Epidemic preparedness: Prenatal Zika virus screening during the next epidemic.

Autor:	Qiao L; Health Equity Action Lab, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK.; School of Medicine, Washington University in St Louis, St Louis, Missouri, USA., Martelli CMT; Instituto Aggeu Magalhães, Fundação Oswaldo Cruz, Recife, Pernambuco, Brasil., Raja AI; Health Equity Action Lab, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK., Sanchez Clemente N; Health Equity Action Lab, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK., de Araùjo TVB; Departamento de Medicina Social, Universidade Federal de Pernambuco, Recife, Pernambuco, Brasil., Ximenes RAA; Departamento de Medicina Tropical, Universidade Federal de Pernambuco, Recife, Pernambuco, Brasil.; Departamento de Medicina Interna, Universidade de Pernambuco, Recife, Pernambuco, Brasil., Miranda-Filho DB; Departamento de Medicina Interna, Universidade de Pernambuco, Recife, Pernambuco, Brasil., Ramond A; Health Equity Action Lab, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK., Brickley EB; Health Equity Action Lab, Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK elizabeth.brickley@lshtm.ac.uk.
Jazyk:	angličtina
Zdroj:	BMJ global health [BMJ Glob Health] 2021 Jun; Vol. 6 (6).
DOI:	10.1136/bmjgh-2021-005332
Abstrakt:	Zika virus (ZIKV) is a vectorborne infectious agent of global public health significance due to its potential to cause severe teratogenic outcomes. The question of whether health systems should consider adopting screening programmes for ZIKV infections during pregnancy warrants consideration. In this analysis, we apply the Wilson-Jungner framework to appraise the potential utility of a prenatal ZIKV screening programme, outline potential screening strategies within the case-finding pathway, and consider other epidemiological factors that may influence the planning of such a screening programme. Our evaluation of a potential prenatal ZIKV screening programme highlights factors affirming its usefulness, including the importance of Congenital Zika Syndrome as a public health problem and the existence of analogous congenital prenatal screening programmes for STORCH agents (syphilis, toxoplasmosis, others (eg, human immunodeficiency virus, varicella-zoster virus, parvovirus B19), rubella, cytomegalovirus, and herpes simplex virus). However, our assessment also reveals key barriers to implementation, such as the need for more accurate diagnostic tests, effective antiviral treatments, increased social service capacity, and surveillance. Given that the reemergence of ZIKV is likely, we provide a guiding framework for policymakers and public health leaders that can be further elaborated and adapted to different contexts in order to reduce the burden of adverse ZIKV-related birth outcomes during future outbreaks. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ.)
Databáze:	MEDLINE
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