Dataset Information

The Zika epidemic and abortion in Latin America: a scoping review.

ABSTRACT: Latin America presently has the world's highest burden of Zika virus, but there are unexplained differences in national rates of congenital malformations collectively referred to as Congenital Zika Syndrome (CZS) in the region. While Zika virulence and case detection likely contribute to these differences, policy-related factors, including access to abortion, may play important roles. Our goal was to assess perspectives on, and access to, abortion in Latin America in the context of the Zika epidemic.We conducted a scoping review of peer-reviewed and gray literature published between January 2015 and December 2016, written in English, Spanish, Portuguese, or French. We searched PubMed, Scielo, and Google Scholar for literature on Zika and/or CZS and abortion, and used automated and manual review methods to synthesize the existing information.36 publications met our inclusion criteria, the majority of which were qualitative. Publications were generally in favor of increased access to safe abortion as a policy-level response for mitigating the impact of CZS, but issues with implementation were cited as the main challenge. Aside from the reform of abortion regulation in Colombia, we did not find evidence that the Zika epidemic had triggered shifts in abortion policy in other countries.Abortion policy in the region remained largely unchanged following the Zika epidemic. Further empirical research on abortion access and differential rates of CZS across Latin American countries is required.

SUBMITTER: Carabali M

PROVIDER: S-EPMC5932843 | biostudies-other | 2018

REPOSITORIES: biostudies-other

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The Zika epidemic and abortion in Latin America: a scoping review.

Carabali Mabel M Austin Nichole N King Nicholas B NB Kaufman Jay S JS

Global health research and policy 20180503

<h4>Background</h4>Latin America presently has the world's highest burden of Zika virus, but there are unexplained differences in national rates of congenital malformations collectively referred to as Congenital Zika Syndrome (CZS) in the region. While Zika virulence and case detection likely contribute to these differences, policy-related factors, including access to abortion, may play important roles. Our goal was to assess perspectives on, and access to, abortion in Latin America in the conte ...[more]

PMID: 29750204

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Project description:BackgroundZika virus (ZIKV) emerged in Latin America and the Caribbean (LAC) region in 2013, with serious implications for population health in the region. In 2016, the World Health Organization declared the ZIKV outbreak a Public Health Emergency of International Concern following a cluster of associated neurological disorders and neonatal malformations. In 2017, Zika cases declined, but future incidence in LAC remains uncertain due to gaps in our understanding, considerable variation in surveillance and the lack of a comprehensive collation of data from affected countries.MethodsOur analysis combines information on confirmed and suspected Zika cases across LAC countries and a spatio-temporal dynamic transmission model for ZIKV infection to determine key transmission parameters and projected incidence in 90 major cities within 35 countries. Seasonality was determined by spatio-temporal estimates of Aedes aegypti vectorial capacity. We used country and state-level data from 2015 to mid-2017 to infer key model parameters, country-specific disease reporting rates, and the 2018 projected incidence. A 10-fold cross-validation approach was used to validate parameter estimates to out-of-sample epidemic trajectories.ResultsThere was limited transmission in 2015, but in 2016 and 2017 there was sufficient opportunity for wide-spread ZIKV transmission in most cities, resulting in the depletion of susceptible individuals. We predict that the highest number of cases in 2018 would present within some Brazilian States (Sao Paulo and Rio de Janeiro), Colombia and French Guiana, but the estimated number of cases were no more than a few hundred. Model estimates of the timing of the peak in incidence were correlated (p?<?0.05) with the reported peak in incidence. The reporting rate varied across countries, with lower reporting rates for those with only confirmed cases compared to those who reported both confirmed and suspected cases.ConclusionsThe findings suggest that the ZIKV epidemic is by and large over within LAC, with incidence projected to be low in most cities in 2018. Local low levels of transmission are probable, but the estimated rate of infection suggests that most cities have a population with high levels of herd immunity.

Project description:OBJECTIVES:Despite research documenting significant health disparities among sexual minority women (lesbian, bisexual, and other non-heterosexual women) in high-income countries, few studies of sexual minority women's health have been conducted in low- and middle-income countries. The purpose of this scoping review was to examine the empirical literature related to the health disparities and health needs of sexual minority women in Latin America and the Caribbean (LAC), and to identify research gaps and priorities. DESIGN:A scoping review methodology was used. DATA SOURCES:We conducted a comprehensive search of seven electronic databases. The search strategy combined keywords in three areas: sexual minority women, health, and LAC. English, Spanish, and Portuguese language studies published through 2017 in peer-reviewed journals were included. REVIEW METHODS:A total 1471 articles were retrieved. An additional 5 articles were identified following descendancy search; 3 of these met inclusion criteria. After removal of duplicates and title and abstract screening, we screened the full text of 37 articles, of which 22 (representing 18 distinct studies) met inclusion criteria. At least two authors independently reviewed and abstracted data from all articles. RESULTS:More than half of the studies were conducted in Brazil (n?=?9) and Mexico (n?=?5). Sexual health was the most studied health issue (n?=?11). Sexual minority women were at elevated risk for sexually transmitted infections related to low use of barrier contraceptive methods during sexual encounters with men. Findings suggest that sexual minority women are generally distrustful of healthcare providers and view the healthcare system as heteronormative. Providers are believed to lack the knowledge and skills to provide culturally competent care to sexual minority women. Sexual minority women generally reported low levels of sexual health education and reluctance in seeking preventive screenings due to fear of mistreatment from healthcare providers. Sexual minority women also reported higher rates of poor mental health, disordered eating, and substance use (current tobacco and alcohol use) than heterosexual women. Gender-based violence was identified as a significant concern for sexual minority women in LAC. CONCLUSIONS:Significant knowledge gaps regarding sexual minority women's health in LAC were identified. Additional investigation of understudied areas where health disparities have been observed in other global regions is needed. Future research should explore how the unique social stressors sexual minority women experience impact their health. Nurses and other healthcare providers in the region need training in providing culturally appropriate care for this population.

Dataset Information

The Zika epidemic and abortion in Latin America: a scoping review.

Publications

The Zika epidemic and abortion in Latin America: a scoping review.

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