Analyzing a national health surveillance strategy to reduce mother-to-child transmission of syphilis: The case of Brazilian investigation committees

Thereza Cristina de Souza Mareco; Thaísa Gois Faria de Moura Santos Lima; Maria Natália Pereira Ramos; Marquiony Marques Dos Santos; José Adailton da Silva; Vania Priamo; Cintia Michele Gondim de Brito; Esdras Daniel Dos Santos Pereira; Carlos Alberto Pereira de Oliveira; Lyane Ramalho Cortez; Ion Garcia Mascarenhas de Andrade; Milena Cristina Duarte de Almeida; Ricardo Alexsandro de Medeiros Valentim

doi:10.1016/j.ijregi.2023.07.008

Analyzing a national health surveillance strategy to reduce mother-to-child transmission of syphilis: The case of Brazilian investigation committees

IJID Reg. 2023 Aug 10:8:164-171. doi: 10.1016/j.ijregi.2023.07.008. eCollection 2023 Sep.

Authors

Thereza Cristina de Souza Mareco^{1

2}, Thaísa Gois Faria de Moura Santos Lima¹, Maria Natália Pereira Ramos³, Marquiony Marques Dos Santos¹, José Adailton da Silva^{1

4}, Vania Priamo¹, Cintia Michele Gondim de Brito^{1

5}, Esdras Daniel Dos Santos Pereira⁶, Carlos Alberto Pereira de Oliveira⁷, Lyane Ramalho Cortez^{1

4}, Ion Garcia Mascarenhas de Andrade¹, Milena Cristina Duarte de Almeida¹, Ricardo Alexsandro de Medeiros Valentim¹

Affiliations

¹ Laboratory for Technological Innovation in Health, Federal University of Rio Grande do Norte, Natal, Brazil.
² University of Brasília, Brasília, Federal District, Brazil.
³ Open University of Portugal, Lisbon, Portugal.
⁴ Graduate Program in Health Management and Innovation, Federal University of Rio Grande do Norte, Natal, Brazil.
⁵ University of Pernambuco, Recife, Brazil.
⁶ Oswaldo Cruz Foundation, Rio de Janeiro, Brazil.
⁷ State University of Rio de Janeiro, Rio de Janeiro, Brazil.

Abstract

Objectives: This study aimed to analyze the relevance of investigation committees in eliminating mother-to-child transmission of syphilis in Brazil.

Methods: Questionnaires and interviews were conducted with health managers of 25 Brazilian Federative Units and Brazil's Federal District. Data were analyzed using Bardin's content analysis technique and subsequently compared with the global prescriptions for syphilis response of the Pan American Health Organization, World Health Organization, and recent research publications examining the course of syphilis in Brazil, in Brazilian regions, and globally.

Results: While the investigation committees drew on the successful experience of those in reducing maternal mortality, which helped the country achieve the Millennium Development Goals, they are not demonstrated to be sufficient for preventing mother-to-child transmission of syphilis. The committees' systematic and bureaucratic agenda has not been efficient in managing avoidable factors for syphilis, nor do they operate in the scope of the integration of surveillance and care actions, as recommended by the health policy.

Conclusion: The committees' model needs to be reviewed in the context of Brazil's National Health System. The research process should be rescaled in order to remain a cornerstone for the induction of health policy that integrates surveillance and healthcare across Brazilian Federative Units. The advancement toward an automated case management model becomes relevant for the country to meet global commitments to eliminate congenital syphilis transmission and achieve the goals outlined in the 2030 Agenda.

Keywords: Congenital syphilis; Mother-to-child transmission of infectious diseases; Public health policy.