Socioeconomic disparities associated with symptomatic Zika virus infections in pregnancy and congenital microcephaly: A spatiotemporal analysis from Goiânia, Brazil (2016 to 2020).

Autor: Rosado LEP; Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Brazil.; Department of Obstetrics, of Maternal Children's Hospital, Goiania, Brazil., Aquino EC; Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Brazil., Brickley EB; Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom., França DDDS; Department of Surveillance, Health Secretary of Goiania, Goiania, Brazil., Silva FPA; Department of Surveillance, Health Secretary of Goiania, Goiania, Brazil., Silva VLD; Public Health Laboratory of Goias, Goiania, Brazil., Lopes AF; Faculty of Pharmacy, Federal University of Goias, Goiânia, Brazil., Turchi MD; Institute of Tropical Pathology and Public Health, Federal University of Goiás, Goiânia, Brazil.
Jazyk: angličtina
Zdroj: PLoS neglected tropical diseases [PLoS Negl Trop Dis] 2022 Jun 17; Vol. 16 (6), pp. e0010457. Date of Electronic Publication: 2022 Jun 17 (Print Publication: 2022).
DOI: 10.1371/journal.pntd.0010457
Abstrakt: The Zika virus (ZIKV) epidemic, which was followed by an unprecedented outbreak of congenital microcephaly, emerged in Brazil unevenly, with apparent pockets of susceptibility. The present study aimed to detect high-risk areas for ZIKV infection and microcephaly in Goiania, a large city of 1.5 million inhabitants in Central-West Brazil. Using geocoded surveillance data from the Brazilian Information System for Notifiable Diseases (SINAN) and from the Public Health Event Registry (RESP-microcefalia), we analyzed the spatiotemporal distribution and socioeconomic indicators of laboratory confirmed (RT-PCR and/or anti-ZIKV IgM ELISA) symptomatic ZIKV infections among pregnant women and clinically confirmed microcephaly in neonates, from 2016 to 2020. We investigated temporal patterns by estimating the risk of symptomatic maternal ZIKV infections and microcephaly per 1000 live births per month. We examined the spatial distribution of maternal ZIKV infections and microcephaly cases across the 63 subdistricts of Goiania by manually plotting the geographical coordinates. We used spatial scan statistics estimated by discrete Poisson models to detect high clusters of maternal ZIKV infection and microcephaly and compared the distributions by socioeconomic indicators measured at the subdistrict level. In total, 382 lab-confirmed cases of maternal ZIKV infections, and 31 cases of microcephaly were registered in the city of Goiania. More than 90% of maternal cases were reported between 2016 and 2017. The highest incidence of ZIKV cases among pregnant women occurred between February and April 2016. A similar pattern was observed in the following year, although with a lower number of cases, indicating seasonality for ZIKV infection, during the local rainy season. Most congenital microcephaly cases occurred with a time-lag of 6 to 7 months after the peak of maternal ZIKV infection. The highest estimated incidence of maternal ZIKV infections and microcephaly were 39.3 and 2.5 cases per 1000 livebirths, respectively. Districts with better socioeconomic indicators and with higher proportions of self-identified white inhabitants were associated with lower risks of maternal ZIKV infection. Overall, the findings indicate heterogeneity in the spatiotemporal patterns of maternal ZIKV infections and microcephaly, which were correlated with seasonality and included a high-risk geographic cluster. Our findings identified geographically and socio-economically underprivileged groups that would benefit from targeted interventions to reduce exposure to vector-borne infections.
Competing Interests: The authors have declared that no competing interests exist.
Databáze: MEDLINE
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