Avaliação da pandemia de COVID-19 no enfrentamento à sífilis no município de Belo Horizonte-MG

Abstract

Introduction: Syphilis has become a global public health problem and requires strategic actions to combat and reduce all its complications, notably congenital syphilis (CS). Social isolation, which began with the COVID-19 pandemic, may have contributed to a drop in the number of syphilis notifications and the consequent worsening of indicators. Objective: to analyze the COVID-19 pandemic in the actions developed to combat syphilis and CS in Belo Horizonte (BH). Methodology: retrospective study with a descriptive epidemiological evaluation profile in order to analyze data on syphilis and the COVID-19 pandemic. The data was divided into three distinct periods: pre-pandemic (2018-2019), period of greater social restrictions (2020) and after the start of vaccination (2021). The socio-demographic, clinical and laboratory variables present in the notification forms for acquired syphilis in pregnant women and congenital syphilis were analyzed and software was used to combine the syphilis databases in pregnant women and CS, to assess the presence of duplication and inconsistencies. Then, statistical relationship analysis was used using Pearson's Chi-Square test, considering the value to be significant at p<0.05. In addition to evaluating the construction and implementation of the municipal project to combat syphilis in BH. Results: There was a loss of 68.8% of information in the CS database due to a lack of adequate completion of the notification forms. We found a drop in the number of reports of acquired syphilis, 3,744 in 2019 and 3,134 in 2020; significant difference in education, race/color and age group, in the period evaluated, with a value of p=0.03, p<0.001 and p=0.04, respectively, in acquired syphilis. Drop in syphilis in pregnant women, 751 in 2019 and 714 in 2020, and significant difference in prenatal qualification assessed by performing the rapid test (p value <0.001), indicating timely diagnosis and treatment carried out in pregnant women with syphilis; and increased treatment of sexual partnerships for pregnant women with syphilis. Drop in CS data, 285 in 2019 and 201 in 2020, with a statistically significant difference, p=0.004, in symptomatic cases, contrasting with an increase of 95% in symptomatic cases when comparing this period with 2021. In the joint analysis of syphilis banks in pregnant women and CS, 2,052 pregnant women with syphilis did not have a CS outcome and 917 cases were reported as CS; found statistical significance in black pregnant women (82.7%) with education up to complete elementary school (51.1%) and age group up to 29 years old (76.7%) among pregnant women with greater chances of becoming infected with syphilis and having vertical transmission as a consequence. The project to combat syphilis provided prenatal training and systematic monitoring of pregnant women with syphilis, acquired syphilis and CS. Conclusion: the period of greater social restrictions caused a drop in the total number of notifications of acquired syphilis, possibly due to imposed social restrictions and low demand for diagnostic services, but demonstrated a qualification of prenatal care, with improvements in syphilis data in pregnant women and CS, due to actions to combat the disease established in the municipality through the “Sífilis Não” project.