Health care of sexual partners of adolescents with gestational syphilis and their children: an integrative review

Laurentino, Arnaldo Cezar Nogueira; Ramos, Beatriz Alves; Lira, Carollyne da Silva; Lessa, Isadora Fiaux; Taquette, Stella Regina

doi:10.1590/1413-81232024295.12162023EN

Arnaldo Cezar Nogueira Laurentino

conception of the study

production

final review of the manuscript

data collection and analysis

Faculdade de Ciências Médicas, Universidade de Estado do Rio de Janeiro. Av. Prof. Manoel de Abreu 444, Maracanã. 20550-170 Rio de Janeiro RJ Brasil. laurentino.acn@gmail.com

https://orcid.org/0000-0002-3195-120X

Beatriz Alves Ramos

conception of the study

production

final review of the manuscript

data collection and analysis

Faculdade de Ciências Médicas, Universidade de Estado do Rio de Janeiro. Av. Prof. Manoel de Abreu 444, Maracanã. 20550-170 Rio de Janeiro RJ Brasil. laurentino.acn@gmail.com

https://orcid.org/0009-0002-1605-7418

Carollyne da Silva Lira

conception of the study

production

final review of the manuscript

data collection and analysis

Faculdade de Ciências Médicas, Universidade de Estado do Rio de Janeiro. Av. Prof. Manoel de Abreu 444, Maracanã. 20550-170 Rio de Janeiro RJ Brasil. laurentino.acn@gmail.com

https://orcid.org/0009-0004-5584-2544

Isadora Fiaux Lessa

conception of the study

production

final review of the manuscript

data collection and analysis

Faculdade de Ciências Médicas, Universidade de Estado do Rio de Janeiro. Av. Prof. Manoel de Abreu 444, Maracanã. 20550-170 Rio de Janeiro RJ Brasil. laurentino.acn@gmail.com

https://orcid.org/0009-0002-7039-3877

Stella Regina Taquette

conception of the study

production

final review of the manuscript

Faculdade de Ciências Médicas, Universidade de Estado do Rio de Janeiro. Av. Prof. Manoel de Abreu 444, Maracanã. 20550-170 Rio de Janeiro RJ Brasil. laurentino.acn@gmail.com

https://orcid.org/0000-0001-7388-3025

Chief editors:

Romeu Gomes, Antônio Augusto Moura da Silva

Search key 1		Search key 2
Congenital syphilis	AND	Gestational syphilis	AND
Teenage pregnancy	OR	Teenage pregnancy	OR
Prenatal care	OR	Prenatal care	OR
Sexual partners	OR	Sexual partners	OR
Masculinity	OR	Masculinity	OR
Gender role	OR	Gender role	OR
Disease notification	OR	Disease notification	OR
Search for communicant	OR	Search for communicant	OR

