Prevalence and factors associated with syphilis in parturient women in Northeast, Brazil

BMC Public Health

Raimunda Magalhães da Silva⁴  Ana Paula Soares Gondim¹  Heber José de Moura²  Silvio Carlos Rocha de Freitas³  Maria Alix Leite Araújo⁴ 

[1] Pharmaceutical Sciences Program, Federal University of Ceará, Rua Capitão Francisco Pedro, 1210, Bairro Rodolfo Teófilo, Fortaleza, Ceará, CEP 60.430-170, Brazil;Administration Program, University of Fortaleza – UNIFOR, Av. Washington Soares, 1321, Edson Queiróz, Fortaleza, Ceará, CEP 60.811-905, Brazil;Municipality of Fortaleza, Ceará, Rua Assunção, 283, Centro, Fortaleza, Ceará, CEP 60.055-090, Brazil;Collective Health Program, University of Fortaleza - UNIFOR, Av. Washington Soares, 1321, Edson Queiróz, Fortaleza, Ceará, CEP 60.811-905, Brazil

关键词: Associated factors;    Prevalence;    Parturient;    Syphilis;   

Others  :  1162473
DOI  :  10.1186/1471-2458-13-206

 received in 2012-09-02, accepted in 2013-02-23,  发布年份 2013

【 摘 要 】

Background

Congenital syphilis is a major public health concern, even after the implementation of intervention protocols in several countries. This study aimed to analyze the prevalence and socio-demographic, behavioral and institutional factors associated with syphilis in parturient women attending public maternity hospitals in Northeast, Brazil.

Methods

A cross-sectional study was conducted from June to September 2010 with a proportionate stratified sampling of 222 parturient women using a structured questionnaire. The study analyzed socio-demographic, behavioral and institutional variables. The structured questionnaire was conducted with parturient women and complementary information was obtained through hospitals records, admission forms and prenatal cards. Data were stored using the Statistical Package SPSS version 18. A descriptive statistical analysis was performed using frequency distribution, central tendency and measures of spread for the variables. A bivariate analysis was done using chi square test and Fisher’s exact test, with a significance level of 5% and a 95% confidence interval, in order to analyze the relation between the variables and risk factors for syphilis. The multivariate logistic regression analysis was done in the statistical package STATA, version 11.0.

Results

The prevalence of syphilis in parturient women was 7.7%. The bivariate analyses showed that the rate was higher among women who: were from Fortaleza (p = 0.019), studied for less than nine years (p = 0.044), had more than one sexual partner in life (p = 0.021), did not live with partner (p = 0.022), used illegal drugs (p < 0.0001), whose partner used illegal drugs and had diagnosis of syphilis (p = 0.001 and p < 0.0001 respectively). The non-adjusted analysis found significant positive association between syphilis and the following variable: being from Fortaleza (OR = 7.26; CI 95% = 1.49-100.20), having studied for less than nine years (OR = 7.97; CI 95% = 0.87-12.89), having more than one sexual partner in life (OR = 3.75; CI 95% = 1.59-107.11), not living with partner (OR = 3.75; CI95% = 1.03-12.15), and parturient women and partner used illegal drugs (OR = 7.34; CI95% = 1.69-27.57; OR = 4.93; CI95% = 1.58-16.05), respectively. The adjusted multiple logistic regression analysis showed that none of the variables remained significant.

Conclusion

This study enabled to identify a high prevalence of syphilis in parturient women and that this situation is associated with socio-demographic, behavioral and institutional variables.

