Time trends and spatial patterns corresponding to maternal-child syphilis in the Brazilian North region: an ecological study
ABSTRACT Objective: To analyze time trends and spatial patterns corresponding to gestational and congenital syphilis in the Brazilian North region between 2014 and 2023. Method: A time-based ecological study conducted with secondary data from the National Live Births System and from the national panel of syphilis indicators. The gestational and congenital syphilis rates were analyzed by means of log-linear regression and “joinpoint” models to estimate the Annual Percent Change. The associations were estimated via fixed-effects count and population-based offset methods, in turn, spatial dependence was estimated through spatial autoregressive regressions. Results: Gestational Syphilis presented continuous growth in the historical series. Congenital Syphilis showed heterogeneity across the states, with an 80.5% annual increase in Amazonas until 2017, followed by a reverse trend after 2018; in turn, the increasing trend remained in Pará during the entire period. Conclusion: Social and territorial inequalities remain as core determinants of persistent mother-to-child syphilis transmission in the Brazilian Amazon.