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Background: according to national surveillance data the notification of congenital syphilis in Brazil increased in the last 10 years (incidence: 3,9/100.000 in 2012). Achieving elimination (<0,5/100.000) by 2015 is a strategic goal and challenging target for the Ministry of Health (MOH).
Methods: we assessed frequency of potential determinants of vertical transmission of syphilis in Brazil analyzing surveillance data from the National Information System of Diseases Notification (SINAN). Analysis was done by Region and State.
Results: regarding cases of syphilis in pregnant women in 2012: 22,9% were diagnosed in the first trimester, 30,3% in the second and 38,7% in the third; 83,4% were treated with penicillin, 3,3% with other drugs, and 7,3% did not receive any treatment (range:0-22,4%) - in 6,0% data were not available. Frequency of untreated mothers varied among States: in Acre (22,4%), Tocantins (15,0%), Paraná (11,8%), Rio de Janeiro (11,2%), Mato Grosso do Sul (10,4%), Espirito Santo (10,1%), Minas Gerais (9,4%) Pernambuco (8,9%) and Bahia (8,2%) frequency was higher than national average. Regarding cases of congenital syphilis in 2012: 73,3% of their mothers had at least one antenatal consultation and, among these, 56,8% had their syphilis diagnosed during antenatal care. Among syphilis positive mothers, 14,4% did not receive any treatment and in 61,9% their male partner was not treated. In addition, the proportion of mothers of cases of congenital syphilis with 1-3 (8,9%) and with 4-7 (31,6%) years of education was greater than in pregnant women in general, respectively 5,4% and 24,7%(data from National Live-birth Information System).
Conclusions: gaps still exists in antenatal care and a significant number of cases may be averted with timely diagnosis and adequate treatment of syphilis during pregnancy. In 2014 MOH will implement Local Congenital Syphilis Committees in capital cities and to scale up the use of penicillin during pregnancy in primary health