ZIKA Virus infection in pregnant women in French Guiana: More precarious-more at risk

Edouard Hallet (1) , Claude Flamand (2) , Dominique Rousset (3) , Timothée Bonifay (4) , Camille Fritzell (2) , Séverine Matheus (3) , Maryvonne Dueymes (5) , Balthazar Ntab (6) , Mathieu Nacher (1, 7)

1 UG - Université de Guyane
2 Institut Pasteur de la Guyane
3 CNR - laboratoire associé - Centre National de Référence pour les Arbovirus - Laboratoire de Virologie [Cayenne, Guyane française]
4 UMIT - Unité des Maladies Infectieuses et Tropicales
5 Centre Hospitalier Andrée Rosemon [Cayenne, Guyane Française]
6 CHOG - Centre Hospitalier de l'Ouest Guyanais
7 CIC - Antilles Guyane - Centre d'Investigation Clinique Antilles-Guyane

Background: A recent study in French Guiana suggested that populations living in precarious neighborhoods were more at risk for Chikungunya CHIKV than those living in more privileged areas. The objective of the present study was to test the hypothesis that Zika virus (ZIKV) infection was more frequent in precarious pregnant women than in non-precarious pregnant women, as reflected by their health insurance status. Methods: A multicentric cross-sectional study was conducted in Cayenne hospital including ZIKV pregnant women with serological or molecular proof of ZIKV during their pregnancy between January and December 2016. Health insurance information was recorded at delivery, which allowed separating women in: undocumented foreigners, precarious but with residence permit, and non-precarious. Results: A total of 6654 women were included. Among them 1509 (22,7%) had confirmed ZIKV infection. Most women were precarious (2275/3439) but the proportion of precarious women was significantly greater in ZIKV-confirmed 728/906 (80.4%) than the ZIKV-negatives 1747/2533 (69.0%), p<0.0001. There were 1142 women classified as non-precarious, 1671 were precarious legal residents, and 1435 were precarious and undocumented. Precariousness and undocumented status were associated with a higher prevalence of ZIKV during pregnancy (adjusted prevalence ratio = 1.59 (95%CI = 1.29-1.97), p<0.0001), (adjusted prevalence ratio = 1.5 (95%CI = 1.2-1.8), p<0.0001), respectively. Conclusions: These results illustrate that in French Guiana ZIKV transmission disproportionately affected the socially vulnerable pregnant women, presumably because of poorer housing conditions, and lack of vector control measures in poor neighborhoods.

Domaines: Santé publique et épidémiologie; Maladies infectieuses; Maladies émergentes

Edouard Hallet, Claude Flamand, Dominique Rousset, Timothée Bonifay, Camille Fritzell, et al.. ZIKA Virus infection in pregnant women in French Guiana: More precarious-more at risk. PLoS Neglected Tropical Diseases, 2020, 14 (3), pp.e0008193. ⟨10.1371/journal.pntd.0008193⟩. ⟨hal-02615906⟩