English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Global: Zendy Plus annual

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Global: Zendy Tools annual

Global: Zendy Free Plan

Global: Zendy Tools monthly

Global: Zendy Plus monthly

The increased occurrence of syphilis during pregnancy, and its severe repercussions to the fetal environment, has been a cause for concern among health care professionals. It is hard to comprehend why congenital syphilis has not yet been controlled, since its agent, the spirochaete Treponema pallidum, is well known and is highly susceptible to penicillin, a low cost and easily available drug. When we compare the control of mother-to-child transmission (MTCT) of HIV with that of syphilis, it is even harder to understand why we have such success with the first one and disastrous results with the second!1 When we evaluate the epidemiology of syphilis in pregnancy and in the general adult population, we notice that there were great expectations to eradicate this disease after WWII, when penicillin was discovered, and its high efficacy in controlling Treponema confirmed. There was actually a reduction in the number of cases in the mid-1950s. Nevertheless, therewas a significant increase starting in the 1960s, due probably to sexual liberation and the growing use of illicit drugs. A new reduction in the number of cases occurred again in the 1970s, due to public health campaigns. In the 1980s, a new growth in the number of cases was detected, strongly associatedwith the HIVepidemic around the world, sexual promiscuity and the sexual practices ofmenwho have sex withmen (MSM). At that time, increasing rateswere also observed in heterosexual individuals who were associated with promiscuity, unprotected sexual practices and prostitution. Until today, despite many initiatives to reduce the number of cases, the infection rate in adults is alarming, particularly among pregnant women and newborns.2,3 Many public health campaigns launched in Brazil in the last decades, specifically targeting pregnant women, tried to control the disease and prevent the infection in newborns. By the end of the 1980s, a new campaign was launched to “eradicate congenital syphilis by the year 2000”. This campaign focused on educating pregnant women about the importance of being tested and treated during prenatal care. Unfortunately, we arrived to the year 2000 with a higher occurrence of congenital syphilis. At this point, a new campaign was created trying to control congenital syphilis by 2012, since eradicating the disease seemed unrealistic. Again, the campaign failed to reach its goals and a higher number of infections was observed.3–5 Why is it so hard to face the congenital syphilis problem in our country? Because syphilis can be easily diagnosed and efficient treatment is available at low cost, potential barriers for the control of the disease have been studied. The role of health care workers is one of them. The new campaign from the Ministry of Health in Brazil is focusing on evaluating the health professional’s role in caring for pregnant women and preventing congenital syphilis in newborns.4,5 Recent data on syphilis during pregnancy and congenital syphilis in our country are alarming. A significant proportion of women and newborns are infected. Among pregnant women, there was an increase of 1047% between 2005 and 2013. During this same period, an increase of 135% in congenital syphilis notifications was observed. These numbersmightmean that the notification has improved,which in fact has happened. Nevertheless, this is not enough to explain the epidemic number of cases in pregnant women and newborns.5 Data about syphilis cases around the world show that more than 12 million cases a year, registered by the World Editorial

Syphilis in Pregnancy and Congenital Syphilis: Why Can We not yet Face This Problem?