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Dowling R, Kolokotronis SO, Thompson AB. Zika Virus Infection Knowledge and Communication Preferences Among Women of Reproductive Age in Central Brooklyn, New York: A Thematic Analysis. J Community Health 2024:10.1007/s10900-024-01365-2. [PMID: 38824473 DOI: 10.1007/s10900-024-01365-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2024] [Indexed: 06/03/2024]
Abstract
The 2016 outbreak of Zika virus (ZIKV) infected millions and resulted in thousands of infants born with malformations. Though the clusters of severe birth defects resulting from this outbreak have subsided, ZIKV continues to be a concern throughout much of Latin America and the Caribbean. Travel and sexual intercourse remain the dominant transmission risk factors for women of reproductive age and their partners. This is particularly true for communities in Brooklyn, New York, that comprise large immigrant and foreign-born populations. Practitioners of public health understand little about how women at risk for ZIKV are most likely to receive information about the virus or who they trust most to provide that information. In the context of five focus group discussions, this study explored the knowledge and communication preferences of 20 women of reproductive age in Central Brooklyn. Results derived from a thematic analysis suggest that while most women are familiar with mosquitos as ZIKV vectors, knowledge of sexual transmission is considerably lower. Many respondents believe that only women who are pregnant or trying to become pregnant are at risk, and public health agencies, such as the U.S. Centers for Disease Control and Prevention, remain the most trusted sources of information. These findings can support more effective communication about the risks of ZIKV infection and other vector-borne diseases to women in New York City and similar urban communities.
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Affiliation(s)
- Russell Dowling
- Department of Community Health Sciences, School of Public Health, SUNY Downstate Health Sciences University, Brooklyn, NY, USA.
| | - Sergios-Orestis Kolokotronis
- Department of Epidemiology and Biostatistics, School of Public Health, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
- Division of Infectious Diseases, Department of Medicine, College of Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
- Department of Cell Biology, College of Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
- Institute for Genomics in Health, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Azure B Thompson
- Department of Community Health Sciences, School of Public Health, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
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Dowling R, Thompson AB, Kolokotronis SO. Knowledge, Attitudes and Practices About Zika Virus Infection Among Women of Reproductive Age in Central Brooklyn, New York City, USA. J Community Health 2024; 49:78-85. [PMID: 37507524 DOI: 10.1007/s10900-023-01258-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2023] [Indexed: 07/30/2023]
Abstract
Zika virus (ZIKV) is spread by mosquitos, sexual intercourse and vertically during pregnancy. The 2015-2016 ZIKV epidemic infected millions in the Americas and resulted in thousands of infants born with malformations. Though the clusters of severe birth defects have subsided since 2017, ZIKV transmission remains a concern throughout Latin America and the Caribbean. Travel-associated and sexually-transmitted Zika, therefore, remain potential routes of transmission for women of reproductive age and their partners. This is particularly true for communities with high immigrant and foreign-born populations in Central Brooklyn, New York. Limited information has been collected on the perception by this population of ZIKV and how high-risk women engage in preventive practices. Using a survey adapted from the WHO, we assessed engagement in mosquito-related preventive practices while traveling. Data from 483 respondents on knowledge and perceived ZIKV concern, along with demographics as correlates of engagement in preventive practices were collected using a convenience sample between September 2020 and January 2021. Data were collected via a multipronged approach using social media in REDCap. Our findings show that being white/not Hispanic, pregnant, knowledgeable and concerned about ZIKV, and having enough information about ZIKV were all significantly associated with an increased likelihood of engaging in preventive practices while traveling. Multivariable logistic modeling revealed that knowledge was significantly associated with an increased likelihood of engaging in preventive practices while traveling (AOR = 1.90, 95% CI [1.28-2.83]). These findings underscore the importance of directing tailored health education efforts to vulnerable populations.
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Affiliation(s)
- Russell Dowling
- Department of Community Health Sciences, School of Public Health, SUNY Downstate Health Sciences University, Brooklyn, NY, USA.
| | - Azure B Thompson
- Department of Community Health Sciences, School of Public Health, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Sergios-Orestis Kolokotronis
- Department of Epidemiology and Biostatistics, School of Public Health, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
- Institute for Genomics in Health, School of Public Health, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
- Division of Infectious Diseases, Department of Medicine, College of Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
- Department of Cell Biology, College of Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
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SteelFisher GK, Caporello HL, Lubell KM, Ben-Porath EN, Green AR, Luo F, Briseno L, Lane L, Sheff SE, Taillepierre JD, Espino L, Boyea A. Getting Critical Information During the COVID-19 Pandemic: Experiences of Spanish and Chinese Speakers With Limited English Proficiency. Health Secur 2022; 20:273-285. [PMID: 35771967 DOI: 10.1089/hs.2021.0218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
People with limited English proficiency in the United States have suffered disproportionate negative health outcomes during the COVID-19 pandemic. Effective communications are critical tools in addressing inequities insofar as they can motivate adoption of protective behaviors and reduce incidence of disease; however, little is known about experiences of communities with limited English proficiency receiving relevant information during COVID-19 or other outbreaks. To address this gap and provide inputs for communication strategies, we completed a study based on 2 novel and nationally representative surveys conducted between June and August 2020 among Spanish and Chinese speakers with limited English proficiency (n = 764 and n = 355, respectively). Results first showed that Spanish and Chinese speakers did not consistently receive information about protective behaviors from key public health and government institutions early in the pandemic. Second, for such information, Spanish and Chinese speakers used a diverse set of information resources that included family and friends, social media, and traditional media from both inside and outside the United States. Third, Spanish and Chinese speakers faced challenges getting COVID-19 information, including receiving media messages that felt discriminatory toward Latinx or Chinese people. Together, these findings suggest gaps in effectively reaching Spanish and Chinese speakers. Data highlight the important role of bilingual materials to support sharing of information between Spanish or Chinese speakers and English speakers within their social networks, and the need for digital news content for traditional and social media. Finally, efforts are needed to address discriminatory messaging in media and to actively counter it in public health communications.
