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Neighbourhood-level income and Zika virus infection during pregnancy in Recife, Pernambuco, Brazil: an ecological perspective, 2015–2017

Zika virus (ZIKV) infections during pregnancy can lead to adverse neurodevelopmental and clinical outcomes in congenitally infected offspring. As the city of Recife in Pernambuco State, Brazil—the epicentre of the Brazilian microcephaly epidemic—has considerable disparities in living conditions, thi...

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Autores principales: Lobkowicz, Ludmila, Power, Grace M, De Souza, Wayner Vieira, Montarroyos, Ulisses Ramos, Martelli, Celina Maria Turchi, de Araùjo, Thalia Velho Barreto, Bezerra, Luciana Caroline Albuquerque, Dhalia, Rafael, Marques, Ernesto T A, Miranda-Filho, Demócrito de Barros, Brickley, Elizabeth B, Ximenes, Ricardo Arraes de Alencar
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8640636/
https://www.ncbi.nlm.nih.gov/pubmed/34857522
http://dx.doi.org/10.1136/bmjgh-2021-006811
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author Lobkowicz, Ludmila
Power, Grace M
De Souza, Wayner Vieira
Montarroyos, Ulisses Ramos
Martelli, Celina Maria Turchi
de Araùjo, Thalia Velho Barreto
Bezerra, Luciana Caroline Albuquerque
Dhalia, Rafael
Marques, Ernesto T A
Miranda-Filho, Demócrito de Barros
Brickley, Elizabeth B
Ximenes, Ricardo Arraes de Alencar
author_facet Lobkowicz, Ludmila
Power, Grace M
De Souza, Wayner Vieira
Montarroyos, Ulisses Ramos
Martelli, Celina Maria Turchi
de Araùjo, Thalia Velho Barreto
Bezerra, Luciana Caroline Albuquerque
Dhalia, Rafael
Marques, Ernesto T A
Miranda-Filho, Demócrito de Barros
Brickley, Elizabeth B
Ximenes, Ricardo Arraes de Alencar
author_sort Lobkowicz, Ludmila
collection PubMed
description Zika virus (ZIKV) infections during pregnancy can lead to adverse neurodevelopmental and clinical outcomes in congenitally infected offspring. As the city of Recife in Pernambuco State, Brazil—the epicentre of the Brazilian microcephaly epidemic—has considerable disparities in living conditions, this study used an ecological approach to investigate the association between income at the neighbourhood level and the risk of ZIKV infections in pregnant individuals between December 2015 and April 2017. The spatial distribution of pregnant individuals with ZIKV infection was plotted on a map of Recife stratified into four categories based on mean monthly income of household heads. Additionally, a Poisson regression model with robust variance was fitted to compare proportions of ZIKV infections among pregnant individuals in relation to the mean monthly income of household heads, based on the 2010 census data, across 94 neighbourhoods in Recife. The results provide evidence that the risk of ZIKV infection to pregnant individuals was higher among those residing in lower-income neighbourhoods: relative to neighbourhoods that had a mean monthly income of ≥5 times minimum wage, neighbourhoods with <1 and 1 to <2 times minimum wage had more than four times the risk (incidence rate ratio, 95% CI 4.08, 1.88 to 8.85 and 4.30, 2.00 to 9.20, respectively). This study provides evidence of a strong association between neighbourhood-level income and ZIKV infection risks in the pregnant population of Recife. In settings prone to arboviral outbreaks, locally targeted interventions to improve living conditions, sanitation, and mosquito control should be a key focus of governmental interventions to reduce risks associated with ZIKV infections during pregnancy.
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spelling pubmed-86406362021-12-15 Neighbourhood-level income and Zika virus infection during pregnancy in Recife, Pernambuco, Brazil: an ecological perspective, 2015–2017 Lobkowicz, Ludmila Power, Grace M De Souza, Wayner Vieira Montarroyos, Ulisses Ramos Martelli, Celina Maria Turchi de Araùjo, Thalia Velho Barreto Bezerra, Luciana Caroline Albuquerque Dhalia, Rafael Marques, Ernesto T A Miranda-Filho, Demócrito de Barros Brickley, Elizabeth B Ximenes, Ricardo Arraes de Alencar BMJ Glob Health Original Research Zika virus (ZIKV) infections during pregnancy can lead to adverse neurodevelopmental and clinical outcomes in congenitally infected offspring. As the city of Recife in Pernambuco State, Brazil—the epicentre of the Brazilian microcephaly epidemic—has considerable disparities in living conditions, this study used an ecological approach to investigate the association between income at the neighbourhood level and the risk of ZIKV infections in pregnant individuals between December 2015 and April 2017. The spatial distribution of pregnant individuals with ZIKV infection was plotted on a map of Recife stratified into four categories based on mean monthly income of household heads. Additionally, a Poisson regression model with robust variance was fitted to compare proportions of ZIKV infections among pregnant individuals in relation to the mean monthly income of household heads, based on the 2010 census data, across 94 neighbourhoods in Recife. The results provide evidence that the risk of ZIKV infection to pregnant individuals was higher among those residing in lower-income neighbourhoods: relative to neighbourhoods that had a mean monthly income of ≥5 times minimum wage, neighbourhoods with <1 and 1 to <2 times minimum wage had more than four times the risk (incidence rate ratio, 95% CI 4.08, 1.88 to 8.85 and 4.30, 2.00 to 9.20, respectively). This study provides evidence of a strong association between neighbourhood-level income and ZIKV infection risks in the pregnant population of Recife. In settings prone to arboviral outbreaks, locally targeted interventions to improve living conditions, sanitation, and mosquito control should be a key focus of governmental interventions to reduce risks associated with ZIKV infections during pregnancy. BMJ Publishing Group 2021-12-02 /pmc/articles/PMC8640636/ /pubmed/34857522 http://dx.doi.org/10.1136/bmjgh-2021-006811 Text en © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY. Published by BMJ. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: https://creativecommons.org/licenses/by/4.0/.
spellingShingle Original Research
Lobkowicz, Ludmila
Power, Grace M
De Souza, Wayner Vieira
Montarroyos, Ulisses Ramos
Martelli, Celina Maria Turchi
de Araùjo, Thalia Velho Barreto
Bezerra, Luciana Caroline Albuquerque
Dhalia, Rafael
Marques, Ernesto T A
Miranda-Filho, Demócrito de Barros
Brickley, Elizabeth B
Ximenes, Ricardo Arraes de Alencar
Neighbourhood-level income and Zika virus infection during pregnancy in Recife, Pernambuco, Brazil: an ecological perspective, 2015–2017
title Neighbourhood-level income and Zika virus infection during pregnancy in Recife, Pernambuco, Brazil: an ecological perspective, 2015–2017
title_full Neighbourhood-level income and Zika virus infection during pregnancy in Recife, Pernambuco, Brazil: an ecological perspective, 2015–2017
title_fullStr Neighbourhood-level income and Zika virus infection during pregnancy in Recife, Pernambuco, Brazil: an ecological perspective, 2015–2017
title_full_unstemmed Neighbourhood-level income and Zika virus infection during pregnancy in Recife, Pernambuco, Brazil: an ecological perspective, 2015–2017
title_short Neighbourhood-level income and Zika virus infection during pregnancy in Recife, Pernambuco, Brazil: an ecological perspective, 2015–2017
title_sort neighbourhood-level income and zika virus infection during pregnancy in recife, pernambuco, brazil: an ecological perspective, 2015–2017
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8640636/
https://www.ncbi.nlm.nih.gov/pubmed/34857522
http://dx.doi.org/10.1136/bmjgh-2021-006811
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