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

Abstract

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.

“One feels anger to know there is no one to help us!”. Perceptions of mothers of children with Zika virus-associated microcephaly in Caribbean Colombia: A qualitative study

“…Besides, healthcare professionals need to provide coping strategies and social support for stress reduction, especially for those families living in low-resource settings [ 11 ]. Recent epidemics, such as ZIKV, have spread in poor countries, characterized by structural inequalities, high unemployment rates, poor sanitation, lower healthcare awareness, lack of healthcare access, mental health, etc., factors that contribute to viral spread and barriers that hinder adherence to treatment [ 47 ].…”

“…In the current study, one mother pointed out that she felt abandoned by the government, society, and even, by the family members. In the study of Romero-Acosta, et al, some mothers in Colombia also felt stigmatized by their own families [ 11 ]. This stigma could be perceived as abandonment from family members, above all, extended family.…”

“…Participants were identified from a study conducted in rural and peri-urban areas in Córdoba and Sucre departments, Caribbean Colombia. That study included a clinical follow-up of microcephalic children born at the study hospital “Clínica Salud Social” in Sincelejo (Sucre) during the first semester of 2016 [ 11 , 36 ]. Mothers of followed-up children were contacted by phone calls to participate in the current study.…”

“…Mothers of children affected by microcephaly experience significant emotional and psychological distress; as most of them are stigmatized, abandoned by their partners, relatives, and communities [ 5 ]. Additionally, it has been reported that their mental health worsens over the years [ 6 , 11 ]. Families were also affected by changes produced in the daily routine, which in turn, impacts the couple’s relationship, the possibility to work, as sometimes one parent needs to leave the job for child care, leading to economic difficulties [ 12 ].…”

High Seroprevalence of Antibodies against Arboviruses among Pregnant Women in Rural Caribbean Colombia in the Context of the Zika Virus Epidemic

“…These pregnant adolescents are especially vulnerable to access appropriate health care services, including fewer antenatal care visits compared to adult pregnant women and resulting in poorer maternal and child health [ 25 ]. The importance of a prompt diagnosis of arboviral infection during pregnancy lies on the psychosocial impact it has for affected women’s mental health and emotional state [ 26 , 27 ].…”