Vital Caroline Luz, Reis Renato Barbosa, Soares Jorgana Fernanda de Souza, Miranda Diego Lopes Paim, Reis Mitermayer Galvão
Pathology and Molecular Biology Laboratory, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil.
Department of Medicine of Bahia of Federal University of Bahia, Salvador, Bahia, Brazil.
Front Epidemiol. 2023 Sep 8;3:1234580. doi: 10.3389/fepid.2023.1234580. eCollection 2023.
To describe the temporal trend and spatial distribution of congenital syphilis (CS) cases in the state of Bahia, Brazil between 2009 and 2018.
Mixed ecological study conducted through the analysis of data obtained from the Notifiable Diseases Information System and the Live Birth Information System. Global Moran Index I was performed in order to analyze spatial autocorrelation of CS cases in the municipalities of Bahia and the Local Spatial Association Indicator (LISA) was used to identify the formation of spatial regimes in the GeoDA software.
8,786 cases of CS were registered in the period. An increasing growth in CS incidence, with a 511% increase between 2009 and 2018. Spatial autocorrelation was observed between the municipalities (I Moran = 0.452; < 0.001) and four clusters were identified. More frequently, mothers were aged 20-29 years (50.7%); had incomplete primary education (54.9%); were Black and multiracial (93.2%); received prenatal care (82.2%); 49.0% were diagnosed with syphilis during prenatal care; 68.8% were not adequately treated, and 81.1% of their partners were not treated.
The results showed that CS consolidates as a serious public health problem in Bahia, with an incidence 8.4 times higher in the period than the WHO target of 0.5/1,000 live births, predominantly related to inadequate prenatal care and social vulnerability indicators: young mothers with low education levels, as well as individuals identified as Black and multiracial. Thus, programs aimed at women of childbearing age and pregnant women need to be intensified.
描述2009年至2018年巴西巴伊亚州先天性梅毒（CS）病例的时间趋势和空间分布。
通过分析从法定传染病信息系统和活产信息系统获得的数据进行混合生态研究。进行全局莫兰指数I以分析巴伊亚州各市CS病例的空间自相关性，并使用局部空间关联指标（LISA）在GeoDA软件中识别空间格局的形成。
该时期共登记了8786例CS病例。CS发病率呈上升趋势，2009年至2018年期间增长了511%。各市之间存在空间自相关性（莫兰指数I = 0.452；P < 0.001），并识别出四个聚类。母亲的年龄多为20 - 29岁（50.7%）；小学教育未完成（54.9%）；为黑人和多种族（93.2%）；接受了产前护理（82.2%）；49.0%在产前护理期间被诊断出患有梅毒；68.8%未得到充分治疗，其伴侣中有81.1%未接受治疗。
结果表明，CS在巴伊亚州已成为一个严重的公共卫生问题，该时期的发病率比世界卫生组织设定的每1000例活产0.5例的目标高出8.4倍，主要与产前护理不足和社会脆弱性指标有关：教育水平低的年轻母亲，以及被认定为黑人和多种族的个体。因此，需要加强针对育龄妇女和孕妇的项目。
