CONGENITAL SYPHILIS IN MARANHÃO, BRAZIL, 2020–2024: TEMPORAL TREND, INCIDENCE, AND MORTALITY

Abstract

 This study aimed to analyze temporal changes in congenital syphilis cases, incidence, and mortality in Maranhão from 2020 to 2024 and to compare the state with the Northeast Region and Brazil. This ecological, descriptive, retrospective study used aggregated data from the 2025 Brazilian Syphilis Epidemiological Bulletin. Records from the Notifiable Diseases Information System, the Live Birth Information System, and the Mortality Information System were analyzed. Absolute frequencies, annual and cumulative percentage changes, the state share of national cases, and incidence-rate comparisons were calculated. A total of 3,006 cases were reported in Maranhão. Annual cases increased from 503 in 2020 to 736 in 2024, a 46.3% rise, while incidence increased from 4.7 to 7.6 cases per 1,000 live births, a 61.7% increase. The year 2024 had the highest number in the series and accounted for 24.5% of all cases in the five-year period. Although the state incidence remained lower than the Northeast and Brazilian rates, the gap relative to the national indicator narrowed from 3.9 to 2.0 cases per 1,000 live births. Thirty-one deaths among children younger than one year were recorded, including 20 in 2023 and 2024; the mortality coefficient reached 10.3 per 100,000 live births in both years. Maranhão therefore showed continuous worsening of its indicators, in contrast to the recent national decline. The findings support strengthening screening, timely treatment of pregnant women and their sexual partners, case investigation, and integration between prenatal care and epidemiological surveillance.