Author/Year and place of the study	Objective of the study	Population and sample	Results/conclusions
Amorim et al. (2021) Ecological study; Minas Gerais	Analyze the tendencies of GS and CS notifications.	20,348 cases of GS and 11,173 of CS.	The incidence rates of GS and CS showed a growing tendency, which may be related to inadequate treatment for GS or a lack of it.
Silva et al. (2021); Cross-sectional study; Paraná	Analyze CS incidence and vertical transmission.	308 pregnant and 149 children with syphilis.	It was verified that women’s access to prenatal care did not ensure the quality of the care provided.
Roehrs et al. (2021) Quantitative; Santa Catarina	Estimate GS prevalence and associated factors.	212 pregnant women.	The high rate of inadequate treatment indicates the need for new strategies for GS control.
Lobato et al. (2021) Quanti/qualitative; Amapá	Analyze the situation of inadequate treatment for CS.	61 cases of CS; 8 primary care nurses.	Fragility was noticed in the treatment of CS, with a high presence of inadequate treatment.
Rigo et al. (2021) Control case; Minas Gerais	Investigate information on pregnant women regarding syphilis and its association with the CS diagnostic.	70 pregnant women in the case group and 120 in the control group.	The pregnant women in the group had lower educational levels and had 24 times more chances of having information regarding CS and 5 times more chance of having received a prior syphilis treatment, and the pregnant women in the control group had 10 times more chances of having received information on STI during prenatal treatment.
Lucena et al. (2021) Cross-sectional study; Alagoas	Describe the CS scenario.	2,115 cases of CS and 408 cases of GS.	Most of the pregnant women were diagnosed at the time of delivery or curettage and had no treatment. Most of the children were diagnosed with recent CS.
Silva et al. (2021) Cross-sectional study; Maranhão	Analyze sociodemographic and reproductive data in the prenatal data of women with GS.	151 GS cases.	41% of the women interviewed, and 40.4% of the partners were considered adequately treated. The fight against GS demands action from different spheres and capacitation of the professionals.
Araújo et al. (2020) Exploratory descriptive study; Rio Grande do Norte	Identify adherence to the quick test for STIs during prenatal care and administration of penicillin.	18 towns, 94 BHU, and 100 FHS teams.	93% of the teams offered tests on a routine basis, 97.8% during prenatal care and 57% offered to sexual partners. Penicillin was available for 87.1% of the teams, but 49.5% did not use it.
Ozelame et al. (2020) Cross-sectional study; Mato Grosso do Sul	Analyze the occurrence of GS and CS in terms of vulnerabilities.	2,673 cases of CS and 9,526 of GS.	GS and CS had multifactorial causes and the struggle against the diseases must consider social vulnerability, individual vulnerability, and the programmatic vulnerability of the population.
Vescovi et al. (2020) Retrospective cohort; Santa Catarina	Estimate the incidence of CS and the temporal tendency of the notified cases.	2,898 CS cases.	There was an exponential increase in the number of cases of CS, revealing flaws in prenatal care, late diagnosis, and inadequate treatment for the pregnant women and their partners.
Nonato et al. (2020) Cross-sectional study; Acre	Analyze the epidemiological data about the population with syphilis.	5,239 syphilis cases.	Information on preventing infection should be intensified, especially aimed at adolescents, the elderly, and indigenous populations.
Heringer et al. (2020) Descriptive of temporal series; Rio de Janeiro	Describe the temporal and epidemiological distribution of CS.	754 CS cases.	Incidence of CS in young, black individuals, with low educational levels and without prenatal care. 57.6% of the pregnant women were diagnosed with GS during prenatal care. The treatment was inadequate for 87.7% of them, and only 12.2% of the partners were treated.
Silva et al. (2020) Cross-sectional study; Tocantins	Describe the epidemiological distribution of CS.	1,029 notified cases of CS.	There was an increase of 216.1% of CS, with higher rates in the center and north part of the state. Most of the pregnant women were between 15 and 24 years of age, had an Elementary education, and had inadequate prenatal care.
Costa et al. (2020) Ecological study; Pará	Analyze the temporal tendency of CS and its spatial distribution.	5,949 CS cases.	There was a tendency of continuous growth of CS and for its territorial expansion. The results point to inefficient prenatal follow-up.
Dias et al. (2019) Systematic review	Present the results for the struggle against CS in PHC.	20 articles.	Identification of four actions to reduce and fight CS, which have the potential to support the construction of PHA policies.
Maraschin et al. (2019) Cross-sectional study; Paraná	Know the profile of notified GS and CS cases.	114 cases of GS and 114 of CS	65.78% of the GS cases were diagnosed during prenatal care, 57.90% with inadequate treatment, and 75.43% of the sexual partners were not treated.
