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Maternal HIV and syphilis are not syndemic in Brazil: Hot spot analysis of the two epidemics.
Cambou, Mary Catherine; Saad, Eduardo; McBride, Kaitlyn; Fuller, Trevon; Swayze, Emma; Nielsen-Saines, Karin.
Afiliación
  • Cambou MC; Department of Medicine, Division of Infectious Diseases, UCLA David Geffen School of Medicine, Los Angeles, California, United States of America.
  • Saad E; Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, California, United States of America.
  • McBride K; Department of Pediatrics, Division of Pediatric Infectious Diseases, UCLA David Geffen School of Medicine, Los Angeles, California, United States of America.
  • Fuller T; Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, California, United States of America.
  • Swayze E; Department of Pediatrics, Division of Pediatric Infectious Diseases, UCLA David Geffen School of Medicine, Los Angeles, California, United States of America.
  • Nielsen-Saines K; Department of Medicine, Western Michigan University Homer Stryker School of Medicine, Kalamazoo, Michigan, United States of America.
PLoS One ; 16(8): e0255590, 2021.
Article en En | MEDLINE | ID: mdl-34343219
While the annual incidence of HIV diagnosis in pregnancy in Brazil remains relatively stable, rates of maternal syphilis increased over six-fold in the past decade. We hypothesized that maternal HIV and syphilis are two distinct epidemics. Data on all cases of maternal HIV or syphilis detected in pregnancy between January 1, 2010 to December 31, 2018 were requested from the Brazilian Ministry of Health. In order to evaluate how the epidemics evolved over the time period, ArcGIS software was used to generate spatiotemporal maps of annual rates of detection of maternal HIV and syphilis in 2010 and 2018. We utilized Euclidean-distance hot spot analysis to identify state-specific clusters in 2010 and 2018. From 2010 to 2018, there were 66,631 cases of maternal HIV, 225,451 cases of maternal syphilis, and 150,414 cases of congenital syphilis in Brazil. The state of Rio Grande do Sul had the highest rate of maternal HIV detection in both 2010 and 2018. Hot spots of maternal HIV were identified in the three most Southern states in both 2010 and 2018 (99% confidence, z-score >2.58, p <0.01). While syphilis incidence >30 per 1,000 live births in 2018 in four states, only the two coastal states of Rio de Janeiro and Espirito Santo in Southeastern Brazil were significant hot spots (90% confidence, z-score 1.65-1.95, p <0.10). Contrary to the general assumption, HIV and syphilis epidemics in Brazil are not syndemic in pregnant women. There is a spatial cluster of maternal HIV in the South, while syphilis is increasing throughout the country, more recently on the coast. Focusing on maternal HIV hot spots in the Southern states is insufficient to curtail the maternal and congenital syphilis epidemics throughout the country. New strategies, including ongoing hot spot analysis, are urgently needed to monitor, identify and treat maternal syphilis.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Sífilis / Infecciones por VIH / VIH / Exposición Materna Tipo de estudio: Prognostic_studies Límite: Adult / Female / Humans / Pregnancy País/Región como asunto: America do sul / Brasil Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Sífilis / Infecciones por VIH / VIH / Exposición Materna Tipo de estudio: Prognostic_studies Límite: Adult / Female / Humans / Pregnancy País/Región como asunto: America do sul / Brasil Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2021 Tipo del documento: Article País de afiliación: Estados Unidos Pais de publicación: Estados Unidos