Mortality in children under 5 years of age with congenital syphilis in Brazil: a nationwide cohort study

Detalhes bibliográficos
Autor(a) principal: Paixão, Enny S.
Data de Publicação: 2018
Outros Autores: Ferreira, Andrêa J. F., Santos, Idália Oliveira dos, Rodrigues, Laura C., Fiaccone, Rosemeire, Salvi, Leonardo, Oliveira, Guilherme Lopes de, Santana, José Guilherme, Cardoso, Andrey Moreira, Teles, Carlos Antônio de S. S., Soares, Maria Auxiliadora, Amaral, Eliana, Smeeth, Liam, Barreto, Mauricio L., Ichihara, Maria Yury
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo: https://www.arca.fiocruz.br/handle/icict/27200
Resumo: London School of Hygiene and Tropical Medicin. London, United Kingdom / Fundação Oswaldo Cruz. Instituto Gonçalo Muniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil.
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spelling Paixão, Enny S.Ferreira, Andrêa J. F.Santos, Idália Oliveira dosRodrigues, Laura C.Fiaccone, RosemeireSalvi, LeonardoOliveira, Guilherme Lopes deSantana, José GuilhermeCardoso, Andrey MoreiraTeles, Carlos Antônio de S. S.Soares, Maria AuxiliadoraAmaral, ElianaSmeeth, LiamBarreto, Mauricio L.Ichihara, Maria Yury2018-06-29T16:05:23Z2018-06-29T16:05:23Z2023PAIXÃO, Enny S. et al. Mortality in children under 5 years of age with congenital syphilis in Brazil: a nationwide cohort study. PLOS Medicine, v. 20, n. 4, p. 1-16, Apr. 7, 2023.1549-1277https://www.arca.fiocruz.br/handle/icict/2720010.1371/journal.pmed.1004209engPublic Library of ScienceMortality in children under 5 years of age with congenital syphilis in Brazil: a nationwide cohort studyinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleLondon School of Hygiene and Tropical Medicin. London, United Kingdom / Fundação Oswaldo Cruz. Instituto Gonçalo Muniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil.Fundação Oswaldo Cruz. Instituto Gonçalo Muniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil.Fundação Oswaldo Cruz. Instituto Gonçalo Muniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil.London School of Hygiene and Tropical Medicin. London, United Kingdom / Fundação Oswaldo Cruz. Instituto Gonçalo Muniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil.Fundação Oswaldo Cruz. Instituto Gonçalo Muniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil / Universidade Federal da Bahia. Instituto de Matemática e Estatística. Salvador, BA, Brasil.Fundação Oswaldo Cruz. Instituto Gonçalo Muniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil.Fundação Oswaldo Cruz. Instituto Gonçalo Muniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil / Centro Federal de Educação Tecnológica de Minas Gerais. Belo Horizonte, MG, Brasil.Fundação Oswaldo Cruz. Instituto Gonçalo Muniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil / Universidade Federal da Bahia. Instituto de Matemática e Estatística. Salvador, BA, Brasil.Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sergio Arouca. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Gonçalo Muniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil.Fundação Oswaldo Cruz. Instituto Gonçalo Muniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil.University of Campinas. School of Medical Sciences. Campinas, SP, Brasil.London School of Hygiene and Tropical Medicin. London, United Kingdom.Fundação Oswaldo Cruz. Instituto Gonçalo Muniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil / Universidade Federal da Bahia. Instituto de Saúde Coletiva. Salvador, BA, Brasil.Fundação Oswaldo Cruz. Instituto Gonçalo Muniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil.Background: Congenital syphilis (CS) is a major and avoidable cause of neonatal death worldwide. In this study, we aimed to estimate excess all-cause mortality in children under 5 years with CS compared to those without CS. Methods and findings: In this population-based cohort study, we used linked, routinely collected data from Brazil from January 2011 to December 2017. Cox survival models were adjusted for maternal region of residence, maternal age, education, material status, self-declared race and newborn sex, and year of birth and stratified according to maternal treatment status, non-treponemal titers and presence of signs and symptoms at birth. Over 7 years, a total of 20 057 013 live-born children followed up (through linkage) to 5 years of age, 93 525 were registered with CS, and 2 476 died. The all-cause mortality rate in the CS group was 7·84/1 000 person-years compared with 2·92/1 000 person-years in children without CS, crude hazard ratio (HR) = 2·41 (95% CI 2·31 to 2·50). In the fully adjusted model, the highest under-five mortality risk was observed among children with CS from untreated mothers HR = 2·82 (95% CI 2·63 to 3·02), infants with non-treponemal titer higher than 1:64 HR = 8·87 (95% CI 7·70 to 10·22), and children with signs and symptoms at birth HR = 7·10 (95% CI 6·60 to 7·63). Among children registered with CS, CS was recorded as the underlying cause of death in 33% (495/1 496) of neonatal, 11% (85/770) of postneonatal, and 2·9% (6/210) of children 1 year of age. The main limitations of this study were the use of a secondary database without additional clinical information and the potential misclassification of exposure status. Conclusions: This study showed an increased mortality risk among children with CS that goes beyond the first year of life. It also reinforces the importance of maternal treatment that infant non-treponemal titers and the presence of signs and symptoms of CS at birth are strongly associated with subsequent mortality.Congenital syphilisChildrenMortalityinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZORIGINALPaixao_Enny_etal_IGM_ENSP_2023.pdfPaixao_Enny_etal_IGM_ENSP_2023.pdfapplication/pdf737377https://www.arca.fiocruz.br/bitstream/icict/27200/2/Paixao_Enny_etal_IGM_ENSP_2023.pdf90d3a84a88ddf6e8e223c1afc3fc720fMD52LICENSElicense.txtlicense.txttext/plain; charset=utf-83134https://www.arca.fiocruz.br/bitstream/icict/27200/1/license.txt4f0b8b537342850040456617144dec21MD51icict/272002023-04-28 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dc.title.pt_BR.fl_str_mv Mortality in children under 5 years of age with congenital syphilis in Brazil: a nationwide cohort study
title Mortality in children under 5 years of age with congenital syphilis in Brazil: a nationwide cohort study
spellingShingle Mortality in children under 5 years of age with congenital syphilis in Brazil: a nationwide cohort study
Paixão, Enny S.
