Análise dos casos notificados e investigados de sífilis congênita entre residentes em Niterói, RJ, diagnosticados no período de 2018 a 2019

Abstract

This study performed a descriptive analysis of notifications and investigations of cases of congenital syphilis diagnosed in 2018 and 2019 among residents in Niteroi, Rio de Janeiro, based on data from the vertical transmission investigation questionnaires, seeking questions that can elucidate the outcome of congenital syphilis. An analysis performed considering: maternal sociodemographic variables; prenatal characteristics; epidemiological background of the mother and vulnerabilities; laboratory and clinical data on the child; case definition situation; treatment, evolution, and conclusion of the case. In 2018, 19 (41.3%) and in 2019, 70 (65.4%) of the notifications occurred among mothers aged 20 to 29 years. Most mothers declared themselves brown colored, 21 (45.6%) in 2018 and 52 (48.6%) in 2019. In 2018, 16 (34.8%) and in 2019 35 (32.7%) of the mothers had from 5th to 8th education grade incomplete. Mothers who had prenatal care were more frequent, 38.0 (82.6%) in 2018 and 103.0 (96.3%) in 2019. Most were diagnosed with maternal syphilis during prenatal care, 33.0 (86.8%) in 2018 and 87.0 (84.5%) in 2019, received adequate treatment 19.0 (57.6%) in 2018 and 55.0 (51.4%) in 2019, attended 7 consultations or more, 21.0 (45.6%) in 2018 and 64.0 (59.8%) in 2019. Twenty-five (54.3%) pregnant women were not tested in 2018 and 63 (58.9%) in 2019, and 32 (69.6%) in 2018 and 77 (72%) in 2019 were not treated. Case definition category “situation 1” was more frequent, 37.0 (80.4%) in 2018 and 71.0 (66.4%) in 2019. Most newborns had no changes in CSF, 31.0 (67.4%) in 2018 and 65.0 (60.7%) in 2019, had no radiographic changes 28.0 (60.9%) and 67.0 (62.6%), had no symptoms 34, 0 (73.9%) in 2018 and 75.0 (70.09%) in 2019, and 44 (95.6%) in 2018 and 103 (96.3%) in 2019 were born alive. The most prevalent vulnerabilities among the notified and investigated cases were that of "low-income family" which represented 52.2% of cases in 2018 and 47.7% in 2019 and that of "alcohol and drug user" - in 2018 41 .3% and in 2019 31.6%. In 2018, 11.0 (23.9%) underwent prenatal care, had a reactive screening test in prenatal care, but did not receive adequate treatment. In 2019, 32.0 (29.9%) underwent prenatal care, had a reactive syphilis screening test during prenatal care, had adequate treatment, but confirmed SC by other criteria. In the two years analyzed, the second most frequent conclusion was that the mothers had prenatal care, had a reactive syphilis screening test in the prenatal period, had adequate treatment, but reinfected, with 10.0 (21.7%) in 2018 and 23.0 (21.5%) in 2019. The case investigation process becomes crucial for decision-making at the municipal level on this grievance. After the investigation, it was verified that social vulnerability is an important point to be worked on, and it demands articulation with other sectors.