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Affiliation(s)
- Gillian K SteelFisher
- Gillian K. SteelFisher, PhD, MSc, is a Senior Research Scientist and Deputy Director, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Hannah L Caporello
- Hannah L. Caporello is Senior Research Projects Manager, Harvard Opinion Research Program, Department of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Keri M Lubell
- Keri M. Lubell, PhD, is a Behavioral Scientist, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Eran N Ben-Porath
- Eran N. Ben-Porath, PhD, is Executive Vice President, SSRS, Glen Mills, PA
| | - Alexander R Green
- Alexander R. Green, MD, MPH, was an Associate Professor of Medicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA
| | - Feijun Luo
- Feijun Luo, PhD, is a Senior Economist, National Center for Chronic Disease Prevention and Health Promotion, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Lisa Briseno
- Lisa Briseno, MS, is a Senior Health Communication Specialist, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Lindsay Lane
- Lindsay Lane, MPH, is a Health Communication Specialists, Center for Preparedness and Response, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Sarah E Sheff
- Sarah E. Sheff, PhD, is a Health Communication Specialists, Center for Preparedness and Response, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Julio Dicent Taillepierre
- Julio Dicent Taillepierre, MS, is Team Lead, Initiatives and Partnerships Team, Office of Minority Health and Health Equity, US Centers for Disease Control and Prevention, Atlanta, GA
| | - Laura Espino
- Laura Espino is Membership Director, National Public Health Information Coalition, Canton, GA
| | - Alyssa Boyea
- Alyssa Boyea, MPH, CPH, is Director, Infectious Disease Preparedness, Association of State and Territorial Health Officials, Arlington, VA
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Manuli ER, Pereira GM, Bernat MC, Novaes CR, Sabino EC, Avelino-Silva VI. Knowledge about clinical presentation, prevention strategies and sexual transmission of Zika virus infection among women of reproductive age in an endemic area. Braz J Infect Dis 2021; 25:101629. [PMID: 34627783 PMCID: PMC9392182 DOI: 10.1016/j.bjid.2021.101629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 09/06/2021] [Accepted: 09/20/2021] [Indexed: 12/05/2022] Open
Abstract
Background The recognition of the causal association between Zika virus (ZIKV) infection during pregnancy and congenital abnormalities including microcephaly underlines the importance of preventing this disease in pregnant women (PW) and women of childbearing age (WCA). Although Brazil and other Latin American countries reported a significant reduction in the number of ZIKV infections in recent years, epidemic waves can recur in settings with previous outbreaks as conditions for transmission remain optimal and susceptible populations are continuously replenished. Methods In this cross-sectional study, we enrolled 64 PW and 260 non-pregnant WCA attending routine medical appointments in two primary care units in Sao Paulo, Brazil, and assessed knowledge and attitudes about ZIKV infection and prevention. Results Most women reported knowing that ZIKV is transmitted through the bite of Aedes mosquitos, and most knew that acute symptoms are similar to those seen in Dengue infection. Furthermore, most participants correctly described that ZIKV infection during pregnancy may cause detrimental outcomes for the newborn. However, most ignored that ZIKV infection can be asymptomatic, and only 15% knew about the risk of ZIKV sexual transmission. We found no statistically significant differences between PW and WCA regarding knowledge about ZIKV sexual transmission. Knowledge about ZIKV sexual transmission was significantly associated with education; among participants with ≤12 schooling years, only 9.0% (95%CI 3.4-18.5%) correctly answered that ZIKV can be sexually transmitted, compared to 12.9% (95%CI 8.2-18.8%) among participants with 12-14 schooling years, and to 24.4% (95%CI 15.9-34.9%) of participants with ≥15 schooling years (p = 0.015). Education remained independently associated with knowledge about sexual transmission of ZIKV in a multivariate logistic regression model adjusted for age, race and pregnancy status (p = 0.022). Conclusion Our findings underscore the urgent need of educational and family planning programs that may help prevent detrimental outcomes of ZIKV infection in an endemic area of Brazil.
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Affiliation(s)
- Erika R Manuli
- Department of Infectious and Parasitic Diseases, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil; Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Geovana M Pereira
- Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Maria Cristina Bernat
- Centro de Saude Escola Geraldo de Paula Souza, Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, SP, Brazil
| | - Celia R Novaes
- Centro de Saude I "Dr. Victor Araujo Homem de Mello ", Departamento de Gerenciamento Ambulatorial da Capital, Secretaria de Estado da Saúde, São Paulo, São Paulo, SP, Brazil
| | - Ester C Sabino
- Department of Infectious and Parasitic Diseases, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil; Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Vivian I Avelino-Silva
- Department of Infectious and Parasitic Diseases, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil; Instituto de Medicina Tropical, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
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Anderson EJ, Ernst K, Garcia DO, Lopez E, Pogreba Brown K, Austhof E, Carr McCuin D, Hayden MH, Koss MP. Knowledge of Sexual Transmission of Zika Virus Among Women Who Are Pregnant or Intend to Become Pregnant, Arizona, 2017. Public Health Rep 2021; 137:488-497. [PMID: 33798396 PMCID: PMC9109529 DOI: 10.1177/00333549211006986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
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.
