Análise espaço-temporal dos casos de sífilis gestacional no estado de Santa Catarina, Brasil, 2013 a 2022

Abstract

Introduction: The growth of gestational syphilis in Brazil is a sign of great concern for public health. Furthermore, it can be seen as a social problem since the absence of appropriate treatment can lead to serious consequences, such as spontaneous abortions, premature abortions, premature births and congenital syphilis. Objective: to analyze the global and local relationship between confirmed cases of gestational syphilis in Santa Catarina, Brazil, based on the historical series from 2013-2022. Method: Quantitative ecological research which used secondary and public information available on the DIVE and Ministry of Health websites. The data was extracted in May 2024. The data used were: syphilis detection rate during pregnancy according to municipality /year, age group of the pregnant woman/year, Human Development Index (HDI) and Family Health Strategy Coverage (CESF). The study was conducted in all municipalities in the state, which is home to approximately 7.6 million people and 2.2 million women of childbearing age. Results and discussion: Data were collected from 17,656 pregnant women from 2013 to 2022. Descriptive analysis, spatial distribution and correlation analysis were performed. The Statistical Package for the Social Sciences (SPSS) was used to perform the descriptive analysis, while ArcGIS was used to analyze the incidence of gestational syphilis, through choropleth maps and the Moran Global Index, which evaluates spatial autocorrelation. When analyzing the spatial distribution of the incidence rate throughout this historical period, areas were found that presented a greater concentration of cases, this factor is related to inequalities in access to health services, prenatal coverage and socioeconomic aspects. Between 2013 and 2022, cases of gestational syphilis in Santa Catarina increased significantly, with the highest number of records in 2022. The Moran Global Index and LISA demonstrated the existence of clusters of municipalities with similar incidence rates. The municipalities of Joinville, Blumenau, Caçador, Itajaí and Balneário Camboriú are classified as having the highest concentrations, covering regions with different socioeconomic conditions. Initially, the cases were concentrated in the northeast of the state, but expanded to Vale do Itajaí, Greater Florianópolis and Sul Catarinense. The most affected pregnant women are between the ages of 20 and 29. However, more than half of the data related to education, diagnosis and treatment are incomplete, which hinders a more detailed analysis. Although Santa Catarina has a high average HDI, there are regional inequalities, with Family Health team coverage below 90% in high incidence areas. To combat gestational syphilis, it is essential to expand primary care coverage, strengthen diagnosis and treatment, in addition to adopting public policies to reduce inequalities and improve the health of pregnant women and their babies.