{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,11]],"date-time":"2026-10-11T13:11:35Z","timestamp":1791724295186,"version":"4.3.4"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2021,2,12]],"date-time":"2021-02-12T00:00:00Z","timestamp":1613088000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,10,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Congenital syphilis is an infectious disease that affects 1 million children a year worldwide.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The objective of this study was to describe a spatial analysis of the epidemiological characteristics of congenital syphilis in the state of Maranh\u00e3o, Brazil from 2007 to 2018. This was an ecological study using data obtained in May 2020 from three Brazilian information systems. The spatial correlation was analyzed according to local and global Moran indexes.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>During the 12-y period, 1 426 177 children were born. Of these children, 3684 acquired congenital syphilis (0.26%; mean annual rate of 2.62\/1000 live births) and 70 died (1.90%; mean annual rate 0.05). The clusters were statistically significant according to the global Moran index of 0.40 (p=0.01). Spearman's correlation coefficient between the rate of detection of syphilis in pregnant women and family health strategy teams was strong, positive and significant (\u03c1=0.73; p&amp;lt;0.00). Most of the variables studied showed a trend of annual increase (p&amp;lt;0.05).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The use of spatial analysis tools have made it possible to detect areas with both a greater and a lesser need for intervention, and to more effectively improve and monitor those areas to change the epidemiological profile of the disease.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/trstmh\/traa191","type":"journal-article","created":{"date-parts":[[2020,12,23]],"date-time":"2020-12-23T14:08:42Z","timestamp":1608732522000},"page":"1207-1217","source":"Crossref","is-referenced-by-count":2,"title":["Spatial analysis of congenital syphilis in a federative unit in northeastern Brazil"],"prefix":"10.1093","volume":"115","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9201-480X","authenticated-orcid":false,"given":"Iolanda","family":"Graepp Fontoura","sequence":"first","affiliation":[{"name":"Departm ent of Nursing, Universidade Federal do Maranh\u00e3o, 65.915-240, Imperatriz, Maranh\u00e3o, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valckinara Carreiro","family":"Lima","sequence":"additional","affiliation":[{"name":"Departm ent of Nursing, Universidade Federal do Maranh\u00e3o, 65.915-240, Imperatriz, Maranh\u00e3o, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volmar Morais","family":"Fontoura","sequence":"additional","affiliation":[{"name":"Department of Nursing, Universidade Estadual do Tocantins, 77.960-000, Augustin\u00f3polis, Tocantins, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Floriacy Stabnow","family":"Santos","sequence":"additional","affiliation":[{"name":"Departm ent of Nursing, Universidade Federal do Maranh\u00e3o, 65.915-240, Imperatriz, Maranh\u00e3o, Brazil"},{"name":"Department of Master Course in Health and Technology, Universidade Federal do Maranh\u00e3o, Avenue da Universidade, without number, 65.915-240, Imperatriz, Maranh\u00e3o, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana Cristina Pereira","family":"de Jesus Costa","sequence":"additional","affiliation":[{"name":"Departm ent of Nursing, Universidade Federal do Maranh\u00e3o, 65.915-240, Imperatriz, Maranh\u00e3o, Brazil"},{"name":"Department of Master Course in Health and Technology, Universidade Federal do Maranh\u00e3o, Avenue da Universidade, without number, 65.915-240, Imperatriz, Maranh\u00e3o, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francisca Jacinta