Lucena Sá Ana Carolyne de Carvalho, Oliveira André Luiz Sá de, Miranda-Filho Demócrito de Barros, Martelli Celina Maria Turchi, Araújo Thalia Velho Barreto de, Brickley Elizabeth B, Ximenes Ricardo Arraes de Alencar, Montarroyos Ulisses Ramos
Universidade de Pernambuco - UPE, Faculdade de Ciências Médicas, Postgraduate Program in Health Sciences, Recife, Pernambuco, Brazil.
Department of Statistics and Geoprocessing, Fundação Oswaldo Cruz - Fiocruz, Aggeu Magalhães Institute, Recife, Pernambuco, Brazil.
PLoS Negl Trop Dis. 2025 Jul 9;19(7):e0013240. doi: 10.1371/journal.pntd.0013240. eCollection 2025 Jul.
Using spatial analysis techniques, this study investigates the associations between socioeconomic indicators measured at the census tract level and the incidence of Zika virus (ZIKV) infection in pregnant persons and microcephaly in newborns in Recife, Pernambuco, Brazil, from 2015 to 2021.
In this ecological study, data on cases of ZIKV infections among pregnant persons registered in the Brazilian Information System for Notifiable Diseases (Sistema de Informação de Agravos de Notificaçao, SINAN-Zika) and cases of microcephaly among live births registered in the Public Health Event Registration System (Registro de Eventos em Saúde Pública, RESP-Microcefalia) and the Live Birth Information System (Sistema de Informações Sobre Nascidos Vivos, SINASC) were georeferenced based on residential address and aggregated within census tracts. Spatial autocorrelation was performed using the bivariate global and local Moran's I indices, which considered the incidence rates of maternal ZIKV infections and microcephaly during the epidemic (2015-2017) and post-epidemic (2018-2021) time periods in relation to each other as well as social, economic, sanitation, and urban infrastructure covariates derived from the 2010 census.
From 2015 to 2021, the city of Recife registered 253 cases (n = 240 in 2015-2017 and n = 13 in 2018-2021) of ZIKV infection in pregnant persons and 147 cases (n = 137 in 2015-2017 and n = 10 in 2018-2021) of microcephaly in newborns. The global bivariate Moran's I index between the incidences of ZIKV infection in pregnant persons and microcephaly were 0.127 (p = 0.001) in 2015-2017 and 0.074 (p = 0.002) in 2018-2021, indicating a positive spatial correlation, as higher was the ZIKV infection in pregnant persons, higher was the incidence of microcephaly. Furthermore, incidences of maternal ZIKV infection and microcephaly were consistently associated with indicators of greater social vulnerability and economic deprivation at the census tract level.
During the epidemic and post-epidemic periods in Recife, cases of ZIKV in pregnant persons and microcephaly were concentrated in census tracts with relatively higher socioeconomic vulnerability, reinforcing the need for research to inform the development of social protection and environmental policies to mitigate ZIKV-related risks.
本研究运用空间分析技术，调查了巴西伯南布哥州累西腓市2015年至2021年人口普查区层面的社会经济指标与孕妇寨卡病毒（ZIKV）感染发病率以及新生儿小头畸形之间的关联。
在这项生态学研究中，巴西法定传染病信息系统（Sistema de Informação de Agravos de Notificação, SINAN-Zika）登记的孕妇寨卡病毒感染病例数据，以及公共卫生事件登记系统（Registro de Eventos em Saúde Pública, RESP-Microcefalia）和活产信息系统（Sistema de Informações Sobre Nascidos Vivos, SINASC）登记的活产儿小头畸形病例数据，根据居住地址进行地理定位，并在人口普查区内汇总。使用双变量全局和局部莫兰指数进行空间自相关分析，该指数考虑了疫情期间（2015 - 2017年）和疫情后（2018 - 2021年）孕妇寨卡病毒感染和小头畸形的发病率之间的相互关系，以及来自2010年人口普查的社会、经济、卫生和城市基础设施协变量。
2015年至2021年，累西腓市登记了253例孕妇寨卡病毒感染病例（2015 - 2017年为240例，2018 - 2021年为13例）和147例新生儿小头畸形病例（2015 - 2017年为,137例，2018 - 2021年为10例）。孕妇寨卡病毒感染发病率与小头畸形发病率之间的全局双变量莫兰指数在2015 - 2017年为0.127（p = 0.001），在2018 - 2021年为0.074（p = 0..002），表明存在正空间相关性，即孕妇寨卡病毒感染率越高，小头畸形发病率越高。此外，孕妇寨卡病毒感染和小头畸形的发病率在人口普查区层面始终与更大的社会脆弱性和经济贫困指标相关。
在累西腓市的疫情期间和疫情后时期，孕妇寨卡病毒感染病例和小头畸形病例集中在社会经济脆弱性相对较高的人口普查区，这进一步凸显了开展研究以为制定社会保护和环境政策提供信息以降低寨卡病毒相关风险的必要性。
