Syphilis is a sexually transmitted infection caused by T. pallidum and can occur with vertical transmission, resulting in congenital syphilis (CS). CS can lead to severe fetal complications such as malformations and death. Congenital syphilis is a major public health problem in Brazil despite effective prevention, diagnostic, and treatment methods. To identify the spatial pattern of congenital syphilis from 2019 to 2022 in municipalities in Brazil’s North region. Ecological study using public secondary notification data from DATASUS (SINAN/SINASC) in the seven states. Incidence rates were calculated per 1,000 live births (LB). Spatial analysis used TerraView 4.2.2 and GeoDa, which also calculated Global Moran’s Index (Im). The analysis included the Brazilian Deprivation Index (IBP), GDP, and maternal variables (maternal age, number of prenatal visits, marital status, maternal education) as correlation factors. Thematic maps of rates were created. Among 450 municipalities, 1,213,748 live births were identified and 8,731 CS cases observed (rate = 7.19/1,000 LB), with univariate Im = 0.41 (p = 0.01) from 2019 to 2022, varying from 0.00 to 39.11 cases/1,000 LB; only 73 municipalities had rates up to 0.50 cases/1,000 LB (as recommended by PAHO in 2016). There were 820,526 live births to mothers aged 20–34; 1,046,541 live births with adequate weight and gestational age; 146,293 were preterm; 190,696 had insufficient prenatal care; 610,986 had mothers in stable union/married; and 176,076 had pregnant individuals with 12 or more years of schooling. Clusters were identified in the Southeast, Northwest, North, and part of Acre, highlighting cases in the state of Tocantins. The Boxmap identified 127 municipalities with high rates (High–High) surrounded by municipalities also with high rates, warranting attention from municipal and regional health managers for possible intervention. The Moran Map highlighted 43 municipalities with statistical significance, almost all in Tocantins. It was possible to identify municipalities requiring intervention by health managers to mitigate congenital syphilis cases in Brazil’s North region.
Almeida et al. (Sun,) studied this question.