【 授权许可】

   
2013 Araújo et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Broutet N, Hossain M, Hawkes S, The Elimination of Congenital Syphilis: A comparison of the proposed world health organization action plan for the elimination of congenital syphilis with existing national maternal and congenital syphilis policies. Sex Transm Dis 2007, 34:S22-S30.
• [2]World Health Organization: The Global elimination of congenital syphilis: rationale and strategy for action. Geneva, Switzerland: World Health Organization; 2007.
• [3]Brasil. Ministério da Saúde: DST: Prevalências e frequências relativas de doenças sexualmente transmissíveis em populações selecionadas de seis capitais brasileiras, 2005. 1st edition. Brasília, DF: Série G: Estatística e Informação em Saúde; 2008.
• [4]Brasil. Ministério da Saúde: Boletim epidemiológico: AIDS/DST. Brasília, DF: Secretária de Vigilância em Saúde; 2009/2010. [Ano VII]
• [5]Campos ALA, Araújo MAL, Melo SP: Epidemiology of gestational syphilis in Fortaleza, Ceará State, Brazil: an uncontrolled disease. Cad Saude Publica 2010, 26:1747-1755.
• [6]Nascimento MI, Cunha AA, Guimarães EV: Pregnancies complicated by maternal syphilis and fetal death. Rev Bras Ginecol Obstet 2012, 34(2):56-62.
• [7]Hawkes S, Miller ST, Reichenbach L: Antenatal syphilis control: people, programs, policies and politics. Bull World Health Organ 2004, 82:417-423.
• [8]Nações Unidas: Declaração do Milênio. Cimeira do Milénio. Nova Iorque: Estados Unidos da América; 2000.
• [9]Brasil. Ministério da Saúde: Secretaria de Vigilância em Saúde. Programa Nacional de DST e Aids. Brasília, DF: Série B: Textos Básicos de Saúde; 2007. [Protocolo para a prevenção de transmissão vertical de HIV e sífilis: manual de bolso]
• [10]Brasil. Ministério da Saúde: Secretaria de Vigilância em Saúde. Programa Nacional de DST e Aids. Diretrizes para o Controle da sífilis Congênita. Brasília, DF: Série Manuais nº 62; 2005.
• [11]Abarzúa CF, Belmar JC, Rioseco RA: Pesquisa de sífilis congénita al momento del parto: ¿Suero materno o sangue do cordón? Rev Chil Infect 2008, 25:155-161.
• [12]Gonzalez SR, Molina CF, Salgueiro MBM: Biological false positive VDRL results in the serological diagnosis of syphilis. Rev Cubana Med Trop 2006, 58(1):0-0.
• [13]Instituto Brasileiro de Geografia e Estatística (IBGE): Estimativa populacional de 2008. Fortaleza: Ministério do Planejamento, Orçamento e Gestão; 2009.
• [14]Torres TZG, Magnanini MMF, Luiz RR: Amostragem. In Epidemiologia. 2a edition. Edited by Medronho RA. São Paulo: Atheneu; 2009:403-414.
• [15]Ferreira AW: Diagnóstico Laboratorial das Principais Doenças Infecciosas e auto-imunes. 2nd edition. Rio de Janeiro: Editora Guanabara Koogan; 2001.
• [16]Brasil. Conselho Nacional de Saúde: Resolução nº 196/96, de 10 de outubro de 1996. Dispõe sobre diretrizes e normas técnicas regulamentadoras de pesquisas envolvendo seres humanos. Brasília, DF: Diário Oficial da União; 1996. 21: seção 1: 21082-21085
• [17]Revollo R, Tinajeros F, Hilari C, García SG, Zegarra L, Díaz-Olavarrieta C, Conde-González CJ: Sífilis materna y congénita em cuatro provincias de Bolivia de México. Salud Pública de México 2007, 49(6):422-28.
• [18]Miranda AE, Rosetti Filho E, Trindade CR: Prevalence of syphilis e HIV using rapid tests among parturients attended in públicas maternity hospitals in Vitória, Estado do Espírito Santo. Rev Soc Bras Med Trop 2009, 42:386-391.
• [19]Msuya SE, Uriyo J, Hussain A: Prevalence of sexually transmitted infections among pregnant women with known HIV status in Northern Tanzania. Reprod Heal 2009, 6:8. BioMed Central Full Text
• [20]Romoren M, Rahman M: Syphilis screening in the antenatal care: a cross-sectional study from Botswana. BMC Int Health Hum Right 2006, 6:5. BioMed Central Full Text
• [21]Doreto DT, Vieira EM: Knowledge on sexually transmitted diseases among low-income adolescentes in Ribeirão Preto, São Paulo State, Brazil. Cad SaúdePublica 2007, 23:2516-2522.
• [22]Guimarães EA, Witter GP: Adolescent pregnancy: knowledge and prevention between youngsters. Bol Acad Paul Psicol 2007, 27:167-180.
• [23]Paiva V, Calazans G, Venturi G, Dias R, Grupo de Estudos em População, Sexualidade e Aids: Age and condom use at first sexual intercourse of Brazilian adolescentes. Rev Saude Publica 2008., 42(Supl 1) http://dx.doi.org/ webcite
• [24]Miranda AE, Figueiredo NC, Pinto VM, Kimberly P, Sinésio T: Risk factors for syphilis in young women attending a family health program in Vitória, Brazil. An Bras Dermatol 2012, 87(1):76-83.
• [25]Ramos AN Jr, Matida LH, Saraceni V, Veras MASM, Pontes RJS: Control of mother-to-child transmission of infectious diseases in Brazil: progress in HIV/AIDS and failure in congenital syphilis. Cad Saude Publica 2007, 23:S370-S378. Rodrigues CS, Guimarães MDG, César CG
• [26]Rodrigues CS, Guimarães MDC, Cesar CC: Missed opportunities for congenital syphilis and HIV perinatal transmission prevention. Rev Saude Publica 2008, 42:851-858.
• [27]Domingues RMSM, Hartz ZMA, Leal MC: Na evaluation of action taken to control syphilis and HIV in public-sector prenatal care in the municipality of Rio de Janeiro, Brazil. Rev Bras Saúde Matern Infant, Recife 2012, 12(3):269-280.