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Affiliation(s)
- Elizabeth J Anderson
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA.,10969 International Center for Research on Women, Washington, DC, USA
| | - Kacey Ernst
- 10969 International Center for Research on Women, Washington, DC, USA
| | - David O Garcia
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Elise Lopez
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Kristen Pogreba Brown
- 8041 Department of Epidemiology & Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Erika Austhof
- College of Public Health, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Dametreea Carr McCuin
- 8041 Department of Epidemiology & Biostatistics, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
| | - Mary H Hayden
- 14676 National Institute for Human Resilience, University of Colorado, Colorado Springs, CO, USA
| | - Mary P Koss
- Department of Health Promotion Sciences, Mel and Enid Zuckerman College of Public Health, University of Arizona, Tucson, AZ, USA
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Ndibuagu EO, Chime PE, Nweze SO. Knowledge of Zika Virus Disease Prevention Methods, among Female Caregivers That Bring Babies for Immunization in a Teaching Hospital, Southeast Nigeria. Health (London) 2021. [DOI: 10.4236/health.2021.1311101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Ramisetty-Mikler S, Boyce L. Communicating the risk of contracting Zika virus to low income underserved pregnant Latinas: A clinic-based study. PLoS One 2020; 15:e0241675. [PMID: 33216763 PMCID: PMC7679023 DOI: 10.1371/journal.pone.0241675] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Accepted: 10/19/2020] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Frequent travel between the Southern border states in the USA, Mexico, and Latin American countries increases the risk of the Zika virus (ZIKV) spread. Patient education on virus transmission is fundamental in decreasing the number of imported cases, particularly among pregnant women. METHODS The study used cross-sectional methodology to investigate information sources and knowledge concerning the ZIKV virus among 300 under-served pregnant Latinas recruited from prenatal care clinics in the North Texas region. Bivariate and multiple logistic regression models were used to investigate associations between the primary outcomes and patient characteristics. RESULTS Physicians, nurses, and families are the major sources for pregnancy information, while media/internet (65%) and physician/nurse (33%) are the main sources for ZIKV information. Less than one-half of the mothers reported that their physician/nurse did not discuss safe sexual practices or inquired about their sexual practices. A considerable proportion of women from the community clinic were neither warned nor queried about travel to ZIKV risk countries. There is an overall understanding of Zika virus transmission, symptoms, complications, and recommended guidelines. Younger age and single mother status are risk factors for lack of ZIKV knowledge. Foreign-born mothers are 2.5-3.0 times more likely to have knowledge on disease transmission, symptoms, and microcephaly condition. While, younger mothers (18-24) are less likely to have knowledge of ZIKV infection symptoms (fever, rash and pink eye) and transmission of infection via unprotected sexual (vaginal, anal, or oral) behavior, compared to older mothers. CONCLUSIONS Interventions are needed to heighten the knowledge of ZIKV, particularly among women of reproductive age and their male partners in the community health care setting. Our study underscores the need for health care providers to be trained in delivering messages to enhance risk perception during health emergencies to vulnerable and underserved families (lower economic background, language ability, and culture). During health emergencies, clinics must disseminate crucial information via multi modalities to ensure messages reach the targeted patients.
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Affiliation(s)
- Suhasini Ramisetty-Mikler
- Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, United States of America
| | - LeAnn Boyce
- Department of Information Science, University of North Texas, Denton, TX, United States of America
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"Too Much to Ask, Too Much to Handle": Women's Coping in Times of Zika. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124613. [PMID: 32604943 PMCID: PMC7344537 DOI: 10.3390/ijerph17124613] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 06/23/2020] [Accepted: 06/24/2020] [Indexed: 12/13/2022]
Abstract
Zika virus infection during pregnancy is a cause of congenital brain abnormalities. Its consequences for pregnancies have made governments and both national and international agencies issue advice and recommendations to women. This study was designed to understand the impacts of Zika on women who were less directly affected and less vulnerable to Zika. Women were recruited from various locations in Brazil, Puerto Rico, and the United States. Data were collected through semi-structured interviews and analyzed using thematic analysis. Women perceived that public health systems placed an unfair responsibility for preventing health complications from Zika onto women who had limited ability to do so. They also stated that the measures recommended to them were invasive, while creating the perception that women were the sole determinant of whether they contracted Zika. The results indicate that women with higher levels of education understood the limitations of the information, government actions, and medical care they received, which ended up producing higher levels of anguish and worry. Gender inequality and discrimination must be recognized and rendered visible in the public health emergency response. The social effects of the epidemic affected women more than had been thought before and at deeper emotional levels.
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Williams L, D'Angelo DV, Bauman B, Dieke AC, Ellington SR, Shapiro-Mendoza CK, Cox S, Hastings P, Shulman H, Harrison L, Kapaya M, Barfield WD, Warner L. Women's Awareness and Healthcare Provider Discussions about Zika Virus during Pregnancy, United States, 2016-2017. Emerg Infect Dis 2020; 26:998-1001. [PMID: 32310074 PMCID: PMC7181904 DOI: 10.3201/eid2605.190727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
We surveyed women with a recent live birth who resided in 16 US states and 1 city during the 2016 Zika outbreak. We found high awareness about the risk of Zika virus infection during pregnancy and about advisories to avoid travel to affected areas but moderate levels of discussions with healthcare providers.
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Abu-Rish EY, Elayeh ER, Albsoul-Younes AM. The Role of the Middle East in ZIKA Virus Circulation: Implications of a Cross-Sectional Study in Jordan. Am J Trop Med Hyg 2020; 100:974-980. [PMID: 30675847 DOI: 10.4269/ajtmh.18-0715] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
ZIKA virus (ZIKAV) outbreak in Latin America was associated with international concerns of ZIKAV circulation. The lack of vaccine and Food and Drug Administration (FDA)-approved drugs against this virus rendered prevention as the single most effective method to control its spread. Hence, this study aimed to assess Jordanian population knowledge, attitude, and practices toward ZIKAV and its prevention. An anonymous questionnaire was administered to adults in Amman, Jordan. The overall knowledge of participants was poor (mean knowledge score of 13.7/32). Between 75% and 86% of the respondents did not know the highest risk group of ZIKAV infection, its complications, and the major routes of transmission. About 40% of the population did not know that ZIKAV is sexually transmitted. Only 40% of the population believed that prevention measures are effective. Female gender, working in the medical field, having children, and the source of medical information were associated with significantly higher level of knowledge (R 2 = 0.143, P-value < 0.0001). Being pregnant, however, was not associated with a significantly high knowledge score. Physician recommendations and government's role were the most important predictors of practices toward ZIKAV prevention. Of the 14 returnees from outbreak areas, only six were tested for ZIKAV on coming back and only three continued the use of prevention measures for a sufficient time. Therefore, formulation of a national health policy, preparedness plans against any potential transmission, and organization of educational campaigns to meet the population's health educational needs are required. Special emphasis should be placed on pregnant women and travelers to/returnees from ZIKAV-affected areas.
