{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T05:00:40Z","timestamp":1791435640308,"version":"4.3.3"},"reference-count":46,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2022,10,25]],"date-time":"2022-10-25T00:00:00Z","timestamp":1666656000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Brazil lacks data from syphilis in its border areas. We aimed to describe the spatial and temporal distribution of acquired syphilis (AS), in pregnancy (SP) and congenital syphilis (CS) in Brazilian municipalities in the arches border contexts.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>An ecological, cross-sectional study was conducted from 2010 to 2020. The study was based on the cases of syphilis available in the Notifiable Diseases Information System (SINAN), and on the Primary Health Care Information System. The detection rates of AS and SP, and the incidence of CS were estimated, and the time series was analyzed. Data between the border arches were compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In 2020, data showed 7,603 cases of AS (detection rate 64.8\/100,000 inhabitants), 3,960 cases of SP (detection rate of 21.6\/1,000 live births) and 836 cases of CS (incidence of 4.6\/1,000 live births) in the border region. Between 2010 and 2020, the mean annual increase of detection rate of SP was 53.4% in Brazil, 48.0% in the border region, 59.6% in the North Arch, 28.8% in the Central and 67.2% in the South. Annual variation on the incidence of CS for the same period was 31.0% in Brazil 38.4% at the border, in the North and South Arcs 18.3% and 65.7% respectively. The Central Arch showed an increase only between 2010 and 2018 (62.7%). A total of 427 (72.6%) municipalities has primary health care coverage \u2265 95% of the population. In 2019, 538 (91.8%) municipalities reported using rapid tests for syphilis, which decreased to 492 (84%) in 2020. In 2019, 441 (75.3%) municipalities reported administering penicillin, and 422 (72%) in 2020.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our data show syphilis reman problem at the Brazilian border, rates in pregnant are high. It was observed a reduction in the detection rates, SP and the incidence of CS between 2018 and 2020. Syphilis should be included on the agenda of all management levels, aiming at expanding access and quality care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0275253","type":"journal-article","created":{"date-parts":[[2022,10,25]],"date-time":"2022-10-25T13:25:34Z","timestamp":1666704334000},"page":"e0275253","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":14,"title":["Gestational and congenital syphilis across the international border in Brazil"],"prefix":"10.1371","volume":"17","author":[{"given":"Leonor H.","family":"Lannoy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patr\u00edcia C.","family":"Santos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8667-0125","authenticated-orcid":true,"given":"Ronaldo","family":"Coelho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adriano S.","family":"Dias-Santos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9216-8593","authenticated-orcid":true,"given":"Ricardo","family":"Valentim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerson M.","family":"Pereira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5556-8379","authenticated-orcid":true,"given":"Angelica E.","family":"Miranda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2022,10,25]]},"reference":[{"key":"pone.0275253.ref001","unstructured":"Brasil. Instituto Brasileiro de Geografia e Estat\u00edstica. IBGE divulga a rela\u00e7\u00e3o dos munic\u00edpios na faixa de fronteira. Ed. Geoci\u00eancias. Atualizado em 28\/03\/2019. https:\/\/www.ibge.gov.br\/geociencias\/organizacao-do-territorio\/estrutura-territorial\/24073-municipios-da-faixa-de-fronteira.html?