34118 - SOCIOECONOMIC STATUS AND ZIKA VIRUS TRANSMISSION: A BRAZILIAN URBAN SLUM COHORT STUDY
JUAN PABLO AGUILAR TICONA - INSTITUTO DE SAÚDE COLETIVA, UNIVERSIDADE FEDERAL DA BAHIA, SALVADOR, BAHIA, BRAZIL., IMÉZE HIELTJES - INSTITUTO RADBOUD UNIVERSITY, NIJMEGEN, NETHERLANDS., NIVISON NERY JR. - INSTITUTO DE SAÚDE COLETIVA, UNIVERSIDADE FEDERAL DA BAHIA, SALVADOR, BAHIA, BRAZIL., MAX T. EYRE - CENTRE FOR HEALTH INFORMATICS, COMPUTING, AND STATISTICS, LANCASTER UNIVERSITY MEDICAL SCHOOL, LANCASTER UK., JUAN CARLOS QUINTERO VELEZ - DEPARTMENT OF EPIDEMIOLOGY OF MICROBIAL DISEASES, YALE SCHOOL OF PUBLIC HEALTH, NEW HAVEN, CONNECTICUT, USA., GIELSON SACRAMENTO - INSTITUTO GONÇALO MONIZ, FUNDAÇÃO OSWALDO CRUZ/MS, SALVADOR, BAHIA, BRAZIL., EDUARDO J. M. NASCIMENTO - DEPARTMENT OF INFECTIOUS DISEASE AND MICROBIOLOGY, UNIVERSITY OF PITTSBURGH, PITTSBURGH, PA, USA., ERNESTO T. A. MARQUES - DEPARTMENT OF INFECTIOUS DISEASE AND MICROBIOLOGY, UNIVERSITY OF PITTSBURGH, PITTSBURGH, PA, USA., MITERMAYER G. REIS - INSTITUTO GONÇALO MONIZ, FUNDAÇÃO OSWALDO CRUZ/MS, SALVADOR, BAHIA, BRAZIL., ALBERT I. KO - DEPARTMENT OF EPIDEMIOLOGY OF MICROBIAL DISEASES, YALE SCHOOL OF PUBLIC HEALTH, NEW HAVEN, CONNECTICUT, USA., FEDERICO COSTA - INSTITUTO DE SAÚDE COLETIVA, UNIVERSIDADE FEDERAL DA BAHIA, SALVADOR, BAHIA, BRAZIL.
Objective: To characterize the role of socioeconomic status in the transmission of Zika virus (ZIKV) in an urban community.
Methods: We analyzed data collected since 2003 from a prospective cohort of 3,171 urban slum residents in Salvador, Brazil. We included the bi-annual serosurveys performed during August–November, 2015. Socioeconomic data was collected through questionnaires and ZIKV infection was determined using a validated IgG3 as diagnostic test. The WHO methodology was followed to quantify Wealth Index and include variables of non-productive assets that were defined in socioeconomic status quantiles. Principal Component Analysis was used to evaluate socioeconomic status. We used generalized linear mixed effects model, with random effects at the level of the participants' households.
Results: In the analysis 1,442 residents from 696 homes were included. The attack rate was 63.8%(920/1,442). The median per capita income was 2.19(IIQ 1.1-3.7) dollars/day, 47.9%(690/1,442) reported <6 years of schooling and 26.1%(376/1,442) had an informal job. The PCA categorized 8.2%(118/1,442) of residents in the lowest quintile. The multivariable model showed that, when adjusting by age, an increased risk of ZIKV infection in people with an informal job (aRR 1.2, 95%CI1.1-1.3) occurs and those belonging to the lowest quintile of socioeconomic status (aRR 1.2, 95%CI 1.1-1.4).
Conclusions: Socioeconomic differences within slum communities are associated with the transmission of ZIKV, increasing the risk of infection by a factor of 20%. In addition to vector control efforts, public health policies for reducing ZIKV transmission, should also aim to improve living conditions within communities and reduce social inequalities.
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