Sífilis congênita: análise epidemiológica e intervenção educacional na atenção primária à saúde no Rio Grande do Norte

Abstract

Congenital syphilis is a severe bacterial disease that can be prevented through the detection and proper treatment of pregnant women with syphilis during prenatal care. Given the increasing number of congenital syphilis cases worldwide, failures in the implementation of public health policies to combat syphilis are evident, particularly within Primary Health Care (PHC). In this context, Permanent Health Education (PHE), which involves learning processes and professional development based on the daily needs of healthcare services, plays a key role in promoting changes in healthcare practices and becomes an important ally in this scenario. An analysis was conducted on the temporal and spatial distribution, as well as the characterization of reported cases of congenital syphilis, at a reference hospital for maternal and child care in the 5th Health Region of RN. Based on these findings, an educational intervention was implemented with PHC healthcare professionals to combat the vertical transmission of syphilis in a municipality identified as highly vulnerable to the occurrence of cases in the region. To achieve this, an observational, exploratory, and descriptive study was initially conducted, using a quantitative, documentary, and retrospective approach. The study analyzed the temporal and spatial distribution and the characteristics of congenital syphilis cases reported by Huab between June 2016 and 2023. A total of 307 congenital syphilis notification forms from the Notifiable Diseases Information System (Sinan) were examined. Following the data analysis, the municipality of Bom Jesus – RN was selected for the implementation of an educational intervention—the workshop "Combating Syphilis from Gestation to Birth." The epidemiological study showed a growing progression of congenital syphilis cases between June 2016 and 2023, with a notification growth rate of 64,58%. The municipalities with the highest average incidence rates of congenital syphilis (per 1.000 live births) were: São Bento do Trairi (23,6), São Pedro (23,4), Lajes Pintadas (23,2), and Bom Jesus (22,4). Additionally, from 2019 onward, gestational syphilis was predominantly diagnosed at the time of delivery, highlighting the fragility of prenatal care in the studied region. Subsequently, the educational intervention was implemented, aiming to raise awareness and train different categories of PHC healthcare professionals in the fight against syphilis and congenital syphilis. The workshop discussions covered the epidemiological situation of syphilis, the disease's etiopathogenesis, clinical and laboratory diagnosis, treatment, mandatory notification, and case monitoring. Therefore, identifying areas with higher incidence rates of congenital syphilis in the 5th Health Region of RN enabled the recognition of regions more vulnerable to vertical transmission. A higher mother-to-child transmission rate of syphilis was observed among women aged 20 to 29 years, with low education levels, of mixed-race ethnicity, living in urban areas, who underwent prenatal care but whose sexual partners did not receive adequate treatment. Thus, PHE strategies targeting PHC professionals serve as key allies in transforming this scenario, as they contribute to enhancing the quality of prenatal care.