Pinto Márcia, Moreira Maria Elisabeth Lopes, Barros Letícia Baptista de Paula, Costa Ana Carolina Carioca da, Fernandes Silke, Kuper Hannah
Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, U.K.
Cad Saude Publica. 2021 Nov 22;37(11):e00007021. doi: 10.1590/0102-311X00007021. eCollection 2021.
In 2015, there was an increase in cases of congenital malformations in newborns in Brazil, associated with maternal Zika virus infection, having serious social and economic repercussions for the families. The study aimed to estimate the prevalence of catastrophic expenditure by families of children with severe or mild/moderate congenital Zika syndrome (CZS) in comparison to families of children without a diagnosis of CZS in the state of Rio de Janeiro. Catastrophic expenditure occurs when spending exceeds a given proportion of the family income due to a disease. Family caregivers of children with severe CZS were younger and had less schooling and lower income. Prevalence of catastrophic expenditure was higher in families of children with CZS. Among caregivers of children with severe CZS, the prevalence of catastrophic expenditure was higher in those with severe or very severe depression, anxiety, and stress. Low social support among caregivers was also a determinant factor for increased prevalence of catastrophic expenditure. The burden on caregivers of children with severe CZS exacerbates a situation of vulnerability that requires the expansion of mechanisms for financial and social protection, through linkage of various policies capable of effectively reaching this group.
2015年，巴西新生儿先天性畸形病例有所增加，这与孕妇感染寨卡病毒有关，给家庭带来了严重的社会和经济影响。该研究旨在估计里约热内卢州患有严重或轻度/中度先天性寨卡综合征（CZS）儿童的家庭与未诊断出CZS儿童的家庭相比，灾难性支出的患病率。当因疾病导致支出超过家庭收入的一定比例时，就会发生灾难性支出。患有严重CZS儿童的家庭照顾者更年轻，受教育程度更低，收入也更低。CZS儿童家庭的灾难性支出患病率更高。在患有严重CZS儿童的照顾者中，患有严重或非常严重抑郁、焦虑和压力的照顾者灾难性支出的患病率更高。照顾者之间社会支持较低也是灾难性支出患病率增加的一个决定性因素。患有严重CZS儿童的照顾者负担加剧了脆弱状况，这需要通过将各种能够有效惠及该群体的政策联系起来，扩大金融和社会保护机制。
