Effectiveness of Congenital Syphilis Prevention Strategies in Brazil: A Literature Review

Abstract

Introduction: Despite the availability of rapid tests and effective treatment with benzathine penicillin, gestational syphilis (GS) and congenital syphilis (CS) remain chronic public health challenges in Brazil. Vertical transmission of Treponema pallidum leads to severe fetal and neonatal consequences, with CS being directly linked to inadequate prenatal care and delayed diagnosis. Objective: To critically analyze the effectiveness of Brazilian strategies for the prevention and control of congenital syphilis as reported in the scientific literature, identifying factors contributing to successful care and persistent barriers within the healthcare network. Methodology: This is a narrative literature review guided by the PICO framework. Searches were conducted in PubMed/MEDLINE, SciELO, and BVS/LILACS databases, as well as in indexed national and international journals, focusing on primary studies published between 2016 and 2026. The qualitative synthesis included 12 articles. Results and Discussion: A discrepancy is evident between the regulatory framework of the Unified Health System (SUS) and its actual implementation. Expanding the quantity of prenatal care coverage does not guarantee a reduction in CS cases without effective care outcomes. Key barriers identified include fragmented care, intermittent shortages of benzathine penicillin in vulnerable areas, and underreporting in information systems. A critical bottleneck is the lack of sexual partner engagement; fewer than one-third of partners receive adequate treatment in the country, thereby perpetuating the cycle of maternal reinfection. The role of multidisciplinary teams in Primary Health Care (PHC) is a crucial pillar for timely screening, active case finding, and serological monitoring. Conclusion: While strategies to combat CS in Brazil are theoretically robust, their effectiveness is limited by logistical and operational shortcomings. Sustained reduction of the condition requires strengthening screening at the point of care, ensuring the supply and administration of penicillin in primary health care, institutionalizing partner treatment, and fostering interdisciplinary coordination in epidemiological surveillance.