Geography of Microcephaly in the Zika Era: A Study of Newborn Distribution and Socio-environmental Indicators in Recife, Brazil, 2015-2016

Souza, Ariani Impieri de; Siqueira, Marília Teixeira de; Ferreira, Ana Laura Carneiro Gomes; Freitas, Clarice Umbelino de; Bezerra, Anselmo César Vasconcelos; Ribeiro, Adeylson Guimarães; Nardocci, Adelaide Cássia

doi:10.1177/0033354918777256

Cited by 19 publications

(19 citation statements)

References 21 publications

(30 reference statements)

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“…This may be potentially associated with lower socioeconomic status, implying residence in more densely populated areas with less-regular garbage recollection, providing enhanced availability of virus for mosquito vectors and higher mosquito density. This hypothesis is consistent with area-level analyses of socioeconomic factors affecting ZIKV exposure in Bahia ( 1 ) and affecting occurrence of cases of microcephaly in Recife ( 20 ).…”

Section: Observationsupporting

confidence: 85%

Exhaustive TORCH Pathogen Diagnostics Corroborate Zika Virus Etiology of Congenital Malformations in Northeastern Brazil

Moreira-Soto

Cabral

Pedroso

et al. 2018

mSphere

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The Latin American Zika virus (ZIKV) outbreak had a major impact on reproductive health worldwide. The reasons for the massively increased reports of neonatal microcephaly in northeastern Brazil are still unclear. Beyond the technical limitations of laboratory diagnostics, unambiguous diagnosis of ZIKV as the cause of congenital malformations is hampered by similar clinical pictures elicited by other pathogens known as TORCH pathogens. We performed a case-control study comparing mothers of children with congenital malformations to age-matched controls from Salvador, Brazil, one of the areas most extensively affected by the ZIKV outbreak. The ZIKV and Chikungunya virus seroprevalence rates differed significantly, whereas the levels of maternal exposure to TORCH pathogens were similar between cases and controls. Our data support a link between maternal ZIKV infection and congenital malformations and suggest the occurrence of predominantly vector-borne ZIKV transmission in these cases. In addition, some highly prevalent TORCH pathogens may be misinterpreted as representative of ongoing ZIKV activity in the absence of exhaustive diagnostics in northeastern Brazil.

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Section: Observationsupporting

confidence: 85%

Exhaustive TORCH Pathogen Diagnostics Corroborate Zika Virus Etiology of Congenital Malformations in Northeastern Brazil

Moreira-Soto

Cabral

Pedroso

et al. 2018

mSphere

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“…A major study limitation herein was the lack of achievement of the target sample size. One major reason was an outbreak of microcephaly associated with Zika virus infection [42], which posed a major distraction to participant recruitment and the availability of resources. For example, there was concern among women about the use of medications in pregnancy, given that the etiology of the microcephaly outbreak was unclear at that time.…”

Section: Discussionmentioning

confidence: 99%

BRAzil magnesium (BRAMAG) trial: a double-masked randomized clinical trial of oral magnesium supplementation in pregnancy

Araújo

Ray

Figueirôa

et al. 2020

BMC Pregnancy Childbirth

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Background: There is conflicting evidence about the role of oral magnesium supplementation in the prevention of preterm birth and related adverse outcomes. The objective of this study was to compare magnesium citrate with placebo in the prevention of adverse perinatal and maternal outcomes among women at higher risk. Methods: This multicenter, double-masked, placebo-controlled randomized superiority clinical trial compared oral magnesium citrate 300 mg to matched placebo, from 12 to 20 weeks' gestation until delivery. This trial was completed in three centers in northeastern Brazil. Eligible women were those with a singleton pregnancy and ≥ 1 risk factor, such as prior preterm birth or preeclampsia, or current chronic hypertension or pre-pregnancy diabetes mellitus, age > 35 years or elevated body mass index. The primary perinatal composite outcome comprised preterm birth < 37 weeks' gestation, stillbirth > 20 weeks, neonatal death or NICU admission < 28 days after birth, or small for gestational age birthweight < 3rd percentile. The co-primary maternal composite outcome comprised preeclampsia or eclampsia < 37 weeks, severe gestational hypertension < 37 weeks, placental abruption, or maternal stroke or death during pregnancy or ≤ 7 days after delivery. Results: Analyses comprised 407 women who received magnesium citrate and 422 who received placebo. The perinatal composite outcome occurred among 75 (18.4%) in the magnesium arm and 76 (18.0%) in the placebo groupan adjusted odds ratio (aOR) of 1.10 (95% CI 0.72-1.68). The maternal composite outcome occurred among 49 (12.0%) women in the magnesium arm and 41 women (9.7%) in the placebo groupan aOR of 1.29 (95% CI 0.83-2.00). Conclusions: Oral magnesium citrate supplementation did not appear to reduce adverse perinatal or maternal outcomes in high-risk singleton pregnancies. Trial registration: ClinicalTrials.gov NCT02032186, registered January 9, 2014.

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“…The people afflicted by the Zika virus in Brazil were frequently portrayed as living in impoverished urban areas (Costa et al 2017; Souza et al 2018; Worth and Mizner 2016). Most often carried from human to human by the Aedes aegypti mosquito, transmission of the disease is more likely in places where the pest more easily breeds.…”

Section: Figurementioning

confidence: 99%

“…In this article I seek to understand why a disease often portrayed to largely plague the people of the densely populated urban slums of the Brazilian coast expanded to have some of the highest incidence rates in the wealthier and less populated agricultural interior. Academic and popular studies that link infectious disease outbreaks to the material conditions in which impoverished people live usefully draw attention to a number of sociospatial inequalities (Costa et al 2017; Souza et al 2018; Worth and Mizner 2016). However, such studies—some more intentionally than others—reify the notion that infectious diseases are diseases of the urban poor.…”

Section: Figurementioning

confidence: 99%

Pathogenic Metabolisms: A Rift and the Zika Virus in Mato Grosso, Brazil

Kaup

2020

Antipode

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The Zika virus in Brazil is often portrayed as emerging in and more severely inflicting the country’s impoverished coastal urban areas. However, the virus also impacted residents in wealthier and more rural areas. To understand how the Zika virus moved to seemingly less likely places, I bring political ecological approaches to health and disease into conversation with scholarly accounts of metabolic rifts. Making an incorporated comparison of the ways in which global finance and the Brazilian state shaped the relationship between urban and rural areas, I demonstrate how the era of modernist urban industrialisation resulted in the creation of more traditional spaces of Zika emergence in the country’s urban impoverished areas and the shift towards neoliberal agricultural extractivism resulted in the creation of seemingly more unusual spaces of Zika emergence in the wealthier less populated interior.

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Geography of Microcephaly in the Zika Era: A Study of Newborn Distribution and Socio-environmental Indicators in Recife, Brazil, 2015-2016

Abstract: The disproportionate incidence of microcephaly in newborns in poor areas of Recife reinforces the need for government and public health authorities to formulate policies that promote social equity and support for families and their children with microcephaly.

Cited by 19 publications

References 21 publications

Exhaustive TORCH Pathogen Diagnostics Corroborate Zika Virus Etiology of Congenital Malformations in Northeastern Brazil

Exhaustive TORCH Pathogen Diagnostics Corroborate Zika Virus Etiology of Congenital Malformations in Northeastern Brazil

BRAzil magnesium (BRAMAG) trial: a double-masked randomized clinical trial of oral magnesium supplementation in pregnancy

Pathogenic Metabolisms: A Rift and the Zika Virus in Mato Grosso, Brazil

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