ZIKA Virus infection in pregnant women in French Guiana: More precarious-more at risk.
Adolescent
Adult
Child
Cross-Sectional Studies
Female
French Guiana
/ epidemiology
Humans
Insurance, Health
/ statistics & numerical data
Middle Aged
Pregnancy
Pregnancy Complications, Infectious
/ epidemiology
Prevalence
Risk Assessment
Socioeconomic Factors
Young Adult
Zika Virus Infection
/ epidemiology
Journal
PLoS neglected tropical diseases
ISSN: 1935-2735
Titre abrégé: PLoS Negl Trop Dis
Pays: United States
ID NLM: 101291488
Informations de publication
Date de publication:
03 2020
03 2020
Historique:
received:
13
09
2019
accepted:
03
03
2020
revised:
03
04
2020
pubmed:
26
3
2020
medline:
14
5
2020
entrez:
26
3
2020
Statut:
epublish
Résumé
A recent study in French Guiana suggested that populations living in precarious neighborhoods were more at risk for Chikungunya CHIKV than those living in more privileged areas. The objective of the present study was to test the hypothesis that Zika virus (ZIKV) infection was more frequent in precarious pregnant women than in non-precarious pregnant women, as reflected by their health insurance status. A multicentric cross-sectional study was conducted in Cayenne hospital including ZIKV pregnant women with serological or molecular proof of ZIKV during their pregnancy between January and December 2016. Health insurance information was recorded at delivery, which allowed separating women in: undocumented foreigners, precarious but with residence permit, and non-precarious. A total of 6654 women were included. Among them 1509 (22,7%) had confirmed ZIKV infection. Most women were precarious (2275/3439) but the proportion of precarious women was significantly greater in ZIKV-confirmed 728/906 (80.4%) than the ZIKV-negatives 1747/2533 (69.0%), p<0.0001. There were 1142 women classified as non-precarious, 1671 were precarious legal residents, and 1435 were precarious and undocumented. Precariousness and undocumented status were associated with a higher prevalence of ZIKV during pregnancy (adjusted prevalence ratio = 1.59 (95%CI = 1.29-1.97), p<0.0001), (adjusted prevalence ratio = 1.5 (95%CI = 1.2-1.8), p<0.0001), respectively. These results illustrate that in French Guiana ZIKV transmission disproportionately affected the socially vulnerable pregnant women, presumably because of poorer housing conditions, and lack of vector control measures in poor neighborhoods.
Sections du résumé
BACKGROUND
A recent study in French Guiana suggested that populations living in precarious neighborhoods were more at risk for Chikungunya CHIKV than those living in more privileged areas. The objective of the present study was to test the hypothesis that Zika virus (ZIKV) infection was more frequent in precarious pregnant women than in non-precarious pregnant women, as reflected by their health insurance status.
METHODS
A multicentric cross-sectional study was conducted in Cayenne hospital including ZIKV pregnant women with serological or molecular proof of ZIKV during their pregnancy between January and December 2016. Health insurance information was recorded at delivery, which allowed separating women in: undocumented foreigners, precarious but with residence permit, and non-precarious.
RESULTS
A total of 6654 women were included. Among them 1509 (22,7%) had confirmed ZIKV infection. Most women were precarious (2275/3439) but the proportion of precarious women was significantly greater in ZIKV-confirmed 728/906 (80.4%) than the ZIKV-negatives 1747/2533 (69.0%), p<0.0001. There were 1142 women classified as non-precarious, 1671 were precarious legal residents, and 1435 were precarious and undocumented. Precariousness and undocumented status were associated with a higher prevalence of ZIKV during pregnancy (adjusted prevalence ratio = 1.59 (95%CI = 1.29-1.97), p<0.0001), (adjusted prevalence ratio = 1.5 (95%CI = 1.2-1.8), p<0.0001), respectively.
CONCLUSIONS
These results illustrate that in French Guiana ZIKV transmission disproportionately affected the socially vulnerable pregnant women, presumably because of poorer housing conditions, and lack of vector control measures in poor neighborhoods.
Identifiants
pubmed: 32208419
doi: 10.1371/journal.pntd.0008193
pii: PNTD-D-19-01516
pmc: PMC7122809
doi:
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0008193Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
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