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Affiliation(s)
- Eman Y Abu-Rish
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan
| | - Eman R Elayeh
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan
| | - Abla M Albsoul-Younes
- Department of Biopharmaceutics and Clinical Pharmacy, School of Pharmacy, The University of Jordan, Amman, Jordan
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Moore E, Rodriguez X, Fernandez D, Griffin I, Fermin ME, Cap N, Zhang G. Zika Testing Behaviors and Risk Perceptions Among Pregnant Women in Miami-Dade County, One Year After Local Transmission. Matern Child Health J 2019; 23:1140-1145. [PMID: 31209616 DOI: 10.1007/s10995-019-02756-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVES This study sought to describe the knowledge and perceptions of pregnant women in Miami-Dade County concerning Zika virus (ZIKV) in their community, to characterize their testing behaviors, and to identify any barriers that would keep them from seeking testing. METHODS The Florida Department of Health in Miami-Dade County partnered with the Healthy Start Coalition of Miami-Dade to administer an assessment survey in eight OBGYN clinics from June to August 2017. The survey captured past ZIKV testing practices, attitudes towards testing, barriers to testing, risk perception of ZIKV in the participants' community, and ZIKV-related knowledge. Descriptive analyses were performed on variables of interest. Chi squared tests examined associations between categorical variables. RESULTS A total of 363 participants were included in the analysis. Of these, 203 (55.9%) thought they should be tested for ZIKV, and less than half of the participants reported having been previously tested (152, 41.9%). Participants with some high school education were significantly more likely than those with higher education levels to see ZIKV as a "big problem" in the community (p = 0.0026). There was a significant association (p ≤ 0.0001) between women who thought that they should be tested, and those who perceived ZIKV to be a medium or big problem in their community. CONCLUSIONS FOR PRACTICE Health interventions that focus on increasing ZIKV knowledge should also place greater emphasis on risk communication when targeting the pregnant population. Having a higher risk perception may be more predictive of testing behaviors than having a lack of barriers or a high level of ZIKV-related knowledge.
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Affiliation(s)
- Emily Moore
- Florida Department of Health in Miami-Dade County, Epidemiology, Disease Control, and Immunization Services, 8600 NW 17th Street, Miami, FL, 33126, USA.
| | - Xeniamaria Rodriguez
- Florida Department of Health in Miami-Dade County, Epidemiology, Disease Control, and Immunization Services, 8600 NW 17th Street, Miami, FL, 33126, USA
| | - Danielle Fernandez
- Florida Department of Health in Miami-Dade County, Epidemiology, Disease Control, and Immunization Services, 8600 NW 17th Street, Miami, FL, 33126, USA
| | - Isabel Griffin
- Florida Department of Health in Miami-Dade County, Epidemiology, Disease Control, and Immunization Services, 8600 NW 17th Street, Miami, FL, 33126, USA
| | - Manuel E Fermin
- Healthy Start Coalition of Miami-Dade, 701 SW 27th Ave, Miami, FL, 33135, USA
| | - Natalia Cap
- Healthy Start Coalition of Miami-Dade, 701 SW 27th Ave, Miami, FL, 33135, USA
| | - Guoyan Zhang
- Florida Department of Health in Miami-Dade County, Epidemiology, Disease Control, and Immunization Services, 8600 NW 17th Street, Miami, FL, 33126, USA
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McDonald JA, Selchau K, Acquah-Baidoo B. Scope of Knowledge About Zika Among Women in US-Mexico Border Communities. J Community Health 2019; 43:705-716. [PMID: 29428987 DOI: 10.1007/s10900-018-0474-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Maternal Zika virus infection (ZIKV) has serious health consequences for unborn offspring. Knowledge about prevention is critical to reducing risk, yet what women in the high-risk US-Mexico border region know about protecting themselves and their babies from ZIKV is mostly unknown. This study aimed to assess knowledge of ZIKV among pregnant and inter-conception women and to identify sources of information that might address knowledge gaps. Clients in five federally-funded, border region Healthy Start programs (N = 326) were interviewed in late 2016 about their knowledge of ZIKV prevention methods and whether they believed themselves or their babies to be at risk. Sources of information about ZIKV and demographic characteristics were also measured. Chi square tests identified important associations between variables; adjusted odds ratios (AOR) and 95% confidence intervals for knowledge and beliefs were calculated. Among the 305 women aware of ZIKV, 69.5% could name two ways to prevent infection. Only 16.1% of women named using condoms or abstaining from sex as a prevention method. While 75.3% heard about ZIKV first from TV/radio, just 9.5% found the information helpful. Women who received helpful information from health care providers had greater odds of knowing two prevention methods (AOR = 2.0; 1.1-3.7), when to test for ZIKV (AOR = 5.2; 2.1-13.2), and how long to delay pregnancy after infection in a male partner (AOR = 1.9; 1.1-3.2). Those who said web-based and social media sources were helpful had greater odds of knowing when to test for ZIKV (AOR = 2.8; 1.3-6.3). Results can inform messaging for safe pregnancy and ZIKV prevention.
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Affiliation(s)
- Jill A McDonald
- Department of Public Health Sciences, College of Health and Social Services, New Mexico State University, PO Box 30001, Las Cruces, NM, 88003-8001, USA.
| | | | - Bridget Acquah-Baidoo
- Department of Public Health Sciences, College of Health and Social Services, New Mexico State University, PO Box 30001, Las Cruces, NM, 88003-8001, USA
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Melo VAD, Silva JRS, Corte RL. Personal protective measures of pregnant women against Zika virus infection. Rev Saude Publica 2019; 53:72. [PMID: 31483008 PMCID: PMC6707619 DOI: 10.11606/s1518-8787.2019053001146] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 11/23/2018] [Indexed: 12/25/2022] Open
Abstract
OBJECTIVE To evaluate the adherence of pregnant women to personal protective measures against mosquito bites, recommended by the Ministry of Health, and to investigate the factors associated with the non-adoption of these measures. METHODS We interviewed 177 pregnant women between November 2016 and February 2017 in the 10 basic health units of the municipality of Propriá, state of Sergipe, two located in the rural area and eight in the urban area, during prenatal appointments, to raise information about the use of preventive measures against the vector transmission of Zika virus. Data were analyzed using descriptive statistical methods, chi-square test or Fisher’s exact test, and the odds ratio was calculated. The independent variables were grouped by the analysis of principal components, and the dependents (the use of repellent, mosquito nets, garments, screens and insecticides) were analyzed using the logistic regression method. RESULTS Among the measures recommended by the Ministry of Health, mosquito nets were the most used by pregnant women living in rural areas and with low education level, while the repellents were more used by women in the urban area and with higher education level. Women in a vulnerable socio-economic situation presented a risk 2.4 times higher for not using screens in their homes, 1.9 times higher for not changing clothes and 2.5 times higher for not using repellent than pregnant women in better economic conditions. CONCLUSIONS The socioeconomic status of pregnant women, especially among the less privileged, influenced the use of protective measures against Zika virus, from the purchase of repellent, clothing, insecticides to other resources in the municipality of Propriá, SE.