=&t=o-que-e."},{"key":"pone.0275253.ref002","unstructured":"Organizaci\u00f3n Pan-Americana de salud\u2014OPS. Programa Sub-regional para Am\u00e9rica do Sul\u2014SAM. Boletim Informativo, Ed 1, agosto 2020. https:\/\/www.rets.epsjv.fiocruz.br\/sites\/default\/files\/arquivos\/biblioteca\/boletin_sam_edicion_1_agosto_2020.pdf"},{"issue":"N.1","key":"pone.0275253.ref003","doi-asserted-by":"crossref","first-page":"117","DOI":"10.36403\/espacoaberto.2020.30068","article-title":"Desigualdades e Rela\u00e7\u00f5es Socioecon\u00f4micas nas Cidades-G\u00eameas da Fronteira Brasil-Bol\u00edvia [Inequalities and Socio-economic Relations in the Twin Cities of the Brazilian-Bolivian Border]","volume":"V. 10","author":"VG Ferraro","year":"2020","journal-title":"Espa\u00e7o Aberto, PPGG\u2014UFRJ, Rio de Janeiro"},{"issue":"n. 102","key":"pone.0275253.ref004","doi-asserted-by":"crossref","first-page":"222","DOI":"10.1590\/S0101-66282010000200003","article-title":"A descentraliza\u00e7\u00e3o da pol\u00edtica nacional de sa\u00fade nos sistemas municipais na linha da fronteira Mercosul","author":"J Augustin","year":"2010","journal-title":"Serv. Soc. Soc., S\u00e3o Paulo"},{"key":"pone.0275253.ref005","unstructured":"Pego B; Moura R. Fronteiras do Brasil: uma avalia\u00e7\u00e3o de pol\u00edtica p\u00fablica. v1. Rio de Janeiro: Ipea, 2018. ISBN: 9788578113377 http:\/\/repositorio.ipea.gov.br\/handle\/11058\/8791."},{"key":"pone.0275253.ref006","unstructured":"World Health Organization\u2014WHO. Global progress report on HIV, viral hepatitis and sexually transmitted infections, 2021 Accountability (WHO). https:\/\/www.who.int\/publications\/i\/item\/9789240027077."},{"issue":"2","key":"pone.0275253.ref007","doi-asserted-by":"crossref","first-page":"e0211720","DOI":"10.1371\/journal.pone.0211720","article-title":"Global burden of maternal and congenital syphilis and associated adverse birth outcomes-Estimates for 2016 and progress since 2012","volume":"14","author":"EL Korenromp","year":"2019","journal-title":"PLoS One"},{"key":"pone.0275253.ref008","unstructured":"Brasil. Minist\u00e9iro da S\u00e1ude. Secretaria de Vigil\u00e2ncia em Sa\u00fade. Boletim Epidemiol\u00f3gico S\u00edfilis 2021. Bras\u00edlia. out, 2021a. www.aids.gov.br."},{"key":"pone.0275253.ref009","unstructured":"Brasil. Minist\u00e9rio da Sa\u00fade. Secretaria de Vigil\u00e2ncia em Sa\u00fade. Departamento de Vigil\u00e2ncia, Preven\u00e7\u00e3o e Controle das Infec\u00e7\u00f5es Sexualmente Transmiss\u00edveis, do HIV\/Aids e das Hepatites Virais. Agenda de A\u00e7\u00f5es Estrat\u00e9gicas para Redu\u00e7\u00e3o da S\u00edfilis no Brasil. Bras\u00edlia: 2017. 34 p. chrome-extension:\/\/efaidnbmnnnibpcajpcglclefindmkaj\/http:\/\/www.aids.gov.br\/system\/tdf\/pub\/2017\/65000\/agenda_sifilis_10_2017.pdf?file=1&type=node&id=6500"},{"key":"pone.0275253.ref010","unstructured":"Brasil. Minist\u00e9rio da Sa\u00fade. e-Gestor AB. Informa\u00e7\u00e3o e Gest\u00e3o da Aten\u00e7\u00e3o B\u00e1sica. Accessed at: https:\/\/egestorab.saude.gov.br\/paginas\/acessoPublico\/relatorios\/relHistoricoCoberturaAB.xhtml. Bras\u00edlia, 2021b."},{"key":"pone.0275253.ref011","unstructured":"Brasil. Minist\u00e9rio da Sa\u00fade. Secretaria de Vigil\u00e2ncia em Sa\u00fade. Protocolo Cl\u00ednico e Diretrizes Terap\u00eauticas para Aten\u00e7\u00e3o Integral \u00e0s Pessoas com Infec\u00e7\u00f5es Sexualmente Transmiss\u00edveis (IST) 2020. Bras\u00edlia. 2020."