Burden of syphilis in Brazil and federated units, 1990-2016: estimates from the Global Burden of Disease Study 2019

BACKGROUND: Syphilis is a chronic infectious disease that has created challenging situations for humanity for centuries. Transmission can occur sexually or vertically, with great repercussions on populations, particularly among women and children. The present study presents information on the main burden imposed by syphilis generated by the Global Burden of Disease (GBD) Study 2019 for Brazil and its 27 federated units. METHODS: We described the metrics of incidence, deaths, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs), standardized by age and per 100,000 inhabitants, from 1990 to 2019, and we compared the disease burden between the years 1990 and 2019. RESULTS: In Brazil, the disease burden increased between 2005 and 2019 for all metrics. Although a higher incidence of syphilis was found among women in 2019, DALYs [YLLs (males: 15.9%; females: 21.8%), YLDs (males: 25.0%; females: 50.0%), and DALYs (males: 16.2%; females: 22.4%)] were higher among men. In 2019, the highest DALY rate per 100,000 inhabitants was observed in individuals aged above 50 years. The State of Maranhão presented the highest values of DALYs {1990: 165.2 [95% uncertainty interval (UI) 96.2-264.4]; 2005: 43.8 [95% UI 30.3-62.4]; 2019: 29.1 [95% UI 19.8-41.1]} per 100,000 inhabitants in the three years analyzed. CONCLUSIONS: The burden of syphilis has increased in recent years. Men presented higher DALYs, although the incidence of the disease was higher in women. Syphilis affects a large number of people across all age groups, causing different degrees of disability and premature death (DALYs).