Programa de Ginecología y Obstetricia, Universidad Libre, Cali, Colombia.
Programa de Ginecología y Obstetricia, Universidad Libre, Cali, Colombia; Posgrado en Ciencias Biomédicas y Psiquiatría, Universidad del Valle, Cali, Colombia.
Biomedica. 2021 Oct 15;41(Sp. 2):140-152. doi: 10.7705/biomedica.6003.
Introduction: Gestational syphilis is considered an event of public health interest given its impact on mother and child. In Colombia, despite having specific protocols for its notification, diagnosis, and management, there are still limitations in its control. Objectives: To describe the sociodemographic and clinical characteristics, as well as the spatial distribution of gestational syphilis in Cali, Colombia, in 2018. Materials and methods: We conducted a cross-sectional study of 427 gestational syphilis cases reported to the Colombian national epidemiological surveillance system (Sivigila). For the statistical processing, we used the R program, version 3.5.3. We expressed qualitative variables as proportions and quantitative ones through central tendency and dispersion measures, and to establish the spatial distribution we used the Qgis program, version 3.0. Results: The prevalence of gestational syphilis was 17 cases per 1,000 live births (including stillbirths); 57.1% of patients belonged to the subsidized healthcare system and 16.6% had no health insurance; 90.4% of cases were diagnosed during pregnancy; 47.2% of the pregnant women received three doses of penicillin, yet only 57.6% of contacts were treated. Conclusions: The prevalence of gestational syphilis in Cali during 2018 exceeded the national rate with a higher frequency among women in socioeconomic vulnerability conditions consistent with the general spatial distribution. There was a lack of opportunity in the early detection and management of the infection both among pregnant women and their contacts, which hinders the control of the disease and reflects the inadequate application of the comprehensive maternal and perinatal health care route guidelines.
妊娠梅毒被认为是公共卫生关注的事件,因为它会对母婴产生影响。在哥伦比亚,尽管有专门的通知、诊断和管理方案,但在控制方面仍存在限制。目的:描述 2018 年哥伦比亚卡利妊娠梅毒的社会人口学和临床特征以及空间分布情况。材料和方法:我们对哥伦比亚国家流行病学监测系统(Sivigila)报告的 427 例妊娠梅毒病例进行了横断面研究。为了进行统计处理,我们使用了 R 程序,版本 3.5.3。我们用比例表示定性变量,用集中趋势和离散度指标表示定量变量,并用 Qgis 程序(版本 3.0)确定空间分布。结果:妊娠梅毒的患病率为每 1000 例活产(包括死产)中有 17 例;57.1%的患者属于补贴医疗保健系统,16.6%的患者没有医疗保险;90.4%的病例是在怀孕期间诊断出来的;47.2%的孕妇接受了三剂青霉素治疗,但只有 57.6%的接触者得到了治疗。结论:2018 年卡利妊娠梅毒的流行率高于全国水平,处于社会经济弱势条件下的孕妇更频繁,这与一般的空间分布一致。无论是孕妇还是其接触者,在感染的早期发现和管理方面都存在机会不足的问题,这阻碍了疾病的控制,反映了综合孕产妇和围产期保健途径指南的应用不足。