Parental Stress in Primary Caregivers of Children with Evidence of Congenital Zika Virus Infection in Northeastern Brazi
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REVIEW PAPER
Parental Stress in Primary Caregivers of Children with Evidence of Congenital Zika Virus Infection in Northeastern Brazil Isabela Ornelas Pereira1 · Ana C. F. S. Santelli2 · Priscila L. Leite3 · Jacob Attell4,5 · Jeanne Bertolli6 · Kim Kotzky7 · Wildo N. Araújo8 · Georgina Peacock6 Accepted: 6 November 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Despite the well-known role of parents as caregivers, few studies have addressed their health outcomes related to the Zika virus epidemic. Methods A cross-sectional study was carried out with 146 primary caregivers of children 15–26 months of age, with laboratory and/or clinical evidence of Zika infection between August and October 2017 in three Brazilian municipalities: João Pessoa and Campina Grande in the state of Paraíba and Fortaleza in the state of Ceará. Caregivers reported on their child’s life and health, family circumstances and underwent screening for stress using the Parenting Stress Index-Short Form. Children were evaluated for developmental delays and clinical outcomes. Differences in the prevalence of risk factors between caregivers with high or clinically relevant stress and those with normal stress were evaluated. Results Of the 146 participants, 13% (n = 19) were classified as having high or clinically relevant stress, all of them mothers. The two risk factors significantly and independently associated with high levels of stress, compared with individuals with normal stress levels, were “reporting difficulty in covering basic expenses” (adjusted OR 3.6 (95% CI 1.1–11.8; p = 0.034)) and “having a child with sleep problems” (adjusted OR 10.4 (95% CI 1.3–81.7; p = 0.026)). Conclusions Some factors seem to contribute significantly more than others to the level of stress experienced by caregivers of children with evidence of Zika virus congenital infection. Interventions and preventive strategies should also target caregivers, who in turn will be able to respond to the unique characteristics of their child. Keywords Zika virus infection · Developmental disabilities · Psychological stress · Coping behavior · Brazil Abbreviations ASQ Ages and stages questionnaire CONEP National Committee for Ethics in Research
CP Cerebral palsy CZI Congenital Zika infection DAG Directed acyclic graph DQ Developmental quotients ELISA Enzyme-linked immunosorbent assay
Disclaimer The opinions expressed herein are those of the authors and do not necessarily reflect the position of the funding agencies. * Isabela Ornelas Pereira [email protected] 1
Secretariat of Health Surveillance (SVS), Ministry of Health of Brazil, SRTVN Quadra 701, Lote D, Ed. PO700, 5º andar, Brasília, DF 70719‑040, Brazil
Center for Global Health (CGH), Centers for Disease Control and Prevention (CDC), Country Office in Brazil, Brasília 70719‑040, Brazil
2
3
Foundation for Scientific and Technological Development in Health (FIOTEC), Rio de Janeiro 21040‑361, Brazil
4
Eagle Global Scientific, LLC, Atlanta, GA 30341, USA
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