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Affiliation(s)
| | - José Rodrigo Santos Silva
- Universidade Federal de Sergipe. Programa de Pós-Graduação em Biologia Parasitária. São Cristovão, SE, Brasil.,Universidade Federal de Sergipe. Departamento de Estatística e Ciências Atuariais. Centro de Ciências Exatas e Tecnologia. São Cristovão, SE, Brasil
| | - Roseli La Corte
- Universidade Federal de Sergipe. Programa de Pós-Graduação em Biologia Parasitária. São Cristovão, SE, Brasil.,Universidade Federal de Sergipe. Departamento de Morfologia. Centro de Ciências Biológicas e da Saúde. São Cristovão, SE, Brasil
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Harapan H, Rajamoorthy Y, Utomo PS, Anwar S, Setiawan AM, Alleta A, Bambang A, Ramadana MR, Ikram I, Wahyuniati N, Maulana R, Ichsan I, Indah R, Wagner AL, Kuch U, Groneberg DA, Rodríguez-Morales AJ, Andalas M, Müller R, Mudatsir M, Imrie A. Knowledge and attitude towards pregnancy-related issues of Zika virus infection among general practitioners in Indonesia. BMC Infect Dis 2019; 19:693. [PMID: 31387537 PMCID: PMC6683397 DOI: 10.1186/s12879-019-4297-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Accepted: 07/18/2019] [Indexed: 03/20/2023] Open
Abstract
Background The aim of this study was to assess the knowledge and attitudes towards pregnancy-related issues of Zika virus (ZIKV) infection among general practitioners (GPs), a frontline healthcare worker group, in Indonesia. Methods A cross-sectional, online survey assessing knowledge and attitudes towards ZIKV infection on multiple-item scales was sent to GPs in the Sumatra and Java islands of Indonesia. The associations between independent factors and either knowledge or attitude were assessed with logistic regressions. The correlation and association between knowledge and attitude were estimated. Results We included 457 (53.7%) out of 850 responses in the analysis. Among these, 304 (66.5%) and 111 (24.2%) respondents had a good knowledge and attitude, respectively. No demographic, workplace, professional development, or experiential characteristics related to ZIKV infection were associated with knowledge. In the multivariate analysis, only contact experience was associated with attitude. There was a significant, positive correlation between knowledge and attitude scores. Conclusions Although knowledge of pregnancy-related complications of ZIKV infection is relatively high among GPs in Indonesia, more than 75% of them had a poor attitude towards pregnancy-related issues of Zika. Strategies for enhancing the capacity of GPs to develop positive attitudes and respond to ZIKV infection are needed. Electronic supplementary material The online version of this article (10.1186/s12879-019-4297-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Harapan Harapan
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia. .,Tropical Disease Centre, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia. .,Department of Microbiology, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia. .,School of Biomedical Sciences, The University of Western Australia, Nedlands, Australia.
| | | | - Prattama S Utomo
- Department of Medical Education, Faculty of Medicine, Gadjah Mada University, Jogjakarta, Indonesia
| | - Samsul Anwar
- Department of Statistics, Faculty of Mathematics and Natural Sciences, Universitas Syiah Kuala, Banda Aceh, Indonesia
| | - Abdul M Setiawan
- Department of Microbiology, Faculty of Medicine and Health Sciences, Maulana Malik Ibrahim State Islamic University of Malang, Malang, Indonesia
| | - Alma Alleta
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia.,Department of Family Medicine, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
| | - Alfredo Bambang
- Department of Microbiology, School of Medicine, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | - Muhammad R Ramadana
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
| | - Ikram Ikram
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
| | - Nur Wahyuniati
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
| | - Reza Maulana
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
| | - Ichsan Ichsan
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia.,Tropical Disease Centre, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia.,Department of Microbiology, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
| | - Rosaria Indah
- Medical Education Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia.,Sydney School of Education and Social Work, Faculty of Arts and Social Sciences, The University of Sydney, Sydney, Australia
| | - Abram L Wagner
- Department of Epidemiology, University of Michigan, Ann Arbor, MI, USA
| | - Ulrich Kuch
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Frankfurt am Main, Germany
| | - David A Groneberg
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Frankfurt am Main, Germany
| | - Alfonso J Rodríguez-Morales
- Public Health and Infection Research Incubator and Group, Faculty of Health Sciences, Universidad Tecnológica de Pereira, Pereira, Risaralda, Colombia.,Research Group Medical and Diagnostic Images (GRIMEID), IPS Imágenes Diagnósticas S.A, Pereira, Risaralda, Colombia
| | - Mohd Andalas
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia.,Department of Obstetrics and Gynecology, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
| | - Ruth Müller
- Institute of Occupational Medicine, Social Medicine and Environmental Medicine, Goethe University, Frankfurt am Main, Germany.,Unit of Medical Entomology, Institute of Tropical Medicine, Antwerp, Belgium
| | - Mudatsir Mudatsir
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia. .,Tropical Disease Centre, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia. .,Department of Microbiology, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia.
| | - Allison Imrie
- School of Biomedical Sciences, The University of Western Australia, Nedlands, Australia
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15
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Swale DR, Bloomquist JR. Is DEET a dangerous neurotoxicant? PEST MANAGEMENT SCIENCE 2019; 75:2068-2070. [PMID: 31069958 DOI: 10.1002/ps.5476] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 05/03/2019] [Accepted: 05/03/2019] [Indexed: 06/09/2023]
Abstract
Controversies surrounding the safety of N,N-diethyl-meta-toluamide (DEET) when used as an insect repellent are centered around conflicting findings in the scientific literature and inaccurate reporting in the public media. Lethal cases of DEET poisoning are few, and usually due to deliberate or other overdoses that ignore product label instructions. Deleterious effects of DEET typically involve skin reactions and even when encephalopathies, such as seizures, occur they often abate without sequelae. Recent mode-of-action studies prove it has little direct effect on acetylcholinesterase, and have identified G protein-coupled receptors as a site of action deserving of further investigation. Studies with pregnant women found that DEET had no effect on the developing fetus from proper use and its continued deployment as a repellent is endorsed by both the Centers for Disease Control and Prevention and the Environmental Protection Agency, with specific recommendations of how it should be used on children. © 2019 Society of Chemical Industry.
