Programa de Pós-graduação em Bioética Ética Aplicada e Saúde Coletiva, Fundação Oswaldo Cruz, Brasília, Brasil.
Anis - Instituto de Bioética Direitos Humanos e Gênero, Brasília, Brasil.
Cad Saude Publica. 2021 Jan 11;36(12):e00032020. doi: 10.1590/0102-311X00032020. eCollection 2021.
Until 2015, Zika was mostly unknown in Brazil and in the world. Since then, the Zika virus has been found to be vertically transmitted and to cause congenital Zika syndrome (CZS). This study aims to describe and analyze the vulnerabilities of the women and children most affected by the Zika epidemic in Brazil. Alagoas has the lowest Human Development Index in Brazil and one of the highest rates of adolescent pregnancy. Between December 2016 and March 2017, interviews were conducted with 54 women with children affected by Zika. The interviews had two components: a narrative-oriented conversation and a semi-structured questionnaire. This comprehensive mixed methods case study represented 45% of the confirmed CZS cases and 20% of the cases under investigation in the state at that time. The women are predominantly Afro-Brazilian; most experienced their first pregnancy during adolescence, and had little education. Many were not covered by social protection programs and were not receiving adequate health care. The rights and needs of these women and children are impacted by a systemic lack of access to services and medications. There is inadequate transportation to services that many families depend on. Discrimination against their children with disabilities is a new and complex concept in their lives. The Zika epidemic has compounded rights violations in their lives and worsened their social and economic layers of vulnerability. There is an urgent need for a robust public response to guarantee the rights of these women and children and to implement mechanisms to prevent and eliminate their vulnerabilities.
直到 2015 年，寨卡病毒在巴西和世界范围内还鲜为人知。此后，寨卡病毒被发现可垂直传播，并导致先天性寨卡综合征（CZS）。本研究旨在描述和分析巴西受寨卡疫情影响最严重的妇女和儿童的脆弱性。阿拉戈斯州是巴西人类发展指数最低的州，也是青少年怀孕率最高的州之一。2016 年 12 月至 2017 年 3 月期间，对 54 名患有寨卡病毒的儿童的妇女进行了访谈。访谈有两个部分：以叙述为导向的对话和半结构化问卷。这项综合的混合方法案例研究代表了当时该州确诊的 CZS 病例的 45%和正在调查的病例的 20%。这些妇女主要是非洲裔巴西人；大多数人在青少年时期经历了第一次怀孕，且受教育程度较低。许多人没有被纳入社会保护计划，也没有得到足够的医疗保健。这些妇女和儿童的权利和需求受到系统缺乏获取服务和药物的影响。许多家庭依赖的服务缺乏足够的交通。对残疾儿童的歧视是他们生活中的一个新的和复杂的概念。寨卡疫情加剧了他们生活中的权利侵犯，并恶化了他们的社会和经济脆弱性。迫切需要采取强有力的公共对策来保障这些妇女和儿童的权利，并建立预防和消除其脆弱性的机制。
