Sífilis materna y sífilis congénita en América Latina: un problema grave de solución sencilla / Maternal syphilis and congenital syphilis in Latin America: big problem, simple solution

From the data submitted to the Pan American Health Organization (PAHO) by nationwide programs against sexually transmitted diseases (STD), HIV infection, and AIDS (2002), one can estimate the overall prevalence of syphilis among pregnant women to be 3.1 percent and to range from 1.00 percent in Peru to 6.21 percent in Paraguay. According to these data, the incidence of congenital syphilis ranges from 1.4 per 1 000 live births in El Salvador to 12.0 per 1 000 live births in Honduras. Among men who engage in sex with other men, who often classify themselves as heterosexual, as well as in female sex workers, the prevalence of syphilis ranged from 5 percent to 15 percent. Factors that determine the persistence of congenital syphilis as a public health problem include a lack of awareness of the seriousness of the problem among politicians, health officials, and health care providers, difficult access to prenatal care and screening services, a low demand for the test among users, and the stigma and discrimination that surround sexually transmitted diseases (STD). This paper seeks to focus the attention of health professionals on maternal and congenital syphilis so they will undertake actions, using an interprogrammatic approach, to eliminate congenital syphilis from Latin America and the Caribbean. Eliminating congenital syphilis will only become possible if interventions targeting vulnerable groups are also implemented. PAHO's role in eliminating congenital syphilis includes determining the baseline situation in the Region as a whole and in each country, developing communication and procurement strategies, supporting nationwide programs, promoting operational research, and facilitating interprogrammatic coordination.

Ya se dispone de antirretroviricos contra el VIH y el sida: es necesaria ahora la prevencion? / Antiretroviral agents against HIV and AIDS are now available: is prevention still necessary?

New antiretroviral agents have radically changed the treatment of HIV infection and AIDS. In many patients, this treatment has produced substantial improvement, as well as marked reductions in circulating viral particles. Furthermore, there has been a decrease in mortality from AIDS complications resulting from the use of very active retroviral therapy (VART). A source of concern, however, is the current perception that the disease, though not yet curable, can be successfully treated with this new therapy, since this notion could be changing the public's attitude toward the continued need for preventive measures