Understanding social inequalities in Zika infection and its consequences: A model of pathways and policy entry-points
Understanding social inequalities in Zika infection and its consequences: A model of pathways and policy entry-points
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DOI：
10.1080/17441692.2018.1532528
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发表时间：
2019-05-04
影响因子：
3.3
通讯作者：
Perez, Bernadete
中科院分区：
文献类型：
--
作者：
Diderichsen, Finn;da Silva Augusto, Lia Giraldo;Perez, Bernadete
近年来，登革热(DENV)、基孔肯雅热(CHIKV)和寨卡病毒(ZIKV)等虫媒病毒感染的健康后果已成为一项公共卫生挑战，原因是预防失败、发病率增加以及在发生和后果方面存在明显的社会不平等。这促使对产生这些不平等的潜在机制和途径进行更系统的分析。我们在论文中提出了一个模型，描述了导致ZIKV和先天性寨卡病毒综合征(CZS)不平等的五种可能机制。这些问题包括不同的住房和卫生条件暴露，不同的媒介密度和病毒暴露，不同的病毒暴露对健康影响的脆弱性，宫内对寨卡病毒感染的致畸影响的不同易感性，以及照顾残疾儿童的不同社会后果。对于每一种机制，我们提出了经验证据或需要进行更多研究，并讨论了政策含义。
The health consequences of arbovirus infections such as dengue fever (DENV), Chikungunya (CHIKV) and Zika (ZIKV) has in recent years become a public health challenge, due to failure of prevention followed by increased incidence and pronounced social inequality in occurrence and consequences. This motivates a more systematic analysis of the potential mechanisms and pathways that generate these inequalities. We present in the paper a model that delineates five possible mechanisms driving the inequality of ZIKV and congenital Zika syndrome (CZS). They include differential exposure to bad housing and sanitary conditions, differential exposure to vector density and virus, differential vulnerability to the health effects of exposure to virus, differential intrauterine susceptibility to the teratogenic effects of ZIKV infection and differential social consequences of caring for a disabled child. For each mechanism, we present empirical evidence or need for more research as well as a discussion about policy implications.