About This Project
This study is a rapid assessment of women attending health care centers to assess their knowledge of Zika, their reproductive decision-making over the last year, behavior of their partners, and intentions for the immediate future. The results of this study will be shared with health authorities in Brazil, and used to develop with Brazilian colleagues a collaborative proposal to understand the impact of zika on reproductive decision-making and develop relevant and appropriate recommendations.
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Join The DiscussionWhat is the context of this research?
Zika is a declared global public health emergency and endemic in Brazil, especially in the northeast of Brazil. Fortaleza, in the state of Ceará, is the fifth largest city in Brazil with an estimated 3.6 million people in the metropolitan region. Ceará is one of the 22 states in Brazil reporting microcephaly. An Epidemiological Bulletin for Microcephaly reports that as of the first week in February 2016, 335 cases of congenital malformation have been reported in Ceará. Thirty-three have been confirmed ( about half of the cases reviewed ). My primary reason for selecting Fortaleza is that over my 10 years of working here I have established close ties to local researchers, and have access to the clinics in the city and the resources of the Federal University of Ceará.
What is the significance of this project?
Women of reproductive age have been the target of numerous recommendations concerning Zika and the mosquito that transmits Zika virus, including recommendations to control breeding sites in their homes and to postpone pregnancy. While most research is appropriately exploring Zika biology and epidemiology, I have found no research targeting women's response to Zika and their response to these recommendations. Any recommendations need to be built on the reality of women's lives, their partners preferences, and the possibilities available to them. Ultimately, as we learn more about Zika and the epidemiology of infection we will be able to provide more realistic recommendations. This study, and hopefully a larger follow-on, will provide evidence for intervention and a baseline.
What are the goals of the project?
Conduct a Rapid Anthropological Assessment of Women's knowledge of Zika - including transmission, symptoms, effects and care-seeking for Zika - their knowledge and response to recommendations, including mosquito control and postponing pregnancy and partner perspectives.
A total of about 300 women will be interviewed in 12 clinics. The large number of women is designed to capture a wide range of experience: recently pregnant (intentional and unintentional), terminating a pregnancy, postponing pregnancy, planning a pregnancy, and, with respect to Zika, those diagnosed with Zika, diagnosed with Zika during pregnancy, and those with no symptoms. Fieldnotes and relevant parts of the interview will be transcribed and analyzed with dtSearch 7.51. Quantifiable items will be analyzed in Excel.
Budget
My travel to Brazil (March 3, 2016) and expenses are covered by a Science without Borders grant from the Brazilian government. Collaborators are resident in Brazil and fully funded. In this budget I request funding for three Brazilian graduate students to administer a semi-structured instrument to women 18-35 attending public clinics, recruited systematically. Graduate student assistants will receive $400 per month as salary to conduct the interviews and write them up. In addition they will receive transportation expenses to go to the clinics by bus or car. They receive a per diem as well to cover their lunch and ancillary other expenses such as cell phone minutes. A small supplies budget is added. Costs are locally appropriate for Fortaleza. Interviews will be audiotaped when permitted, either on fieldworker smart phones or using available tape recorders.
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Meet the Team
Affiliates
Affiliates
Team Bio
This research will be conducted with the assistance of Dr. Ligia Kerr, MD, MPH, PhD, Senior Professor of Epidemiology in the Department of Community Health, at the School of Medicine, Federal University of Ceará and Dr. Larissa Polejack, M.C.P., PhD. Adjunct Professor, Institute of Psychology, Department of Clinical Psychology, University of Brasilia.
Carl Kendall
Professor Kendall is an applied medical anthropologist. He studies health inequalities and care-seeking among populations made vulnerable by poverty, ethnicity, gender and sexual identity, and by stigmatizing diseases. He has worked in more than 40 countries on topics including childhood diarrhea, care-seeking, vitamin A deficiency, malaria, dengue, leprosy, and HIV. Professor Kendall is especially interested in the surveillance methods used to collect information about diseases, especially stigmatized diseases. He is a Fulbright Senior Scholar, CNPq Senior Scientist and recipient of a Science without Frontiers award from the Brazilian government to bring graduate and post-doctoral students to Tulane. He has worked with colleagues at the Federal University of Ceara and in the Fortaleza health system for more than 10 years.
Professor Kendall pioneered rapid assessment methods in child health programs in 1983 with the World Health Organization's Diarrheal Diseases Control Program. Since then, he has taught qualitative research methods at the Bloomberg Johns Hopkins School of Public Health, the London School of Hygiene and Tropical Medicine and the Tulane School of Public Health and Tropical Medicine. He has more than 140 publications in English, Spanish and Portuguese.
Ligia Kerr
Senior professor at the Federal University of Ceará, graduated from Ribeirão Preto Medical School, University of São Paulo (1983), MPH from University of São Paulo (1988), PhD in Preventive Medicine the University of São Paulo (1992), post-doc in epidemiology at Harvard School of Public Health (1997) and post-doc in epidemiology at the University of California San Francisco (2007). Member of the Ministry of Health Leprosy Elimination Committee, was a member of the Research Committee of the AIDS National Program of the Ministry of Health and the National AIDS Board of the Ministry of Health, was member of the National Committee of Epidemiology of ABRASCO, editor of Epidemiology journal of ABRASCO, advises the National Reference Center for Sanitary Dermatology Dona Libânia (referral center for Leprosy), reviewer for Public Health Journal of USP, JAIDS, AIDS & Behavior, Journal of Infectious Disease in Developing Countries, was a member of the editorial board of Reports in Public Health. She is a member of the editorial board of Culture, Health and Sexuality. She has experience in Public Health Epidemiology.
Larissa Polejack
Adjunct Professor at the University of Brasilia. She has expertise in Psychodrama and Health Education, and has a Master's in Clinical Psychology, and PhD in Human Development and Health (2007) . She is currently a post-doc in the department of Global Community Health and Behavioral Sciences at the School of Public Health and Tropical Medicine, Tulane University, New Orleans. She served as technical advisor for the National STD / AIDS Program of the Ministry of Health of Brazil (2001-2004) and the International Center for AIDS Care and Treatment (ICAP), Columbia University in Mozambique where she was responsible for Counseling, Adherence and Psychosocial Support (2005 -2009). She served as a Supervisor in the Multidisciplinary Residency at the University Hospital of Brasilia with emphasis on oncological care and cardio-pulmonary response from 2010-2015 . She coordinates Brazil's cooperation project with Mozambique, Pro-Mobility CAPES / AULP since 2014. She coordinates the working groups: "Integra: Group of Studies and Intervention in Psychology, Cronicity and Health Public Policy" (2013) and "Welcome: Psychological Attention for people living with pain and chronic diseases "(2010).
Areas of expertise: Health Psychology, Health Promotion, Health Education.
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