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SOCIOECONOMIC RISK MARKERS OF ARTHROPOD-BORNE VIRUS (ARBOVIRUS) INFECTIONS: A SYSTEMATIC LITERATURE REVIEW AND META-ANALYSIS
Fatores socioeconômicos
Vírus artrópodes (arbovírus)
Infecções
Author
Affilliation
Health Equity Action Lab. Department of Infectious Disease Epidemiology. London School of Hygiene & Tropical Medicine. London, UK / Department of Disease Control. London School of Hygiene & Tropical Medicine. London, UK / MRC Integrative Epidemiology Unit. Population Health Sciences. Bristol Medical School. University of Bristol. Bristol, UK.
Health Equity Action Lab. Department of Infectious Disease Epidemiology. London School of Hygiene & Tropical Medicine. London, UK.
Health Equity Action Lab. Department of Infectious Disease Epidemiology. London School of Hygiene & Tropical Medicine. London, UK / Washington University in St. Louis School of Medicine. St. Louis, MO, USA.
Health Equity Action Lab. Department of Infectious Disease Epidemiology. London School of Hygiene & Tropical Medicine. London, UK.
Health Equity Action Lab. Department of Infectious Disease Epidemiology. London School of Hygiene & Tropical Medicine. London, UK.
Health Equity Action Lab. Department of Infectious Disease Epidemiology. London School of Hygiene & Tropical Medicine. London, UK.
Health Equity Action Lab. Department of Infectious Disease Epidemiology. London School of Hygiene & Tropical Medicine. London, UK.
Health Equity Action Lab. Department of Infectious Disease Epidemiology. London School of Hygiene & Tropical Medicine. London, UK.
Fundação Giulio Vargas. Escola de Economia de São Paulo e Centro de Estudos Microeconômicos Aplicados. São Paulo, SP, Brasil.
Fundação Oswaldo Cruz. Instituto Gonçalo Muniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil.
Health Equity Action Lab. Department of Infectious Disease Epidemiology. London School of Hygiene & Tropical Medicine. London, UK.
Health Equity Action Lab. Department of Infectious Disease Epidemiology. London School of Hygiene & Tropical Medicine. London, UK.
Health Equity Action Lab. Department of Infectious Disease Epidemiology. London School of Hygiene & Tropical Medicine. London, UK / Washington University in St. Louis School of Medicine. St. Louis, MO, USA.
Health Equity Action Lab. Department of Infectious Disease Epidemiology. London School of Hygiene & Tropical Medicine. London, UK.
Health Equity Action Lab. Department of Infectious Disease Epidemiology. London School of Hygiene & Tropical Medicine. London, UK.
Health Equity Action Lab. Department of Infectious Disease Epidemiology. London School of Hygiene & Tropical Medicine. London, UK.
Health Equity Action Lab. Department of Infectious Disease Epidemiology. London School of Hygiene & Tropical Medicine. London, UK.
Health Equity Action Lab. Department of Infectious Disease Epidemiology. London School of Hygiene & Tropical Medicine. London, UK.
Fundação Giulio Vargas. Escola de Economia de São Paulo e Centro de Estudos Microeconômicos Aplicados. São Paulo, SP, Brasil.
Fundação Oswaldo Cruz. Instituto Gonçalo Muniz. Centro de Integração de Dados e Conhecimentos para Saúde. Salvador, BA, Brasil.
Health Equity Action Lab. Department of Infectious Disease Epidemiology. London School of Hygiene & Tropical Medicine. London, UK.
Abstract
Introduction: Arthropod-borne viruses (arboviruses) are of notable public health importance worldwide, owing to their potential to cause explosive outbreaks and induce debilitating and potentially life-threatening disease manifestations. This systematic review and meta-analysis aims to assess the relationship between markers of socioeconomic position (SEP) and infection due to arboviruses with mosquito vectors. Methods: We conducted a systematic search on PubMed, Embase, and LILACS databases to identify studies published between 1980 and 2020 that measured the association of SEP markers with arbovirus infection. We included observational studies without geographic location or age restrictions. We excluded studies from grey literature, reviews and ecological studies. Study findings were extracted and summarised, and pooled estimates were obtained using random-effects meta-analyses. Results: We identified 36 observational studies using data pertaining to 106 524 study participants in 23 geographic locations that empirically examined the relationship between socioeconomic factors and infections caused by seven arboviruses (dengue, chikungunya, Japanese encephalitis, Rift Valley fever, Sindbis, West Nile and Zika viruses). While results were varied, descriptive synthesis pointed to a higher risk of arbovirus infection associated with markers of lower SEP, including lower education, income poverty, low healthcare coverage, poor housing materials, interrupted water supply, marital status (married, divorced or widowed), non-white ethnicities and migration status. Pooled crude estimates indicated an increased risk of arboviral infection associated with lower education (risk ratio, RR 1.5 95% CI 1.3 to 1.9); I2=83.1%), interruption of water supply (RR 1.2; 95% CI 1.1 to 1.3; I2=0.0%) and having been married (RR 1.5 95% CI 1.1 to 2.1; I2=85.2%). Conclusion: Evidence from this systematic review suggests that lower SEP increases the risk of acquiring arboviral infection; however, there was large heterogeneity across studies. Further studies are required to delineate the relationship between specific individual, household and community-level SEP indicators and arbovirus infection risks to help inform targeted public health interventions.
Keywords in Portuguese
Marcadores de riscoFatores socioeconômicos
Vírus artrópodes (arbovírus)
Infecções
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