Spatial Distribution and Epidemiological Characterization of Congenital Syphilis in Monterrey, Mexico, 2016–2024

Denisse Natalie Vaquera Aparicio Department of Pediatrics/Infectious Disease Service, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Monterrey, Mexico;

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José Iván Castillo Bejarano Department of Pediatrics/Infectious Disease Service, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Monterrey, Mexico;

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Abiel Mascareñas de los Santos Department of Pediatrics/Infectious Disease Service, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Monterrey, Mexico;

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Paul Santiago Arcos Viscarra Department of Pediatrics/Infectious Disease Service, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Monterrey, Mexico;

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María Fernanda Cid Ramírez Department of Pediatrics/Infectious Disease Service, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Monterrey, Mexico;

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Diego Armando Alvarado-Lara Department of Pediatrics/Infectious Disease Service, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Monterrey, Mexico;

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Sara Paulina Rosales-González Department of Pediatrics/Infectious Disease Service, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Monterrey, Mexico;

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Kassandra Abigail Martínez Rivera Department of Pediatrics, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Monterrey, Mexico;

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Ingrid Gabriela López-Reyna Department of Pediatrics, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Monterrey, Mexico;

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Manuel Alejandro Saldaña Chacón Consejo Regulador de Tequila, Jardines de Guadalupe Zapopan, Mexico;

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Susana Patricia Cantú González Hospital Epidemiological and Surveillance Unit, Christus Muguerza Alta Especialidad, Monterrey, Mexico

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Congenital syphilis is a preventable infectious disease that is rising in low- and middle-income countries. The CDC classifies congenital syphilis into four clinical scenarios to guide diagnosis and treatment: Scenario 1, proven or highly probable congenital syphilis; Scenario 2, possible congenital syphilis; Scenario 3, less likely congenital syphilis; and Scenario 4, unlikely congenital syphilis. Geolocation is crucial for analyzing the distribution of infectious diseases by pinpointing high-prevalence areas and enabling targeted interventions. This retrospective observational study analyzed Scenario 1 and 2 cases from a tertiary hospital in Monterrey, Mexico (2016 to 2024). Geocoding was performed by converting descriptive location data, such as patients’ postal codes, into geographic coordinates (latitude and longitude) using Python v. 3.10.13 (Python Software Foundation, Wilmington, DE). These coordinates were then used in spatial analysis and visualized through kernel density mapping to identify high-incidence zones. Logistic regression identified associations with geographic, socioeconomic, and clinical factors, and odds ratios quantified risks. Data analysis was performed with SPSS version 26 (IBM Corp., Armonk, NY). A total of 167 Scenario 1 and 2 cases were identified, with the highest incidence in 2023 (82.3%, n = 51). The mean maternal age was 23 years; 56.3% of maternal syphilis cases were diagnosed postpartum, 49.7% of cases were late latent syphilis, and 48.5% of patients received no treatment. Higher prevalence was observed in densely populated areas such as Monterrey. This study highlights the utility of geolocation and kernel mapping for designing prevention strategies tailored to high-risk regions. Strengthening prenatal care, early diagnostic testing, and timely treatment is crucial for reducing congenital syphilis rates.

Author Notes

Disclosure: This study was approved by the research ethics committee of our institution (code PE24-00010).

Current contact information: Denisse Natalie Vaquera Aparicio, José Iván Castillo Bejarano, Abiel Mascareñas de los Santos, Paul Santiago Arcos Viscarra, María Fernanda Cid Ramírez, Diego Armando Alvarado-Lara, and Sara Paulina Rosales-González, Department of Pediatrics/Infectious Diseases Service, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo Leon, Monterrey, Mexico, E-mails: dra.denissevaquera@gmail.com, jicastillobejarano@gmail.com, a_mascarenas@hotmail.com, santi.paulmed@gmail.com, fernanda027cidr@gmail.com, alvaradolara22@hotmail.com, and srosales107@gmail.com. Kassandra Abigail Martínez Rivera and Ingrid Gabriela López-Reyna, Department of Pediatrics, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Monterrey, Mexico, E-mails: kassandra.mr96@hotmail.com and ingridlopezreyna@gmail.com. Manuel Alejandro Saldaña Chacón, Consejo Regulador de Tequila, Jalisco, Mexico, E-mail: ing.manuelsaldana16@gmail.com. Susana Patricia Cantú González, Hospital Epidemiological and Surveillance Unit, Christus Muguerza Alta Especialidad, Monterrey, Mexico, E-mail: susana.cantug9@gmail.com.

Address correspondence to José Iván Castillo Bejarano, Department of Pediatrics/Infectious Diseases Service; Hospital Universitario “Dr. José Eleuterio González”, Francisco I. Madero Avenue, Mitras Centro, ZC 64460 Universidad Autónoma de Nuevo León, Monterrey, Mexico. E-mail: jicastillobejarano@gmail.com
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