Journal article
Estimating the real burden of gestational syphilis in Brazil, 2007-2018: a Bayesian modeling study
LANCET REGIONAL HEALTH-AMERICAS, v 25, 100564
Sep 2023
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background Although several studies have estimated gestational syphilis (GS) incidence in several countries, underreporting correction is rarely considered. This study aimed to estimate the level of under-registration and correct the GS incidence rates in the 557 Brazilian microregions.Methods Brazilian GS notifications between 2007 and 2018 were obtained from the SINAN-Syphilis system. A cluster analysis was performed to group microregions according to the quality of GS notification. A Bayesian hierarchical Poisson regression model was applied to estimate the reporting probabilities among the clusters and to correct the associated incidence rates.Findings We estimate that 45,196 (90%-HPD: 13,299; 79,310) GS cases were underreported in Brazil from 2007 to 2018, representing a coverage of 87.12% (90%-HPD: 79.40%; 95.83%) of registered cases, where HPD stands for the Bayesian highest posterior density credible interval. Underreporting levels differ across the country, with micro regions in North and Northeast regions presenting the highest percentage of missed cases. After underreporting correction, Brazil's estimated GS incidence rate increased from 8.74 to 10.02 per 1000 live births in the same period.Interpretation Our findings highlight disparities in the registration level and incidence rate of GS in Brazil, reflecting regional heterogeneity in the quality of syphilis surveillance, access to prenatal care, and childbirth assistance services. This study provides robust evidence to enhance national surveillance systems, guide specific policies for GS detection disease control, and potentially mitigate the harmful consequences of mother-to-child transmission. The methodology might be applied in other regions to correct disease underreporting.
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Details
- Title
- Estimating the real burden of gestational syphilis in Brazil, 2007-2018: a Bayesian modeling study
- Publication Details
- LANCET REGIONAL HEALTH-AMERICAS, v 25, 100564
- Publisher
- ELSEVIER; AMSTERDAM
- Grant note
- National Council for Scientific and Technological Development; The Bill Melinda Gates Foundation and Wellcome Trust.
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Drexel University
- Web of Science ID
- WOS:001068256400001
- Scopus ID
- 2-s2.0-85166588548
- Other Identifier
- 991021861193204721
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- Collaboration types
- Domestic collaboration
- International collaboration
- Web of Science research areas
- Health Care Sciences & Services
- Public, Environmental & Occupational Health