},{"key":"pone.0275253.ref012","doi-asserted-by":"crossref","first-page":"100163","DOI":"10.1016\/j.lana.2021.100163","article-title":"Use of interrupted time series analysis in understanding the course of the congenital syphilis epidemic in Brazil","volume":"7","author":"R Pinto","year":"2021","journal-title":"Lancet Regional Health"},{"issue":"1","key":"pone.0275253.ref013","doi-asserted-by":"crossref","DOI":"10.1590\/0102-311x00057219","article-title":"Adequacy of prenatal care, diagnosis and treatment of syphilis in pregnancy: a study with open data from Brazilian state capitals","volume":"36","author":"AS Benzaken","year":"2020","journal-title":"Cadernos de Sa\u00fade P\u00fablica"},{"key":"pone.0275253.ref014","unstructured":"Brasil. Minist\u00e9rio da Integra\u00e7\u00e3o Nacional. Secretaria de programas nacionais. Faixa de Fronteira Programa de Promo\u00e7\u00e3o do desenvolvimento da Faixa de Fronteira\u2014PDFF. Bras\u00edlia, fev. 2009."},{"key":"pone.0275253.ref015","unstructured":"Brasil. Minist\u00e9rio da Sa\u00fade. Banco de dados do Sistema \u00danico de Sa\u00fade\u2014DATASUS. Indicadores e Dados B\u00e1sicos da S\u00edfilis nos Munic\u00edpios Brasileiros. http:\/\/indicadoressifilis.aids.gov.br\/."},{"key":"pone.0275253.ref016","unstructured":"Brasil. Minist\u00e9rio da Sa\u00fade. Sistema de Informa\u00e7\u00e3o em sa\u00fade para a Aten\u00e7\u00e3o b\u00e1sica\u2014SISAB. https:\/\/sisab.saude.gov.br\/"},{"key":"pone.0275253.ref017","unstructured":"Brasil. Minist\u00e9rio da Sa\u00fade. Secretaria de Vigil\u00e2ncia em Sa\u00fade. Departamento de vigil\u00e2ncia, promo\u00e7\u00e3o e controle das Infec\u00e7\u00f5es Sexualmente Transmiss\u00edveis\/HIV\/AIDS e Hepatites Virais. Nota Informativa N\u00ba 2\u2014SEI\/2017\u2014DIAHV\/SVS\/MS. Bras\u00edlia, out 2017. http:\/\/www.aids.gov.br\/pt-br\/legislacao\/nota-informativa-no-02-sei2017-diahvsvsms"},{"issue":"n.3","key":"pone.0275253.ref018","doi-asserted-by":"crossref","first-page":"565","DOI":"10.5123\/S1679-49742015000300024","article-title":"Uso da an\u00e1lise de s\u00e9ries temporais em estudos epidemiol\u00f3gicos","volume":"vol.24","author":"JLF Antunes","year":"2015","journal-title":"Epidemiol. Serv. Sa\u00fade"},{"issue":"9","key":"pone.0275253.ref019","first-page":"3567","article-title":"PNAD COVID-19: A powerful new tool for Public Health Surveillance in Brazil","volume":"25","author":"GO Penna","year":"2020","journal-title":"Cien Saude Colet"},{"issue":"n. 2","key":"pone.0275253.ref020","first-page":"1","article-title":"Health in the border area: What documents of mercosur and unasur reveal","volume":"v. 29","author":"S Aikes","year":"2020","journal-title":"Saude e Sociedade"},{"key":"pone.0275253.ref021","doi-asserted-by":"crossref","unstructured":"Carneiro Filho CP, Camara LB. Pol\u00edticas p\u00fablicas na faixa de fronteira do Brasil: PDFF, CDIF e as pol\u00edticas de seguran\u00e7a e defesa. Confins\u2014Revista Franco-Brasileira de Geografia. 2019. https:\/\/journals.openedition.org\/confins\/22262.","DOI":"10.4000\/confins.22262"},{"issue":"n. 2","key":"pone.0275253.ref022","first-page":"111","article-title":"O que as pol\u00edticas de controle para as fronteiras brasileiras e o projeto maquila do Paraguai t\u00eam em comum?","volume":"v. 7","author":"SC Kleinschmitt","year":"2016","journal-title":"S\u00e9culo XXI: Revista de Rela\u00e7\u00f5es Internacionais\/ESPM, Porto Alegre"},{"key":"pone.0275253.ref023","unstructured":"Delgado FA. Corumb\u00e1: vias de integra\u00e7\u00e3o e desenvolvimento. X Semin\u00e1rio Internacional Sobre Desenvolvimento Regional\u2014Atores, Ativos e Institui\u00e7\u00f5es: O Desenvolvimento Regional Em Perspectiva, 2021 1\u201315. chrome-extension:\/\/efaidnbmnnnibpcajpcglclefindmkaj\/viewer.html?pdfurl=https%3A%2F%2Fonline.unisc.br%2Facadnet%2Fanais%2Findex.php%2Fsidr%2Farticle%2FviewFile%2F21286%2F1192613450&clen=2915154"},{"key":"pone.0275253.ref024","unstructured":"Gameiro N. Regi\u00f5es de fronteiras est\u00e3o \u00e0 margem dos sistemas de sa\u00fade. 