Perfil epidemiológico da sífilis adquirida em Alagoas: uma década de agravo

Abstract

Introduction: Acquired syphilis (AS), caused by the bacterium Treponema pallidum, is a sexually transmitted infection with a high prevalence, transmitted mainly through unprotected sexual contact, as well as transplacental and blood routes. Although preventable and treatable, with diagnosis and therapy available in the Unified Health System (SUS), AS remains difficult to control and, if left untreated, can progress through four clinical stages, resulting in serious complications such as irreversible sequelae in adults and congenital problems in newborns, including blindness, meningitis, and death. Data from the Notifiable Diseases Information System (SINAN) indicate a 1.6-fold higher prevalence in men, with annual growth in cases in Brazil, especially among vulnerable populations dependent exclusively on the SUS. Mandatory reporting, established by Ordinance No. 2,472/2010, has contributed to improving case registration. General objective: To describe the epidemiological profile of acquired syphilis in Alagoas from 2014 to 2023. Specific objectives: To present the distribution of acquired syphilis cases by age group, sex, race/skin color, and educational level in Alagoas during the study period; to discuss the changes in case notifications, including the reduction observed in 2020 and its possible associations with the COVID-19 pandemic; and to identify the most vulnerable population groups, considering social and behavioral factors related to the occurrence of the disease. Methodology: Descriptive epidemiological study based on secondary data from the Notifiable Diseases Information System (SINAN) and the SUS Department of Informatics (DATASUS). The variables age, race/color, sex, and education level of people infected with acquired syphilis were considered for the investigation of reported cases and evaluation of temporal trends, including observation of specific fluctuations. Results: The study showed a reduction in notifications in 2020, possibly related to underreporting due to restrictions imposed by the COVID-19 pandemic. A higher prevalence was observed among adults aged 20 to 59 years, men, people of brown or black race/color, and those with incomplete elementary education, highlighting social and behavioral vulnerabilities. Conclusion: Despite the advances brought about by Ordinance No. 2,472/2010, it is essential to continuously train health professionals to ensure more accurate notifications. There is an urgent need to intensify educational campaigns, expand testing and treatment, and strengthen sex education in primary care. The fragility of public policies and the underfunding of the SUS keep the epidemic active, requiring rapid and integrated responses to reduce its present and future impact.