Sífilis na gestação assistida na atenção básica em São Paulo: estudo ecológico
Data
2021
Autores
Diniz, Giovanna Mota Alves 
Orientadores
Taminato, Monica
Tipo
Trabalho de conclusão de curso
Título da Revista
ISSN da Revista
Título de Volume
Resumo
Introdução: No Brasil estima-se que cerca de 60% dos óbitos neonatais ocorram por causas evitáveis. A infecção é a principal causa de mortalidade e morbidade principalmente em países em desenvolvimento como o Brasil. A redução da mortalidade infantil obteve amplo reconhecimento a partir dos Objetivos de Desenvolvimento do Milênio (ODS) no período de 1990 a 2013. Dos desfechos negativos gestacionais evitáveis, a transmissão vertical da sífilis é uma das mais graves. Uma parcela considerável de mortes perinatais, nascimentos prematuros, aborto, óbito fetal e problemas relacionados ao desenvolvimento fetal são atribuídos à sífilis congênita. Apesar da gravidade e da possibilidade de contenção deste agravo, os números de sífilis na gestação vêm alcançando números epidêmicos nos últimos anos, sendo um enorme problema de saúde pública no Brasil e no mundo. Os principais desafios estão no rastreio e tratamento correto dessas gestantes, o que torna a compreensão, avaliação e ênfase nessas áreas de extrema importância. Justificativa: Em face da problemática que se tornou a transmissão vertical da sífilis, é de extrema importância o levantamento de dados a respeito da prevalência da sífilis gestacional, bem como descrever a população afetada e avaliar os serviços de rastreio e tratamento a fim de contribuir para a elaboração de estratégias efetivas para o enfrentamento deste agravo. Objetivo: Verificar a prevalência de sífilis em gestantes do município de São Paulo no ano de 2019, descrever o perfil socioepidemiológico das gestantes, avaliar o sistema de diagnóstico e tratamento e comparar os dados Regionais, Estaduais e Nacionais. Material e Método: Estudo Ecológico, com base nos dados publicizados de características epidemiológicas e Sistema de Informação de Agravos de Notificação, Dados da Prefeitura de São Paulo e Observasampa. Resultados: No ano de 2019 foram notificados um total de 5.217 casos de sífilis na gestação, distribuídos entre as seis Coordenadorias Regionais de Saúde, sendo a CRS Sul a que concentra maior número de casos comparada às demais (28,5% do total). A TD (taxa de detecção) do município foi observada em 32,9 casos de sífilis em gestantes por 1000 nascidos vivos. A taxa municipal foi superada pelas CRS Norte, Sul e Leste (40,3, 36,4, 33,6 de casos por 1000 nascidos vivos em cada CRS respectivamente). Em relação ao ano anterior, houve um aumento de 2,8% na TD no município de São Paulo, o contrário da tendência nacional, a qual apresentou decréscimo de 3,3% entre 2018 e 2019. No mesmo período um total de 1.181 casos de transmissão vertical da sífilis foi notificado no município, com uma taxa de incidência de 7,4 casos por 1000 nascidos vivos. Quanto ao perfil sociodemográfico das gestantes, observou-se que 36,6% estava na faixa etária de 20 a 24 anos, 31,4% possuía no máximo ensino fundamental completo e 45,6% se considerava parda. Discussão: O aumento nas taxas de detecção pode ser devido a um melhor rastreio e notificação de casos de sífilis em gestantes. Um estudo mais aprofundado sobre o tratamento e desfecho desses casos faz-se necessário para melhor compreensão dos fatores envolvidos no aumento das taxas estudadas. Conclusão: A melhoria dos indicadores sociais analisados contribui para a redução significativa de ambos os casos de sífilis.
