Avaliação do impacto econômico diante a influência do comportamento sexual e adesão ao tratamento em casos de sífilis gestacional e congênita

Abstract

The rising incidence of congenital syphilis has raised significant public health concerns, making the analysis of sexual behavior and healthcare quality essential to understanding transmission factors. This study aimed to analyze the association between sexual behavior and treatment adherence with the incidence of syphilis in neonates, characterizing the sociodemographic and clinical profile of postpartum women exposed to gestational syphilis and performing a budget impact analysis of existing preventive measures. Methodologically, a case-control study was conducted in two hospitals in Juiz de Fora (MG) with postpartum women who tested reactive for VDRL during pregnancy, divided into a Case Group (neonates with congenital syphilis) and a Control Group (neonates without infection). Thirty-five women were interviewed (aged 14 to 45 years), mostly single and with education levels predominantly in primary school. Although most reported pharmacological treatment, only five partners were treated, highlighting critical failures in the prevention chain and simultaneous treatment. The budget impact analysis revealed that the indirect cost of congenital syphilis per hospitalization (R$ 1,682.03 in Brazil and R$ 1,423.09 in Minas Gerais) is drastically higher than the direct cost of prevention for the mother (R$ 100.48). The implementation of an alternative technology, focused on therapeutic adherence and partner treatment (R$ 172.03), proved sustainable over a three-year horizon. Despite the initial investment generating a negative incremental impact in the first two years, the third year projects a break-even point with positive balances of R$ 258,712.10 in Minas Gerais and over R$ 2.9 million nationally. The progressive reduction of total costs in Brazil, from R$ 26.6 million to R$ 9.9 million, confirms that the qualified management of gestational syphilis is a highly cost-effective strategy. In conclusion, the eradication of this condition requires improved prenatal screening, accurate infection staging, and the implementation of intersectoral policies to mitigate socioeconomic vulnerabilities and ensure effective partner treatment.