The Shortage of Benzathine Penicillin and Its Impact on Congenital Syphilis Incidence: An Ecologic Study in the City of Rio de Janeiro
The Shortage of Benzathine Penicillin and Its Impact on Congenital Syphilis Incidence: An Ecologic Study in the City of Rio de Janeiro
Data
2021
Autores
Braga, José Ueleres
Araujo, Rachel Sarmeiro
Souza, Ana Sara Semeão de
Journal Title
Journal ISSN
Volume Title
Publisher
Clinical Infectious Diseases
Resumo
The Pan American Health Organization indicates that increased incidence of congenital syphilis (CS) can be at-
tributed to the lack of penicillin. This study aimed to analyze the relationship between the benzathine penicillin shortage and the
significant increase in the incidence of congenital syphilis in the city of Rio de Janeiro from 2013 to 2017.
Methods. We used a mixed ecologic study design (temporal and multiple groups). Analysis units were the neighborhoods (spa-
tial) and quarters (temporal) during those years. The study population consisted of CS patients who were living in the city of Rio
de Janeiro. The benzathine penicillin supply measure for use in gestational syphilis considered the ratio between (1) the number of
bottles dispensed to health facilities in each neighborhood and (2) the number of bottles necessary to treat pregnant women diag-
nosed with syphilis and their respective partners residing in each neighborhood. To evaluate the association between shortages and
a significant increase in CS incidence, the negative-inflated zero-binomial regression model (longitudinal model) was used.
Results. During the study period, the incidence rate of CS in Rio de Janeiro neighborhoods was on average 19.6 per 1000 live
births. In the simple analysis, shortage was associated with a 2.17-fold increase in the risk of a significant increase in CS incidence.
After adjustment for the sufficient minimum set, the strength of association increased to 2.23 (95% confidence interval, 1.15–4.30).
Conclusions. We conclude that the benzathine penicillin shortage had an impact on the increase in the incidence of CS in Rio
de Janeiro.
Description
Palavras-chave
congenital syphilis, epidemiological monitoring, spatial analysis.
Citação
Ueleres Braga J, Araujo RS, de Souza ASS. The Shortage of Benzathine Penicillin and Its Impact on Congenital Syphilis Incidence: An Ecologic Study in the City of Rio de Janeiro. Clin Infect Dis. 2021 Mar 1;72(5):e79-e87. doi: 10.1093/cid/ciaa1716. PMID: 33197933.