Feitoza","family":"de Oliveira","sequence":"additional","affiliation":[{"name":"Departm ent of Nursing, Universidade Federal do Maranh\u00e3o, 65.915-240, Imperatriz, Maranh\u00e3o, Brazil"},{"name":"Department of Health Sciences, Faculdade de Medicina do ABC, 09.060-870, Santo Andr\u00e9, S\u00e3o Paulo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcela","family":"de Oliveira Feitosa","sequence":"additional","affiliation":[{"name":"Departm ent of Nursing, Universidade Federal do Maranh\u00e3o, 65.915-240, Imperatriz, Maranh\u00e3o, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanari Santos","family":"de Almeida Tavares","sequence":"additional","affiliation":[{"name":"Department of Nursing, Universidade Estadual do Tocantins, 77.960-000, Augustin\u00f3polis, Tocantins, Brazil"},{"name":"Department of Environmental Sciences Teaching, Universidade Federal do Par\u00e1, 66.075-110, Bel\u00e9m, Par\u00e1, Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lilian Nat\u00e1lia Ferreira","family":"Lima","sequence":"additional","affiliation":[{"name":"Department of Nursing, Universidade Estadual do Tocantins, 77.960-000, Augustin\u00f3polis, Tocantins, Brazil"},{"name":"Department of Infectious and Parasitius Agents Biology, Universidade Federal do Par\u00e1, 66.075-110, Bel\u00e9m, Par\u00e1, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arissane de Sousa","family":"Falc\u00e3o","sequence":"additional","affiliation":[{"name":"Department of Nursing, Faculdade Facimp Wyden, 65.900-000, Imperatriz, Maranh\u00e3o, Brasil"},{"name":"Management Department, Universidade de Taubat\u00e9, 12.081-010, Taubat\u00e9, S\u00e3o Paulo, Brasil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta de Ara\u00fajo e","family":"Silva","sequence":"additional","affiliation":[{"name":"Departm ent of Nursing, Universidade Federal do Maranh\u00e3o, 65.915-240, Imperatriz, Maranh\u00e3o, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ism\u00e1lia Cassandra Costa Maia","family":"Dias","sequence":"additional","affiliation":[{"name":"Departm ent of Nursing, Universidade Federal do Maranh\u00e3o, 65.915-240, Imperatriz, Maranh\u00e3o, Brazil"},{"name":"Department of Master Course in Health and Technology, Universidade Federal do Maranh\u00e3o, Avenue da Universidade, without number, 65.915-240, Imperatriz, Maranh\u00e3o, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonardo Hunaldo","family":"dos Santos","sequence":"additional","affiliation":[{"name":"Departm ent of Nursing, Universidade Federal do Maranh\u00e3o, 65.915-240, Imperatriz, Maranh\u00e3o, Brazil"},{"name":"Department of Master Course in Health and Technology, Universidade Federal do Maranh\u00e3o, Avenue da Universidade, without number, 65.915-240, Imperatriz, Maranh\u00e3o, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janaina Miranda","family":"Bezerra","sequence":"additional","affiliation":[{"name":"Departm ent of Nursing, Universidade Federal do Maranh\u00e3o, 65.915-240, Imperatriz, Maranh\u00e3o, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheila Cristina Teixeira","family":"Fonseca","sequence":"additional","affiliation":[{"name":"Department of Nursing, Universidade Estadual do Tocantins, 77.960-000, Augustin\u00f3polis, Tocantins, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcelino","family":"Santos Neto","sequence":"additional","affiliation":[{"name":"Departm ent of Nursing, Universidade Federal do Maranh\u00e3o, 65.915-240, Imperatriz, Maranh\u00e3o, Brazil"},{"name":"Department of Master Course in Health and Technology, Universidade Federal do Maranh\u00e3o, Avenue da Universidade, without number, 65.915-240, Imperatriz, Maranh\u00e3o, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,2,12]]},"reference":[{"issue":"4","key":"2021100202532632700_bib1","doi-asserted-by":"crossref","first-page":"e0231029","DOI":"10.1371\/journal.pone.0231029","article-title":"Trends of syphilis in Brazil: a growth portrait of the treponemic epidemic","volume":"15","author":"Marques dos Santos","year":"2020","journal-title":"PLoS One"},{"issue":"8","key":"2021100202532632700_bib2","doi-asserted-by":"crossref","first-page":"1469","DOI":"10.3201\/eid2508.180298","article-title":"Congenital syphilis as a measure of maternal and child healthcare, Brazil","volume":"25","author":"Bezerra","year":"2019","journal-title":"Emerg Infect Dis."