Congenital syphilis
Children
Mortality
title_short Mortality in children under 5 years of age with congenital syphilis in Brazil: a nationwide cohort study
title_full Mortality in children under 5 years of age with congenital syphilis in Brazil: a nationwide cohort study
title_fullStr Mortality in children under 5 years of age with congenital syphilis in Brazil: a nationwide cohort study
title_full_unstemmed Mortality in children under 5 years of age with congenital syphilis in Brazil: a nationwide cohort study
title_sort Mortality in children under 5 years of age with congenital syphilis in Brazil: a nationwide cohort study
author Paixão, Enny S.
author_facet Paixão, Enny S.
Ferreira, Andrêa J. F.
Santos, Idália Oliveira dos
Rodrigues, Laura C.
Fiaccone, Rosemeire
Salvi, Leonardo
Oliveira, Guilherme Lopes de
Santana, José Guilherme
Cardoso, Andrey Moreira
Teles, Carlos Antônio de S. S.
Soares, Maria Auxiliadora
Amaral, Eliana
Smeeth, Liam
Barreto, Mauricio L.
Ichihara, Maria Yury
author_role author
author2 Ferreira, Andrêa J. F.
Santos, Idália Oliveira dos
Rodrigues, Laura C.
Fiaccone, Rosemeire
Salvi, Leonardo
Oliveira, Guilherme Lopes de
Santana, José Guilherme
Cardoso, Andrey Moreira
Teles, Carlos Antônio de S. S.
Soares, Maria Auxiliadora
Amaral, Eliana
Smeeth, Liam
Barreto, Mauricio L.
Ichihara, Maria Yury
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.contributor.author.fl_str_mv Paixão, Enny S.
Ferreira, Andrêa J. F.
Santos, Idália Oliveira dos
Rodrigues, Laura C.
Fiaccone, Rosemeire
Salvi, Leonardo
Oliveira, Guilherme Lopes de
Santana, José Guilherme
Cardoso, Andrey Moreira
Teles, Carlos Antônio de S. S.
Soares, Maria Auxiliadora
Amaral, Eliana
Smeeth, Liam
Barreto, Mauricio L.
Ichihara, Maria Yury
dc.subject.en.pt_BR.fl_str_mv Congenital syphilis
Children
Mortality
topic Congenital syphilis
Children
Mortality
description London School of Hygiene and Tropical Medicin. London, United Kingdom / Fundação Oswaldo Cruz. Instituto Gonçalo Muniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil.
publishDate 2018
dc.date.accessioned.fl_str_mv 2018-06-29T16:05:23Z
dc.date.available.fl_str_mv 2018-06-29T16:05:23Z
dc.date.issued.fl_str_mv 2023
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
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status_str publishedVersion
dc.identifier.citation.fl_str_mv PAIXÃO, Enny S. et al. Mortality in children under 5 years of age with congenital syphilis in Brazil: a nationwide cohort study. PLOS Medicine, v. 20, n. 4, p. 1-16, Apr. 7, 2023.
dc.identifier.uri.fl_str_mv https://www.arca.fiocruz.br/handle/icict/27200
dc.identifier.issn.pt_BR.fl_str_mv 1549-1277
dc.identifier.doi.none.fl_str_mv 10.1371/journal.pmed.1004209
identifier_str_mv PAIXÃO, Enny S. et al. Mortality in children under 5 years of age with congenital syphilis in Brazil: a nationwide cohort study. PLOS Medicine, v. 20, n. 4, p. 1-16, Apr. 7, 2023.
1549-1277
10.1371/journal.pmed.1004209
url https://www.arca.fiocruz.br/handle/icict/27200
dc.language.iso.fl_str_mv eng
language eng
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
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dc.publisher.none.fl_str_mv Public Library of Science
publisher.none.fl_str_mv Public Library of Science
dc.source.none.fl_str_mv reponame:Repositório Institucional da FIOCRUZ (ARCA)
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bitstream.url.fl_str_mv https://www.arca.fiocruz.br/bitstream/icict/27200/2/Paixao_Enny_etal_IGM_ENSP_2023.pdf
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