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Affiliation(s)
- Daniel R Swale
- Department of Entomology, Louisiana State University AgCenter, Baton Rouge, LA, USA
| | - Jeffrey R Bloomquist
- Neurotoxicology Laboratory, Entomology and Nematology Department, Emerging Pathogens Institute, Gainesville, FL, USA
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16
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Dantas Melo VA, Santos Silva JR, La Corte R. Use of mosquito repellents to protect against Zika virus infection among pregnant women in Brazil. Public Health 2019; 171:89-96. [PMID: 31112836 DOI: 10.1016/j.puhe.2019.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 03/27/2019] [Accepted: 04/03/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVES To evaluate the use of repellents among pregnant women as a protective measure against infection with the Zika virus. STUDY DESIGN Pregnant women (n = 177) were interviewed between November 2016 and February 2017 at Basic Health Units in the city of Propriá, state of Sergipe, Brazil. Two units were located in rural areas and eight in urban regions. METHODS Data were analysed using descriptive statistical methods, the Chi-squared test or Fisher's exact test and odds ratios. The independent variables were grouped by analysis of the main components, and adherence to the use of the repellent was analysed by the logistic regression method. RESULTS A total of 100 women reported using repellents at the time of the interview (56%). The use of repellents was greater among women with higher levels of education (83%) than those with only high school (68%) or elementary school (36%) education. Women assisted by the income transfer programme (Bolsa Família) presented a 2.27 times greater chance of not using repellents compared with pregnant women who were not receiving benefits of the programme. Regarding the logistic regression model, we observed that low economic and social conditions of pregnant women, as well as their lack of advice, had a negative effect on the use of repellents. CONCLUSIONS Repellents were generally used as a preventive measure in pregnant women with higher levels of schooling and fewer children. The relatively high cost of repellents was the main reason for non-use.
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Affiliation(s)
- V A Dantas Melo
- Graduate Program in Parasitic Biology, Federal University of Sergipe, Avenue Marechal Rondon S/n. Jardim Rosa Elze, University City Professor José Aloísio de Campos São Cristovão, Brazil
| | - J R Santos Silva
- Graduate Program in Parasitic Biology, Federal University of Sergipe, Avenue Marechal Rondon S/n. Jardim Rosa Elze, University City Professor José Aloísio de Campos São Cristovão, Brazil; Department of Statistics and Actuarial Sciences, Federal University of Sergipe, Avenue Marechal Rondon S/n. Jardim Rosa Elze, University City Professor José Aloísio de Campos São Cristovão, Brazil
| | - R La Corte
- Graduate Program in Parasitic Biology, Federal University of Sergipe, Avenue Marechal Rondon S/n. Jardim Rosa Elze, University City Professor José Aloísio de Campos São Cristovão, Brazil; Department of Morphology, Federal University of Sergipe, Avenue Marechal Rondon S/n. Jardim Rosa Elze, University City Professor José Aloísio de Campos São Cristovão, Brazil.
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17
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Piltch-Loeb R, Merdjanoff AA, Abramson DM. How the US Population Engaged with and Prioritized Sources of Information about the Emerging Zika Virus in 2016. Health Secur 2018; 16:165-177. [PMID: 29927341 DOI: 10.1089/hs.2017.0107] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Emerging disease threats like Zika pose a risk to naïve populations. In comparison to chronic diseases, there is scientific uncertainty surrounding emerging diseases because of the lack of medical and public health information available as the threat emerges. Further complicating this are the multiple, diverse channels through which people get information. This article used bivariate and multivariate analysis to first describe the breadth of information sources individuals accessed about the Zika virus, and then describe individuals' primary sources of information for Zika using a nationally representative pooled cross-sectional data set collected at 3 time points in 2016 (N = 3,698). The analysis also highlights how 3 subgroups-high-education, high-income adults; Hispanic women of childbearing age; and retirees over the age of 65 with less than a high school education-varied in their use of information. Results suggest individuals accessed multiple sources, but TV and radio were the primary sources of Zika information for the public, followed by print news. Demographic variation in primary source of information means public health officials should consider alternative channels to reach target groups in an emerging event. Without an understanding of how information has reached people, and who individuals engaged with regarding that information, public health practitioners are missing a key piece of the puzzle to improving public health campaigns during a future event like Zika. This analysis aims to inform the public health community about the message channels the US population uses during an emerging disease event and the most prevalent channels for different demographic groups, who can be targeted with particular messaging.
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18
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Piltch-Loeb R, Kraemer J, Lin KW, Stoto MA. Public Health Surveillance for Zika Virus: Data Interpretation and Report Validity. Am J Public Health 2018; 108:1358-1362. [PMID: 30138063 PMCID: PMC6137786 DOI: 10.2105/ajph.2018.304525] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2018] [Indexed: 11/04/2022]
Abstract
Zika virus provides an example for which public health surveillance is based primarily on health care provider notifications to health departments of potential cases. This case-based surveillance is commonly used to understand the spread of disease in a population. However, case-based surveillance is often biased-whether testing is done and which tests are used and the accuracy of the results depend on a variety of factors including test availability, patient demand, perceptions of transmission, and patient and provider awareness, leading to surveillance artifacts that can provide misleading information on the spread of a disease in a population and have significant public health practice implications. To better understand this challenge, we first summarize the process that health departments use to generate surveillance reports, then describe factors influencing testing and reporting patterns at the patient, provider, and contextual level. We then describe public health activities, including active surveillance, that influence both patient and provider behavior as well as surveillance reports, and conclude with a discussion about the interpretation of surveillance data and approaches that could improve the validity of surveillance reports.
