Cargando…

Maternal HIV and syphilis are not syndemic in Brazil: Hot spot analysis of the two epidemics

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 pr...

Descripción completa

Detalles Bibliográficos
Autores principales: Cambou, Mary Catherine, Saad, Eduardo, McBride, Kaitlyn, Fuller, Trevon, Swayze, Emma, Nielsen-Saines, Karin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8330908/
https://www.ncbi.nlm.nih.gov/pubmed/34343219
http://dx.doi.org/10.1371/journal.pone.0255590
_version_ 1783732820026327040
author Cambou, Mary Catherine
Saad, Eduardo
McBride, Kaitlyn
Fuller, Trevon
Swayze, Emma
Nielsen-Saines, Karin
author_facet Cambou, Mary Catherine
Saad, Eduardo
McBride, Kaitlyn
Fuller, Trevon
Swayze, Emma
Nielsen-Saines, Karin
author_sort Cambou, Mary Catherine
collection PubMed
description 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.
format Online
Article
Text
id pubmed-8330908
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Public Library of Science
record_format MEDLINE/PubMed
spelling pubmed-83309082021-08-04 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 PLoS One Research Article 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. Public Library of Science 2021-08-03 /pmc/articles/PMC8330908/ /pubmed/34343219 http://dx.doi.org/10.1371/journal.pone.0255590 Text en © 2021 Cambou et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Cambou, Mary Catherine
Saad, Eduardo
McBride, Kaitlyn
Fuller, Trevon
Swayze, Emma
Nielsen-Saines, Karin
Maternal HIV and syphilis are not syndemic in Brazil: Hot spot analysis of the two epidemics
title Maternal HIV and syphilis are not syndemic in Brazil: Hot spot analysis of the two epidemics
title_full Maternal HIV and syphilis are not syndemic in Brazil: Hot spot analysis of the two epidemics
title_fullStr Maternal HIV and syphilis are not syndemic in Brazil: Hot spot analysis of the two epidemics
title_full_unstemmed Maternal HIV and syphilis are not syndemic in Brazil: Hot spot analysis of the two epidemics
title_short Maternal HIV and syphilis are not syndemic in Brazil: Hot spot analysis of the two epidemics
title_sort maternal hiv and syphilis are not syndemic in brazil: hot spot analysis of the two epidemics
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8330908/
https://www.ncbi.nlm.nih.gov/pubmed/34343219
http://dx.doi.org/10.1371/journal.pone.0255590
work_keys_str_mv AT camboumarycatherine maternalhivandsyphilisarenotsyndemicinbrazilhotspotanalysisofthetwoepidemics
AT saadeduardo maternalhivandsyphilisarenotsyndemicinbrazilhotspotanalysisofthetwoepidemics
AT mcbridekaitlyn maternalhivandsyphilisarenotsyndemicinbrazilhotspotanalysisofthetwoepidemics
AT fullertrevon maternalhivandsyphilisarenotsyndemicinbrazilhotspotanalysisofthetwoepidemics
AT swayzeemma maternalhivandsyphilisarenotsyndemicinbrazilhotspotanalysisofthetwoepidemics
AT nielsensaineskarin maternalhivandsyphilisarenotsyndemicinbrazilhotspotanalysisofthetwoepidemics