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Petra PC, Marbán-Castro E, Matta G, Sánchez CMH, Pimentel C, Gama GL, Melo A, Daza M, Amado AM, Montoya MCM, Maxwell L, Pérez EA, Mercado M, Paiva E. Pregnant women's perceptions on Information Sources on Zika Virus: a qualitative study. PHYSIS (RIO DE JANEIRO, BRAZIL) 2024; 34:e34SP112. [PMID: 38966594 PMCID: PMC11221405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 07/06/2024]
Abstract
The Zika virus (ZIKV) epidemic had a sanitary, psychosocial, and economic impact on individuals of reproductive age. The primary concern revolved around infection during pregnancy due to possible vertical transmission and its association with adverse fetal and infant outcomes, known as Congenital Zika Syndrome (CZS). This qualitative study employs phenomenology and grounded theory. This study includes interviews with 98 women, some pregnant during the ZIKV epidemic in Brazil, Colombia, and Puerto Rico, who had children with CZS or without diagnosed neurological impairment. Additionally, the study included a group of women who were pregnant during the COVID-19 pandemic in these same countries. In both groups, interviewees had varying levels of knowledge about ZIKV. The study found that messages conveyed through the media tended to be alarmist, in contrast to the information provided by healthcare professionals, which was considered more trustworthy. Pregnant women during the ZIKV epidemic reported receiving their ZIKV and CSZ infection diagnoses late, either during or after childbirth. The study underscores the needs of pregnant women in high-risk scenarios, the importance of health education processes, and the necessity to reinforce communication and continuing education.
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Affiliation(s)
| | | | - Gustavo Matta
- Escola Nacional de Saúde Pública, Fiocruz. Rio de Janeiro-RJ, Brazil
| | | | | | - Gabriela Lopes Gama
- Instituto de Pesquisa Professor Joaquim Amorim Neto. Campina Grande-PB, Brazil
| | - Adriana Melo
- Grupo de Epidemiología Clínica, Universidad Industrial de Santander, Bucaramanga, Santander, Colombia
| | | | | | | | - Lauren Maxwell
- Heidelberg Institute for Global Health, Heidelberg University, Heidelberg Germany
| | - Edna Acosta Pérez
- University of Puerto Rico, Medical Sciences Campus, / University Albizu, San Juan, Puerto Rico
| | | | - Ester Paiva
- Escola Nacional de Saúde Pública, Fiocruz. Rio de Janeiro-RJ, Brazil
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Whitfield B, Marteleto L. Women's Attitudes Towards Abortion in Response to the Zika and COVID-19 Outbreaks in Brazil. SEXUALITY RESEARCH & SOCIAL POLICY : JOURNAL OF NSRC : SR & SP 2023:1-17. [PMID: 37363355 PMCID: PMC10185939 DOI: 10.1007/s13178-023-00813-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 03/29/2023] [Indexed: 06/28/2023]
Abstract
Introduction Abortion attitudes are influenced by people's socioeconomic and demographic circumstances and can be volatile during times of crisis. Brazil is an interesting case for examining abortion attitudes because of its strict abortion policies, changing religious landscape, high income inequality, and extreme uncertainty generated by the back-to-back Zika and COVID-19 crises. This study seeks to assess Brazilian women's attitudes toward abortion and whether religion and income explain these attitudes in the context of novel infectious disease epidemics. Methods We used data from a population-based sample of 3996 women ages 18-34 in Pernambuco, Brazil, collected during the onset of the COVID-19 pandemic (May-September 2020). We conducted paired t-tests and multivariate-adjusted logistic regression models with adjusted Odds Ratios (aORs) and 95% CIs to assess differences in support for abortion in the case of fetal congenital Zika syndrome (CZS), maternal Zika infection during pregnancy, and maternal COVID-19 infection during pregnancy. Results Significantly more women support the right to abortion in the case of fetal CZS (50%) than in the case of maternal Zika infection (40%) and maternal COVID-19 infection (31%). Support for abortion varies by income and religion. Controlling for other demographic characteristics, high-income women have higher odds of supporting abortion in the case of fetal CZS (aOR = 1.92; 95% CI: 1.25-2.94) and maternal Zika infection (aOR = 2.07; 95% CI: 1.33-3.21) than low-income women. Evangelical women have lower odds of supporting abortion in the case of maternal Zika infection (aOR = 0.65; 95% CI: 0.45-0.93) and marginally lower odds of supporting the right to abortion in the case of maternal COVID-19 infection (aOR = 0.69; 95% CI: 0.47-1.00) than women of other religious affiliations. Conclusions and Policy Implications With increasingly conservative religious groups gaining size in Brazil, we expect to see increasing abortion restrictions. However, this research finds that a sizable portion of women across all incomes and religious affiliations support abortion, particularly in the case of fetal anomalies associated with Zika.
