Analysis of the spatial distribution of cases of Zika virus infection and congenital Zika virus syndrome in a state in the southeastern region of Brazil: Sociodemographic factors and implications for public health

Abstract

Objective: To perform spatial distribution analysis of reported cases of Zika virus and congenital Zika syndrome (CZS) in the state of Espírito Santo, Brazil, by neighborhood, and relate the results to sociodemographic indicators and implications for the health process. Methods: An ecological study using data from the 2016 National Notifiable Diseases Surveillance System, epidemiological records, and information on neighborhoods of families confirmed with CZS from qualitative field research. Results: Sociodemographic indicators were analyzed in three distinct groups: general population with Zika virus, pregnant women with Zika virus, and cases of CZS visited.For the three groups, average literacy rates were 71.1%, 71.0%, and 68.3%; the average income per minimum wage was 1.4, 1.1, and 1.4; sanitary sewage coverage was 75.6%, 76.1%, and 71.4%; garbage coverage was 90.8%, 91.2%, and 89.2%; and water supply was 93.8%, 94.1% and 93.8%, respectively. Socioeconomic indicators showed no significant differences between groups, although they were above the national average. A nonsignificant variation of 68.3%-71.1% was seen in the average literacy level above 15 years of age. Conclusion: Socioeconomic and demographic indicators of cases of Zika virus infectionand CZS may indicate that the outbreak had different impacts according to class, social group, or gender, reflecting the persistence and social geography of inequality in Brazil.

Association between socio-environmental factors, coverage by family health teams, and rainfall in the spatial distribution of Zika virus infection in the city of Rio de Janeiro, Brazil, in 2015 and 2016

“…In order to avoid new outbreaks of the disease, it is thus necessary to identify the risk factors for ZIKV. As with other arbovirus infections such as dengue (DENV) and chikungunya (CHIKV), the highest incidence of ZIKV also appears to affect areas with greater social inequality [ 9 – 13 ].…”

Research and research capacity strengthening in the context of an emerging epidemic: Zika virus in Latin America

“…Gomez and Ocampo further highlight women's dissatisfaction with the healthcare system, delayed access to care due to socioeconomic inequities, and high out‐of‐pocket expenses. Freitas et al., Salvador Mocelin et al., and Tirado et al . found, through their separate qualitative assessments of affected women in Brazil and Colombia, that the combined social and medical impact of Zika virus infection disproportionately affects women and is closely linked to poverty—confirming the findings of others—and stressing the inequitable impact of the epidemic.…”

Climatic and socio-economic factors supporting the co-circulation of dengue, Zika and chikungunya in three different ecosystems in Colombia

“…Bello, the municipality with the lowest burden of Aedes borne viruses also had the lowest poverty index, whilst Cúcuta and Moniquirá were much higher in both disease incidence and multidimensional poverty. Higher incidence of Aedes borne disease has been associated with lower socio-economic status and higher poverty levels [120][121][122][123][124][125][126][127]. Cúcuta had the highest rate of critical overcrowding.…”

“…Overcrowding has been reported to be an important contributing factor to dengue incidence [119][120][121]128]. Inadequate sanitation, and no access to improved sources of water are both well-known contributing factors in increasing burden of Aedes borne disease due to the ecology of Aedes mosquitoes [26,119,[123][124][125]129]. These socio-economic risk factors were highest in Moniquirá where there were also high levels of low educational achievement and illiteracy.…”