Association between Knowledge of Zika Transmission and Preventative Measures among Latinas of Childbearing Age in Farm-Working Communities in South Florida

Knowledge of Sexual Transmission of Zika Virus Among Women Who Are Pregnant or Intend to Become Pregnant, Arizona, 2017

OBJECTIVES

Levels of knowledge about the sexual transmission of Zika virus are consistently low in populations at risk of a mosquito-borne outbreak, including among women of childbearing age and women who are pregnant or intend to become pregnant. We investigated the effectiveness of sources of public health messaging about sexual transmission to women who are pregnant or intend to become pregnant in Arizona.

METHODS

In 2017, we conducted an Arizona-statewide survey 15 months after the initial release of US guidelines on sexual transmission of Zika virus. We used Poisson regression, adjusting for demographic factors, to estimate the likelihood among women who were pregnant or intended to become pregnant of knowing that Zika virus is sexually transmitted relative to other women of childbearing age. We used multinomial logistic regression models to explore associations with most used health information sources, either in person (eg, medical providers) or online (eg, Facebook), categorized by extent of dependability.

RESULTS

Women who were pregnant or intended to become pregnant had similarly poor knowledge of the sexual transmission of Zika virus as compared with other women of childbearing age (adjusted prevalence ratio = 1.14 [95% CI, 0.83-1.55]). Only about one-third of all respondents reported knowledge of sexual transmission. Reliance on high- vs low-dependability information sources, whether in person or online, did not predict the extent of Zika virus knowledge among women who were pregnant or intended to become pregnant.

CONCLUSION

As late as the second year of local Zika virus transmission in the United States, in 2017, women in Arizona were not receiving sufficient information about sexual transmission, even though it was available. To prepare for possible future outbreaks, research should explore which aspects of Zika information campaigns were ineffective or inefficient.

Acceptability of a Hypothetical Zika Vaccine among Women from Colombia and Spain Exposed to ZIKV: A Qualitative Study

Zika virus (ZIKV) can cause pregnancy loss and congenital Zika syndrome, among other poor health outcomes. The ZIKV epidemic in 2015-2017 disproportionately affected pregnant women in poor-resource settings. We aimed to understand perceptions and attitudes towards a hypothetical ZIKV vaccine, women's willingness to be vaccinated, and potential barriers and facilitators for vaccine acceptance in 1) migrant women living in Spain who travelled to their countries of origin and were diagnosed with ZIKV infection during pregnancy, and their healthcare providers, and 2) women living in Colombia who delivered a child with microcephaly. An exploratory qualitative study based on phenomenology and grounded theory was conducted. Data were collected through in-depth, paired and semi-structured interviews. Overall, women from both sites were willing to receive a hypothetical ZIKV vaccine. However, some expressed concerns of being vaccinated during pregnancy, yet they would accept it if the vaccine was recommended by a healthcare professional they trust. Main fears towards vaccination were related to vaccine safety and potential adverse effects on child's health. Women reported feeling hesitant to participate in a ZIKV vaccine trial. These results may contribute to guiding the effective delivery of future ZIKV vaccines among populations most at risk and particularly vulnerable.

Information on COVID-19 and Psychological Distress in a Sample of Non-Health Workers during the Pandemic Period

Methods by which the population should be informed when going through a pandemic such as COVID-19 have been questioned because of its influence on the adoption of preventive measures and its effects on mental health. Non-health workers are at risk of psychological distress from exposure to contaminated people or materials or by having to stay at home and adapt their activity to telework. The objective of the study is to analyze information the public receives about COVID-19 and its influence on their level of distress. For this, 1089 questionnaires from non-health workers were collected online between 26 March and 26 April 2020 in Spain, and analysed and distributed by snowball effect. 492 participants carried out essential activities away from home, and 597 did so from home. They were surveyed about information received about COVID-19 regarding its source, time, assessment, or the beliefs expressed in it. Mental health was also measured with Goldberg’s General Health Questionnaire (GHQ-12). The classification and regression tree (CART) method was used to design a binary tree with sample cases. It has been found that the time spent learning about COVID-19 and the level of knowledge about symptoms, pathways, prevention, treatment, or prognosis are associated with the level of distress, where 25% of participants were found to have spent more than 3 h daily on this activity. Social media and television are the most widely used sources, but they are considered to be of lower quality and usefulness than official sources. There is greater confidence in healthcare professionals than in the health system, and the main concern of those working away from home is spreading the virus to family members. It has been concluded that there is a need to enhance quality and truthful information on the Internet for non-health workers due to its accessibility, which should be constantly updated, a fact which international and national public bodies, research centers, and journal publishers have begun to understand during the current pandemic. Such quality information is needed to combat distress.

