkage method in studies that involve the analysis of secondary data obtained from mortality and disease reporting systems. The underreporting of CS as a cause of fetal and infant mortality leads to unawareness of the reality of deaths from this disease, hindering the development of public policies aimed at its prevention.
先天性梅毒(CS)是一些国家,特别是拉丁美洲和加勒比地区死亡的主要原因。本研究旨在分析巴西东北部一个州向卫生信息系统报告的 CS 导致的胎儿和婴儿死亡率。
这是一项横断面研究,通过链接死亡率信息系统(SIM)和法定传染病报告系统(Sinan),分析了 2010 年至 2014 年 CS 导致的死亡。使用社会科学统计软件包(SPSS)版本 23.0 计算胎儿、围产儿、新生儿(早晚期)和新生儿后死亡率。进行简单线性回归。使用 Fisher 确切检验或 Pearson χ2 检验比较比例,使用学生 t 检验比较均值。在 SIM 报告的可能由 CS 引起的 414 例死亡中,44 例(10.6%)CS 为根本死因。2010 年至 2014 年 CS 的婴儿死亡率为每 10 万活产儿 16.3 例(y=0.65x+14.33,R2=0.2338,p=0.003)。死亡率报告漏报率为 89.4%。CS 的围产儿死亡和胎儿死亡分别占总死亡的 87.7%和 73.9%。
该研究结果显示 CS 的胎儿和婴儿死亡率显著,表明在使用死亡率和疾病报告系统获得的二级数据分析研究时,链接方法的重要性。CS 作为胎儿和婴儿死亡原因的低报告率导致人们对该病死亡的实际情况缺乏认识,阻碍了预防该病的公共政策的制定。