Conceição et al. (2019) Ecological study; Maranhão	Analyze the epidemiological profile and the spatial distribution of GS and CS.	149 GS cases.	73% increase in the period. The highest prevalence was among younger women, light-skinned black, with low educational levels, who were housewives during the study period. The handling of the investigation proved to be weak.
Favero et al. (2019) Cross-sectional study; Paraná	Establish a profile for the notified cases of CS and GS, their clinical and sociodemographic relationships.	120 cases of GS and 103 of CS.	Factors associated with CS suggest flaws in prenatal care, especially in terms of adequate treatment for the pregnant women and their partners.
Santos et al. (2019) Cross-sectional study; Piauí	Analyze the profile of GS case.	75 GS cases.	Prevalence of GS in women between 20 and 29 years of age, with incomplete Elementary education. Only 32% of the partners received treatment.
Silva et al. (2019) Cross-sectional study; Pernambuco	Describe the profile of CS cases.	57 CS cases.	There is poor effectiveness of prenatal care in preventing CS. Only 35.08% of the diagnoses of GS happened during prenatal care.
Jesus et al. (2019) Cross-sectional study; São Paulo	Characterize the profile of GS and CS.	32 cases of GS and 06 cases of CS.	There is a predominance of GS among young women with none or only some level of education. CS is almost six times above the target by the MH.
Maschio-Lima et al. (2019) Ecological study; São Paulo	Know the profile of CS and GS.	396 cases of GS and 290 cases of CS.	97% of the GS cases had adequate treatment and 52% of the partners were treated. In terms of CS, 82% of the pregnant women were inadequately treated and 82% of the partners had no treatment.
Bertusso et al. (2018) Cross-sectional study; Paraná	Estimate GS in a university hospital.	121 GS cases.	Treatment was inadequate for 68.7% of the pregnant women and 14.9% of the newborn were diagnosed with CS.
Cunha et al, (2018) Cross-sectional study; Santa Catarina	Know the prevalence of GS in a maternity hospital.	69 GS cases.	Most GS cases were among young, white, single, multigestation, with complete Elementary education or Incomplete High School education. Only 30.4% of the partners received treatment.
Menegazzo et al. (2018) Cross-sectional study; Santa Catarina	Determine the incidence of CS in the last 15 years.	26 CS cases.	The incidence of CS is high, with a 126% increase in the last 15 years, and high underreporting as well.
Cardoso et al. (2018) Cross-sectional study; Ceará	Analyze GS cases and their possible outcomes.	175 GS cases.	More than 85.0% of GS cases were inadequately treated and 62.9% of the partners did not get adequate treatment or no information was available. There was a predominant lack of CS exams.
Silva et al. (2017) Cross-sectional study; Mato Grosso	Analyze the CS profile.	153 CS cases.	Most of the GS cases were between 16 and 20 years of age, light-skinned black, 5th to 8th grade education incomplete, with inadequate prenatal care and treatment; 56.86% of the partners were not treated.
Oliveira et al. (2017) Cross-sectional study; Rio Grande do Sul	Describe the profile of CS cases.	752 CS cases.	Most of the GS cases were among young, with low education and low rate of prenatal care. More than 70% of the pregnant women had inadequate treatment. Only 16.1% of the partners were treated.
Cavalcante et al. (2017) Cross-sectional study; Tocantins	Describe the profile of GS and CS cases.	171 cases of GS and 204 of CS.	Predominance of light-skinned black pregnant women, with low educational levels, late diagnosis during prenatal care, age 20 to 34, complete High School, diagnosis during prenatal and untreated partners.
Barbosa et al. (2017) Cross-sectional study; Piauí	Determine the profile of GS cases.	388 cases of GS and 193 of CS.	Pregnant women between 20 and 39 years of age, incomplete Elementary education. 40.4% had a diagnosis of GS during prenatal care, and in 22.3% of the cases, the partners were treated.
Nonato et al. (2015) Cross-sectional study; Minas Gerais	Estimate incidence and factors associated with CS.	353 GS cases.	The incidence of CS suggests flaws in prenatal care and indicates a need for new strategies to reduce vertical transmission.
França et al. (2015) Cross-sectional study; Paraíba	Analyze factors associated with report of CS.	113 CS cases.	64.5% of the pregnant had inadequate treatment, and the partner was not treated in 85.7% of the cases.
Rezende et al. (2015) Cross-sectional study; Goiás	Analyze CS as an indicator of prenatal care.	3,382 cases of GS and 296 of CS.	The analysis indicates flaws in prenatal care and in actions of health surveillance, given the inadequate treatment for the pregnant women, to untreated partners and to underreporting as well.
Domingues et al. (2013) Cross-sectional study; Rio de Janeiro	Evaluate hurdles in care for GS.	102 professionals.	Access to the content in the protocols through training and technical manuals had a discrete effect on the improvement of care conditions.

