Zika epidemic and microcephaly in Brazil: Challenges for access to health care and promotion in three epidemic areas

Peiter, Paulo Cesar; Pereira, Rafael dos Santos; Moreira, Martha Cristina Nunes; Nascimento, Marcos Antonio Ferreira do; Tavares, Maria de Fatima Lobato; Franco, Vivian da Cruz; Carvajal Cortês, José Joaquin; Campos, Daniel de Souza; Barcellos, Christovam de Castro

Zika epidemic and microcephaly in Brazil: Challenges for access to health care and promotion in three epidemic areas

Detalhes bibliográficos
Autor(a) principal:	Peiter, Paulo Cesar
Data de Publicação:	2020
Outros Autores:	Pereira, Rafael dos Santos, Moreira, Martha Cristina Nunes, Nascimento, Marcos Antonio Ferreira do, Tavares, Maria de Fatima Lobato, Franco, Vivian da Cruz, Carvajal Cortês, José Joaquin, Campos, Daniel de Souza, Barcellos, Christovam de Castro
Tipo de documento:	Artigo
Idioma:	eng
Título da fonte:	Repositório Institucional da FIOCRUZ (ARCA)
Texto Completo:	https://www.arca.fiocruz.br/handle/icict/42186
Resumo:	The authors have declared that no competing interests exist.

