More than 97% of the reported cases of congenital syphilis in Rio Grande do Norte present some kind of inconsistency or inadequacy, which represents an overreporting of the infection that is transmitted to the baby, by the mother, during pregnancy. The data are from the report “INCONSISTENCY IN THE NOTIFICATIONS OF CONGENIC SYPHILIS: AN AN ANALYSIS BASED ON SINAN, CONFIRMED BY CLINICAL, LABORATORY AND EPIDEMIOLOGICAL FINDINGS”, produced by researchers from the Laboratory of Technological Innovation in Health (LAIS/UFRN). The analyzed data are the result of researches from the “Syphilis No” Project, carried out by LAIS in partnership with the Ministry of Health and the Pan-American Health Organization (PAHO).
The document presents even more serious data: all the children who participated in this study and were notified with congenital syphilis in Natal/RN were negative (non-reactive). The analyzed data were collected in the Sistema de Informação de Agravos de Notificação (SINAN) of the Secretaria de Vigilância em Saúde (SVS) of the Ministério da Saúde (MS), considered the period from 2015 to 2020. “However, what stands out the most is that only 3.3% of these children, in fact had a higher titer than the maternal in at least two dilutions (factors that point to signs of congenital syphilis),” explained the executive director of LAIS, Professor Ricardo Valentim, one of the authors of the report.
Based on the records of 1,074 children notified in SINAN, of these, 978 children treated in the maternity hospitals of Natal/RN, an active search was carried out with the objective of further laboratory tests to confirm the diagnosis of congenital syphilis. This process occurred in a coordinated way with the Núcleo de Agravos Notificáveis (NAN) of the municipality of Natal for the performance of serological and molecular tests complementary to the diagnosis of congenital syphilis. At the time of writing, 34 children, 34 mothers, and 11 fathers were included in this study, totaling 79 blood samples collected from September 2021 to February 2022.
The collections were performed in Basic Health Units located in Natal-RN, where 386 children with congenital syphilis were notified between 2018 and the first semester of 2021. Among the retested tests, all pointed negative for syphilis.
This situation does not occur only in Rio Grande do Norte. According to the survey, the scenario is repeated throughout Brazil. According to the SINAN database, in the period from 2015 to 2020, 28.70% of the cases reported with congenital syphilis were from data that presented some inadequacy. This means that 39,895 of the 139,015 records in the period are inadequate to notify newborns with congenital syphilis.
The consequences of over-notification can cause damage to public health, either by promoting inequities in access to health services or by the inefficient use of public health resources (workforce, care services, infrastructure, and budget).
The document brings details about the investigation carried out by the researchers, with emphasis on the importance of the clinical evaluation of hearing and child development. At the end of the report, there are indications of changes in conduct necessary for the transformation of the current picture. To access the report, please go HERE.