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墨西哥的先天性梅毒。从实验室诊断角度分析国家和国际标准。

Congenital syphilis in Mexico. Analysis of national and international standards from the perspective of laboratory diagnosis.

作者信息

Herrera-Ortiz Antonia, López-Gatell Hugo, García-Cisneros Santa, Cortés-Ortiz María Alejandra, Olamendi-Portugal María, Hegewisch-Taylor Jennifer, Sánchez-Alemán Miguel Ángel

机构信息

Centro de Investigación Sobre Enfermedades Infecciosas, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico.

出版信息

Gac Med Mex. 2019;155(5):430-438. doi: 10.24875/GMM.M20000328.

Abstract

INTRODUCTION

Congenital syphilis continues to be a public health problem in Mexico.

OBJECTIVE

To assess the similarities and differences between national standards, guidelines and international documents related to the detection of syphilis in pregnant women and congenital syphilis.

METHOD

Two algorithms were developed based on the standard of female care during pregnancy and on the standard for prevention and control of sexually transmitted infections. Based on the Centers for Disease Control (CDC) guidelines, algorithms were developed for syphilis during pregnancy, syphilis in the newborn and sexual contacts.

RESULTS

The standard for pregnancy mentions that syphilis testing should be carried out in every pregnant woman on her first contact or at delivery, without diagnostic tests being specified. The Official Mexican Standard (NOM) on sexually transmitted infections mentions the traditional algorithm for syphilis detection, treatment follow-up, coinfection with human immunodeficiency virus and congenital syphilis criteria. The CDC recommend reverse algorithm, antibody titer, treatment and follow-up as part of diagnosis.

CONCLUSIONS

The elimination of mother-to-child transmission of syphilis requires NOMs updating and homogenizing, as well as the study of stillbirths and neonates born to mothers with syphilis.

摘要

引言

先天性梅毒在墨西哥仍然是一个公共卫生问题。

目的

评估与孕妇梅毒检测及先天性梅毒相关的国家标准、指南和国际文件之间的异同。

方法

根据孕期女性护理标准和性传播感染预防控制标准制定了两种算法。基于疾病控制中心(CDC)的指南,制定了孕期梅毒、新生儿梅毒和性接触的算法。

结果

孕期标准提到应在每位孕妇首次就诊或分娩时进行梅毒检测,但未指明诊断检测方法。墨西哥官方性传播感染标准(NOM)提到了梅毒检测、治疗随访、与人类免疫缺陷病毒合并感染及先天性梅毒标准的传统算法。疾病控制中心建议采用反向算法、抗体滴度、治疗及随访作为诊断的一部分。

结论

消除梅毒母婴传播需要更新和统一墨西哥官方标准,以及对梅毒母亲所生死产儿和新生儿进行研究。

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