Social determinants of health associated with topical repellent use in pregnancy: a cross-sectional study during a Zika outbreak in Brazil

Cartaxo, M.; Silva, Sophia Maria D; Silva, Jaiurte G M; Beltrão, Eduardo Isidoro Carneiro; Brayner, Fábio André; Filho, José Luiz de Lima; Mattos, Sandra S.; Ceballos, Albanita Gomes da Costa de; Schettini, Juliana A C; Alves, Luíz Carlos

doi:10.1093/trstmh/try114

Cited by 5 publications

(7 citation statements)

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“…Studies carried out during the ZIKV epidemic documented the relationship between the level of education in the face of behavioral changes and the population's knowledge of the prevention of arboviruses. Authors of these studies identified that a lower level of education led to low use of recommended precautions 26,27 , while a higher level of education and better economic conditions favored the adoption of personal protection measures [28][29][30] , corroborating this research. However, approximately 9% of the par-ticipants in this survey reported having a college degree, a number far below the Brazilian level -according to which, in 2019, there were 19.4% women aged 25 years and over who had a college degree 31 , demonstrating that the study participants compose a group of high social vulnerability.…”

Section: Discussionsupporting

confidence: 60%

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Use of insect repellent as personal protection among women of childbearing age in an arbovirus endemic area in Northeastern Brazil

Dias,

Sanhueza-Sanzana,

Pinheiro Júnior

et al. 2024

Rev. bras. epidemiol.

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Objective: To analyze the factors associated with the individual use of insect repellent by women of childbearing age living in area endemic for arboviruses in Fortaleza, Brazil. Methods: This is a cohort study carried out between 2018 and 2019 with women aged between 15 and 39 years in Fortaleza, state of Ceará, Brazil. A total of 1,173 women users of one of the four selected primary health care units participated in the study. The outcome was divided into: continued use, discontinued use, and nonuse of insect repellent. Crude and adjusted multinominal logistic regression analysis was carried out guided by a hierarchical model, with presentation of the respective odds ratio (OR) and 95% confidence intervals (95%CI). The independent variables include: socioeconomic and demographic data, environmental and sanitary characteristics, knowledge of the insect repellent, and behavioral and pregnancy-related aspects. Results: Only 28% of the participants reported using insect repellent during the two waves of the cohort. Women with higher education (OR=2.55; 95%CI 1.44–4.51); who are employed (OR=1.51; 95%CI 1.12–2.03); who received guidance from healthcare professionals (OR=1.74; 95%CI 1.28–2.36) and the media (OR=1.43; 95%CI 1.01–2.02); who intensified precautions against mosquitoes during the epidemic (OR=3.64; 95%CI 2.29–5.78); and who were pregnant between 2016 and 2019 (OR=2.80; 95%CI 1.83–4.30) had increased odds for continued use of insect repellent. Conclusion: The use of insect repellent among women of childbearing age was associated with a higher level of education, employment, guidance on insect repellent provided by healthcare professionals and the media, behavioral changes to protect against mosquitoes during the Zika virus epidemic, and pregnancy when occurring as of the beginning of the epidemic period.

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Section: Discussionsupporting

confidence: 60%

“…The provision of guidance without considering the characteristics of the target audience, behavioral changes, and the application of advances in the theory and practice of health communication 27 , 34 is reflected in low adherence to the measure or irregular use, even when a preventive strategy is accessed 28 , 29 , 37 .…”

Section: Discussionmentioning

confidence: 99%

Use of insect repellent as personal protection among women of childbearing age in an arbovirus endemic area in Northeastern Brazil

Dias,

Sanhueza-Sanzana,

Pinheiro Júnior

et al. 2024

Rev. bras. epidemiol.

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“…Similar findings have been previously reported in other localities with recent history of arboviral diseases 20,33,36,37,38,39 . These outcomes suggest that knowledge does not necessarily lead to adequate prevention practices, especially in contexts where the complex interactions among environmental and social determinants increase human vulnerability to vector borne diseases 12,13,14,40 . Our findings show a high percentage of domestic risk practices associated with great deficiencies in water supply and sanitation services.…”

Section: Key Findings and Other Studies Comparisonmentioning

confidence: 99%

“…Nonetheless, characteristics of environments and public infrastructures, as health determinants fundamental parts, could significantly persuade people's ability to perform preventive behaviors and measures 16 . If the impact of these contextual circumstances on people's behaviors and perceptions is not properly considered and addressed, achieving a real change in prevention practices could be a difficult process 11,12,13,14,22,40 .…”