},{"key":"2021100202532632700_bib3","doi-asserted-by":"crossref","first-page":"95","DOI":"10.11606\/s1518-8787.2019053001284","article-title":"Factors associated with inadequate follow-up of children with congenital syphilis","volume":"53","author":"Cavalcante","year":"2019","journal-title":"Revista de Sa\u00fade P\u00fablica"},{"issue":"8","key":"2021100202532632700_bib4","doi-asserted-by":"crossref","first-page":"2587","DOI":"10.1590\/1413-81232018238.25422016","article-title":"Tend\u00eancia temporal e distribui\u00e7\u00e3o espacial da s\u00edfilis cong\u00eanita no estado do Rio Grande do Sul entre 2001 e 2012","volume":"23","author":"Teixeira","year":"2018","journal-title":"Ci\u00eancia & Sa\u00fade Coletiva"},{"key":"2021100202532632700_bib5","volume-title":"Boletim Epidemiol\u00f3gico de S\u00edfilis","author":"Brasil. Minist\u00e9rio da Sa\u00fade SVES","year":"2018"},{"issue":"3","key":"2021100202532632700_bib6","first-page":"e00074519","article-title":"Relationship between the supply of syphilis diagnosis and treatment in primary care and incidence of gestational and congenital syphilis","volume":"36","author":"de Figueiredo","year":"2020","journal-title":"Cadernos de saude publica"},{"key":"2021100202532632700_bib7","volume-title":"Sistemas de Informa\u00e7\u00e3o de Agravos de Notifica\u00e7\u00e3o (SINAN). Brasil. Minist\u00e9rio da Sa\u00fade","author":"Brasil. Minist\u00e9rio da Sa\u00fade","year":"2020"},{"issue":"4","key":"2021100202532632700_bib8","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1590\/1806-93042019000400007","article-title":"Epidemiological profile of patients with congenital and gestational syphilis in a city in the State of S\u00e3o Paulo, Brazil","volume":"19","author":"Maschio-Lima","year":"2019","journal-title":"Revista Brasileira de Sa\u00fade Materno Infantil"},{"key":"2021100202532632700_bib9","volume-title":"Brasil, Minist\u00e9rio da Sa\u00fade","author":"Instituto Brasileiro de Geografia e Estatistica - IBGE","year":"2020"},{"key":"2021100202532632700_bib10","volume-title":"Sistemas de Informa\u00e7\u00e3o de Agravos de Notifica\u00e7\u00e3o (SINAN). Brasil, Minist\u00e9rio da Sa\u00fade","author":"Brasil. Minist\u00e9rio da Sa\u00fade","year":"2020"},{"key":"2021100202532632700_bib11","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1590\/1980-549720190053","article-title":"Distribui\u00e7\u00e3o espacial das taxas de interna\u00e7\u00e3o de crian\u00e7as por pneumonia no Sistema \u00danico de Sa\u00fade, nos munic\u00edpios do estado de S\u00e3o Paulo","volume":"22","author":"Menezes","year":"2019","journal-title":"Revista Brasileira de Epidemiologia"},{"issue":"6","key":"2021100202532632700_bib12","doi-asserted-by":"crossref","first-page":"1709","DOI":"10.1590\/1413-81232014196.15002013","article-title":"An\u00e1lise da rela\u00e7\u00e3o entre a distribui\u00e7\u00e3o espacial das morbidades por obesidade e hipertens\u00e3o arterial para o estado de S\u00e3o Paulo, Brasil, de 2000 a 2010","volume":"19","author":"da Cunha e Silva","year":"2014","journal-title":"Ci\u00eancia & Sa\u00fade Coletiva"},{"key":"2021100202532632700_bib13","doi-asserted-by":"crossref","first-page":"8","DOI":"10.13102\/rscdauefs.v9i0.3356","article-title":"Tend\u00eancia temporal da s\u00edfilis cong\u00eanita em Sergipe, Brasil, 2006\u20132017","volume":"9","author":"Costa","year":"2019","journal-title":"Revista de Sa\u00fade