27, out.2019. https:\/\/www.fiocruzbrasilia.fiocruz.br\/regioes-de-fronteiras-estao-a-margem-dos-sistemas-de-saude\/"},{"issue":"4","key":"pone.0275253.ref025","doi-asserted-by":"crossref","first-page":"294","DOI":"10.1136\/sextrans-2011-050309","article-title":"HIV and sexually transmitted infections at the borderlands: Situational analysis of sexual health in the Brazilian Amazon","volume":"88","author":"A Benzaken","year":"2012","journal-title":"Sexually Transmitted Infections"},{"issue":"1","key":"pone.0275253.ref026","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1186\/s13643-017-0595-3","article-title":"Syphilis in the Americas: a protocol for a systematic review of syphilis prevalence and incidence in four high-risk groups, 1980\u20132016","volume":"6","author":"K Kitayama","year":"2017","journal-title":"Syst Rev"},{"issue":"1","key":"pone.0275253.ref027","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1590\/S0034-89102013000100019","article-title":"S\u00edfilis cong\u00eanita: evento sentinela da qualidade da assist\u00eancia pr\u00e9-natal","volume":"47","author":"RMSM Domingues","year":"2013","journal-title":"Rev Sa\u00fade P\u00fablica"},{"key":"pone.0275253.ref028","doi-asserted-by":"crossref","first-page":"e20180226","DOI":"10.1590\/0037-8682-0226-2018","article-title":"Reemerging diseases in Brazil: sociodemographic and epidemiological characteristics of syphilis and its under-reporting","volume":"52","author":"AJI Garbin","year":"2019","journal-title":"Ver Soc Bras Med Trop"},{"issue":"1","key":"pone.0275253.ref029","doi-asserted-by":"crossref","first-page":"1070","DOI":"10.1186\/s12913-021-07053-4","article-title":"Quality of antenatal care and its sociodemographic determinants: results of the 2015 Pelotas birth cohort, Brazil","volume":"21","author":"LS Mor\u00f3n-Duarte","year":"2021","journal-title":"BMC Health Serv Res"},{"issue":"5","key":"pone.0275253.ref030","doi-asserted-by":"crossref","first-page":"EN231921","DOI":"10.1590\/0102-311xen231921","article-title":"Assessment of the appropriate management of syphilis patients in primary health care in different regions of Brazil from 2012 to 2018","volume":"38","author":"MO Saes","year":"2022","journal-title":"Cad Saude Publica"},{"key":"pone.0275253.ref031","first-page":"94","article-title":"Effect of the coverage of rapid tests for syphilis in primary care on the syphilis in pregnancy in Brazil","volume":"55","author":"AG Roncalli","year":"2021","journal-title":"Rev Saude Publica"},{"issue":"1","key":"pone.0275253.ref032","doi-asserted-by":"crossref","first-page":"e0262217","DOI":"10.1371\/journal.pone.0262217","article-title":"Evolution of the quality of prenatal care in the primary network of Brazil from 2012 to 2018: What can (and should) improve?","volume":"17","author":"E Tomasi","year":"2022","journal-title":"PLoS One"},{"key":"pone.0275253.ref033","doi-asserted-by":"crossref","first-page":"17073","DOI":"10.1038\/nrdp.2017.73","article-title":"Syphilis","volume":"3","author":"RW Peeling","year":"2017","journal-title":"Nat Rev Dis Primers"},{"key":"pone.0275253.ref034","unstructured":"Uruguay. Minit\u00e9rio de la Salud. Informe Auditorias de s\u00edfilis 2018. https:\/\/www.gub.uy\/ministerio-salud-publica\/comunicacion\/publicaciones\/informe-auditorias-sifilis-2018"},{"key":"pone.0275253.ref035","unstructured":"Argentina. Minist\u00e9rio da la salud. Direcci\u00f3n de Sida, ETS, Hepatites y Tuberculosis. Boletim sobre el VIH, sida e ITS em la Argentina N\u00ba 37\/A\u00f1o XXIII-diciembre 2020. https:\/\/bancos.salud.gob.ar\/recurso\/boletin-sobre-el-vih-sida-e-its-en-la-argentina-ndeg-37"},{"key":"pone.0275253.ref036","unstructured":"Organizaci\u00f3n Pan-America de la Salud\u2014OPS. La s\u00edfilis en Paraguay. Perfil de pa\u00eds, 2018. https:\/\/www.paho.org\/es\/documentos\/sifilis-paraguay-perfil-pais-2018-2019"},{"key":"pone.0275253.ref037","unstructured":"Paraguay. Minist\u00e9rio de la salude p\u00fablica y bien estar social. Programa nacional de control de VIH\/Sida\/ITS (PRONASIDA). Reporte Epidemiol\u00f3gico y Program\u00e1tico de la s\u00edfilis en Paraguay. 