Abstract
ObjectiveTo perform spatial distribution analysis of reported cases of Zika virus and congenital Zika syndrome (CZS) in the state of Espírito Santo, Brazil, by neighborhood, and relate the results to sociodemographic indicators and implications for the health process.MethodsAn ecological study using data from the 2016 National Notifiable Diseases Surveillance System, epidemiological records, and information on neighborhoods of families confirmed with CZS from qualitative field research.ResultsSociodemographic indicators were analyzed in three distinct groups: general population with Zika virus, pregnant women with Zika virus, and cases of CZS visited. For the three groups, average literacy rates were 71.1%, 71.0%, and 68.3%; the average income per minimum wage was 1.4, 1.1, and 1.4; sanitary sewage coverage was 75.6%, 76.1%, and 71.4%; garbage coverage was 90.8%, 91.2%, and 89.2%; and water supply was 93.8%, 94.1% and 93.8%, respectively. Socioeconomic indicators showed no significant differences between groups, although they were above the national average. A nonsignificant variation of 68.3%–71.1% was seen in the average literacy level above 15 years of age.ConclusionSocioeconomic and demographic indicators of cases of Zika virus infection and CZS may indicate that the outbreak had different impacts according to class, social group, or gender, reflecting the persistence and social geography of inequality in Brazil.
Highlights
Zika virus is a mosquito-borne flavivirus transmitted mainly by Aedes aegypti; it was first identified in monkeys on the African continent in 1947 through a network that monitored yellow fever.[1,2] The first outbreak described in the literature occurred in 2007 in the Federated States of Micronesia, Oceania.[3]
Results from the present study show that the Zika virus epidemic primarily affected women of childbearing age both nationally and in the state of Espírito Santo
Several studies are in line with our results showing that the Zika virus epidemic in Brazil mostly impacted women.[34,35]
Summary
Zika virus is a mosquito-borne flavivirus transmitted mainly by Aedes aegypti; it was first identified in monkeys on the African continent in 1947 through a network that monitored yellow fever.[1,2] The first outbreak described in the literature occurred in 2007 in the Federated States of Micronesia, Oceania.[3]. From 2000 to 2014 the average annual number of cases of microcephaly in Brazil was 164, whereas in 2015 alone there were 1608 cases.[14,15] Such an increase could not be explained by genetic factors; exposures to other diseases such as syphilis, toxoplasmosis, rubella, Cytomegalovirus and herpes simplex infections (STORCHZ); severe malnutrition; or exposure to harmful substances (alcohol, certain drugs, or toxic substances).[16] Microcephaly was found to be just one of the manifestations of an anomaly called congenital Zika syndrome (CZS).[17,18] Conditions associated with CZS include eye damage, joint problems, excessive muscle tone, and seizures, among other signs and symptoms.[1,19]. The aim of the present study was to describe the spatial distribution of Zika virus and CZS cases in the state of Espírito Santo according to neighborhoods, and to describe the sociodemographic indicators and their implications in the health–disease process
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