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Affiliation(s)
- Brooke Whitfield
- Population Research Center, University of Texas at Austin, 305 E 23rd St. G1800, Austin, TX 78712 USA
| | - Leticia Marteleto
- Population Research Center, University of Texas at Austin, 305 E 23rd St. G1800, Austin, TX 78712 USA
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TORCH Congenital Syndrome Infections in Central America's Northern Triangle. Microorganisms 2023; 11:microorganisms11020257. [PMID: 36838223 PMCID: PMC9964893 DOI: 10.3390/microorganisms11020257] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 01/08/2023] [Accepted: 01/16/2023] [Indexed: 01/21/2023] Open
Abstract
TORCH pathogens are a group of globally prevalent infectious agents that may cross the placental barrier, causing severe negative sequalae in neonates, including fetal death and lifelong morbidity. TORCH infections are classically defined by Toxoplasma gondii, other infectious causes of concern (e.g., syphilis, Zika virus, malaria, human immunodeficiency virus), rubella virus, cytomegalovirus, and herpes simplex viruses. Neonatal disorders and congenital birth defects are the leading causes of neonatal mortality in Central America's Northern Triangle, yet little is known about TORCH congenital syndrome in this region. This review synthesizes the little that is known regarding the most salient TORCH infections among pregnant women and neonates in Central America's Northern Triangle and highlights gaps in the literature that warrant further research. Due to the limited publicly available information, this review includes both peer-reviewed published literature and university professional degree theses. Further large-scale studies should be conducted to clarify the public health impact these infections in this world region.
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Stein RA, Grayon A, Katz A, Chervenak FA. The Zika virus: an opportunity to revisit reproductive health needs and disparities. Germs 2022; 12:519-537. [PMID: 38021183 PMCID: PMC10660223 DOI: 10.18683/germs.2022.1357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 10/24/2022] [Accepted: 12/29/2022] [Indexed: 12/01/2023]
Abstract
First isolated in 1947, the Zika virus was initially connected only to limited or sporadic human infections. In late 2015, the temporal clustering of a Zika outbreak and microcephaly in newborn babies from northeastern Brazil, and the identification of a causal link between the two, led to the characterization of the congenital Zika syndrome. In the wake of the epidemic, several countries from Latin America advised women to postpone pregnancies for periods ranging from six months to two years. These recommendations initiated critical conversations about the challenges of implementing them in societies with limited access to contraception, widespread socioeconomic inequalities, and high rates of unplanned and adolescent pregnancies. The messaging targeted exclusively women, despite a high prevalence of imbalances in the relationship power, and addressed all women as a group, failing to recognize that the decision to postpone pregnancies will impact different women in different ways, depending on their age at the time. Finally, in several countries affected by the Zika epidemic, due to restrictive reproductive policies, legally terminating a pregnancy is no longer an option even at the earliest time when brain malformations as part of the congenital Zika syndrome can be detected by ultrasonography. The virus continued to circulate after 2016 in several countries. Climate change models predict an expansion of the geographical area where local Zika transmission may occur, indicating that the interface between the virus, teratogenesis, and reproductive rights is a topic of considerable interest for medicine, social sciences, and public health for years to come.