Coletiva da UEFS"},{"key":"2021100202532632700_bib14","doi-asserted-by":"crossref","first-page":"1","DOI":"10.5935\/1415-2762.20170064","article-title":"Male mortality trend, 2002\u20132012: a time series study of a capital of the Brazilian pantanal","volume":"21","author":"Fraga","year":"2017","journal-title":"REME: Revista Mineira de Enfermagem"},{"issue":"14","key":"2021100202532632700_bib15","doi-asserted-by":"crossref","first-page":"1665","DOI":"10.1017\/S0031182020001754","article-title":"Epidemiological aspects and spatial patterns of human visceral leishmaniasis in Brazil","volume":"147","author":"Graepp-Fontoura","year":"2020","journal-title":"Parasitology"},{"key":"2021100202532632700_bib16","first-page":"1","article-title":"AULA 8 \u2013 Opera\u00e7\u00f5es de An\u00e1lise Espacial","volume-title":"Inpe.","author":"Instituto de Pesquisas Espaciais - INPE","year":"2015"},{"issue":"4","key":"2021100202532632700_bib17","doi-asserted-by":"crossref","first-page":"e93770","DOI":"10.1371\/journal.pone.0093770","article-title":"Mortality and case fatality due to visceral leishmaniasis in Brazil: a nationwide analysis of epidemiology, trends and spatial patterns","volume":"9","author":"Martins-Melo","year":"2014","journal-title":"PLoS One"},{"issue":"5","key":"2021100202532632700_bib18","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.4136\/ambi-agua.1870","article-title":"An\u00e1lise espacial da ocorr\u00eancia de leishmaniose visceral no estado do Tocantins, Brasil","volume":"11","author":"Fontoura","year":"2016","journal-title":"Ambiente e Agua."},{"key":"2021100202532632700_bib19","first-page":"30","article-title":"Spatial distribution and definition of priority areas for surveillance of visceral leishmaniasis in S\u00e3o Lu\u00eds, Maranh\u00e3o, Brazil, 1999\u20132007","volume-title":"FIOCRUZ - Funda\u00e7\u00e3o Oswaldo Cruz Escola Nacional de Sa\u00fade P\u00fablica Sergio Arouca Programa de P\u00f3s-gradua\u00e7\u00e3o Epidemiologia em Sa\u00fade P\u00fablica","author":"Barbosa","year":"2011"},{"issue":"6","key":"2021100202532632700_bib20","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1590\/1806-9282.60.06.016","article-title":"Space-time description of dengue outbreaks in Cruzeiro, Sao Paulo, in 2006 and 2011","volume":"60","author":"Renata Marzzano de Carvalho Luiz","year":"2014","journal-title":"Revista da Associa\u00e7\u00e3o M\u00e9dica Brasileira (1992)"},{"issue":"1","key":"2021100202532632700_bib21","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.actatropica.2013.12.002","article-title":"Spatial analysis for identification of priority areas for surveillance and control in a visceral leishmaniasis endemic area in Brazil","volume":"131","author":"Barbosa","year":"2014","journal-title":"Acta Tropica"},{"key":"2021100202532632700_bib22","first-page":"43","article-title":"Boletim Epidemiologico de S\u00edfilis MS","volume":"Ano V n-1","author":"Brasil. Minist\u00e9rio da Sa\u00fade","year":"2019","journal-title":"Brasil, Minist\u00e9rio da Sa\u00fade"},{"key":"2021100202532632700_bib23","volume-title":"Elimination of mother-to-child transmission of HIV and syphilis in the Americas","author":"Pan American Health Organization (PAHO)"},{"issue":"9","key":"2021100202532632700_bib24","first-page":"1","article-title":"Diferenciais intraurbanos da s\u00edfilis cong\u00eanita: an\u00e1lise preditiva por bairros do Munic\u00edpio do Rio de Janeiro, Brasil","volume":"34","author":"dos","year":"2018","journal-title":"Cadernos de Sa\u00fade P\u00fablica"},{"issue":"2","key":"2021100202532632700_bib25","first-page":"430","article-title":"Maternal and congenital syphilis in Karnataka, India","volume":"45","author":"Archana","year":"2014","journal-title":"Southeast Asian J Trop Med Pub Health"},{"key":"2021100202532632700_bib26","doi-asserted-by":"crossref","first-page":"7727","DOI":"10.12659\/MSM.910216","article-title":"Surveillance