Maternal HIV and syphilis are not syndemic in Brazil: Hot spot analysis of the two epidemics.

While the annual incidence of HIV diagnosis in pregnancy in Brazil remains relatively stable, rates of maternal syphilis increased over six-fold in the past decade. We hypothesized that maternal HIV and syphilis are two distinct epidemics. Data on all cases of maternal HIV or syphilis detected in pr...

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Autores principales:	Mary Catherine Cambou, Eduardo Saad, Kaitlyn McBride, Trevon Fuller, Emma Swayze, Karin Nielsen-Saines
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/03b05ca1699a4cb184a920088eaafb0b
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spelling	oai:doaj.org-article:03b05ca1699a4cb184a920088eaafb0b2021-12-02T20:18:48ZMaternal HIV and syphilis are not syndemic in Brazil: Hot spot analysis of the two epidemics.1932-620310.1371/journal.pone.0255590https://doaj.org/article/03b05ca1699a4cb184a920088eaafb0b2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0255590https://doaj.org/toc/1932-6203While the annual incidence of HIV diagnosis in pregnancy in Brazil remains relatively stable, rates of maternal syphilis increased over six-fold in the past decade. We hypothesized that maternal HIV and syphilis are two distinct epidemics. Data on all cases of maternal HIV or syphilis detected in pregnancy between January 1, 2010 to December 31, 2018 were requested from the Brazilian Ministry of Health. In order to evaluate how the epidemics evolved over the time period, ArcGIS software was used to generate spatiotemporal maps of annual rates of detection of maternal HIV and syphilis in 2010 and 2018. We utilized Euclidean-distance hot spot analysis to identify state-specific clusters in 2010 and 2018. From 2010 to 2018, there were 66,631 cases of maternal HIV, 225,451 cases of maternal syphilis, and 150,414 cases of congenital syphilis in Brazil. The state of Rio Grande do Sul had the highest rate of maternal HIV detection in both 2010 and 2018. Hot spots of maternal HIV were identified in the three most Southern states in both 2010 and 2018 (99% confidence, z-score >2.58, p <0.01). While syphilis incidence >30 per 1,000 live births in 2018 in four states, only the two coastal states of Rio de Janeiro and Espirito Santo in Southeastern Brazil were significant hot spots (90% confidence, z-score 1.65-1.95, p <0.10). Contrary to the general assumption, HIV and syphilis epidemics in Brazil are not syndemic in pregnant women. There is a spatial cluster of maternal HIV in the South, while syphilis is increasing throughout the country, more recently on the coast. Focusing on maternal HIV hot spots in the Southern states is insufficient to curtail the maternal and congenital syphilis epidemics throughout the country. New strategies, including ongoing hot spot analysis, are urgently needed to monitor, identify and treat maternal syphilis.Mary Catherine CambouEduardo SaadKaitlyn McBrideTrevon FullerEmma SwayzeKarin Nielsen-SainesPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 8, p e0255590 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Mary Catherine Cambou Eduardo Saad Kaitlyn McBride Trevon Fuller Emma Swayze Karin Nielsen-Saines Maternal HIV and syphilis are not syndemic in Brazil: Hot spot analysis of the two epidemics.
description	While the annual incidence of HIV diagnosis in pregnancy in Brazil remains relatively stable, rates of maternal syphilis increased over six-fold in the past decade. We hypothesized that maternal HIV and syphilis are two distinct epidemics. Data on all cases of maternal HIV or syphilis detected in pregnancy between January 1, 2010 to December 31, 2018 were requested from the Brazilian Ministry of Health. In order to evaluate how the epidemics evolved over the time period, ArcGIS software was used to generate spatiotemporal maps of annual rates of detection of maternal HIV and syphilis in 2010 and 2018. We utilized Euclidean-distance hot spot analysis to identify state-specific clusters in 2010 and 2018. From 2010 to 2018, there were 66,631 cases of maternal HIV, 225,451 cases of maternal syphilis, and 150,414 cases of congenital syphilis in Brazil. The state of Rio Grande do Sul had the highest rate of maternal HIV detection in both 2010 and 2018. Hot spots of maternal HIV were identified in the three most Southern states in both 2010 and 2018 (99% confidence, z-score >2.58, p <0.01). While syphilis incidence >30 per 1,000 live births in 2018 in four states, only the two coastal states of Rio de Janeiro and Espirito Santo in Southeastern Brazil were significant hot spots (90% confidence, z-score 1.65-1.95, p <0.10). Contrary to the general assumption, HIV and syphilis epidemics in Brazil are not syndemic in pregnant women. There is a spatial cluster of maternal HIV in the South, while syphilis is increasing throughout the country, more recently on the coast. Focusing on maternal HIV hot spots in the Southern states is insufficient to curtail the maternal and congenital syphilis epidemics throughout the country. New strategies, including ongoing hot spot analysis, are urgently needed to monitor, identify and treat maternal syphilis.
format	article
author	Mary Catherine Cambou Eduardo Saad Kaitlyn McBride Trevon Fuller Emma Swayze Karin Nielsen-Saines
author_facet	Mary Catherine Cambou Eduardo Saad Kaitlyn McBride Trevon Fuller Emma Swayze Karin Nielsen-Saines
author_sort	Mary Catherine Cambou
title	Maternal HIV and syphilis are not syndemic in Brazil: Hot spot analysis of the two epidemics.
title_short	Maternal HIV and syphilis are not syndemic in Brazil: Hot spot analysis of the two epidemics.
title_full	Maternal HIV and syphilis are not syndemic in Brazil: Hot spot analysis of the two epidemics.
title_fullStr	Maternal HIV and syphilis are not syndemic in Brazil: Hot spot analysis of the two epidemics.
title_full_unstemmed	Maternal HIV and syphilis are not syndemic in Brazil: Hot spot analysis of the two epidemics.
title_sort	maternal hiv and syphilis are not syndemic in brazil: hot spot analysis of the two epidemics.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/03b05ca1699a4cb184a920088eaafb0b
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Maternal HIV and syphilis are not syndemic in Brazil: Hot spot analysis of the two epidemics.

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