Underreporting of Congenital Syphilis as a Cause of Fetal and Infant Deaths in Northeastern Brazil
Open Access
- 12 December 2016
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 11 (12), e0167255
- https://doi.org/10.1371/journal.pone.0167255
Abstract
Of all syphilis-related pregnancy outcomes, fetal death is certainly the most common one, being directly related to the availability, accessibility and quality of prenatal care. The present study aimed to analyze the underreporting of fetal and infant deaths and other maternal factors associated with congenital syphilis (CS) death. This cross-sectional study integrated data of infants that were diagnosed and/or died of CS from the Sistema de Informação de Agravos de Notificação–Sinan (Notifiable Diseases Information System) and the Sistema de Informação de Mortalidade–SIM (Mortality Information System) in Fortaleza, Northeastern Brasil to identify unreported cases of congenital syphilis. We assessed data during the period from 2007 to 2013. The underreporting of CS as a cause of fetal or infant death increased from 41 to 415 cases (90.1%) during 2007–2013. Exactly 3,209 cases of CS were identified in Sinan and 6,578 deaths in SIM. After database linkage, we identified 382 cases that were reported in the SIM and SINAN databases consisting of 309 fetal deaths and 73 infant deaths related to CS. From the children notified at Sinan that born alive, 3.0% (78/2,542) died; Out of these, 39 (50.0%) were early and 25 (32.1%) were late neonatal deaths. The proportion of death by CS increased from 0.62 to 5.8 from 2007 to 2013. At logistic regression, the variable that maintained statistical significance with fetal and infant death outcomes was the presence of CS signs and/or symptoms at birth (OR = 3.20; IC 95% 1.54–6.62; p = 0.002). Neonatal and Infant deaths following CS-associated live births are underreported in Northeastern Brazil. Data base linkage identified unreported fetal and neonatal deaths due to CS leading to an increased awareness of fetal/infant mortality due to this infection.Funding Information
- Cearense Foundation for Research Support and the National Research Council - FUNCAP / CNPq
This publication has 18 references indexed in Scilit:
- Antenatal Syphilis Screening Using Point-of-Care Testing in Sub-Saharan African Countries: A Cost-Effectiveness AnalysisPLoS Medicine, 2013
- Global Estimates of Syphilis in Pregnancy and Associated Adverse Outcomes: Analysis of Multinational Antenatal Surveillance DataPLoS Medicine, 2013
- Untreated maternal syphilis and adverse outcomes of pregnancy: a systematic review and meta-analysisBulletin of the World Health Organization, 2013
- Incidência da sífilis congênita no Brasil e sua relação com a Estratégia Saúde da FamíliaRevista de Saúde Pública, 2012
- Relação entre a cobertura da Estratégia Saúde da Família e o diagnóstico de sífilis na gestação e sífilis congênitaCadernos de Saude Publica, 2012
- Epidemiologia da sífilis gestacional em Fortaleza, Ceará, Brasil: um agravo sem controleCadernos de Saude Publica, 2010
- A Road Map for the Global Elimination of Congenital SyphilisObstetrics and Gynecology International, 2010
- Características dos nascidos vivos, das mães e mortalidade neonatal precoce na Região Metropolitana de São Paulo, BrasilCadernos de Saude Publica, 2009
- Vinculação determinística de Bancos de Dados sobre mortalidade por AidsRevista Brasileira de Epidemiologia, 2008
- Mortalidade perinatal por sífilis congênita: indicador da qualidade da atenção à mulher e à criançaCadernos de Saude Publica, 2005