Análise epidemiológica dos casos de sífilis gestacional e congênita em Feira de Santana/BA, entre 2017 e 2023

Abstract

Introduction: Gestational syphilis (GS) and congenital syphilis (CS) remain major public health challenges, reflecting social inequalities, weaknesses in prenatal care, and failures in the prevention of vertical transmission. Temporal and spatial analyses of these conditions allow a better understanding of their dynamics and help identify priority areas for intervention. Objective: To analyze the temporal trend and spatiotemporal distribution of gestational and congenital syphilis in the municipality of Feira de Santana, Bahia, from 2017 to 2023. Methods: This ecological, descriptive, and retrospective study used secondary data from the Notifiable Diseases Information System (SINAN) and the Live Birth Information System (SINASC). Detection (GS) and incidence (CS) rates, absolute and relative frequencies, and chi-square tests were calculated. Temporal trends were assessed using the Annual Percent Change (APC) with 95% confidence intervals, through segmented regression (Joinpoint Regression). The spatiotemporal analysis was performed using a hierarchical Bayesian model (BYM) within the INLA framework, decomposing temporal, spatial, and space–time interaction effects. Results: A rising trend was observed for GS and CS between 2019 and 2021 (APC = 23.4%; 95%CI: 11.1–35.7 and APC = 30.1%; 95%CI: 14.3–45.7, respectively), followed by a decrease in 2022– 2023. In 2020, the highest temporal risks were found for GS (RR = 1.54; 95%CI: 1.37–1.73) and CS (RR = 2.07; 95%CI: 1.76–2.43), with reduction in 2023 (RR = 1.02 and RR = 0.65). The space–time interaction was not significant. Chronic high-risk clusters were identified in the neighborhoods of Aviário (RR = 2.57; 95%CI: 1.81–3.68) for GS and Asa Branca (RR = 1.71; 95%CI: 1.06–2.93) for CS. Most cases occurred among young, Black women living in urban areas, with prenatal care recorded but diagnosis often made in the third trimester. Conclusion: An increasing trend in syphilis cases was observed until 2020, followed by stabilization, possibly influenced by the COVID-19 pandemic. The persistence of high-risk areas and their association with social vulnerability highlight the need for territorialized surveillance, strengthening of Primary Health Care, and continuous professional education to ensure early detection and timely treatment of pregnant women and their partners.