Prevalence and epidemiological characterization of congenital syphilis at the San Luis de Otavalo Basic Hospital: A descriptive study based on data, not reports

Abstract

Introduction: Congenital syphilis (CS), which is the result of fetal infection by Treponema pallidum, despite being an ancient disease, still continues to affect children around the world; Most cases develop because the mother did not receive prenatal care or received insufficient treatment for syphilis before or during pregnancy. Objective: To describe the prevalence of congenital syphilis and the epidemiological characteristics of patients admitted to the Pediatrics-Neonatology area of the San Luis de Otavalo Basic Hospital (HSLO), as well as their mothers during the period 2020 - 2024. Additionally, the cases of congenital syphilis and the type of trend presented at the level of the province of Imbabura and at the national level are listed. Methodology: An observational, descriptive, and retrospective study was conducted. Data were obtained from the physical and electronic medical records of children diagnosed with CS at the San Luis de Otavalo Basic Hospital during the period 2020-2024. Data on the number of CS cases at the national and provincial levels were also obtained from the National Institute of Statistics and Census (INEC). The variables analyzed were sex, gestational age at birth, birth weight, and newborn symptoms, as well as age, ethnicity, marital status, educational level, and number of follow-ups among their mothers. SPSS v. 30 and Excel 2019 were used for data processing and analysis. The descriptive analysis included prevalence calculations for the cases presented, as well as a description of the sociodemographic characteristics of the patients and their mothers. Additionally, trends in congenital syphilis cases at the national level and in the province of Imbabura are presented. Results: During the period 2020-2024 at the San Luis de Otavalo Basic Hospital, 6,838 births occurred, 16 of which were diagnosed with CS, which represented a prevalence of 0.23%, 63% were men and 37% women, 100% of them were born full-term and with adequate weight; Regarding the symptoms, it was observed that only 16% (1 case) presented symptoms compatible with CS (prolonged jaundice). When referring to their mothers, it was observed that 50% were of Ecuadorian nationality, followed by Venezuelan and Colombian women with 38 and 12% respectively; 69% self-identified as mestizo and 31% as indigenous; If we talk about marital status, 37% were reported as single and in a common-law union each, with married women representing 25%; When speaking of educational level, 56% of these women completed basic education and 44% are high school graduates. An interesting and at the same time worrying fact is the number of prenatal check-ups: 38% of the women studied had 5 prenatal check-ups, the remaining 68% reported fewer than 5 check-ups during their pregnancy. To conclude, there is an upward trend in SC cases occurring nationally and in the province of Imbabura. Conclusions: Congenital syphilis is a disease that at San Luis Otavalo Basic Hospital presented a prevalence of 0.23% during the period 2020-2024. All 16 patients were full-term newborns with adequate birth weight, and only 1 of them presented symptoms (prolonged jaundice). Their mothers, both mostly Ecuadorian and foreign, self-identified as mestizo and indigenous, and most of them were under 33 years old with basic and high school education levels; It is striking that more than half of them did not receive the minimum prenatal checkups recommended by the World Health Organization (WHO). Additionally, reported cases of congenital syphilis in the province of Imbabura and nationwide have been on the rise.