Prenatal approach to syphilis in primary health care: a literature review

Abstract

Syphilis is caused by the infectious agent Treponema Pallidum, which can be vertically transmitted. This can generate serious complications in pregnancy and for the development of the fetus. When transmitted to the fetus, it leads to congenital syphilis. There is a high rate of transmission in the first and third trimesters of pregnancy. When transmitted, the fetal mortality rate is about 40%. Thus, it is a serious public health concern, which can be prevented with effective prenatal care. This is a review of the Medline, SciELO and LILACS databases of articles from the last 10 years. These aim to verify the Brazilian medical aid to gestational and congenital syphilis in primary care. Data shows that 1.3 to 2.0 million women are infected with syphilis per year worldwide, and that about 1/3 of these are not tested for syphilis during pregnancy. In Brazil, the incidence rate of congenital syphilis is 9.0/1000 live births, with a mortality rate of 8.2/1,000 live births in 2018, contrary to the expectations of the Pan American Health Organization to reduce to <0.5/100 live births by 2015. Primary care, although it has increased its coverage up to 87.17% of the population, it has still failed prenatal care due to unpreparedness of healthcare professionals in screening, adequate treatment for pregnant women and their partners, and a lack of prevention programs. Thus, primary health actions to combat gestational and congenital syphilis are insufficient. Therefore, it is necessary to improve the quality of prenatal care to reduce the incidence of the disease in Brazil, where syphilis is a serious and virulent epidemic.

Keywords

• syphilis
• prenatal care
• primary health care