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P745 The pregnancy syphilis cascade of care: “95–95–95” goals for reducing of congenital syphilis in the state of sao paulo, brazil
  1. Carmen Silvia Domingues,
  2. Mariza Tancredi,
  3. Valdir Pinto,
  4. Carla Luppi,
  5. Solange Gomes,
  6. Rosa Alencar,
  7. Maria Clara Gianna,
  8. Artur Kalichman
  1. STI/AIDS Reference Center – Sao Paulo State Program of STI/AIDS, Sao Paulo Department of Health, Sao Paulo, Brazil


Background Congenital syphilis (CS) is a preventable condition. However, in 2017, 4,039 cases were reported in São Paulo State (SPS), with an incidence rate of 6.6 cases/1,000 live births (LB). In 2018, SPS proposed the “95-95-95” goals to reduce CS: 95% of all pregnant women (PW) with timely diagnosis during antenatal care (ANC), 95% of all with timely diagnosis receiving treatment and 95% of all babies from treated PW-syphilis, born without CS. This study aimed evaluates the pregnancy syphilis cascade of care and the “95-95-95” goals for reducing CS in SPS, 2017.

Methods Ecological study, using reported cases of PW-syphilis and CS. The cascade of PW-syphilis care was estimated considering five columns. First column: number of PW-syphilis, calculated considering an estimated prevalence of 2.1% of syphilis in PW; and for the total population of PW, was considered the number of LB increased by 10% for fetal losses. Second: PW-syphilis diagnosed during ANC or delivery. Third: PW-syphilis linked to ANC with timely diagnosis. Fourth: PW-syphilis properly treated. Fifth: potentially avoided CS cases.

Results Were estimated 14,369(100%) PW-syphilis, of these, 82.6% (N=11,875) were diagnosed during ANC or delivery; 73.8% (N=10,606) linked to ANC with timely diagnosis; 66.1% (N=9,500) treated and 54.5% (N=7,836) CS cases avoided. For the “95-95-95” goals, SPS reached the following levels: 89.3% (N=10,606/11,875) of PW-syphilis with diagnosis during ANC; 89.6% (N=9,500/10,606) were timely treated and 82.5% (N=7,836/9,500) of babies born without CS.

Conclusion Prevention actions should be intensified to improve access and qualification of ANC. Specifically: wide screening coverage, availability of medication for the timely treatment and reproductive planning. These challenges can be overcome with an agenda of priorities and political commitment. The integration of STI/HIV/AIDS and maternal-child health programs, as well as the strengthening of primary care, is essential for the sustainability, duration and success of interventions aimed to the CS elimination.

Disclosure No significant relationships.

  • syphilis
  • cascade
  • Brazil

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