Depressive Symptoms and Care Demands Among Primary Caregivers of Young Children with Evidence of Congenital Zika Virus Infection in Brazil

Kotzky, Kim; Allen, Jacob E; Robinson, Lara R.; Satterfield-Nash, Ashley; Bertolli, Jeanne; Smith, Camille; Pereira, Isabela Ornelas; Santelli, Ana Carolina Faria e Silva; Peacock, Georgina

doi:10.1097/dbp.0000000000000666

Cited by 31 publications

(48 citation statements)

References 26 publications

(45 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…M16 reported feeling greater sadness caused by her family's miserable living conditions than her daughter's diagnosis of microcephaly associated with CZS. This reflects the results of a study reporting that primary caregivers of children with CZS present depressive symptoms when faced with economic challenges related to the child's delayed development . In other words, economic challenges have a greater influence on the mental health of primary caregivers than the daily care of the child.…”

Section: Discussionsupporting

confidence: 63%

See 1 more Smart Citation

How do mothers feel? Life with children with congenital Zika syndrome

Freitas

Soares

Mocelin

et al. 2020

Intl J Gynecology & Obste

View full text Add to dashboard Cite

Objective: To describe the repercussions, from the perspectives of caregiver mothers, of confirmed congenital Zika syndrome (CZS) in their offspring. Methods:A descriptive-exploratory study with a qualitative approach was carried out in the state of Espírito Santo in southeastern Brazil, with 25 women who had a child diagnosed with CZS.Results: Emerging themes from the content analysis were grouped into two categories:(1) inequalities experienced by mothers, including social inequality, poverty, and gender inequality; (2) the impact of a child with CZS on mothering, including feelings at the time of diagnosis, maternal isolation and mental health, experiences of stigma and prejudice, and exhausting itineraries searching for therapeutic care. Conclusion:The repercussions of CZS were a huge burden on already vulnerable women, and social inequalities and poverty were important markers in the mothers' reports.Many of the families affected by CZS already lived in precarious social conditions and these conditions were exacerbated further. Robust public and social policies to support these mothers need effective implementation given that babies born with CZS need long-term care and support.

show abstract

Section: Discussionsupporting

confidence: 63%

“…It is important to recognize that abortion is illegal in Brazil and families of low socioeconomic status face the greatest challenges in raising a disabled child. Furthermore, reproductive decisions are intimately related to personal convictions and cultural beliefs and are embedded in sociocultural norms …”

Section: Discussionmentioning

confidence: 99%

How do mothers feel? Life with children with congenital Zika syndrome

Freitas

Soares

Mocelin

et al. 2020

Intl J Gynecology & Obste

View full text Add to dashboard Cite

show abstract

“…These results were expected because uncertainties and feelings of worrisome were detected during pregnancy, but when mothers delivered a healthy baby, their emotional state improved as feelings of worrisome decreased. In the long term, this low perception of risk could be a problem leading to lower attendance to medical visits and under-detection of neurodevelopmental disabilities, because healthy-at-birth infants born to mothers with confirmed ZIKV infection still need long-term follow up to detect neurodevelopmental delays [ 7 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

“…The greater part of the affected populations lives in constraint-resource settings where making the most out of available resources is a major challenge [ 11 ]. Caregivers of children with disabilities are a group particularly susceptible to developing poor mental health, including depression, anxiety, and stress [ 12 , 13 ]. Furthermore, they might suffer an intensification of emotional symptoms, and also unhealthier habits, due to delays in children’s neurodevelopment over the years [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

Perceptions and Emotional State of Mothers of Children with and without Microcephaly after the Zika Virus Epidemic in Rural Caribbean Colombia

Romero-Acosta

Marbán-Castro

Arroyo-Alvis

et al. 2020

Behavioral Sciences

View full text Add to dashboard Cite

Zika virus (ZIKV) infection during pregnancy can cause neurological manifestations such as microcephaly. The aim of this study was to explore perceptions of ZIKV and mental health in women exposed to ZIKV during pregnancy in Colombia. This was a mixed-methods study based on structured interviews and psychological tests. Structured interviews were transcribed and analysed with Atlas Ti software. A grounded theory approach was applied. Quantitative analysis was performed with Statistical Package for Social Science, SPSS, V. 20. The study was approved by the Ethics Committee of the Universidad de Córdoba, Montería. Seventeen women participated in the study; nine of them were mothers of children with microcephaly. Maternal age ranged from 16 to 41 years old. The main themes discussed during interviews were: feelings, support, sources of information, and consequences on children’s health. Women with children affected by microcephaly showed worse mental health compared to women with normocephalic children. Maternal mental health worsened after 24 months from giving birth. Perceptions regarding disease severity and lack of knowledge were considered to affect maternal mental health. Social support and spirituality were key determinants for caregivers. Future research is needed to further study coping mechanisms and mental health outcomes over time by affected populations.