2018. https:\/\/www.mspbs.gov.py\/dependencias\/pronasida\/adjunto\/f36f1a-INFORMESIFILISPARAGUAY20180810191.pdf"},{"key":"pone.0275253.ref038","doi-asserted-by":"crossref","unstructured":"Colombia. Ministerio de la Salud. Instituto nacional de salud. Bolet\u00edn Epidemiol\u00f3gico Semanal. Semana epidemiol\u00f3gica 30. Jul 2020. https:\/\/www.ins.gov.co\/buscador-eventos\/BoletinEpidemiologico\/2020_Boletin_epidemiologico_semana_30.pdf","DOI":"10.33610\/23576189.2020.40"},{"key":"pone.0275253.ref039","unstructured":"Per\u00fa. Minist\u00e9rio de Salud. Bolet\u00edn Epidemiol\u00f3gico Del Per\u00fa 2020. https:\/\/www.dge.gob.pe\/epipublic\/uploads\/boletin\/boletin_202050.pdf"},{"key":"pone.0275253.ref040","unstructured":"France. Sant\u00e9 publique. Surveillance et pr\u00e9vention des infections \u00e0 VIH et autres infections sexuellement transmissibles. Bulletin de sant\u00e9 publique\u2014BSP Guyane. Novembre 2019. https:\/\/www.santepubliquefrance.fr\/maladies-et-traumatismes\/infections-sexuellement-transmissibles\/syphilis\/donnees\/#tabs"},{"key":"pone.0275253.ref041","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2012\/430585","article-title":"Syphilis Infection during Pregnancy: Fetal Risks and Clinical Management","author":"M De Santis","year":"2012","journal-title":"Infectious Diseases in Obstetrics and Gynecology"},{"issue":"1","key":"pone.0275253.ref042","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1080\/26410397.2019.1691897","article-title":"Syphilis management in pregnancy: a review of guideline recommendations from countries around the world","volume":"27","author":"T Trinh","year":"2019","journal-title":"Sex Reprod Health Matters"},{"issue":"n. 6","key":"pone.0275253.ref043","first-page":"e00082415","article-title":"Incid\u00eancia de s\u00edfilis cong\u00eanita e fatores associados \u00e0 transmiss\u00e3o vertical da s\u00edfilis: dados do estudo nascer no Brasil","volume":"v. 32","author":"RMSM Domingues","year":"2016","journal-title":"Cadernos de Sa\u00fade P\u00fablica"},{"issue":"3","key":"pone.0275253.ref044","article-title":"Relationship between the supply of syphilis diagnosis and treatment in primary care and incidence of gestational and congenital syphilis","volume":"36","author":"DCMM Figueiredo","year":"2020","journal-title":"Cadernos de Sa\u00fade Publica"},{"issue":"1","key":"pone.0275253.ref045","first-page":"1","article-title":"Spatiotemporal dynamics of syphilis in pregnant women and congenital syphilis in the state of S\u00e3o Paulo, Brazil","volume":"12","author":"JAR Medeiros","year":"2022","journal-title":"Scientific Reports"},{"issue":"51","key":"pone.0275253.ref046","doi-asserted-by":"crossref","first-page":"137","DOI":"10.32735\/S0718-6568\/2018-N51-1353","article-title":"La construcci\u00f3n pol\u00edtica de la frontera. Entre los discursos nacionalistas y la \u201cproducci\u00f3n\u201d de trabajadores precarios","volume":"17","author":"C Stefoni Espinoza","year":"2019","journal-title":"Polis (Santiago)"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0275253","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,25]],"date-time":"2022-10-25T13:26:08Z","timestamp":1666704368000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0275253"}},"subtitle":[],"editor":[{"given":"Everton","family":"Falc\u00e3o de Oliveira","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2022,10,25]]},"references-count":46,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2022,10,25]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0275253","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,25]]}}}