Author, year, design and place of the study	Objective of the study	Population and sample	Results/conclusions
Oliveira et al. (2021) Cross-sectional study; Goiás	Analyze notifications of GS.	7,774 GS cases.	There was an increase in the number of notifications of latent syphilis in pregnant women, as well as in terms of treatment and completion of the report records.
Soares et al. (2021) Ecological study; Bahia	Describe completion and characteristics of the CS and GS reports.	15,050 cases of GS and 7,812 of CS.	There was an increase in the rates of incidence, failure when filling out the report documents, and the need to implement a routine to evaluate information quality.
Amorim et al. (2021) Ecological study; Minas Gerais	Analyze the tendency of the GS and CS reports.	20,348 cases of GS and 11,173 of CS.	The rates of incidence of GS and CS presented a decreasing tendency, which might be related to inadequate or no treatment of GS.
Silva et al. (2021); Cross-sectional study; Paraná	Analyze the incidence of CS and its vertical transmission.	308 pregnant women, 149 children with syphilis	It was observed that accessibility of women to prenatal care did not ensure the quality of the care provided.
Ozelame et al. (2020) Cross-sectional study; Mato Grosso do Sul	Analyze the occurrence of GS and CS in terms of vulnerability.	2,673 cases of CS and 9,526 of GS.	GS and CS had multifactorial causes, and the fight against them must take into consideration social and individual vulnerability and programmatic vulnerability of the population.
Bertusso et al. (2018) Cross-sectional study; Paraná	Estimate GS in a university hospital.	121 GS cases.	Treatment was inadequate for 68.7% of the pregnant women, and 14.9% of the newborns were diagnosed with CS.
Menegazzo et al. (2018) Cross-sectional study; Santa Catarina	Determine the incidence of CS in the last 15 years.	26 CS cases.	The incidence of CS is high, with 126% increase in the last 15 years and underreporting.
Cardoso et al. (2018) Cross-sectional study; Ceará	Analyze the GS cases and their possible outcomes.	175 GS cases.	More than 85.0% of GS cases were not treated adequately, and 62.9% of the partners were not treated, or the information was missing. There was a predominance of CS exams not having been conducted.
Trevisan et al. (2018) Cross-sectional study; Paraná	Identify the prevalence of GS and CS.	39 cases of GS and 8 of CS.	There is a need for commitment by the professionals in order to ensure the quality of the reports and the strategies for education, prevention, early detection, and treatment.
Lafetá et al. (2016) Cross-sectional study; Minas Gerais	Identify and describe CS and GS cases that were not reported.	93 cases of GS and 54 of CS.	33.3% of the pregnant did not receive treatment, and the total number were considered to have been inadequately treated; 98% of the partners were not treated.
Nonato et al. (2015) Cross-sectional study; Minas Gerais	Estimate incidence and factors associated with CS.	353 GS cases.	CS incidence suggests flaws in prenatal care and indicates a need for new strategies to reduce vertical transmission.
Rezende et al. (2015) Cross-sectional study; Goiás	Analyze CS as an indicator of prenatal care.	3,382 cases of GS and 296 of CS.	The analysis shows flaws in prenatal care and in health surveillance actions, given the inadequate treatment provided to the pregnant women, to untreated partners, and underreporting.
Costa et al. (2013) Cross-sectional study; Ceará	Evaluate the incidence of CS and describe the profile of the pregnant women whose newborn had CS.	2,930 CS cases.	Inadequate treatment of the pregnant women and the lack of treatment for partners are a reality in CE. The increase in CS in the last 10 years reinforces the need for actions aimed at controlling the disease.

[1] Chief editors:

Romeu Gomes, Antônio Augusto Moura da Silva

Brasil

Brasil

Health care of sexual partners of adolescents with gestational syphilis and their children: an integrative review

Abstract