show abstract

“…Additionally, we measured the frequencies of IL-6+ cells within each of these populations, as it has been reported that IL-6 is upregulated during ZIKV infection (45). We found no significant differences in the frequencies of IL-6+ CD45+, IL-6+ CD68+, IL-6+ CD11b+, IL-6+ CD11c+, IL-6+ Ly6C+, or IL-6+ CD103+ cells between groups ( Fig.…”

Section: Resultsmentioning

confidence: 99%

Pregnancy alters innate immune responses to Zika virus infection in the genital tract

Lesteberg

Fader

Beckham

2019

Preprint

View full text Add to dashboard Cite

20Recent outbreaks of Zika virus (ZIKV) have been associated with birth defects, 21 including microcephaly and neurological impairment. However, the mechanisms which 22 confer increased susceptibility to ZIKV during pregnancy remain unclear. We 23 hypothesized that poor outcomes from ZIKV infection during pregnancy are due in part 24 to pregnancy-induced alteration of innate immune cell frequencies and cytokine 25 expression. To examine the impact of pregnancy on innate immune responses, we 26 inoculated pregnant and non-pregnant female C57BL/6 mice with 5x105 FFU of ZIKV 27 intravaginally. Innate immune cell frequencies and cytokine expression were measured 28 by flow cytometry at day 3 post infection. Compared to non-pregnant mice, pregnant 29 mice exhibited higher frequencies of uterine macrophages (CD68+) and tolerogenic 30 dendritic cells (CD11c+ CD103+ and CD11c+ CD11b+). Additionally, ZIKV-infected 31 pregnant mice had lower frequencies of CD45+ IL-12+ and CD11b+ IL-12+ cells in the 32 uterus and spleen. These data show that pregnancy results in an altered innate immune 33 response to ZIKV infection in the genital tract of mice and that pregnancy-associated 34 immune modulation may play an important role in the severity of acute ZIKV infection. 35 Importance 36Pregnant females longer duration that viremia following infection with Zika virus 37 but the mechanism of this is not established. Innate immune cellular responses are 38 important for controlling virus infection and are important for development and 39 maintenance of pregnancy. Thus, the acute immune response to Zika virus during 40 pregnancy may be altered so that the pregnancy can be maintained. To examine this 41 interaction, we utilized a mouse model of Zika virus infection during pregnancy using 42 3 intravaginal inoculation. We found that following Zika virus infection, pregnant mice 43 exhibited increased expression of tolerant or non-inflammatory dendritic cells. 44 Additionally, we found that pregnant mice have significantly depressed ability to secrete 45 the cytokine IL-12 from innate immune cells in the uterus and the spleen while 46 maintaining MHCII expression. These findings show that pregnancy-induced changes in 47 the innate immune cells are biased towards tolerance and can result in decreased 48 antigen-dependent stimulation of immune responses.49 50 Zika virus (ZIKV) is a neurotropic flavivirus originally isolated from a febrile 51 rhesus macaque in the Zika Forest of Uganda (1). Although ZIKV was first identified in 52 humans in 1952, only sporadic infections occurred in humans until 2007, when the first 53major outbreak was reported on Yap Island (2). Since its emergence, infections have 54 been reported in Africa, Asia, the Pacific Islands, and the Americas. ZIKV is transmitted 55 to humans predominantly through bites from Aedes mosquitos, but infections after 56 sexual contact and blood transfusions have also been reported (3, 4). The majority of 57 infected individuals are asymptomatic, with some infections causing mild...

show abstract

Depressive Symptoms and Care Demands Among Primary Caregivers of Young Children with Evidence of Congenital Zika Virus Infection in Brazil

Cited by 31 publications

References 26 publications

How do mothers feel? Life with children with congenital Zika syndrome

How do mothers feel? Life with children with congenital Zika syndrome

Perceptions and Emotional State of Mothers of Children with and without Microcephaly after the Zika Virus Epidemic in Rural Caribbean Colombia

Pregnancy alters innate immune responses to Zika virus infection in the genital tract

Contact Info

Product

Resources

About