of maternal syphilis in China: pregnancy outcomes and determinants of congenital syphilis","volume":"24","author":"Zhang","year":"2018","journal-title":"Med Sci Monitor"},{"issue":"39","key":"2021100202532632700_bib27","doi-asserted-by":"crossref","first-page":"1088","DOI":"10.15585\/mmwr.mm6739a3","article-title":"Factors contributing to congenital syphilis cases \u2014 New York City, 2010\u20132016","volume":"67","author":"Slutsker","year":"2018","journal-title":"Morbidity and Mortality Weekly Report"},{"key":"2021100202532632700_bib28","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2015\/801437","article-title":"Towards the elimination of syphilis in a small developing country","volume":"2015","author":"Mungrue","year":"2015","journal-title":"J Sex Transmit Dis"},{"issue":"1","key":"2021100202532632700_bib29","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1111\/1471-0528.13950","article-title":"The incidence of congenital syphilis in the United Kingdom: February 2010 to January 2015","volume":"124","author":"Simms","year":"2017","journal-title":"BJOG"},{"issue":"sup1","key":"2021100202532632700_bib30","doi-asserted-by":"crossref","first-page":"94","DOI":"10.3109\/14767058.2011.607562","article-title":"Secular trend on congenital infections: insights from Campania region register for perinatal infection, southern Italy","volume":"24","author":"Buffolano","year":"2011","journal-title":"J Mat Fetal Neonat Med"},{"issue":"1","key":"2021100202532632700_bib31","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1590\/S0080-62342013000100019","article-title":"S\u00edfilis cong\u00eanita no Cear\u00e1: an\u00e1lise epidemiol\u00f3gica de uma d\u00e9cada","volume":"47","author":"da Costa","year":"2013","journal-title":"Revista da Escola de Enfermagem da USP"},{"issue":"123","key":"2021100202532632700_bib32","doi-asserted-by":"crossref","first-page":"1145","DOI":"10.1590\/0103-1104201912313","article-title":"An\u00e1lise epidemiol\u00f3gica e espacial dos casos de s\u00edfilis gestacional e cong\u00eanita","volume":"43","author":"da Concei\u00e7\u00e3o","year":"2019","journal-title":"Sa\u00fade em Debate"},{"issue":"2","key":"2021100202532632700_bib33","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1590\/S1413-81232013000200021","article-title":"Incid\u00eancia e fatores de risco para s\u00edfilis cong\u00eanita em Belo Horizonte, Minas Gerais, 2001\u20132008","volume":"18","author":"Lima","year":"2013","journal-title":"Ci\u00eancia & Sa\u00fade Coletiva"},{"issue":"5","key":"2021100202532632700_bib34","doi-asserted-by":"crossref","first-page":"1541","DOI":"10.1590\/1413-81232015205.14672014","article-title":"Indidence of tuberculosis in children in the state of S\u00e3o Paulo, Brazil, under spatial approach","volume":"20","author":"Ven\u00e2ncio","year":"2015","journal-title":"Ci\u00eancia & Sa\u00fade Coletiva"}],"container-title":["Transactions of The Royal Society of Tropical Medicine and Hygiene"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/trstmh\/article-pdf\/115\/10\/1207\/40499129\/traa191.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/trstmh\/article-pdf\/115\/10\/1207\/40499129\/traa191.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,10,2]],"date-time":"2021-10-02T03:14:35Z","timestamp":1633144475000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/trstmh\/article\/115\/10\/1207\/6134242"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,12]]},"references-count":34,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2021,2,12]]},"published-print":{"date-parts":[[2021,10,1]]}},"URL":"https:\/\/doi.org\/10.1093\/trstmh\/traa191","relation":{},"ISSN":["0035-9203","1878-3503"],"issn-type":[{"value":"0035-9203","type":"print"},{"value":"1878-3503","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,10]]},"published":{"date-parts":[[2021,2,12]]}}}