Syndemic Factors Associated with Zika Virus Infection Prevalence and Risk Factors in a Cohort of Women Living in Endemic Areas for Arboviruses in Northeast Brazil.

IF 2.8 4区医学 Q2 INFECTIOUS DISEASES

Tropical Medicine and Infectious Disease Pub Date : 2025-03-01 DOI:10.3390/tropicalmed10030067

Ligia Kerr, Carlos Sanhueza-Sanzana, Marto Leal, Italo Aguiar, Kasim Allel, Moisés H Sandoval, Cristiane Cunha Frota, Marco Túlio Aguiar, Adriano Ferreira Martins, Livia Dias, Rosa Livia Freitas de Almeida, Francisco Herlânio Costa Carvalho, Francisco Gustavo Silveira Correia, Roberto da Justa Pires Neto, Fernanda Montenegro Araújo, Shirlene Telmos Silva de Lima, Leda Maria Simões Mello, Lucas de Lima Nogueira, Terezinha do Menino Jesus Silva Leitão, Maria da Glória Teixeira, Jeni Stolow, Guilherme Loureiro Werneck, Ivo Castelo Branco Coelho, Ronald Blanton, Ana Zaira da Silva, George W Rutherford, Carl Kendall

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Abstract

Background: We sought to explain the seroprevalence of Zika Virus (ZIKV) as a syndemic of socioeconomic, environmental, and health factors in a cohort of women living in Brazil.

Methods: This is a cohort study comprising 1498 women between 15 and 39 years of age followed up in two waves between February 2018 and August 2019. Two questionnaires addressed the arbovirus's socioeconomic, demographic, and behavioral aspects and participants' arbovirus infection history. Blood samples were collected to detect IgM and IgG for ZIKV, chikungunya virus (CHIKV), and dengue virus (DENV), and RT-PCR for ZIKV.

Results: The baseline prevalence for ZIKV was 43% (95%CI: 40.5, 45.6), increasing to 44.7% in the following period (95%CI: 42, 47.1). We found a prevalence of 44.1% among women having one syndemic factor, 49.9% for those having two, and 58% for women having three or more factors. Women reporting a single syndemic factor resulted in higher odds of acquiring ZIKV (OR = 1.6, 95%CI: 1.2-2.4). There were increased adjusted odds among women having two or three or more factors (OR = 2.1, 95%CI: 1.6-3.1; OR = 2.9, 95%CI: 2.0-4.3, respectively).

Conclusions: Tailored interventions targeting syndemic conditions, such as the co-circulation of urban arboviruses and poor living conditions, are crucial to improving the burden produced by ZIKV.

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在巴西东北部虫媒病毒流行地区生活的妇女队列中，与寨卡病毒感染流行和危险因素相关的综合征因素

背景：我们试图将寨卡病毒（ZIKV）的血清患病率解释为生活在巴西的一组妇女的社会经济、环境和健康因素的综合征。方法：这是一项队列研究，包括1498名15至39岁的女性，在2018年2月至2019年8月期间分两波随访。两份调查问卷涉及虫媒病毒的社会经济、人口统计学和行为方面以及参与者的虫媒病毒感染史。采集血样检测寨卡病毒、基孔肯雅病毒（CHIKV）和登革热病毒（DENV）的IgM和IgG，并进行寨卡病毒的RT-PCR检测。结果：寨卡病毒基线流行率为43% (95%CI: 40.5, 45.6)，随后一段时间上升至44.7% （95%CI: 42, 47.1）。我们发现，有一种综合症因素的女性患病率为44.1%，有两种综合症因素的女性患病率为49.9%，有三种或三种以上综合症因素的女性患病率为58%。报告单一综合征因素的妇女感染寨卡病毒的几率较高（OR = 1.6, 95%CI: 1.2-2.4）。有两个或三个或更多因素的女性调整后的几率增加(or = 2.1, 95%CI: 1.6-3.1；OR = 2.9, 95%CI分别为2.0-4.3)。结论：针对疾病状况（如城市虫媒病毒共传播和恶劣的生活条件）量身定制的干预措施对于改善寨卡病毒造成的负担至关重要。

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