CONTRIBUIÇÃO PARA O ESTUDO DO PROBLEMA DA SÍFILIS NA CAPITAL DE SÃO PAULO

Abstract

I - Syphilis, for various reasons, merits special distinction in the study of venereal diseases, and constitutes an important problem in Public Health. It is necessary, for the establishment of a program for the control of syphilis in a region, to know the rates of incidence and prevalence. However, neither São Paulo, nor the rest of Brazil, presents accurate data on the frequency of syphilis in the population. II - The mass ser o logical survey is one o f the best methods for studying the prevalence of the disease in a population, and also takes into consideration the various causes of errors. III - The problem of syphilis m industry is considered as being most important in relation to the number of work hours lost, and for the nurnber of pensions and compensations that result. In São Paulo, an industrial city, the study of syphilis arnong the workers 1s of indubitable importance. IV - A study rnade during 1950-1951 in the paulista capital, revealed a rate o f positive serological reactions of 3.81 %, in 20,892 workers examined. V - The impression was confirrned that the positive rate increases in a more accentuated rnanner up to the age of 30, rernaining more or less stable up to 60 years, diminishing after this age. VI - The masculine workers presented a higher rate of positive serological reactions ( 4.39%) than the feminine sex (2.78%). VIl - The white workers presented a lower rate of positiVIty (3.25%) than was observed arnong mulattos (8.81%), and negroes (9.42%). VIII - In the group of married workers, the percentage of positive reactions was higher ( 4.89%) than the rate encountered among single (2.79%). Married rnen presented a higher r ate ( 4.80%) than single ( 3.63%). Married women workers presented a rate higher ( 4.88%) than non-married ( 1.83%). IX - No significant difference was observed in the rate of positivity between married workers and widows and widowers. X - It was noted that the rate of positive reactions was higher 111 Brazilian {3.92%) than in non-Brazilian workers (2.90%). XI - It seems a relationship exists beween educational and cultural fa ctors and the rate of incidence and prevalence of syphilis. Ali authors agree that Lhe per centage among students is low. A study made from the records of students at the Univer sity of São Paulo matriculated in the Centro de Aprendizado da Faculdade de Higiene e Saúde Pública revealed: In 7,78 male students examined in 1949, 4.3% were found to have had syphi lis at some time in the past. In 1,16-1· serological tests made on students in 1950 a positive rale of 2% 11·as found. lt would be lower if we considered that cases in treatment with repeated tests were included. XII - A serol ogica l survey made in September 1951, among soldiers of the Fôrça Pública presenteei the foll owing resu lts : Of 257 so ldiers of the Ba ta llion of Cuards, a rate of 8.17% positives was observed. Among 165 soldiers o f a Cavai ry Hegiment, 17.5%. XIII - Studies made in prisons in various parts of Lhe world show a high r ate o f syphil is among pri soners. On analising the records of 1,121 prisioners of the Penitenciária do . Estado de São Paulo, we encountered a positive rate of 32.9%. XIV - The capital of São Paulo presents a degrading spectacle, with a red li ght di stri ct whi ch is rarely seen in other civilized cities. A serological survey of 1,000 prostitutes of Bom Retiro, in 194-8, showed a positive rate of 86.3%. This survey was repeated in 1951, with the rate dropping to 35.3% positive tests among 465 prostitutes from the s ame distri ct. The frequent use of penicillin by prostitutes for venereal diseases and other illnesses, is considered one of the principal factors in the recent' Jower rate of positive reactions for syphilis among these women. XV - The in cidence and prevalence rate has been followed in var!ous parts of the world, and studies have been made. Some authors find that the optimism of the sanitary experts in relation to the possibility of easy erradi cation of this disease among populations, is premature. ln the capital of São Paulo, following comparative studies, a diminution of the rate of prevalence of syphilis in certain social groups has been observed. XVI - The r ates o f positive serological reactions f o r the diagnosis o f syphiis, encountered in some groups of the pau listana population are not, generally speaking, high . Considering the · economic and educationa l leve! of Lhe group of workers examined in this present survey, a rate of 3.8% is low. Higher rates, nevertheless, apparently exi st in other region s, as suggested by data found among the immigrants from the north and northeastern part of the country. XVII - A person afflicted with syphilis and/ or other venereal diseases, presents from a psychological viewpoint, an important problem for public hea lth workers. The psychologica l aspect is seldom taken into consideration in campaigns against venereal disease, a fact which is recognized as a greater failing o f psych iatrists and modern venereologists.