Introduction: In Brazil it is estimated that about 60% of neonatal deaths occur from preventable causes. Infection is the main cause of mortality and morbidity, especially in developing countries such as Brazil. The reduction in infant mortality has gained wide recognition since the Millennium Development Goals (MDGs) from 1990 to 2013. Of the preventable negative pregnancy outcomes, vertical transmission of syphilis is one of the most serious. A considerable proportion of perinatal deaths, premature births, abortion, stillbirth and problems related to fetal development are attributed to congenital syphilis. Despite the seriousness and the possibility of containing this disease, the numbers of syphilis during pregnancy have reached epidemic numbers in recent years, being an important public health problem in Brazil and in the world. The main challenges are in the screening and correct treatment of these pregnant women, which makes understanding, evaluating and emphasizing these areas of extreme importance. Justification: Given the problem that vertical transmission of syphilis has become, it is extremely important to collect data on the prevalence of gestational syphilis, as well as describe the affected population and evaluate screening and treatment services in order to contribute to the development of effective strategies for coping with this problem. Objective: To verify the prevalence of syphilis in pregnant women in the city of São Paulo in 2019, describe the socio-epidemiological profile of pregnant women, evaluate the diagnosis and treatment system and compare Regional and State data and Nationals. Material and Method: Ecological Study, based on published data on epidemiological characteristics and Information System for Notifiable Diseases, Data from the City of São Paulo and Observasampa. Results: In 2019, a total of 5,217 cases of syphilis during pregnancy were notified, distributed among the six Regional Health Coordinations, with RHC South having the highest number of cases compared to the others (28.5% of the total). The city's DR (detection rate) was observed in 32.9 cases of syphilis in pregnant women per 1000 live births. The municipal rate was surpassed by the North, South and East RHC (40.3, 36.4, 33.6 cases per 1000 live births in each RHC respectively). Compared to the previous year, there was a 2.8% increase in DR in the city of São Paulo, contrary to the national trend, which showed a decrease of 3.3% between 2018 and 2019. In the same period, a total of 1,181 cases of vertical transmission of syphilis was reported in the municipality, with an incidence rate of 7.4 cases per 1000 live births. As for the sociodemographic profile of pregnant women, it was observed that 36.6% were aged between 20 and 24 years, 31.4% had completed elementary school at most and 45.6% considered themselves brown. Discussion: The increase in detection rates may be due to better screening and reporting of syphilis cases in pregnant women. A more in-depth study on the treatment and outcome of these cases is necessary for a better understanding of the factors that involve augmentation. Conclusion: The improvement of the analyzed social indicators contributes to a significant reduction in both cases of syphilis.
Introduction: In Brazil it is estimated that about 60% of neonatal deaths occur from preventable causes. Infection is the main cause of mortality and morbidity, especially in developing countries such as Brazil. The reduction in infant mortality has gained wide recognition since the Millennium Development Goals (MDGs) from 1990 to 2013. Of the preventable negative pregnancy outcomes, vertical transmission of syphilis is one of the most serious. A considerable proportion of perinatal deaths, premature births, abortion, stillbirth and problems related to fetal development are attributed to congenital syphilis. Despite the seriousness and the possibility of containing this disease, the numbers of syphilis during pregnancy have reached epidemic numbers in recent years, being an important public health problem in Brazil and in the world. The main challenges are in the screening and correct treatment of these pregnant women, which makes understanding, evaluating and emphasizing these areas of extreme importance. Justification: Given the problem that vertical transmission of syphilis has become, it is extremely important to collect data on the prevalence of gestational syphilis, as well as describe the affected population and evaluate screening and treatment services in order to contribute to the development of effective strategies for coping with this problem. Objective: To verify the prevalence of syphilis in pregnant women in the city of São Paulo in 2019, describe the socio-epidemiological profile of pregnant women, evaluate the diagnosis and treatment system and compare Regional and State data and Nationals. Material and Method: Ecological Study, based on published data on epidemiological characteristics and Information System for Notifiable Diseases, Data from the City of São Paulo and Observasampa. Results: In 2019, a total of 5,217 cases of syphilis during pregnancy were notified, distributed among the six Regional Health Coordinations, with RHC South having the highest number of cases compared to the others (28.5% of the total). The city's DR (detection rate) was observed in 32.9 cases of syphilis in pregnant women per 1000 live births. The municipal rate was surpassed by the North, South and East RHC (40.3, 36.4, 33.6 cases per 1000 live births in each RHC respectively). Compared to the previous year, there was a 2.8% increase in DR in the city of São Paulo, contrary to the national trend, which showed a decrease of 3.3% between 2018 and 2019. In the same period, a total of 1,181 cases of vertical transmission of syphilis was reported in the municipality, with an incidence rate of 7.4 cases per 1000 live births. As for the sociodemographic profile of pregnant women, it was observed that 36.6% were aged between 20 and 24 years, 31.4% had completed elementary school at most and 45.6% considered themselves brown. Discussion: The increase in detection rates may be due to better screening and reporting of syphilis cases in pregnant women. A more in-depth study on the treatment and outcome of these cases is necessary for a better understanding of the factors that involve augmentation. Conclusion: The improvement of the analyzed social indicators contributes to a significant reduction in both cases of syphilis.
Descrição
Citação
DINIZ, G.M.A. Sífilis na gestação assistida na atenção básica em São Paulo: estudo ecológico. São Paulo, 2021. 20 f. Trabalho de Conclusão de Curso (Graduação em Enfermagem) - Escola Paulista de Enfermagem (EPE), Universidade Federal de São Paulo (UNIFESP). São Paulo, 2021.