Social determinants associated with Zika virus infection in pregnant women

Author(s):Show less -

Nery, Jr., Nivison ^{[1, 2]} ; Aguilar Ticona, Juan P. ^[1] ; Gambrah, Claudia ^[3] ; Doss-Gollin, Simon ^[4] ; Aromolaran, Adeolu ^[3] ; Rastely-Junior, Valmir ^[5] ; Lessa, Millani ^[1] ; Sacramento, Gielson A. ^[2] ; Cruz, Jaqueline S. ^[2] ; de Oliveira, Daiana ^[2] ; dos Santos, Laiara Lopes ^[2] ; da Silva, Crislaine G. ^[2] ; Botosso, Viviane F. ^[6] ; Soares, Camila P. ^[7] ; Araujo, Danielle Bastos ^[7] ; Oliveira, Danielle B. ^{[7, 6]} ; dos Santos Alves, Rubens Prince ^[8] ; Andreata-Santos, Robert ^[8] ; Durigon, Edison L. ^{[9, 6]} ; de Souza Ferreira, Luis Carlos ^[8] ; Wunder, Jr., Elsio A. ^{[2, 3]} ; Khouri, Ricardo ^{[2, 5]} ; Oliveira-Filho, Jamary ^[5] ; de Siqueira, Isadora C. ^[2] ; Almeida, Antonio R. P. ^[5] ; Reis, Mitermayer G. ^{[2, 3, 5]} ; Ko, Albert I. ^{[2, 3]} ; Costa, Federico ^{[1, 2, 3]}

Affiliation

^[1] Univ Fed Bahia, Inst Saude Colet, Salvador, BA - Brazil

^[2] Fundacao Oswaldo Cruz, Minist Saude, Inst Goncalo Moniz, Salvador, BA - Brazil

^[3] Yale Sch Publ Hlth, Dept Epidemiol Microbial Dis, New Haven, CT - USA

^[4] Boston Childrens Hosp, Div Infect Dis, Precis Vaccines Program, Boston, MA - USA

^[5] Univ Fed Bahia, Fac Med Bahia, Salvador, BA - Brazil

^[6] Butantan Inst, Lab Virol, Dev & Innovat Ctr, Sao Paulo - Brazil

^[7] Univ Sao Paulo, Inst Ciencias Biomed, Dept Microbiol, Sao Paulo - Brazil

^[8] Univ Sao Paulo, Inst Ciencias Biomed, Dept Microbiol, Lab Desenvolvimento Vacinas, Sao Paulo - Brazil

^[9] Sci Platform Pasteur USP, Sao Paulo - Brazil

• Document type: Journal article
• Source: PLoS Neglected Tropical Diseases; v. 15, n. 7 JUL 2021.
• Web of Science Citations: 0

Abstract

This study aims to describe the sociodemographic determinants associated with exposure to Zika Virus (ZIKV) in pregnant women during the 2015-2016 epidemic in Salvador, Brazil. Methods We recruited women who gave birth between October 2015 and January 2016 to a cross-sectional study at a referral maternity hospital in Salvador, Brazil. We collected information on their demographic, socioeconomic, and clinical characteristics, and evaluated their ZIKV exposure using a plaque reduction neutralization test. Logistic regression was then used to assess the relationship between these social determinants and ZIKV exposure status. Results We included 469 pregnant women, of whom 61% had a positive ZIKV result. Multivariate analysis found that lower education (adjusted Prevalence Rate {[}aPR] 1.21; 95%CI 1.04-1.35) and food insecurity (aPR 1.17; 95%CI 1.01-1.30) were positively associated with ZIKV exposure. Additionally, age was negatively associated with the infection risk (aPR 0.99; 95%CI 0.97-0.998). Conclusion Eve after controlling for age, differences in key social determinants, as education and food security, were associated with the risk of ZIKV infection among pregnant women in Brazil. Our findings elucidate risk factors that can be targeted by future interventions to reduce the impact of ZIKV infection in this vulnerable population. Author summary The Zika virus (ZIKV) epidemic in Brazil has intensified global concern about congenital defects associated with intrauterine exposure. Social determinants are factors that reinforce and contribute to the transmission and spread of ZIKV as well as other arboviruses like Dengue. We performed a cross-sectional study to describe the prevalence of ZIKV and the contribution of social determinants to transmission among pregnant women during the 2015-2016 ZIKV epidemic in Salvador, Brazil. We found that 61% of pregnant women were ZIKV seropositive. We also found that lower education level, food insecurity and lower maternal age were associated with higher ZIKV infection risk. These findings contribute to understanding the role of social determinants in ZIKV transmission, providing key social factors that can be combined with pre-existing tactics (vector control and environmental improvement) to create policies and interventions which reduce social inequalities and risk of infection in vulnerable populations like pregnant women. (AU)

• FAPESP's process: 16/20045-7 - Antigen discovery and development of serological diagnostic methods and vaccine approaches against the Zika Virus (ZIKV)
• Grantee: Luis Carlos de Souza Ferreira
• Support Opportunities: Research Projects - Thematic Grants