Zika Virus infection and microcephaly: anxiety burden for women
Ikenna Desmond Ebuenyi, Soumitra Sudip Bhuyan, Luchuo Engelbert Bain
The Pan African Medical Journal. 2018;30:2. doi:10.11604/pamj.2018.30.2.11794

Create an account  | Log in
PAMJ Conf Proceedings Supplement 2
"Better health through knowledge sharing and information dissemination "

Commentary

Zika Virus infection and microcephaly: anxiety burden for women

Cite this: The Pan African Medical Journal. 2018;30:2. doi:10.11604/pamj.2018.30.2.11794

Received: 26/01/2017 - Accepted: 04/03/2018 - Published: 03/05/2018

Key words: Zika virus, microcephaly, anxiety

© Ikenna Desmond Ebuenyi et al. The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Available online at: http://www.panafrican-med-journal.com/content/article/30/2/full

Corresponding author: Ikenna Desmond Ebuenyi, Athena Institute, Faculty of Earth and Life Sciences, Vrije Universiteit, Amsterdam, Netherlands (i.d.ebuenyi@vu.nl)


Zika Virus infection and microcephaly: anxiety burden for women

Ikenna Desmond Ebuenyi1,&, Soumitra Sudip Bhuyan2, Luchuo Engelbert Bain1

 

1Athena Institute, Faculty of Earth and Life Sciences, Vrije Universiteit, Amsterdam, Netherlands, 2Division of Health Systems, Management and Policy, University of Memphis, USA

 

 

&Corresponding author
Ikenna Desmond Ebuenyi, Athena Institute, Faculty of Earth and Life Sciences, Vrije Universiteit, Amsterdam, Netherlands

 

 

Abstract

The re-emergence of Zika virus in Brazil and other contiguous countries is a source of anxiety for pregnant women on account of its association with microcephaly. Adverse pregnancy outcome has huge mental health implications. It is essential for health providers to incorporate psychosocial care as part of pre and postnatal care for women in all countries affected by the Zika virus infection.

 

 

Commentary    Down

The resurgence of Zika virus in Brazil and the dire medical implications for the populace and pregnant women, in particular, led to its declaration as a public health emergency in November 2015 [1]. This declaration was in response to the widespread association of Zika virus with microcephaly, abortions, and deaths. The fears and concern of the Brazilian health authorities were confirmed as about some months later; the World Health Organization made a similar declaration amidst growing global concerns about Zika virus. As at November 2016, evidence of Zika virus infection (ZIKV) had been reported in over 67 countries and territories since the first report in 2015 [1]. In the light of new evidence for a causal link between Zika virus infection and microcephaly, there is heightened uncertainty and anxiety for women of reproductive age in Brazil and all over the world who are faced with the dilemma of a turning off their biological clock in the face of fatal consequences of microcephaly. The association of Zika virus with pregnancy and microcephaly is perhaps its greatest threat [1]. Pregnancy is an important event in the lives of women and a time of uncertainty. Pregnant women and the fetus are vulnerable to infectious disease, and history is fraught with examples of the effect of infectious disease on pregnancy [2, 3]. Susceptibility to infectious diseases is heightened in pregnancy with associated negative outcomes for both the fetus and women [2, 3]. Zika virus infection is a threat to the reproductive rights of women. The threat to the fetus and possibility of microcephaly is a burden and source of anxiety which has huge mental health implications [4]. Women in affected countries have to live with the fear of abortions due to Zika virus infection and the inability to procure abortion following a prenatal diagnosis of ZIKV [5]. Studies are in agreement that pregnancy is a source of worry for pregnant women and indeed the startling statistics of child death, and microcephaly would be a source of trauma for both mothers who have suffered a loss and those who are still pregnant [2, 3]. The true extent of the psychological trauma faced by the affected women is unknown but like in all epidemics as shown in the recent Ebola outbreak, a burdensome atmosphere of fear, anxiety, and uncertainty pervades in the local communities and indeed contiguous communities in the whole of Latin America [2, 6, 7]. The chronic effect of maternal psychosocial stress on maternal health and wellbeing has been demonstrated and hence the need to take proactive steps to salvage the health of women in Brazil and other affected areas. What should be done in the light of this uncertainty and fatal associations between Zika Virus and fatal pregnancy outcomes?

 

Recommendations

The WHO and the Brazilian health authorities must be commended for recognizing and declaring the Zika virus outbreak a public health emergency and forming a multidisciplinary committee but so much needs to be done and lessons drawn from the recent Ebola outbreak. Ultimately, all-inclusive health systems approach that combines flexibility with effectiveness is needed to achieve the health objectives. A three-pronged approach is recommended:

 

Strengthening of the health facilities in Brazil and other neighboring countries on emergency preparedness and proactive handling of the Zika virus through adequate testing, surveillance and case management: there should be an aggressive contact tracing and provision of requisite equipment for laboratory testing and diagnosis of all suspected cases of Zika Virus. Psychosocial support is very essential and the long term effects of anxiety and trauma (post-traumatic stress disorder (PTSD) must be expected in the women that lost their pregnancy or babies during the outbreak. Psychotherapy for pregnant women and families affected is essential. Clinical psychologist and psychiatrist should be included in the high-level team set up by affected countries to address the health challenges. The WHO guideline on the provision of psychosocial support for women and families affected by Zika virus [8] should be adopted by health care providers in all countries affected by ZIKV.

