ABSTRACT BACKGROUND: Syphilis is a major public health issue worldwide. In people living with human immunodeficiency virus (PLHIV), there are higher incidences of both syphilis and neurosyphilis. The criteria for referring PLHIV with syphilis for lumbar puncture is controversial, and the diagnosis of neurosyphilis is challenging. OBJECTIVE: To describe the knowledge, attitudes, and practices of infectious disease specialists and residents in the context of care for asymptomatic HIV-syphilis coinfection using close-ended questions and case vignettes. DESIGN AND SETTING: Cross-sectional study conducted in three public health institutions in São Paulo (SP), Brazil. METHODS: In this cross-sectional study, we invited infectious disease specialists and residents at three academic healthcare institutions to answer a self-completion questionnaire available online or in paper form. RESULTS: Of 98 participants, only 23.5% provided answers that were in line with the current Brazilian recommendation. Most participants believed that the criteria for lumbar puncture should be extended for people living with HIV with low CD4+ cell counts (52.0%); in addition, participants also believed that late latent syphilis (29.6%) and Venereal Disease Research Laboratory (VDRL) titers ≥ 1:32 (22.4%) should be conditions for lumbar puncture in PLHIV with no neurologic symptoms. CONCLUSION: This study highlights heterogeneities in the clinical management of HIV-syphilis coinfection. Most infectious disease specialists still consider syphilis stage, VDRL titers and CD4+ cell counts as important parameters when deciding which patients need lumbar puncture for investigating neurosyphilis.

OBJETIVO: Analisar e comparar os cuidados primários prestados à população materno-infantil e contribuir para a avaliação da assistência integral a esse grupo. MÉTODOS: Inquérito populacional realizado por entrevistas, no principal posto de vacinação do Município de Teresópolis, RJ, no Dia Nacional de Vacinação, que abrangeu questões sobre utilização de serviços de saúde e prestação de cuidados primários preventivos. RESULTADOS: Foram colhidas informações de 329 crianças e suas respectivas mães. Mais de 90% das crianças haviam comparecido à consulta pediátrica nos três meses anteriores e quase todas possuíam o cartão da criança, embora em 30% desses cartões não havia qualquer peso registrado no período. Observou-se associação positiva entre consulta de puericultura e registro de peso no cartão da criança (RP = 1,34; IC: 1,13-1,58; p = 0,0002). Cerca de 59% das mães compareceram à consulta de revisão de parto, mas 25% referiram nunca ter feito exame colpocitológico-oncótico e 36% nunca haviam realizado exame de mama. Observou-se associação positiva entre a idade materna acima de 20 anos e a realização de algum exame colpocitológico-oncótico durante a vida reprodutiva (RP = 1,56; IC: 1,08-2,26; p = 0,03). Quase 70% das mães relataram uso de algum método anticoncepcional, principalmente pílula, condom e laqueadura tubária. CONCLUSÕES: Apesar de algumas limitações, os resultados sugerem a viabilidade da metodologia utilizada, permitindo a identificação de deficiências importantes na prestação de cuidados primários de saúde para crianças e principalmente para mães.

OBJECTIVE: To describe and analyze primary health care provided to mother-and-child population in Teresópolis, state of Rio de Janeiro, Brazil. METHODS: A population survey was performed at the main vaccination station on the local Vaccine National Day, to collect information about the use of health care services and preventive primary care. RESULTS: Information was collected from 329 mothers and their children. More than 90% of children had at least one pediatric visit in the past three months. Almost all had their growth chart, but in 30% of them the child's weight was not registered. There was a positive association between having a routine visit and the registration of the child's weight in the card (RP = 1.34; IC: 1.13-1.58; p = 0.0002). Around 59% of the mothers had a medical visit after giving after birth; 25% said they had never had a Pap smear test before, and 36% never had a breast examination. There was a positive association between the mother's age being over 20 years and ever having a Pap smear test (RP = 1.56; IC: 1.08-2.26; p = 0.03). Almost 70% of the mothers referred the use of any contraceptional method, and the most common used were contraceptive pills, condoms and tubal ligation. CONCLUSIONS: Despite some limitations, the results suggest a valid and useful methodology, which allows the identification of important needs in primary health care delivery to children and their mothers.

OBJETIVO: Analisar e comparar os cuidados primários prestados à população materno-infantil e contribuir para a avaliação da assistência integral a esse grupo. MÉTODOS: Inquérito populacional realizado por entrevistas, no principal posto de vacinação do Município de Teresópolis, RJ, no Dia Nacional de Vacinação, que abrangeu questões sobre utilização de serviços de saúde e prestação de cuidados primários preventivos. RESULTADOS: Foram colhidas informações de 329 crianças e suas respectivas mães. Mais de 90% das crianças haviam comparecido à consulta pediátrica nos três meses anteriores e quase todas possuíam o cartão da criança, embora em 30% desses cartões não havia qualquer peso registrado no período. Observou-se associação positiva entre consulta de puericultura e registro de peso no cartão da criança (RP = 1,34; IC: 1,13-1,58; p = 0,0002). Cerca de 59% das mães compareceram à consulta de revisão de parto, mas 25% referiram nunca ter feito exame colpocitológico-oncótico e 36% nunca haviam realizado exame de mama. Observou-se associação positiva entre a idade materna acima de 20 anos e a realização de algum exame colpocitológico-oncótico durante a vida reprodutiva (RP = 1,56; IC: 1,08-2,26; p = 0,03). Quase 70% das mães relataram uso de algum método anticoncepcional, principalmente pílula, condom e laqueadura tubária. CONCLUSÕES: Apesar de algumas limitações, os resultados sugerem a viabilidade da metodologia utilizada, permitindo a identificação de deficiências importantes na prestação de cuidados primários de saúde para crianças e principalmente para mães.

OBJECTIVE: To describe and analyze primary health care provided to mother-and-child population in Teresópolis, state of Rio de Janeiro, Brazil. METHODS: A population survey was performed at the main vaccination station on the local Vaccine National Day, to collect information about the use of health care services and preventive primary care. RESULTS: Information was collected from 329 mothers and their children. More than 90% of children had at least one pediatric visit in the past three months. Almost all had their growth chart, but in 30% of them the child's weight was not registered. There was a positive association between having a routine visit and the registration of the child's weight in the card (RP = 1.34; IC: 1.13-1.58; p = 0.0002). Around 59% of the mothers had a medical visit after giving after birth; 25% said they had never had a Pap smear test before, and 36% never had a breast examination. There was a positive association between the mother's age being over 20 years and ever having a Pap smear test (RP = 1.56; IC: 1.08-2.26; p = 0.03). Almost 70% of the mothers referred the use of any contraceptional method, and the most common used were contraceptive pills, condoms and tubal ligation. CONCLUSIONS: Despite some limitations, the results suggest a valid and useful methodology, which allows the identification of important needs in primary health care delivery to children and their mothers.