Zika virus in American Samoa: challenges to prevention in the context of health disparities and non-communicable disease

Abstract

Background: Zika virus (ZIKV) is linked to deleterious foetal and neonate outcomes. Maternal exposure to ZIKV through mosquitoes and sexual fluids creates a public health challenge for communities and policymakers, which is exacerbated by high levels of chronic non-communicable diseases in American Samoa. Aim: This study aimed to identify structural barriers to ZIKV prevention in American Samoa and situate them within locally relevant cultural and epidemiological contexts. Subjects and methods: This study assessed knowledge, attitudes and access to ZIKV prevention among 180 adults in American Samoan public health clinics. It queried knowledge about pre-natal care, protection against mosquitoes and condom use. Results: Women were most likely to identify pre-natal care as important. The majority of participants were able to identify how to prevent mosquito bites, but may have been unable to follow through due to socioeconomic and infrastructure limitations. Few participants identified condom use as a preventative measure against ZIKV. Prevention misconceptions were most pronounced in women of low socioeconomic status. Conclusions: These findings reinforce the need for a multi-pronged approach to ZIKV. This study highlights the need for information on culturally specific barriers and recognition of additional challenges associated with dual burden in marginal populations where social inequalities exacerbate health issues.

Keywords

• zika virus
• pre-natal care
• sexual health
• dual burden
• american samoa