Metadados do item

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spelling	Peiter, Paulo CesarPereira, Rafael dos SantosMoreira, Martha Cristina NunesNascimento, Marcos Antonio Ferreira doTavares, Maria de Fatima LobatoFranco, Vivian da CruzCarvajal Cortês, José JoaquinCampos, Daniel de SouzaBarcellos, Christovam de Castro2020-07-10T12:37:14Z2020-07-10T12:37:14Z2020PEITER, Paulo Cesar et al. Zika epidemic and microcephaly in Brazil: Challenges for access to health care and promotion in three epidemic areas. PLoS ONE, v. 15, n. 7, p. 1-15, 2020.1932-6203https://www.arca.fiocruz.br/handle/icict/4218610.1371/journal.pone.0235010The authors have declared that no competing interests exist.Desde 2015, o Brasil experimenta as repercussões sociais da epidemia do vírus zika, suscitando um debate sobre: dificuldades de diagnóstico; acesso à saúde de crianças com Síndrome Congênita do Zika (ZCS); a busca de benefícios pelas famílias afetadas; desigualdades sociais e de gênero; e uma discussão sobre direitos reprodutivos, entre outros. O objetivo deste artigo é analisar o acesso a serviços de saúde especializados para o atendimento de crianças nascidas com ZCS em três estados do Nordeste do Brasil. Trata-se de um estudo transversal exploratório que analisa casos registrados de microcefalia no nível municipal entre 2015 e 2017. A maioria dos casos de ZCS estava concentrada na costa nordeste. Rio Grande do Norte e Paraíba tiveram a maior incidência de microcefalia no período estudado. Os estados da Bahia, Paraíba e Rio Grande do Norte foram selecionados por sua alta incidência de microcefalia devido ao vírus zika. A vulnerabilidade sócio-territorial foi estratificada usando o acesso aos indicadores de diagnóstico e tratamento da microcefalia. A rede de atenção especializada foi mapeada de acordo com os Protocolos das Secretarias Estaduais de Saúde. Estabeleceu-se um raio limiar de 100 km como a distância máxima entre os centróides dos municípios e os serviços de saúde especializados para crianças com microcefalia. A cobertura pré-natal foi satisfatória na maior parte da área de estudo, embora a disponibilidade de equipamentos de ultrassom tenha sido desigual nos estados e regiões de saúde. O oeste da Bahia tinha a menor cobertura de equipamentos de ultrassom e faltava serviços de reabilitação em saúde. Os serviços de saúde especializados da ZCS estavam espalhados por grandes áreas, algumas das quais fora dos municípios de origem dos pacientes afetados, de modo que os deslocamentos eram caros e consumiam muito tempo, representando um fardo extra para as famílias afetadas. Este estudo é o primeiro a abordar a acessibilidade de crianças com microcefalia a serviços de saúde especializados e aponta para a necessidade urgente de ampliar a cobertura desses serviços no Brasil, especialmente nos estados do nordeste, os mais afetados pela epidemia.Since 2015 Brazil has experienced the social repercussions of the Zika virus epidemic, thus raising a debate about: difficulties of diagnosis; healthcare access for children with Zika Congenital Syndrome (ZCS); the search for benefits by affected families; social and gender inequalities; and a discussion on reproductive rights, among others. The objective of this article is to analyse access to specialized health services for the care of children born with ZCS in three North-eastern states of Brazil. This is an exploratory cross-sectional study which analyses recorded cases of microcephaly at the municipal level between 2015 and 2017. Most of the cases of ZCS were concentrated on the Northeast coast. Rio Grande do Norte and Paraiba had the highest incidence of microcephaly in the study period. The states of Bahia, Paraiba and Rio Grande do Norte were selected for their high incidence of microcephaly due to the Zika Virus. Socio-territorial vulnerability was stratified using access to microcephaly diagnosis and treatment indicators. The specialized care network was mapped according to State Health Secretaries Protocols. A threshold radius of 100 km was stablished as the maximum distance from municipalities centroids to specialised health care for children with microcephaly. Prenatal coverage was satisfactory in most of the study area, although availability of ultrasound equipment was uneven within states and health regions. Western Bahia had the lowest coverage of ultrasound equipment and lacked health rehabilitation services. ZCS's specialized health services were spread out over large areas, some of which were outside the affected patients' home municipalities, so displacements were expensive and very time consuming, representing an extra burden for the affected families. This study is the first to address accessibility of children with microcephaly to specialised health care services and points to the urgent need to expand coverage of these services in Brazil, especially in the northeastern states, which are most affected by the epidemic.This research is part of the project “Health promotion in the context of the Zika epidemic: actors and scenarios in decision-making processes” funded by the Zikalliance Consortium. Total funding USD 70,000.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional da Saúde da Mulher da Criança e do Adolescente Fernandes Figueira. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional da Saúde da Mulher da Criança e do Adolescente Fernandes Figueira. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Escola Nacional de Saúde Pública Sérgio Arouca. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Oswaldo Cruz. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Institute Leônidas & Maria Deane. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto Nacional da Saúde da Mulher da Criança e do Adolescente Fernandes Figueira. Rio de Janeiro, RJ, Brasil.Fundação Oswaldo Cruz. Instituto de Comunicação e Informação Científica e Tecnológica em Saúde. Rio de Janeiro, RJ, Brasil.engPublic Library of ScienceZika VirusCriançaBrasilZika VirusZika Congenital SyndromeChildrenBrazilZika epidemic and microcephaly in Brazil: Challenges for access to health care and promotion in three epidemic areasinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleinfo:eu-repo/semantics/openAccessreponame:Repositório Institucional da FIOCRUZ (ARCA)instname:Fundação Oswaldo Cruz (FIOCRUZ)instacron:FIOCRUZLICENSElicense.txtlicense.txttext/plain; charset=utf-82991https://www.arca.fiocruz.br/bitstream/icict/42186/1/license.txt5a560609d32a3863062d77ff32785d58MD51ORIGINALjournal.pone.0235010.pdfjournal.pone.0235010.pdfapplication/pdf3092171https://www.arca.fiocruz.br/bitstream/icict/42186/2/journal.pone.0235010.pdfc034ff593b4ae3b54bd9a3bdd0c1048aMD52TEXTjournal.pone.0235010.pdf.txtjournal.pone.0235010.pdf.txtExtracted 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dc.title.pt_BR.fl_str_mv	Zika epidemic and microcephaly in Brazil: Challenges for access to health care and promotion in three epidemic areas
title	Zika epidemic and microcephaly in Brazil: Challenges for access to health care and promotion in three epidemic areas
spellingShingle	Zika epidemic and microcephaly in Brazil: Challenges for access to health care and promotion in three epidemic areas Peiter, Paulo Cesar Zika Virus Criança Brasil Zika Virus Zika Congenital Syndrome Children Brazil
title_short	Zika epidemic and microcephaly in Brazil: Challenges for access to health care and promotion in three epidemic areas
title_full	Zika epidemic and microcephaly in Brazil: Challenges for access to health care and promotion in three epidemic areas
title_fullStr	Zika epidemic and microcephaly in Brazil: Challenges for access to health care and promotion in three epidemic areas
title_full_unstemmed	Zika epidemic and microcephaly in Brazil: Challenges for access to health care and promotion in three epidemic areas
title_sort	Zika epidemic and microcephaly in Brazil: Challenges for access to health care and promotion in three epidemic areas
author	Peiter, Paulo Cesar
author_facet	Peiter, Paulo Cesar Pereira, Rafael dos Santos Moreira, Martha Cristina Nunes Nascimento, Marcos Antonio Ferreira do Tavares, Maria de Fatima Lobato Franco, Vivian da Cruz Carvajal Cortês, José Joaquin Campos, Daniel de Souza Barcellos, Christovam de Castro
author_role	author
author2	Pereira, Rafael dos Santos Moreira, Martha Cristina Nunes Nascimento, Marcos Antonio Ferreira do Tavares, Maria de Fatima Lobato Franco, Vivian da Cruz Carvajal Cortês, José Joaquin Campos, Daniel de Souza Barcellos, Christovam de Castro
author2_role	author author author author author author author author
dc.contributor.author.fl_str_mv	Peiter, Paulo Cesar Pereira, Rafael dos Santos Moreira, Martha Cristina Nunes Nascimento, Marcos Antonio Ferreira do Tavares, Maria de Fatima Lobato Franco, Vivian da Cruz Carvajal Cortês, José Joaquin Campos, Daniel de Souza Barcellos, Christovam de Castro
dc.subject.other.pt_BR.fl_str_mv	Zika Virus Criança Brasil
topic	Zika Virus Criança Brasil Zika Virus Zika Congenital Syndrome Children Brazil
dc.subject.en.pt_BR.fl_str_mv	Zika Virus Zika Congenital Syndrome Children Brazil
description	The authors have declared that no competing interests exist.
publishDate	2020
dc.date.accessioned.fl_str_mv	2020-07-10T12:37:14Z
dc.date.available.fl_str_mv	2020-07-10T12:37:14Z
dc.date.issued.fl_str_mv	2020
dc.type.status.fl_str_mv	info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv	info:eu-repo/semantics/article
format	article
status_str	publishedVersion
dc.identifier.citation.fl_str_mv	PEITER, Paulo Cesar et al. Zika epidemic and microcephaly in Brazil: Challenges for access to health care and promotion in three epidemic areas. PLoS ONE, v. 15, n. 7, p. 1-15, 2020.
dc.identifier.uri.fl_str_mv	https://www.arca.fiocruz.br/handle/icict/42186
dc.identifier.issn.pt_BR.fl_str_mv	1932-6203
dc.identifier.doi.none.fl_str_mv	10.1371/journal.pone.0235010
identifier_str_mv	PEITER, Paulo Cesar et al. Zika epidemic and microcephaly in Brazil: Challenges for access to health care and promotion in three epidemic areas. PLoS ONE, v. 15, n. 7, p. 1-15, 2020. 1932-6203 10.1371/journal.pone.0235010
url	https://www.arca.fiocruz.br/handle/icict/42186
dc.language.iso.fl_str_mv	eng
language	eng
dc.rights.driver.fl_str_mv	info:eu-repo/semantics/openAccess
eu_rights_str_mv	openAccess
dc.publisher.none.fl_str_mv	Public Library of Science
publisher.none.fl_str_mv	Public Library of Science
dc.source.none.fl_str_mv	reponame:Repositório Institucional da FIOCRUZ (ARCA) instname:Fundação Oswaldo Cruz (FIOCRUZ) instacron:FIOCRUZ
instname_str	Fundação Oswaldo Cruz (FIOCRUZ)
instacron_str	FIOCRUZ
institution	FIOCRUZ
reponame_str	Repositório Institucional da FIOCRUZ (ARCA)
collection	Repositório Institucional da FIOCRUZ (ARCA)
bitstream.url.fl_str_mv	https://www.arca.fiocruz.br/bitstream/icict/42186/1/license.txt https://www.arca.fiocruz.br/bitstream/icict/42186/2/journal.pone.0235010.pdf https://www.arca.fiocruz.br/bitstream/icict/42186/3/journal.pone.0235010.pdf.txt
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Zika epidemic and microcephaly in Brazil: Challenges for access to health care and promotion in three epidemic areas

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