 

Community engagement and participation by all stakeholders: productive dialogue and information channels must be created to serve as a two-way information link between the communities, women the health authorities. Community engagement would foster understanding and dispel the atmosphere of misinformation and fear that subsist in similar epidemics [6]. Aggressive public health information in the affected communities would ameliorate the fear and uncertainty being experienced by women and help people make informed decisions.

 

Adequate prevention and Vaccine development of a vaccine is essential: the proactive prevention guidelines set up by the Public Health England (PHE) and the Royal College of Obstetrics and Gynaecology is recommended for health care providers everywhere [7]. Zika virus has been around for quite some time and perhaps neglected because of the mild presentations [9-11]. Time has shown that every infectious disease has the potential to be lethal and perhaps the best remedy is a vaccine. Vaccine development involves time and finance but also government, and international donors should commit to the world free from the ill effects of infectious disease. It is pertinent to state that region-specific models are indispensable in managing emergency epidemics like Zika virus outbreaks. Conflicts between traditionally held beliefs and conceptions about disease might clash with classical evidence-based management plans affecting uptake of life-saving interventions [12].

 

 

Conclusion Up    Down

Zika virus is major public health issue with implications for women of reproductive age. From the health systems perspective, it is important to adequately allocate resources, build capacity, and develop appropriate clinical protocols for the healthcare workforce for diagnosis and treatment. Emergency response preparedness in virus outbreaks is glaringly sub-optimal and the mental health needs of affected individuals must be made a priority.

 

 

Competing interests Up    Down

The authors declare no competing interests.

 

 

Authors’ contributions Up    Down

All authors read and agreed to the final version of this manuscript and equally contributed to its content and to the management of the case.

 

 

References Up    Down

  1. World Health Organization. Zika virus situation reports 2016. 2016. Accessed January 2017.

  2. Al-Gailani S. From Rubella to Zika: pregnancy, disability, abortion and the spectre of an epidemic. 7 October 2016. Accessed January 2017

  3. Sappenfield E, Jamieson DJ, Kourtis AP. Pregnancy and susceptibility to infectious diseases. Infect Dis Obstet Gynecol. 2013;2013. PubMed | Google Scholar

  4. dos Santos Oliveira SJG, de Melo ES, Reinheimer DM, Gurgel RQ, Santos VS, Martins-Filho PRS. Anxiety, depression and quality of life in mothers of newborns with microcephaly and presumed congenital Zika virus infection. Archives of Women's Mental Health. 2016;19(6):1149-51. PubMed | Google Scholar

  5. Women Enabled International. Talking Points: Zika, Microcephaly, Women's Rights, and Disability Rights . Avril 2016. Accessed January 2017.

  6. Brasil P, Pereira J, Jose P, Raja Gabaglia C, Damasceno L, Wakimoto M, Ribeiro Nogueira RM et al. Zika virus infection in pregnant women in Rio de Janeiro-preliminary report. N Engl J Med. 2016 Dec 15;375(24):2321-233. Google Scholar

  7. Burke RM, Pandya P, Nastouli E, Gothard P. Zika virus infection during pregnancy: what, where and why?. Br J Gen Pract. 2016;66(644):122-3. PubMed | Google Scholar

  8. World Health Organization. Psychosocial support for pregnant women and for families with microcephaly and other neurological complications in the context of Zika virus: interim guidance for health-care providers. 2016. Google Scholar

  9. Dick G, Kitchen S, Haddow A. Zika virus (I): isolations and serological specificity. Trans R Soc Trop Med Hyg. 1952;46(5):509-20. PubMed | Google Scholar

  10. Faye O, Freire CC, Iamarino A, Faye O, de Oliveira JVC, Diallo M et al. Molecular evolution of Zika virus during its emergence in the 20 th century. PLoS Negl Trop Dis. 2014;8(1):e2636. PubMed | Google Scholar

  11. Macnamara F. Zika virus: a report on three cases of human infection during an epidemic of jaundice in Nigeria. Trans R Soc Trop Med Hyg. 1954;48(2):139-45. PubMed | Google Scholar

  12. Awah PK, Boock AU, Kum KA. Ebola Virus Diseases in Africa: a commentary on its history, local and global context. Pan African medical journal. 2015;22(Suppl 1):18. PubMed | Google Scholar

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


The Pan African Medical Journal articles are archived on Pubmed Central. Access PAMJ archives on PMC here

Volume 30 (May - August 2018)

Article tools

Rate this article

Altmetric

PAMJ is a member of the Committee on Publication Ethics
Next abstract

PAMJ is published in collaboration with the African Field Epidemiology Network (AFENET)
Currently tracked by: DOAJ, AIM, Google Scholar, AJOL, EBSCO, Scopus, Embase, IC, HINARI, Global Health, PubMed Central, PubMed/Medline, Ulrichsweb, More to come . Member of COPE.

ISSN: 1937-8688. © 2018 - Pan African Medical Journal. All rights reserved