Prevalencia y factores asociados a sífilis congénita en recién nacidos y mortinatos atendidos en la subred integrada de salud centro oriente E.S.E en Bogotá entre los años 2018 a 2021. Estudio multimétodo
Thesis
Congenital syphilis is currently one of the most significant public health challenges in Colombia due to the increasing number of cases in recent years. This study aims to determine the prevalence and factors associated with congenital syphilis in newborns and stillbirths treated at the Centro Oriente Integrated Health Services Network in Bogotá between 2018 and 2021. The study design is a multi-method qualitative and quantitative approach. The qualitative component follows a phenomenological approach, where an in-depth review was conducted on 10 medical records of women whose children were diagnosed with congenital syphilis and 12 women with healthy children. Categories and subcategories were established, such as the perception of obstetric risk, income level, and external migration. The quantitative component corresponds to an observational cross-sectional analytical study based on the analysis of all live births and stillbirths attended in the SISSCO during the years 2018 to 2021. Results: An accumulated prevalence of congenital syphilis over the four years evaluated was identified at 8.8 x 1,000 live births + stillbirths, with 2020 showing the highest prevalence at 11.2 x 1,000 live births + stillbirths. A relationship was established between congenital syphilis and variables such as the number of prenatal checkups and institutional deliveries, which were identified as protective factors. Conversely, variables such as lack of affiliation to the SGSSS, low educational level, homelessness, and migration were established as risk factors. Through the analysis of medical records, categories and subcategories related to economic income, external migration, and the perception of obstetric risk were identified. These were constructed from narratives reflecting low educational levels, salary instability, traditional distribution of household tasks, homelessness, lack of prenatal checkups, late access to health services, and migration. Conclusion: Congenital syphilis may be linked to social factors such as poverty, illiteracy, access barriers, and a lack of economic resources, among other social inequalities and inequities. The lack of prenatal care highlights the low quality of healthcare, which is not only influenced by geographical borders but also by invisible barriers that affect the patient and her family. This situation requires not only strategies based on a biomedical model but also an intercultural and intersectoral intervention.