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Affiliation(s)
- Rachael Piltch-Loeb
- Rachael Piltch-Loeb is with the College of Global Public Health, New York University, New York, NY. John Kraemer and Michael A. Stoto are with the Department of Health Systems Administration, Georgetown University, Washington, DC. Kenneth W. Lin is with the Department of Family Medicine, Georgetown University Medical Center, Washington, DC
| | - John Kraemer
- Rachael Piltch-Loeb is with the College of Global Public Health, New York University, New York, NY. John Kraemer and Michael A. Stoto are with the Department of Health Systems Administration, Georgetown University, Washington, DC. Kenneth W. Lin is with the Department of Family Medicine, Georgetown University Medical Center, Washington, DC
| | - Kenneth W Lin
- Rachael Piltch-Loeb is with the College of Global Public Health, New York University, New York, NY. John Kraemer and Michael A. Stoto are with the Department of Health Systems Administration, Georgetown University, Washington, DC. Kenneth W. Lin is with the Department of Family Medicine, Georgetown University Medical Center, Washington, DC
| | - Michael A Stoto
- Rachael Piltch-Loeb is with the College of Global Public Health, New York University, New York, NY. John Kraemer and Michael A. Stoto are with the Department of Health Systems Administration, Georgetown University, Washington, DC. Kenneth W. Lin is with the Department of Family Medicine, Georgetown University Medical Center, Washington, DC
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19
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Burgos-Muñoz SJ, Toro-Huamanchumo CJ. Zika knowledge and preventive practices among reproductive-age women from Lambayeque, Peru. Eur J Obstet Gynecol Reprod Biol 2018; 228:255-260. [DOI: 10.1016/j.ejogrb.2018.07.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 07/11/2018] [Accepted: 07/16/2018] [Indexed: 10/28/2022]
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20
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Teich A, Lowenfels AB, Solomon L, Wormser GP. Gender disparities in Zika virus knowledge in a potentially at-risk population from suburban New York City. Diagn Microbiol Infect Dis 2018; 92:315-318. [PMID: 30097295 DOI: 10.1016/j.diagmicrobio.2018.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2018] [Revised: 06/15/2018] [Accepted: 07/03/2018] [Indexed: 10/28/2022]
Abstract
Zika virus is an emerging infection transmitted in multiple ways. In 2016 we assessed the level of knowledge about Zika virus transmission in an underserved, predominantly Hispanic, mixed gender population living in suburban New York City, many of whom potentially travel to affected regions. Based on a convenience sample of 147 participants, 134 (91%) were aware of Zika virus transmission by mosquitoes; 116 (79%) knew about transmission from a pregnant female to the fetus; and 89 (61%) were aware of sexual transmission. Age, marital status, education, and native language were unrelated to knowledge (P > 0.10). Women, however, were significantly more likely than men to know about sexual transmission (P = 0.023) and about maternal transmission to the fetus (P = 0.044). Travel to Zika virus endemic areas was unrelated to level of knowledge (P = 0.40). Greater awareness of the risk of sexual transmission of Zika virus is needed for at risk populations in the US, especially for males.
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Affiliation(s)
- Alice Teich
- Department of Family Medicine, New York Medical College, Valhalla, NY 10595
| | - Albert B Lowenfels
- Emeritus Professor of Surgery, and Department of Family Medicine, New York Medical College, Valhalla, NY. 10595
| | - Lori Solomon
- Department of Family Medicine, New York Medical College, Valhalla, NY 10595
| | - Gary P Wormser
- Division of Infectious Diseases, New York Medical College, Valhalla, NY 10595.
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21
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Brissett DI, Tuholske C, Allen IE, Larios NS, Mendoza DJ, Murillo AG, Bloch EM. Zika Virus: Knowledge Assessment of Residents and Health-Care Providers in Roatán, Honduras, following an Outbreak. Am J Trop Med Hyg 2018; 99:211-215. [PMID: 29761757 DOI: 10.4269/ajtmh.18-0014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Few studies have evaluated the effectiveness of Zika virus (ZIKV) public health educational campaigns. Following a ZIKV educational campaign in Roatán, Honduras (October 2016), a survey was administered (March-May 2017) to residents (N = 348) and health-care professionals ([HCPs]; N = 44) to evaluate ZIKV knowledge, attitudes, and preventive practices, with attention to sexual health. Knowledge scores were calculated and mapped using participants' home locations. The knowledge scores between HCPs and residents were significantly different (mean 17 versus 11; P < 0.001). Only 6% of residents and 14% of HCPs knew that ZIKV was sexually transmissible. Few reported abstinence (2.6% residents; 9.4% HCPs) or condom use (1.6% residents; 12.5% HCPs) to prevent ZIKV infection. Of all subjects, 15.6% were pregnant or had a pregnant partner in the past year; 57.6% expressed concern over ZIKV. Mapping demonstrated spatial heterogeneity in knowledge. The findings suggest a need for improved public health messaging in ZIKV-affected areas.
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Affiliation(s)
- Daniela I Brissett
- School of Medicine, University of California, San Francisco, San Francisco, California
| | - Cascade Tuholske
- Department of Geography, University of California, Santa Barbara, Santa Barbara, California
| | - Isabel E Allen
- Department of Epidemiology, University of California, San Francisco, San Francisco, California
| | - Noely S Larios
- Facultad de Ciencias Sociales, School of Medicine, Universidad Nacional Autonoma de Honduras, Tegucigalpa, Honduras
| | - Diego J Mendoza
- School of Medicine, Universidad Catolica de Honduras, Tegucigalpa, Honduras
| | - Ana G Murillo
- School of Medicine, Universidad Catolica de Honduras, Tegucigalpa, Honduras
| | - Evan M Bloch
- Department of Pathology, Johns Hopkins Medicine, Baltimore, Maryland
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22
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Heitzinger K, Thoroughman DA, Porter KA. Knowledge, attitudes, and practices of women of childbearing age testing negative for Zika virus in Kentucky, 2016. Prev Med Rep 2018; 10:20-23. [PMID: 29868354 PMCID: PMC5984209 DOI: 10.1016/j.pmedr.2018.01.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2017] [Revised: 12/27/2017] [Accepted: 01/11/2018] [Indexed: 01/20/2023] Open
Abstract
Because infection with Zika virus during pregnancy can cause microcephaly and other birth defects, women of childbearing age are an important population for targeting of Zika-related public health messaging. To improve Zika-related communication and outreach in Kentucky, we conducted a survey to assess Zika knowledge, attitudes, and practices among all women of childbearing age who received a negative Zika test result from the state public health laboratory during February to July 2016. Although >90% of the 55 respondents knew the virus could be transmitted by mosquitoes and caused birth defects, just 56% (31/55) knew the virus could be sexually transmitted. These findings underscore the importance of continued efforts by CDC and state and local health departments to educate female travelers of childbearing age about risks for and prevention of Zika virus infection, particularly emphasizing use of condoms and abstinence to prevent transmission.
