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产前检查期间未进行梅毒血清学检测:患病率及相关因素

Non-performance of serological tests for syphilis during prenatal care: prevalence and associated factors.

作者信息

Cesar Juraci Almeida, Camerini Adriana Vieira, Paulitsch Renata Gomes, Terlan Rodrigo Jacobi

机构信息

Programa de Pós-graduação em Saúde Pública, Faculdade de Medicina, Universidade Federal do Rio Grande - Rio Grande (RS), Brasil.

出版信息

Rev Bras Epidemiol. 2020 Feb 21;23:e200012. doi: 10.1590/1980-549720200012. eCollection 2020.

Abstract

INTRODUCTION

Syphilis is a sexually transmitted disease, easy to diagnose and treat, but whose incidence is increasing in Brazil. This study estimated the prevalence of the non-performance of serological tests for syphilis during prenatal care, in addition to evaluating its trend and identifying its associated factors in the municipality of Rio Grande, Rio Grande do Sul, Southern Brazil.

METHODS

This is a cross-sectional survey that included all pregnant women living in this municipality who gave birth between January 1 and December 31, 2007, 2010, and 2013. A single standardized questionnaire was administered to the mothers within 48 hours of delivery, while they were still in the maternity ward. We used the χ2 test for proportions and linear trend, and Poisson regression with robust adjustment in the multivariate analysis. The effect measure adopted was prevalence ratio (PR).

RESULTS

Among the 7,351 mothers who had at least one prenatal visit, the prevalence of non-performance of serological tests for syphilis in the three years studied was 2.9% (95% confidence interval - 95%CI 2.56 - 3.33), with 3.3% (95%CI 2.56 - 3.97) in 2007, 2.8% (95%CI 2.20 - 3.52) in 2010, and 2.7% (95%CI 2.12 - 3.38) in 2013. Black mothers, those with low household income and schooling, and who had few prenatal visits showed higher PR of non-performance of this test.

DISCUSSION

The prevalence of non-performance has virtually not changed in the period, and women with high-risk pregnancy showed a greater probability of not undergoing the test.

CONCLUSIONS

This municipality needs to reach mothers with lower socioeconomic status, restructure the local health services, and enhance their operationalization to improve the quality of prenatal care.

摘要

引言

梅毒是一种性传播疾病,易于诊断和治疗,但在巴西其发病率正在上升。本研究估计了巴西南部南里奥格兰德州里奥格兰德市产前检查期间未进行梅毒血清学检测的患病率,此外还评估了其趋势并确定了相关因素。

方法

这是一项横断面调查,纳入了2007年、2010年和2013年1月1日至12月31日期间在该市分娩的所有孕妇。在母亲仍在产科病房时,于分娩后48小时内对其进行单一标准化问卷调查。我们使用χ2检验进行比例和线性趋势分析,并在多变量分析中采用稳健调整的泊松回归。采用的效应量为患病率比(PR)。

结果

在至少进行过一次产前检查的7351名母亲中,在所研究的三年中,未进行梅毒血清学检测的患病率为2.9%(95%置信区间 - 95%CI 2.56 - 3.33),2007年为3.3%(95%CI 2.56 - 3.97),2010年为2.8%(95%CI 2.20 - 3.52),2013年为2.7%(95%CI 2.12 - 3.38)。黑人母亲、家庭收入和受教育程度低以及产前检查次数少的母亲,该检测未进行的PR更高。

讨论

在此期间,未进行检测的患病率几乎没有变化,高危妊娠妇女未进行检测的可能性更大。

结论

该市需要接触社会经济地位较低的母亲,重组当地卫生服务,并加强其运作,以提高产前检查的质量。

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