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Fertility trends during successive novel infectious disease outbreaks: Zika and COVID-19 in Brazil.

ABSTRACT: This study aims to estimate fertility trends in Brazil in the 2010s and early 2020s during a period of back-to-back novel infectious disease outbreaks - Zika virus and COVID-19. We use Brazilian Ministry of Health and Association of Civil Registrar data from 2011-2021 to measure general fertility rates at the national and state levels. We also used seasonal ARIMA model to forecast fertility rates by month and state in 2021 and compared these forecasts with observed fertility rates. We find that fertility rates were steady over 2011-2015 with no statistically significant variation, followed by a sharp decline during the Zika outbreak in 2016 followed by a return to pre-Zika levels after the end of the epidemic. Furthermore, to evaluate the effect of the COVID-19 pandemic, we make comparisons with observed and forecast rates from 2020-2021, showing that declines were generally larger for observed than for forecast rates, yet statistically insignificant. We argue that the resurgence of the COVID-19 pandemic in 2021 might lead to further declines, as women might have not had enough time to adjust rebound from either the effects of the Zika epidemic. We also discuss the importance of timely availability of live births data during a public health crisis with immediate consequences for fertility rates.

SUBMITTER: Marteleto LJ

PROVIDER: S-EPMC9744098 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

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Fertility trends during successive novel infectious disease outbreaks: Zika and COVID-19 in Brazil.

Marteleto Leticia Junqueira LJ Sereno Luiz Gustavo Fernandes LGF Coutinho Raquel Zanatta RZ Dondero Molly M Alves Sandra Valongueiro SV Lloyd Ryan R Koepp Andrew A

Cadernos de saude publica 20220429 4

This study aims to estimate fertility trends in Brazil in the 2010s and early 2020s during a period of back-to-back novel infectious disease outbreaks - Zika virus and COVID-19. We use Brazilian Ministry of Health and Association of Civil Registrar data from 2011-2021 to measure general fertility rates at the national and state levels. We also used seasonal ARIMA model to forecast fertility rates by month and state in 2021 and compared these forecasts with observed fertility rates. We find that ...[more]

PMID: 35508025

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Project description:BackgroundSince the beginning of the new coronavirus pandemic, there has been much information about the disease and the virus has been in the spotlight, shared and commented upon on the Internet. However, much of this information is infodemics and can interfere with the advancement of the disease and that way that populations act. Thus, Brazil is a country that requires attention, as despite the fact that in almost two years of pandemic it has shown a devastating numbers of deaths and number of cases, and generates false, distorted and malicious news about the pandemic. This work intends to understand the attitudes of the Brazilian population using infodemic queries from the Google Trends search tool and social and income variables.MethodsData from infodemic research carried out on Google Trends, between January 1, 2020 and June 30, 2021, with socioeconomic data, such as income and education, were unified in a single database: standardization and exploratory and multivalued techniques based on grouping were used in the study.ResultsIn the analysis of the search trend of infodemic terms, it is clear that the categories of Prevention and Beliefs should stand out in Brazil, where there is a diverse culture. It is followed by the COVID-19 Treatment category, with treatments that were not those recommended by the authorities. Income transfer programs and information on socioeconomic variables did not have much impact on infodemic surveys, but it was observed that states where President Bolsonaro has more supporters had researched more infodemic information.ConclusionsIn a country as geographically large as Brazil, it is important that political authorities go to great lengths to disseminate reliable information and monitor the infodemic in the media and on the internet. It was concluded that the denial of the pandemic and the influence of political leaders influenced the search for infodemic information, contributing to a disorganization in the control of the disease and prevention measures.

Project description:During 2015 to 2016, Brazil reported more Zika virus (ZIKV) cases than any other country, yet population exposure remains unknown. Serological studies of ZIKV are hampered by cross-reactive immune responses against heterologous viruses. We conducted serosurveys for ZIKV, dengue virus (DENV), and Chikungunya virus (CHIKV) in 633 individuals prospectively sampled during 2015 to 2016, including microcephaly and non-microcephaly pregnancies, HIV-infected patients, tuberculosis patients, and university staff in Salvador in northeastern Brazil using enzyme-linked immunosorbent assays (ELISAs) and plaque reduction neutralization tests. Sera sampled retrospectively during 2013 to 2015 from 277 HIV-infected patients were used to assess the spread of ZIKV over time. Individuals were georeferenced, and sociodemographic indicators were compared between ZIKV-positive and -negative areas and areas with and without microcephaly cases. Epidemiological key parameters were modeled in a Bayesian framework. ZIKV seroprevalence increased rapidly during 2015 to 2016, reaching 63.3% by 2016 (95% confidence interval [CI], 59.4 to 66.8%), comparable to the seroprevalence of DENV (75.7%; CI, 69.4 to 81.1%) and higher than that of CHIKV (7.4%; CI, 5.6 to 9.8%). Of 19 microcephaly pregnancies, 94.7% showed ZIKV IgG antibodies, compared to 69.3% of 257 non-microcephaly pregnancies (P = 0.017). Analyses of sociodemographic data revealed a higher ZIKV burden in low socioeconomic status (SES) areas. High seroprevalence, combined with case data dynamics allowed estimates of the basic reproduction number R0 of 2.1 (CI, 1.8 to 2.5) at the onset of the outbreak and an effective reproductive number Reff of <1 in subsequent years. Our data corroborate ZIKV-associated congenital disease and an association of low SES and ZIKV infection and suggest that population immunity caused cessation of the outbreak. Similar studies from other areas will be required to determine the fate of the American ZIKV outbreak.IMPORTANCE The ongoing American Zika virus (ZIKV) outbreak involves millions of cases and has a major impact on maternal and child health. Knowledge of infection rates is crucial to project future epidemic patterns and determine the absolute risk of microcephaly upon maternal ZIKV infection during pregnancy. For unknown reasons, the vast majority of ZIKV-associated microcephaly cases are concentrated in northeastern Brazil. We analyzed different subpopulations from Salvador, a Brazilian metropolis representing one of the most affected areas during the American ZIKV outbreak. We demonstrate rapid spread of ZIKV in Salvador, Brazil, and infection rates exceeding 60%. We provide evidence for the link between ZIKV and microcephaly, report that ZIKV predominantly affects geographic areas with low socioeconomic status, and show that population immunity likely caused cessation of the outbreak. Our results enable stakeholders to identify target populations for vaccination and for trials on vaccine efficacy and allow refocusing of research efforts and intervention strategies.

Dataset Information

Fertility trends during successive novel infectious disease outbreaks: Zika and COVID-19 in Brazil.

Publications

Fertility trends during successive novel infectious disease outbreaks: Zika and COVID-19 in Brazil.

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