CONGENITAL SYPHILIS: CLINICAL ASPECTS AND PREVENTION IN PRIMARY HEALTH CARE — A LITERATURE REVIEW

Abstract

Introduction: Congenital syphilis (CS) remains a serious public health problem in Brazil, resulting in miscarriages, prematurity, and developmental sequelae in children. The incidence of CS serves as a sentinel marker for the quality of prenatal care within Primary Health Care (PHC). Objective: To analyze scientific evidence regarding the clinical manifestations of congenital syphilis, as well as prevention and management strategies within the Brazilian PHC context. Methodology: This is a narrative literature review based on the PICO strategy. Searches were conducted in databases such as PubMed/MEDLINE, SciELO, LILACS, and indexed journals, prioritizing publications from 2017 to 2026. The final sample consisted of a qualitative synthesis of 12 studies and technical documents. Results and Discussion: The persistence of CS in Brazil stems not from a lack of technology, but from failures in care processes. Merely expanding prenatal care coverage does not ensure a reduction in cases without adequate quality of care. Key obstacles identified include late diagnosis, institutional barriers to administering benzathine penicillin at Basic Health Units (UBS), and underreporting of severe outcomes. A critical weakness highlighted is the management of sexual partners: fewer than one-third receive appropriate therapy, thereby perpetuating the cycle of maternal reinfection. Evidence points to the need for decentralizing rapid testing, training nursing and medical professionals for the immediate administration of penicillin, and implementing localized active case-finding. Conclusion: CS is a largely preventable condition. Sustained reduction of its rates in Brazil depends on transforming the quantitative expansion of prenatal care into excellence in PHC service delivery. To achieve this, it is essential to ensure a steady supply of medical inputs, overcome administrative barriers to treatment at the UBS, improve epidemiological surveillance, and ensure a comprehensive approach to treating both partners.