Uncertainties, Fear and Stigma: Perceptions of Zika Virus among Pregnant Women in Spain

Similar to other epidemics, knowledge about Zika virus (ZIKV) relies upon information often coming from outside the health system. This study aimed to explore views, perceptions and attitudes towards ZIKV among migrant women from Central and South America, diagnosed with ZIKV infection during pregnancy, and to comprehend healthcare professionals’ perceptions of ZIKV. An exploratory qualitative study, based on phenomenology and grounded theory, was conducted in Barcelona, Spain. Data were collected through in-depth and paired interviews with women diagnosed with ZIKV infection during pregnancy, and semi-structured interviews with healthcare professionals. Women showed good level of awareness of ZIKV, despite some knowledge gaps. The most consulted source of information about ZIKV was the Internet. Women expressed they suffered from anxiety and depression due to potential effects of ZIKV on their babies. They conveyed their sources of support came primarily from their partners and relatives, as well as healthcare professionals. This study stresses the dramatic health, social and emotional burden that the epidemic imposed on migrant women infected with ZIKV during pregnancy. These results may help guide psychosocial support and health measures for pregnant women and their children as part of the public health emergency response in emergent epidemics.

Psycho-Emotional Approach to the Psychological Distress Related to the COVID-19 Pandemic in Spain: A Cross-Sectional Observational Study

Anxiety, depression, and stress are common and expected reactions to the coronavirus disease (COVID-19) pandemic. The objective of this study is to analyze psychological distress in a sample of Spanish population, identifying the predictive nature of the information received, the preventive measures taken, level of concern, beliefs, and knowledge about the infection. A cross-sectional observational study was conducted on a sample of 4615 participants. Data were collected through a self-prepared questionnaire and the general health questionnaire (GHQ-12). Bivariate analyses and logistic regressions were performed. Of the total participants, 71.98% presented psychological distress. The study population actively sought information about coronavirus, expressed a high level of concern and knowledge, and the most frequent preventive behavior was hand washing. As predictive factors, the degree of concern for COVID-19 was identified (odds ratio (OR) = 1.244, 95% confidence interval (CI) = [1.179, 1.312]), the number of hours spent consulting information on COVID-19 (OR = 1.038, 95% CI = [1.009, 1.068]), or the need for psychological support (OR = 1.135, 95% CI = [1.094, 1.177]), among others. These results could help design more effective strategies towards a psycho-emotional approach for the population when in similar health crisis situations. There is a need for interventions aimed at the psychological well-being of the population that meet the needs of their reality.

Women's Health Perceptions and Beliefs Related to Zika Virus Exposure during the 2016 Outbreak in Northern Brazil

During the 2016 Zika pandemic in Brazil, women's perceptions of infection risk, ability to adhere to Zika prevention strategies, or access to services following exposure were not emphasized in the public health response. Women in Fortaleza, Brazil, responded to a questionnaire on social factors related to perceived Zika risk and access to health care in June 2016. Data were coded using prespecified categories, and response frequency was reported. Of 37 respondents, most reported a lack of public services to support mosquito control (n = 19) or delayed access to reproductive health care (n = 14). Only 22% described specific maternal risks or fetal outcomes as a consequence of Zika infection. Respondents indicated an overall disconnect between public health efforts and women's perceptions of their reproductive control, including limited support concerning microcephaly in infants. Interventions targeting Zika may require a greater emphasis on strengthening health systems and infrastructure to realistically prevent transmission.