Gestational syphilis in Brazil between 2008 and 2022: Ethnic disparities and clinical-stage trends

This study investigated gestational syphilis trends in Brazil from 2008 to 2022, focusing on ethnic disparities, temporal progression, and clinical-stage distribution. Using retrospective data from Brazil’s Notifiable Diseases Information System (SINAN), we analyzed 410,630 reported cases to quantify annual trends and interactions between ethnicity, time, and disease severity. A Negative Binomial regression model revealed a 35% annual increase in cases (Incidence Rate Ratio [IRR] = 1.35, 95% CI: 1.20–1.53), with the highest burden observed among the Brown (Parda) population (53.5% of cases). Latent-stage infections predominated (44.2%), followed by primary (37.1%), tertiary (12.1%), and secondary stages (6.6%). Indigenous populations exhibited marginally slower progression (IRR = 0.86, p= 0.090), while no significant differences emerged between Black (Preta) and other ethnic groups. Structural inequities, including delayed diagnosis and inconsistent prenatal care, were linked to persistent latent-stage infections and elevated tertiary-stage rates in marginalized communities. These findings underscore the urgent need for equity-focused interventions, such as expanded rapid testing and culturally tailored healthcare programs, to mitigate Brazil’s escalating syphilis epidemic.