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Affiliation(s)
- Richard A. Stein
- MD, PhD, NYU Tandon School of Engineering, Department of Chemical and Biomolecular Engineering, 6 MetroTech Center, Brooklyn 11201, NY, USA
| | - Alexis Grayon
- NYU Tandon School of Engineering, Department of Chemical and Biomolecular Engineering, 6 MetroTech Center, Brooklyn 11201, NY, USA
| | - Adi Katz
- MD, Department of Obstetrics and Gynecology, Lenox Hill Hospital, Donald and Barbara Zucker School of Medicine at Hofstra Northwell, 110 E 77th Street, New York, NY, 10075, USA
| | - Frank A. Chervenak
- MD, Department of Obstetrics and Gynecology, Lenox Hill Hospital, Donald and Barbara Zucker School of Medicine at Hofstra Northwell, 110 E 77th Street, New York, NY, 10075, USA
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Marbán-Castro E, Enguita-Fernàndez C, Romero-Acosta KC, Arrieta GJ, Marín-Cos A, Mattar S, Menéndez C, Maixenchs M, Bardají A. “One feels anger to know there is no one to help us!”. Perceptions of mothers of children with Zika virus-associated microcephaly in Caribbean Colombia: A qualitative study. PLoS Negl Trop Dis 2022; 16:e0010328. [PMID: 35436298 PMCID: PMC9015150 DOI: 10.1371/journal.pntd.0010328] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 03/14/2022] [Indexed: 01/07/2023] Open
Abstract
Background
The epidemic of Zika virus (ZIKV) was associated with a sudden and unprecedented increase in infants born with microcephaly. Colombia was the second most affected country by the epidemic in the Americas. Primary caregivers of children with ZIKV-associated microcephaly, their mothers mainly, were at higher risk of suffering anxiety and depression. Often, these women were stigmatized and abandoned by their partners, relatives, and communities.
Methodology/Principal findings
This study aimed to understand the perceptions about ZIKV infection among mothers of children born with microcephaly during the ZIKV epidemic in Caribbean Colombia, and the barriers and facilitators affecting child health follow-up. An exploratory qualitative study, based on Phenomenology and Grounded Theory, was conducted in Caribbean Colombia. Data were collected through In-Depth Interviews (IDI) from women who delivered a baby with microcephaly during the ZIKV epidemic at Clínica Salud Social, Sincelejo, Sucre District (N = 11). The themes that emerged during the interviews included experiences from their lives before pregnancy; knowledge about ZIKV; experiences and perceptions when diagnosed; considering a possible termination of pregnancy, and children’s clinical follow-up. In some cases, women reported having been told they were having a baby with microcephaly but decided not to terminate the pregnancy; while in other cases, women found out about their newborn’s microcephaly condition only at birth. The main barriers encountered by participants during children’s follow-up included the lack of psychosocial and economic support, the stigmatization and abandonment by some partners and relatives, and the frustration of seeing the impaired development of their children.
Conclusions
This study contributed to identifying the social, medical, psychological, and economic needs of families with children affected by the ZIKV epidemic. Commitment and action by local and national governments, and international bodies, is required to ensure sustained and quality health services by affected children and their families.
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Affiliation(s)
- Elena Marbán-Castro
- ISGlobal, Hospital Clínic—Universitat de Barcelona, Barcelona, Spain
- * E-mail:
| | | | | | - Germán J. Arrieta
- Corporación Universitaria del Caribe (CECAR), Group of Public Health, Sincelejo, Sucre, Colombia
- Clínica Salud Social, Sincelejo, Sucre, Colombia
- Universidad de Córdoba—Instituto de investigaciones biológicas del Trópico, Montería, Córdoba, Colombia
| | - Anna Marín-Cos
- ISGlobal, Hospital Clínic—Universitat de Barcelona, Barcelona, Spain
| | - Salim Mattar
- Clínica Salud Social, Sincelejo, Sucre, Colombia
- Universidad de Córdoba—Instituto de investigaciones biológicas del Trópico, Montería, Córdoba, Colombia
| | - Clara Menéndez
- ISGlobal, Hospital Clínic—Universitat de Barcelona, Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
| | - Maria Maixenchs
- ISGlobal, Hospital Clínic—Universitat de Barcelona, Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Azucena Bardají
- ISGlobal, Hospital Clínic—Universitat de Barcelona, Barcelona, Spain
- Consorcio de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
- Centro de Investigação em Saúde de Manhiça (CISM), Maputo, Mozambique
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Pitchforth E, Hussein J. Moving ahead together, on a foundation of rights-based evidence. Sex Reprod Health Matters 2021; 29:1913788. [PMID: 33882795 PMCID: PMC8079037 DOI: 10.1080/26410397.2021.1913788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Emma Pitchforth
- Executive Editor (incoming), Sexual and Reproductive Health Matters, London, UK
| | - Julia Hussein
- Editor-in-Chief (outgoing), Sexual and Reproductive Health Matters, London, UK
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