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Affiliation(s)
- Kristen Heitzinger
- Kentucky Department for Public Health, 275 E. Main St., HS 2-GWC, Frankfort, KY 40621, United States
| | - Douglas A Thoroughman
- Kentucky Department for Public Health, 275 E. Main St., HS 2-GWC, Frankfort, KY 40621, United States.,Centers for Disease Control and Prevention, Office of Public Health Preparedness and Response, 1600 Clifton Rd., Atlanta, GA 30329, United States
| | - Kimberly A Porter
- Kentucky Department for Public Health, 275 E. Main St., HS 2-GWC, Frankfort, KY 40621, United States.,Centers for Disease Control and Prevention, Office of Public Health Preparedness and Response, 1600 Clifton Rd., Atlanta, GA 30329, United States
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23
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Berenson AB, Hirth JM, Guo F, Fuchs EL, Weaver SC. Prevention Practices among United States Pregnant Women Who Travel to Zika Outbreak Areas. Am J Trop Med Hyg 2018; 98:178-180. [PMID: 29141747 DOI: 10.4269/ajtmh.17-0595] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
We surveyed pregnant women from the United States to assess the prevention practices they used when traveling to countries with ongoing Zika virus (ZIKV) outbreaks. Of the 749 who agreed to participate, 710 completed the survey's travel questions and 59 of those had traveled to a ZIKV outbreak area in the past 12 months. Only 43% of the women who had traveled to ZIKV outbreak areas reported frequently using mosquito repellant with 32% stating they did not use it at all. They also did not frequently use other recommended methods to prevent mosquito bites. With the established risks to babies born to women who contract the ZIKV during pregnancy, it is a great concern that a large number of women who travel to outbreak areas during pregnancy are not protecting themselves against mosquito bites. Pregnant women need to be educated on the importance of taking precautions.
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Affiliation(s)
- Abbey B Berenson
- Center for Interdisciplinary Research in Women's Health, University of Texas Medical Branch, Galveston, Texas.,Department of Obstetrics & Gynecology, University of Texas Medical Branch, Galveston, Texas
| | - Jacqueline M Hirth
- Department of Obstetrics & Gynecology, University of Texas Medical Branch, Galveston, Texas.,Center for Interdisciplinary Research in Women's Health, University of Texas Medical Branch, Galveston, Texas
| | - Fangjian Guo
- Department of Obstetrics & Gynecology, University of Texas Medical Branch, Galveston, Texas.,Center for Interdisciplinary Research in Women's Health, University of Texas Medical Branch, Galveston, Texas
| | - Erika L Fuchs
- Department of Obstetrics & Gynecology, University of Texas Medical Branch, Galveston, Texas.,Center for Interdisciplinary Research in Women's Health, University of Texas Medical Branch, Galveston, Texas
| | - Scott C Weaver
- Department of Microbiology and Immunology, University of Texas Medical Branch, Galveston, Texas.,Institute of Human Infections and Immunology, Department of Pathology, University of Texas Medical Branch, Galveston, Texas
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24
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Chaw L, Tuah NA, Wong JY, Naing L. Knowledge, attitudes and practice survey on Zika virus infection among pregnant women in Brunei Darussalam. ASIAN PAC J TROP MED 2018. [DOI: 10.4103/1995-7645.246340] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Ellingson MK, Bonk CM, Chamberlain AT. A survey-based study of Zika virus communication preferences among pregnant women in Georgia, United States. BMC Pregnancy Childbirth 2017; 17:325. [PMID: 28950830 PMCID: PMC5615434 DOI: 10.1186/s12884-017-1516-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Accepted: 09/18/2017] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Because of the particularly severe perinatal outcomes associated with antenatal Zika virus infection, it is important for prenatal care providers to communicate Zika virus risks and strategies for prevention to their patients. Although face-to-face communication is ideal, clinic visits may not allow for in-depth discussion of all concerns. While previous studies have shown prenatal providers to be pregnant women's most trusted sources of health information, there is little knowledge on what secondary communication modalities pregnant women prefer for receiving information from their providers about an evolving public health emergency. METHODS A cross-sectional, descriptive anonymous 27-item survey was distributed to pregnant women at four clinics around Atlanta, Georgia from May 5th to June 20th, 2016. The survey assessed women's interest in and communication preferences about prenatal topics, including Zika virus. Descriptive statistics were calculated and chi-square tests were used to evaluate associations between the primary outcomes and patient characteristics. RESULTS Four-hundred and eight women completed the survey. The most popular resource for obtaining Zika virus information was the Centers for Disease Control and Prevention (CDC) website (73.0%). While their prenatal provider's own website for Zika information ranked 5th among sources currently accessed for Zika information, it ranked third behind educational brochures and emails for ways in which women wanted to receive information. The characteristics of Zika virus information deemed most important were: evidence-based (87.5%), endorsed by the CDC (74.1%), and endorsed by their own provider (67.9%). CONCLUSION In any public health emergency affecting pregnant women, women are going to seek advice from their obstetric providers. Because providers may lack sufficient time to discuss concerns with every patient, they may consider providing patient education in other ways. For the women included in this study, educational brochures, emails and providers' own practice websites were preferred. Providers should consider taking greater advantage of these modalities to supplement in-person exchanges, particularly during a public health emergency.
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Affiliation(s)
- Mallory K Ellingson
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, GA, 30322, USA.
| | | | - Allison T Chamberlain
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd. NE, Atlanta, GA, 30322, USA
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