Syphilis Trigram: a domain-specific visualisation to combat syphilis epidemic and improve the quality of maternal and child health in Brazil

Background: The Brazilian health system is a large and complex system, specially considering its mixed public and private funding. The amount of syphilis case has been increasing greatly in the last four years, even though it has cheap and simple treatment. The syphilis notification are compulsory by law and the public health surveillance pays great importance to syphilis notification during the pregnancy. Syphilis infection can cause severe newborn conditions, even premature birth and abortion. Methods: The Action Research methodology was applied to deal with the complex syphilis surveillance reality in Pernambuco, Brazil. Iterative learning cycles were used, totaling six cycles with a formal validation of an operational version of the syphilis Trigram visualisation at the end of the process. The original data source was analyzed and prepared to use without any new data or change in the ordinary procedure of the current system. Results: The main result of this work is the Syphilis Trigram, a domain-specific infographic for presenting gestational data and birth data. The second contribution of this work is the Average Trigram, an organized pie chart which synthesizes the Syphilis Trigram relationship in an aggregated way. Both visualization are presented in an Infographic User Interface, a tool that gathers an infographic broad visualization sense to data visualization. This interfaces also gathers selections and filters tools to assist and refine the presented information. The user can experience a specific case-by-case view and an aggregated perspective by any city monitored by the system. Conclusions: The proposed domain-specific visualization amplifies the understanding of each syphilis case and the overall case characteristic of a city. This new information produced by the Trigram can clarify the reinfection/relapse cases, optimize resource allocation and enhance the syphilis healthcare policies without any new data. Thus, the health surveillance professionals can see the broad tendency, understand the key patterns through visualization, and take action in a feasible time.