Managing an epidemic: Zika interventions and community responses in Belize

Caring for children with Congenital Zika Syndrome: The unmet needs of mothers in Southern Colombia

ABSTRACTIn Latin America, the Zika virus (ZIKV) epidemic of 2015-2016 resulted in children being born with a spectrum of neurological disorders called Congenital Zika Syndrome (CZS). Women are the primary caregivers of those children. The objective of the study was to identify the perceived needs of women to care for their children with CZS in Southern Colombia. In 2019, a qualitative ethnographic study was conducted in southern Colombia, including 21 women belonging to a self-managed support group and who had prenatal ZIKV between 2015 and 2016 and, as a consequence, their children were born with CZS. Three discussion groups and six semi-structured interviews were conducted and analyzed through qualitative content analysis. Three main perceived needs to care for their children were identified: knowledge and skills to provide the complex care their children require and for which they did not feel prepared, economic and social support. This study showed that women face unmet needs when caring for their children with CZS, especially regarding social support. Therefore, it is urgent to generate public policies and intervention strategies for professionals to support these women in order to meet not only the needs of their children but also their own.

Social risks, economic dynamics and the local politics of COVID-19 prevention in Eldoret town, Kenya

A steady and consistent national and local government leadership is crucial in times of crisis. The trust in government - which can be so fragile - was strong in Eldoret town, a large municipal in western Kenya widely known for ethnic conflicts. In our interviews with 20 business people and 30 community members from Eldoret town, we found that the trust built early in the pandemic was broken due to individual leaders who eventually dismissed public health promotion and engaged in politics and corruption of funds for COVID-19 relief. When leadership was strong, locals in Eldoret town (and especially business owners) engaged in public health prevention measures for the greater good. But when leadership slipped, people complained and eventually ignored public health prevention measures at home, on the bus, and in businesses around town, causing the intensification of outbreaks. This was most common among those engaged in the formal economy as those in the informal economy were more likely to mistrust the government altogether. We show who falls through the cracks when government policy targets viral threats and suggest how local government and public health agencies might work to control COVID-19 infections while ensuring that all Eldoret residents are cared for.

Emerging Mosquito-Borne Viruses Linked to Aedes aegypti and Aedes albopictus: Global Status and Preventive Strategies

Emerging mosquito-borne viruses continue to cause serious health problems and economic burden among billions of people living in and near the tropical belt of the world. The highly invasive mosquito species Aedes aegypti and Aedes albopictus have successively invaded and expanded their presence as key vectors of Chikungunya virus, dengue virus, yellow fever virus, and Zika virus, and that has consecutively led to frequent outbreaks of the corresponding viral diseases. Of note, these two mosquito species have gradually adapted to the changing weather and environmental conditions leading to a shift in the epidemiology of the viral diseases, and facilitated their establishment in new ecozones inhabited by immunologically naive human populations. Many abilities of Ae. aegypti and Ae. albopictus, as vectors of significant arbovirus pathogens, may affect the infection and transmission rates after a bloodmeal, and may influence the vector competence for either virus. We highlight that many collaborating risk factors, for example, the global transportation systems may result in sporadic and more local outbreaks caused by mosquito-borne viruses related to Ae. aegypti and/or Ae. albopictus. Those local outbreaks could in synergy grow and produce larger epidemics with pandemic characters. There is an urgent need for improved surveillance of vector populations, human cases, and reliable prediction models. In summary, we recommend new and innovative strategies for the prevention of these types of infections.

How can countries create outbreak response policies that are sensitive to maternal health?

Ensuring women’s need for sexual and reproductive healthcare are met should be a priority during disease outbreaks, say Maira L S Takemoto and colleagues

On the front line: Health professionals and system preparedness for Zika virus in Peru

Objectives

To analyze the initial healthcare response to the Zika virus in Piura, Peru, and assess the perceptions of midwives and nurses regarding their role in prevention of Zika virus and management of congenital Zika syndrome (CZS).

Methods

This ethnographic study used a rapid qualitative assessment design. Data were collected through a focus group with midwives and in‐depth interviews with midwives (n=11) and nurses (n=5).

Results

The focus of the early Zika virus response in Piura was on pregnant women and vector control. Midwives received some training on Zika‐related care during the early response. Nurses did not receive any Zika‐specific training. Neither nurses nor midwives were trained in neonatal CZS surveillance. Midwives were clear about the value and feasibility of incorporating Zika virus surveillance in their daily work, however nurses were not. They referred to lack of training and appropriate tools as limitations. Confusion about Zika virus and CZS symptomatology and effects persisted in both groups. Concerns about their own personal risk influenced the ways they engaged with Zika virus prevention in the community.

Conclusion

Long‐term management of endemic Zika virus in Piura will require the engagement of both nurses and midwives as primary care providers.

A cost‐effective and culturally competent approach should include a broader focus on family planning and child development surveillance. This requires cross‐disciplinary collaboration between nurses and midwives.