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The 2016 Zika Epidemic in Leon, Nicaragua: Spatial Distribution, Predictors, and 4-Year Neurodevelopmental Impact on Children Exposed to Zika Virus In Utero
The 2016 Zika Epidemic in Leon, Nicaragua: Spatial Distribution, Predictors, and 4-Year Neurodevelopmental Impact on Children Exposed to Zika Virus In Utero
상세정보
- 자료유형
- 학위논문 서양
- 최종처리일시
- 20260202104806
- ISBN
- 9798291554463
- DDC
- 614.4
- 서명/저자
- The 2016 Zika Epidemic in Leon, Nicaragua: Spatial Distribution, Predictors, and 4-Year Neurodevelopmental Impact on Children Exposed to Zika Virus In Utero
- 발행사항
- [Sl] : The University of North Carolina at Chapel Hill, 2025
- 발행사항
- Ann Arbor : ProQuest Dissertations & Theses, 2025
- 형태사항
- 106 p
- 주기사항
- Source: Dissertations Abstracts International, Volume: 87-02, Section: B.
- 주기사항
- Advisor: Gower, Emily;Becker-Dreps, Sylvia.
- 학위논문주기
- Thesis (Ph.D.)--The University of North Carolina at Chapel Hill, 2025.
- 초록/해제
- 요약Zika virus (ZIKV) is a flavivirus transmitted between humans by Aedes mosquitoes and whose typical clinical presentation includes fever, rash, conjunctivitis and joint pain. A 2015-2016 epidemic in the Americas exposed large numbers of susceptible individuals to ZIKV and revealed an association between ZIKV exposure in utero and a variety of congenital defects and early developmental issues subsequently classified as "congenital Zika syndrome."The first aim of this research examined the spatial distribution and predictors of ZIKV seropositivity among participants in an observational cohort that prospectively followed mother-infant pairs in Leon, Nicaragua from 2017 through 2023. This analysis found that the majority of enrolled women were seropositive for ZIKV, and while there was spatial autocorrelation and variation in seropositivity, there were no statistically significant hotspots. Few individual or household-level characteristics were significant predictors of seropositivity, although prior arboviral infection and the use of public wells were associated with seropositivity while outdoor spraying of insecticides by the Ministry of Health was inversely associated with seropositivity. The most significant predictors observed were at the neighborhood level, where vector control activities such as indoor and outdoor application of insecticides by the Ministry of Health were inversely associated with seropositivity.The second aim followed the children of mothers enrolled in Leon as well as a second cohort in Managua through 48 months of age to assess neurodevelopmental outcomes among children with ZIKV exposure in utero, but without congenital Zika syndrome at birth. Early Learning Composite and subdomain-specific scores on the Mullen Scales of Early Learning neurodevelopmental assessment were compared between exposed and unexposed children, adjusting for potential confounders using inverse probability weighted generalized estimating equations. No statistically significant differences between ZIKV-exposed and -unexposed children persisted at 36 or 48 months of age, suggesting that differences in neurodevelopment previously observed in the first two years of life may resolve as children reach preschool age.The results of this research emphasize the importance of coordinated public health and vector control interventions in the prevention of ZIKV infection, and of follow-up with ZIKV-exposed children to ensure adequate developmental support during the first years of life.
- 일반주제명
- Epidemiology
- 일반주제명
- Public health
- 일반주제명
- Pediatrics
- 일반주제명
- Virology
- 키워드
- Zika virus
- 키워드
- Leon
- 키워드
- Nicaragua
- 키워드
- Children
- 기타저자
- The University of North Carolina at Chapel Hill Epidemiology
- 기본자료저록
- Dissertations Abstracts International. 87-02B.
- 전자적 위치 및 접속
- 로그인 후 원문을 볼 수 있습니다.
MARC
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■1001 ▼aMax, Ryan Jordan.
■24510▼aThe 2016 Zika Epidemic in Leon, Nicaragua: Spatial Distribution, Predictors, and 4-Year Neurodevelopmental Impact on Children Exposed to Zika Virus In Utero
■260 ▼a[Sl]▼bThe University of North Carolina at Chapel Hill▼c2025
■260 1▼aAnn Arbor▼bProQuest Dissertations & Theses▼c2025
■300 ▼a106 p
■500 ▼aSource: Dissertations Abstracts International, Volume: 87-02, Section: B.
■500 ▼aAdvisor: Gower, Emily;Becker-Dreps, Sylvia.
■5021 ▼aThesis (Ph.D.)--The University of North Carolina at Chapel Hill, 2025.
■520 ▼aZika virus (ZIKV) is a flavivirus transmitted between humans by Aedes mosquitoes and whose typical clinical presentation includes fever, rash, conjunctivitis and joint pain. A 2015-2016 epidemic in the Americas exposed large numbers of susceptible individuals to ZIKV and revealed an association between ZIKV exposure in utero and a variety of congenital defects and early developmental issues subsequently classified as "congenital Zika syndrome."The first aim of this research examined the spatial distribution and predictors of ZIKV seropositivity among participants in an observational cohort that prospectively followed mother-infant pairs in Leon, Nicaragua from 2017 through 2023. This analysis found that the majority of enrolled women were seropositive for ZIKV, and while there was spatial autocorrelation and variation in seropositivity, there were no statistically significant hotspots. Few individual or household-level characteristics were significant predictors of seropositivity, although prior arboviral infection and the use of public wells were associated with seropositivity while outdoor spraying of insecticides by the Ministry of Health was inversely associated with seropositivity. The most significant predictors observed were at the neighborhood level, where vector control activities such as indoor and outdoor application of insecticides by the Ministry of Health were inversely associated with seropositivity.The second aim followed the children of mothers enrolled in Leon as well as a second cohort in Managua through 48 months of age to assess neurodevelopmental outcomes among children with ZIKV exposure in utero, but without congenital Zika syndrome at birth. Early Learning Composite and subdomain-specific scores on the Mullen Scales of Early Learning neurodevelopmental assessment were compared between exposed and unexposed children, adjusting for potential confounders using inverse probability weighted generalized estimating equations. No statistically significant differences between ZIKV-exposed and -unexposed children persisted at 36 or 48 months of age, suggesting that differences in neurodevelopment previously observed in the first two years of life may resolve as children reach preschool age.The results of this research emphasize the importance of coordinated public health and vector control interventions in the prevention of ZIKV infection, and of follow-up with ZIKV-exposed children to ensure adequate developmental support during the first years of life.
■590 ▼aSchool code: 0153.
■650 4▼aEpidemiology
■650 4▼aPublic health
■650 4▼aPediatrics
■650 4▼aVirology
■653 ▼aZika virus
■653 ▼aLeon
■653 ▼aNicaragua
■653 ▼aSpatial distribution
■653 ▼aNeurodevelopmental impact
■653 ▼aChildren
■690 ▼a0766
■690 ▼a0720
■690 ▼a0767
■690 ▼a0573
■71020▼aThe University of North Carolina at Chapel Hill▼bEpidemiology.
■7730 ▼tDissertations Abstracts International▼g87-02B.
■790 ▼a0153
■791 ▼aPh.D.
■792 ▼a2025
■793 ▼aEnglish
■85640▼uhttp://www.riss.kr/pdu/ddodLink.do?id=T17358891▼nKERIS▼z이 자료의 원문은 한국교육학술정보원에서 제공합니다.
