Salus: uma arquitetura de saúde digital aplicada à gestão de casos de sífilis

Abstract

Syphilis in Brazil grew by over 500% between 2012 and 2017, this drew the attention of the Ministry of Health, which in 2017 declared a syphilis epidemic Brazil. The hardest side of syphilis is in vertical transmission, that is, when a pregnant woman transmits Treponema Pallidum to her baby. The Federal Court of Accounts (TCU - Brazil), through a serious and in-depth audit regarding the increase in syphilis cases in Brazil, made several notes and recommendations, among them the need to develop tools and technologies that make it possible to monitor more efficiently the evolution of syphilis countrywide. However, when it comes to monitoring it is important to look beyond epidemiological issues, diagnosis, care, treatment and cure. These factors are important, for example, to eliminate vertical transmission of syphilis and, consequently, congenital syphilis, the latter being one of the greatest challenges for Brazil. In this context, it is necessary, therefore, that the actions to face syphilis in Brazil are coordinated between Health Surveillance and Health Care. These two areas, despite being conceived by the Brazilian Health System (SUS) as essentially articulated with each other, operate in a large part of the country in a dichotomous way, including in the Ministry of Health itself. This sometimes occurs due to the lack of integration between the teams that they work in different areas of health, or because the technologies made available by DATASUS are far from understanding the need to mediate a logic of integration between these strategic areas of SUS. The present doctoral thesis is, therefore, situated in this dimension, it brings in its discussion the development of a technological architecture that in fact is a digital health solution that mediates the integration between Health Surveillance and Health Care through technology. both, it incorporates in its flow the management of cases of Syphilis in the territory, that is, in the municipality, places where health is closest to the population. At the same time, it produces epidemiological and care indicators on syphilis. The construction and validation of this architecture were carried out in the city of Natal-RN and the entire discussion surrounding the development and application is presented in this doctoral thesis.