Sífilis congênita e materna em Montes Claros – Minas Gerais: diagnóstico tardio e subnotificação

Abstract

Syphilis is a sexually transmitted, infectious systemic disease caused by the bacterium Treponema pallidum. The main route of transmission is the sexual contact, but can also be transmitted from mother to fetus during pregnancy or at birth, resulting in congenital syphilis. The notification of the latter is compulsory. This study aimed to identify the cases of congenital and maternal syphilis reported and not reported in the city of Montes Claros, Minas Gerais, in the period 2007-2013. The information was obtained from records of epidemiological report, from the medical records in maternity and pediatric referral center in the city of Montes Claros. Data were colleted in the period may to august 2013, from a collection instrument, being transferred to a database and analyzed using SPSS ® version 19.0 for Windows. From 214 records with positive non treponemal test for syphilis, 93 cases of maternal syphilis and 54 congenital, excluded men and other city residents were identified. The women studied were predominantly mulatto (63.4%), with Medium/Higher Education (44.2%), aged between 21-30 years (50.5%), and marital status single (53.8%). Considering the prenatal care of pregnant women with syphilis in 21.5% of cases investigated any prenatal consultation was held, most diagnostic for syphilis was identified late after delivery or curettage (62.4%) and no treatment of pregnant women was considered appropriate to the guidelines of the Ministry of Health. Among the newborns of pregnant women with syphilis, 25.8% were not submitted non treponemal serologic test, 42.6% were not treated properly and 79.6% were not referenced to pediatric follow up. The maternal variables evaluated were not decisive to prevent vertical transmission. The lack of notification of maternal and congenital syphilis by health professionals was notorious since 6 cases of syphilis in pregnant women and 13 congenital cases have been reported. These results confirm the persistence of the disease and the rate of vertical transmission, signaling that it is poor quality of antenatal and perinatal care. An improvement in the quality of the care for pregnant women with concomitant treatment of partners, diagnosis, early treatment and proper monitoring of the newborn it is necessary.