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Spatial distribution of congenital syphilis in the state of Bahia, Brazil from 2009 to 2018
Caroline Luz Vital1,2, Renato Barbosa Reis1,3,4, Jorgana Fernanda de Souza Soares5,6
1Pathology and Molecular Biology Laboratory, Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil.
Insights
Congenital syphilis (CS) cases in Bahia, Brazil, surged by 511% between 2009-2018, highlighting inadequate prenatal care and social vulnerability as key drivers. Intensified public health programs are crucial to combat this growing epidemic.
Area of Science:
- Public Health
- Epidemiology
- Infectious Diseases
Background:
- Congenital syphilis (CS) poses a significant global health challenge.
- Understanding temporal and spatial trends is crucial for effective intervention strategies.
Purpose of the Study:
- To analyze the temporal trends and spatial distribution of congenital syphilis (CS) in Bahia, Brazil, from 2009 to 2018.
- To identify key demographic and care-related factors associated with CS incidence.
Main Methods:
- A mixed ecological study utilizing data from the Notifiable Diseases Information System and Live Birth Information System.
- Spatial analysis including Global Moran Index I and Local Spatial Association Indicator (LISA) to assess spatial autocorrelation and clustering of CS cases.
Main Results:
- A dramatic 511% increase in CS incidence was observed between 2009 and 2018, with 8,786 cases registered.
- Significant spatial autocorrelation of CS cases was identified, with four distinct clusters.
- Inadequate prenatal care (68.8% not adequately treated) and untreated partners (81.1%) were prevalent, alongside a high incidence among young, low-education, Black, and multiracial mothers.
Conclusions:
- Congenital syphilis is a critical public health issue in Bahia, with incidence rates 8.4 times the WHO target.
- The high rates are strongly linked to inadequate prenatal care and social vulnerability indicators.
- Urgent intensification of public health programs targeting women of childbearing age and pregnant women is recommended.
Objective:
To describe the temporal trend and spatial distribution of congenital syphilis (CS) cases in the state of Bahia, Brazil between 2009 and 2018.
Method:
Mixed ecological study conducted through the analysis of data obtained from the Notifiable Diseases Information System and the Live Birth Information System. Global Moran Index I was performed in order to analyze spatial autocorrelation of CS cases in the municipalities of Bahia and the Local Spatial Association Indicator (LISA) was used to identify the formation of spatial regimes in the GeoDA software.
Results:
8,786 cases of CS were registered in the period. An increasing growth in CS incidence, with a 511% increase between 2009 and 2018. Spatial autocorrelation was observed between the municipalities (I Moran = 0.452; p < 0.001) and four clusters were identified. More frequently, mothers were aged 20-29 years (50.7%); had incomplete primary education (54.9%); were Black and multiracial (93.2%); received prenatal care (82.2%); 49.0% were diagnosed with syphilis during prenatal care; 68.8% were not adequately treated, and 81.1% of their partners were not treated.
Conclusion:
The results showed that CS consolidates as a serious public health problem in Bahia, with an incidence 8.4 times higher in the period than the WHO target of 0.5/1,000 live births, predominantly related to inadequate prenatal care and social vulnerability indicators: young mothers with low education levels, as well as individuals identified as Black and multiracial. Thus, programs aimed at women of childbearing age and pregnant women need to be intensified.
