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

Background: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.Methods: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.Results: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.Conclusion: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.

Presence of three dengue serotypes in Ouagadougou(Burkina Faso):research and public health implications

Background:The significant malaria burden in Africa has often eclipsed other febrile illnesses.Burkina Faso’s first dengue epidemic occurred in 1925 and the most recent in 2013.Yet there is still very little known about dengue prevalence,its vector proliferation,and its poverty and equity impacts.Methods:An exploratory cross-sectional survey was performed from December 2013 to January 2014.Six primary healthcare centers in Ouagadougou were selected based on previously reported presence of Flavivirus.All patients consulting with fever or having had fever within the previous week and with a negative rapid diagnostic test(RDT)for malaria were invited to participate.Sociodemographic data,healthcare use and expenses,mobility,health-related status,and vector control practices were captured using a questionnaire.Blood samples of every eligible subject were obtained through finger pricks during the survey for dengue RDT using SD BIOLINE Dengue Duo(NS1Ag and IgG/IgM)®and to obtain blood spots for reverse transcription polymerase chain reaction(RT-PCR)analysis.In a sample of randomly selected yards and those of patients,potential Aedes breeding sites were found and described.Larvae were collected and brought to the laboratory to monitor the emergence of adults and identify the species.Results:Of the 379 subjects,8.7%(33/379)had positive RDTs for dengue.Following the 2009 WHO classification,38.3%(145/379)had presumptive,probable,or confirmed dengue,based on either clinical symptoms or laboratory testing.Of 60 samples tested by RT-PCR(33 from the positive tests and 27 from the subsample of negatives),15 were positive.The serotypes observed were DENV2,DENV3,and DENV4.Odds of dengue infection in 15-to-20-year-olds and persons over 50 years were 4.0(CI 95%:1.0–15.6)and 7.7(CI 95%:1.6–37.1)times higher,respectively,than in children under five.Average total spending for a dengue episode was 13771 FCFA[1300–67300 FCFA](1$US=478 FCFA).On average,2.6 breeding sites were found per yard.Potential Aedes breeding sites were found near 71.4%(21/28)of patients,but no adult Aedes were found.The most frequently identified potential breeding sites were water storage containers(45.2%).Most specimens collected in yards were Culex(97.9%).Conclusions:The scientific community,public health authorities,and health workers should consider dengue as a possible cause of febrile illness in Burkina Faso.

Priorities and needs for research on urban interventions targeting vector-borne diseases: rapid review of scoping and systematic reviews

This paper highlights the critical importance of evidence on vector-borne diseases(VBD)prevention and control interventions in urban settings when assessing current and future needs,with a view to setting policy priorities that promote inclusive and equitable urban health services.Research should produce knowledge about policies and interventions that are intended to control and prevent VBDs at the population level and to reduce inequities.Such interventions include policy,program,and resource distribution approaches that address the social determinants of health and exert influence at organizational and system levels.

Containment measures for emerging and re-emerging vector-borne and other infectious diseases of poverty in urban settings:a scoping review

Background:The emergence and re-emergence of vector-borne and other infectious diseases of poverty pose a threat to the health of populations living in urban and low-income settings.A detailed understanding of intervention strategies,including effectiveness of past outbreak containment,is necessary to improve future practices.The objective was to determine what is known about the effectiveness of containment measures for emerging and re-emerging vector-borne and other infectious diseases of poverty in urban settings and identify research gaps and implications for public health practice.Main body:We conducted a scoping review and systematically searched peer-reviewed and grey literature published between 2000 and 2016.Different data extraction tools were used for data coding and extraction,and data on implementation process and transferability were extracted from all studies.A quality assessment was conducted for each included study.We screened 205 full-text articles and reports for a total of 31 articles included in the review.The quality of the studies was generally low to moderate.The largest body of evidence concerned control activities for Ebola virus and dengue fever.The majority of interventions(87%)relied on multiple types of measures,which were grouped into four categories:1)healthcare provision;2)epidemiological investigation and/or surveillance;3)environmental or sanitary interventions;and 4)community-based interventions.The quality of the majority of studies(90%)was poor or moderate,and one-third of the studies did not provide a clear description of the outcomes and of the procedures and/or tools used for the intervention.Conclusions:Our results highlight the difficulty of establishing causation when assessing the effect of containment measures.Studies that extend beyond solely reporting on effectiveness and take into account the complexity of real-world settings are urgently needed.We recommend the allocation of research efforts to the evaluation of the implementation processes of interventions as well as their comprehensive and systematic description using validated checklists.