Section: Key Findings and Other Studies Comparisonmentioning

confidence: 99%

Emerging arboviruses (dengue, chikungunya, and Zika) in Southeastern Mexico: influence of socio-environmental determinants on knowledge and practices

et al. 2020

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Abstract: The proliferation of arboviruses and their vectors is influenced by a complex interplay between vector, environment and human behaviors. The aim of this work is to analyze the influence of socio-environmental determinants on knowledge and practices regarding arboviruses transmission, among the residents of three communities on the southern border of Mexico. Between June 2017 and August 2018, a set of 149 households from three communities of Tapachula (Chiapas) and Villahermosa (Tabasco) were covered. This study consists of the application of a community prevention project. Different surveys and methodological approaches were used. Associations between socio-environmental determinants and knowledge and practices for arboviruses transmission control were estimated by odds ratio. Logistic regression and qualitative techniques were used. Although around 75% of households had an adequate knowledge about arboviruses’ origin and transmission, only 30% of them adopted adequate practices. Domestic risk practices were associated with serious deficiencies in water and sanitation services. Furthermore, a perception of greater risk and difficulty in complying with preventive measures were detected. An adequate knowledge does not necessarily lead to adequate prevention practices. Intermediate social determinants influence on the persistence of risk behaviors for arboviruses proliferation. Addressing such related aspects requires the achievement of an effective and sustainable vector management.

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“…Estudos realizados durante a epidemia do ZIKV documentaram a relação entre o nível de escolaridade frente às mudanças comportamentais e o conhecimento da população na prevenção às arboviroses. Identificaram que uma menor escolaridade levou ao baixo uso das precauções recomendadas 26,27 , enquanto que um maior nível de escolaridade e melhores condições econômicas favoreceram a adoção de medidas de proteção pessoal [28][29][30] , corroborando com esta pesquisa. Porém, aproximadamente 9% das participantes desta pesquisa informaram possuir o ensino superior, um quantitativo muito abaixo do nível brasileiro que, em 2019, registrou que 19,4% das mulheres com 25 anos ou mais tinham o ensino superior completo 31 , revelando que as mulheres participantes compõem um grupo de alta vulnerabilidade social.…”

Section: Discussionunclassified

Uso de repelente como medida de proteção pessoal por mulheres em idade fértil residentes em áreas endêmicas para arboviroses no Nordeste do Brasil

Dias,

Sanhueza-Sanzana,

Pinheiro Júnior

et al. 2024

Rev. bras. epidemiol.

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RESUMO Objetivo: Analisar os fatores associados ao uso de repelente individual por mulheres em idade fértil residentes em área endêmicas para arboviroses em Fortaleza, Brasil. Métodos: Coorte realizada entre 2018 e 2019, com mulheres entre 15 e 39 anos, moradoras em Fortaleza, Ceará, Brasil. Participaram 1.173 mulheres, usuárias de quatro unidades primárias de saúde do município. O desfecho foi categorizado em: uso continuado, uso descontinuado e não uso de repelente. Realizada análise de regressão logística multinominal norteada por modelo hierárquico, com apresentação dos respectivos odds ratio (OR) e intervalos de confiança de 95% (IC95%). As variáveis independentes incluem: dados socioeconômicos e demográficos, características ambientais e sanitárias, conhecimento sobre o repelente e aspectos comportamentais e relacionados à gravidez. Resultados: Somente 28% das participantes referiram o uso de repelente durante as duas ondas da coorte. Mulheres com escolaridade superior (OR=2,55; IC95% 1,44–4,51); com emprego (OR=1,51; IC95% 1,12–2,03); que receberam orientações por profissionais da saúde (OR=1,74; IC95% 1,28–2,36) e pela mídia (OR=1,43; IC95% 1,01–2,02); que intensificaram os cuidados contra o mosquito na epidemia (OR=3,64; IC95% 2,29–5,78); estavam grávidas entre 2016 e 2019 (OR=2,80; IC95% 1,83–4,30) tiveram as chances aumentadas para uso continuado de repelente. Conclusões: O uso de repelente entre mulheres em idade fértil mostrou-se associado a um maior nível de escolaridade, ao emprego, às orientações sobre repelente fornecidas por profissionais de saúde e pela mídia, às mudanças comportamentais de cuidado contra o mosquito durante a epidemia da Zika e à gravidez quando ocorrida a partir do início do período epidêmico.

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Social determinants of health associated with topical repellent use in pregnancy: a cross-sectional study during a Zika outbreak in Brazil

Cited by 5 publications

References 29 publications

Use of insect repellent as personal protection among women of childbearing age in an arbovirus endemic area in Northeastern Brazil

Use of insect repellent as personal protection among women of childbearing age in an arbovirus endemic area in Northeastern Brazil

Emerging arboviruses (dengue, chikungunya, and Zika) in Southeastern Mexico: influence of socio-environmental determinants on knowledge and practices

Uso de repelente como medida de proteção pessoal por mulheres em idade fértil residentes em áreas endêmicas para arboviroses no Nordeste do Brasil

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