Touchton Michael, Wampler Brian
Department of Political Science, University of Miami, Coral Gables, FL 33146, USA.
Faculty Lead for Global Health, Institute for Advanced Studies of the Americas, University of Miami, Coral Gables, FL 33146, USA.
Trop Med Infect Dis. 2023 Jan 5;8(1):38. doi: 10.3390/tropicalmed8010038.
The Zika virus is a mosquito-borne virus spread primarily by mosquitoes. Zika cases have been detected throughout the mosquito's range, with an epidemic occurring from 2015 to 2017 in Brazil. Many Zika cases are mild or asymptomatic, but infections in pregnant women can cause microcephaly in children, and a small percentage of cases result in Guillan-Barré syndrome. There is currently little systematic information surrounding the municipal spread of the Zika Virus in Brazil. This article uses coarsened exact matching with negative binomial estimation and ordinary least squares estimation to assess the determinants of Zika incidence across the ~280,000 cases confirmed and recorded by Brazil's Ministry of Health in 2016 and 2017. These data come from Freedom of Information Act (FOIA) requests in Brazil and have not been published. We use data on the universe of individual Zika cases in Brazil and Geographic Information Systems (GIS) software to examine the virus at the municipal level across 5570 municipalities and construct a unique, unusually rich dataset covering daily Zika transmission. Additionally, our dataset includes corresponding local data on democratic governance, mosquito control efforts, and environmental conditions to estimate their relationship to Zika transmission. The results demonstrate that the presence of subnational democratic, participatory policymaking institutions and high levels of local state capacity are associated with low rates of Zika contraction. These models control for local healthcare spending and economic conditions, among other factors, that also influence Zika contraction rates. In turn, these findings provide a better understanding of what works for local health governance and mosquito control and makes important data public so that scholars and practitioners can perform their own analyses. Stronger models of Zika transmission will then inform mosquito abatement efforts across the Global South, as well as provide a blueprint for combatting Dengue fever, which is also transmitted by mosquitoes.
寨卡病毒是一种主要由蚊子传播的蚊媒病毒。在蚊子分布的整个区域都检测到了寨卡病例，2015年至2017年在巴西发生了疫情。许多寨卡病例症状轻微或无症状，但孕妇感染可导致儿童小头畸形，一小部分病例会引发吉兰-巴雷综合征。目前，关于巴西寨卡病毒在各市传播的系统性信息很少。本文使用粗化精确匹配与负二项式估计以及普通最小二乘法估计，来评估2016年和2017年巴西卫生部确认并记录的约28万例寨卡发病率的决定因素。这些数据来自巴西的信息自由法案（FOIA）请求，尚未发表。我们使用巴西寨卡病例个体全集的数据和地理信息系统（GIS）软件来在5570个市的市级层面研究该病毒，并构建一个独特的、异常丰富的数据集，涵盖寨卡病毒的每日传播情况。此外，我们的数据集包括关于民主治理、蚊虫控制措施和环境状况的相应本地数据，以估计它们与寨卡病毒传播之间的关系。结果表明，地方民主、参与性决策机构的存在以及高水平的地方政府能力与寨卡感染率较低有关。这些模型控制了也会影响寨卡感染率的其他因素，如地方医疗支出和经济状况等。反过来，这些发现能让人们更好地理解哪些措施对地方卫生治理和蚊虫控制有效，并公开重要数据，以便学者和从业者能够进行自己的分析。更强大的寨卡病毒传播模型将为全球南方地区的蚊虫防治工作提供参考，同时也为抗击同样由蚊子传播的登革热提供蓝图。
