Universidade Estadual de Maringá, Departamento de Enfermagem, Maringá, PR, Brazil.
Universidade Estadual de Maringá, Programa de Pós-Graduação em Enfermagem, Maringá, PR, Brazil.
Epidemiol Serv Saude. 2024 Jun 10;33:e2024188. doi: 10.1590/S2237-96222024V33E2024188.en. eCollection 2024.
OBJECTIVE: To describe temporal trends in the detection rates of gestational and congenital syphilis, by maternal age and health macro-region of the state of Paraná, Brazil, 2007-2021. METHODS: This was a time-series study using surveillance data; the trend analysis was performed by means of joinpoint regression, and average annual percent change (AAPC) and 95% confidence intervals (95%CI) were estimated. RESULTS: An increase in statewide detection of gestational syphilis (AAPC = 21.7; 95%CI 17.7; 32.8) and congenital syphilis (AAPC = 14.8; 95%CI 13.0; 19.7) was found; an increase was also found in the health macro-regions, with the Northwest (gestational, AAPC = 26.1; 95%CI 23.4; 31.6) and North (congenital, AAPC = 23.8; 95%CI 18.8; 48.9) macro-regions standing out; statewide rising trends were observed for young women [gestational, AAPC = 26.2 (95%CI 22.4; 40.6); congenital, AAPC = 19.4 (95%CI 17.6; 21.8)] and adult women [gestational, AAPC = 21.3 (95%CI 16.9; 31.9); congenital, AAPC = 13.7 (95%CI 11.9; 19.3)]. CONCLUSION: Maternal and child syphilis detection rates increased in the state, regardless of maternal age and health macro-region. MAIN RESULTS: Increasing trends were found for the detection rates of gestational and congenital syphilis in Paraná state and its health macro-regions, including in the analysis stratified by maternal age group; however, there was a decline during the COVID-19 period. IMPLICATIONS FOR SERVICES: There is a need for strategic and immediate action by the state health services, focusing on expanding access and linkage to care, in order to ensure maternal and child well-being and reverse the rising trends observed. PERSPECTIVES: Prevention and control actions towards the elimination of syphilis are needed to overcome these obstacles, directing efforts towards strengthening health education, early detection and appropriate treatment for pregnant women and their partners.
目的:描述巴西帕拉纳州妊娠和先天性梅毒检测率的时间趋势,按产妇年龄和州卫生大区划分。 方法:这是一项利用监测数据进行的时间序列研究;采用 joinpoint 回归进行趋势分析,并估计平均年变化百分比(AAPC)和 95%置信区间(95%CI)。 结果:发现全州妊娠梅毒(AAPC = 21.7;95%CI 17.7;32.8)和先天性梅毒(AAPC = 14.8;95%CI 13.0;19.7)的检测率有所增加;卫生大区也呈上升趋势,西北部(妊娠,AAPC = 26.1;95%CI 23.4;31.6)和北部(先天性,AAPC = 23.8;95%CI 18.8;48.9)大区尤为明显;全州年轻女性(妊娠,AAPC = 26.2(95%CI 22.4;40.6);先天性,AAPC = 19.4(95%CI 17.6;21.8))和成年女性(妊娠,AAPC = 21.3(95%CI 16.9;31.9);先天性,AAPC = 13.7(95%CI 11.9;19.3))的妊娠和先天性梅毒上升趋势明显。 结论:无论产妇年龄和卫生大区如何,该州的母婴梅毒检测率均呈上升趋势。 主要结果:在巴西南大河州及其卫生大区,妊娠和先天性梅毒的检测率呈上升趋势,包括按产妇年龄组分层分析时也是如此;然而,在 COVID-19 期间有所下降。 对服务的影响:州卫生服务部门需要采取战略性和即时行动,重点是扩大获得和联系护理的机会,以确保母婴健康并扭转观察到的上升趋势。 展望:需要采取预防和控制梅毒的行动来克服这些障碍,努力加强健康教育,早期发现和对孕妇及其伴侣的适当治疗。
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