Racial and educational disparities are potential influencing factors in a staggering 89% of mother-to-child syphilis transmissions in Brazil, according to a recent research study published in The Lancet Global Health. This observational research, spearheaded by the London School of Hygiene & Tropical Medicine (LSHTM), scrutinized an extensive dataset comprising over 15 million birth records from across Brazil. Among these records were more than 144,000 documented instances of maternal syphilis and over 79,000 cases of congenital syphilis, which occurs when syphilis is present at birth.
The findings of this study indicate that Black and Parda/Brown women face an elevated risk of syphilis infection compared to their white counterparts. Specifically, Black women exhibited over twice the likelihood of contracting syphilis than white women, while Parda/Brown women were more than one-and-a-half times as likely to be infected compared to white women.
Furthermore, the research suggests that a significant portion of syphilis infections in both mothers and infants could have been averted if all women in the dataset bore the same risk as white women. A substantial 35% of syphilis cases recorded during pregnancy and 41% of syphilis transmissions to infants could potentially have been prevented.
These percentages escalate to a striking 86% of syphilis cases during pregnancy and 89% of syphilis transmissions to infants if all women shared the same risk as white women with more than 12 years of education.
The research team also unearthed disparities in timely syphilis diagnoses, adequate treatment for syphilis infections, and treatment for their partners among Black and Parda/Brown women when compared to their white counterparts.
Dr. Enny Paixao Cruz, an Associate Professor at LSHTM who led the research, voiced her concern: “Untreated syphilis in expectant mothers has been linked to numerous adverse health outcomes in babies, including stillbirths and neurodevelopmental issues. Despite international efforts to eliminate syphilis transmission from mother to baby, it remains prevalent in several low- and middle-income countries.”
She continued, “The highest rates are currently observed in the African and Eastern Mediterranean regions yet until now, there has been no estimation of the burden of syphilis attributed to ethnic-racial inequities. The World Health Organization’s (WHO) global health initiative to eliminate mother-to-child syphilis transmission by 2030 can only be achieved if ethnic-racial and educational inequities are considered.”
The study utilized administrative data documenting the births of single children from January 1, 2012, to December 31, 2017, sourced from the Brazilian Live Births Information System, which encompasses more than 90% of all births in Brazil.
It is important to note that this research constitutes an observational study based on medical records, and further controlled studies are required to confirm these disparities.
