Reflections on the difficulties in treating gestational syphilis: from the patient to the health system

Abstract

Syphilis, an infection caused by the bacterium Treponema pallidum, is a worldwide systemic disease with a chronic course that affects only humans as its host. Transmission can occur through sexual or vertical means. Newborns of mothers with untreated syphilis or those who did not undergo proper treatment may present with either an asymptomatic or severe systemic symptoms. The aim of this study was to conduct a literature review on patient behavioral factors and public health actions that can impact the treatment of gestational syphilis. Articles published in Portuguese, available in full text in the databases Medline, Scielo, Biblioteca Virtual da Saúde (BVS), Lilacs, and PubMed, were considered. Official publications from the Ministry of Health within the same time frame were also taken into account. The results indicate that the main difficulties related to the treatment of gestational syphilis include: deficiencies and/or lack of prenatal care; a shortage of information aimed at pregnant women about the disease; limited access to the primary medication or a failure to seek it; limited adherence of partners to treatment and the use of condoms in sexual relationships. It is necessary to adjust prevention campaigns and monitoring/treatment follow-up for syphilis cases in pregnant women to reduce the negative impact on public health of a treatable and curable disease.