CONGENITAL SYPHILIS IN BRAZIL: A COMPARATIVE STUDY OF INCIDENCE BETWEEN 2019 AND 2023, CONSIDERING PRE-PANDEMIC AND PANDEMIC PERIODS

Abstract

Introduction: Congenital syphilis results from the hematogenous spread of untreated or inadequately treated Treponema pallidum from the pregnant woman to the fetus via the placenta. Despite continuous efforts, gaps in prenatal care were exemplified during the COVID-19 pandemic by significant disruptions in reproductive health services, hindering access to preventive care and increasing the risk of undetected congenital syphilis. Objective: To evaluate the incidence of congenital syphilis in different regions of Brazil between 2019 and 2023. Methodology: This is an ecological time-series study using secondary data from the Notifiable Diseases Information System (SINAN) from 2019 to 2023. The variables analyzed included reported cases of congenital syphilis, year of diagnosis, geographical region, presence of maternal syphilis, prenatal care attendance, course of congenital syphilis, partner treatment, and final classification. Data were analyzed using descriptive statistics. Results: Analysis of reported case distribution by region and year highlighted the Southeast region with 50,670 cases over five years, followed by the Northeast with 32,308 cases. Additionally, analysis of congenital syphilis cases during the COVID-19 pandemic (2020-2022) did not reveal statistically significant differences in incidence compared to the pre-pandemic period (2019). Discussion: During the COVID-19 pandemic, diagnostic and treatment procedures for syphilis in Brazil's Unified Health System (SUS) experienced a significant reduction, with a decline in procedures performed in the first seven months of 2020 compared to the period from 2016 to 2019. The "Syphilis No!" project exemplifies the success of comprehensive public health interventions, particularly in the Northeast region, where there was a significant reduction in notifications. However, challenges persist in integrating research into health policies, especially in epidemiological surveillance and equitable access to health services. Conclusion: Therefore, to combat congenital syphilis, it is essential to implement evidence-based policies, strengthen health systems, and promote additional research, adopting a multifaceted approach to guide effective and sustainable interventions in global maternal and child health.