Viral Infections and Outbreaks Research / Mosquito Borne Diseases and Control · Journal article
International Journal of Women S Health · September 1, 2026
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This is a secondary analysis of Global Burden of Disease 2023 data comparing epidemiological patterns of Ebola and Zika in women of childbearing age across regions and time periods (2011–2023). EVD shows extremely high fatality but low incidence in endemic areas; ZVD shows high incidence but very low fatality, with strong correlation between Zika incidence and live births in Latin America and Caribbean. The findings are descriptive and correlational, not interventional; they identify epidemiological patterns that should inform surveillance and prevention strategy design but do not constitute evidence of efficacy for any maternal-neonatal protection intervention.
Secondary analysis of Global Burden of Disease 2023 data; comparative epidemiological descriptive study. Women of childbearing age and males aged 15–49 years in Sub-Saharan Africa, Latin America, and Caribbean with EVD or ZVD; data from Global Burden of Disease 2023 study.. Compared with: EVD versus ZVD; WCBA versus males aged 15–49 years; endemic versus outbreak periods; regional comparisons.. Sub-Saharan Africa, Latin America, Caribbean; Brazil and Brazilian states analysed separately for ZVD..
During 2012–2022, WCBA generally experienced higher cumulative and annual EVD incidence than males aged 15–49 years in Sub-Saharan Africa; higher ZVD incidences were also observed among WCBA in Latin America and Caribbean, although no differences were significant. EVD exhibited low incidence but extremely high fatality (MIR 0.39–0.70) in WCBA; ZVD showed high incidence but low fatality (MIR 1.92 × 10−6–9.45 × 10−6). EVD DALYs primarily driven by years of life lost; ZVD DALYs mainly driven by years lived with disability.
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Clinicians and public health professionals should use these epidemiological comparisons to understand the distinct risk profiles of EVD and ZVD in pregnant women and to inform regional surveillance, prevention, and maternal-neonatal protection strategies. The strong correlation between ZVD incidence and live births in Latin America and Caribbean suggests that live births may be a useful marker for identifying populations at risk of MTCT; however, this is an observational association and does not establish causation or support a specific intervention.
A descriptive comparative epidemiological analysis of disease burden data from a secondary source (GBD 2023), lacking intervention trials, primary outcome data, or causal evidence; provides useful contextual framing for maternal-neonatal protection but cannot support practice change or strong recommendations on its own.
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Clinicians and public health professionals should use these epidemiological comparisons to understand the distinct risk profiles of EVD and ZVD in pregnant women and to inform regional surveillance, prevention, and maternal-neonatal protection strategies. The strong correlation between ZVD incidence and live births in Latin America and Caribbean suggests that live births may be a useful marker for identifying populations at risk of MTCT; however, this is an observational association and does not establish causation or support a specific intervention.
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Background: Comparative epidemiological evidence on Ebola virus disease (EVD) and Zika virus disease (ZVD) in women of childbearing age (WCBA) is limited, hindering understanding of their mother-to-child transmission (MTCT) potential and maternal–neonatal protection. This study aimed to compare EVD and ZVD epidemiology in WCBA, assess sex-specific differences, and examine the association between ZVD incidence and live births to inform maternal–neonatal protection and disease control. Methods: Data on incidence, deaths, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life-years (DALYs) of EVD and ZVD (2011– 2023) among WCBA and other populations were extracted from the Global Burden of Disease 2023 study. Cumulative cases, age-standardised incidence rates (ASIRs), and mortality-to-incidence ratios (MIRs) were calculated. Sex-specific differences and correlations between ZVD ASIRs and live births were assessed. Results: During 2012– 2022, WCBA generally experienced higher cumulative and annual EVD incidence than males aged 15– 49 years in Sub-Saharan Africa; higher ZVD incidences were also observed among WCBA in Latin America and Caribbean, although no differences were significant. In main-endemic super-regions, EVD exhibited low incidence but extremely high fatality (MIR 0.39– 0.70) in WCBA, with DALYs primarily driven by YLLs; whereas ZVD showed high incidence but low fatality (MIR 1.92 × 10 − 6 – 9.45 × 10 − 6 ), with DALYs mainly driven by YLDs. Two EVD outbreaks occurred amid low endemicity in Sub-Saharan Africa, while a ZVD outbreak occurred in 2016 during persistent endemicity in Latin America and Caribbean. ZVD ASIRs in WCBA were strongly correlated with corresponding live births in Latin America and Caribbean, Brazil (2011– 2022), and constitute countries/territories and Brazilian states in 2016. Conclusion: Strengthened EVD monitoring in Sub-Saharan Africa and a Latin America-Caribbean-centred strategy for ZVD prevention targeting WCBA may improve maternal-neonatal protection and control of neglected tropical diseases with MTCT potential. Keywords: Ebola virus disease, Zika virus disease, women of childbearing age, mother-to-child transmission, comparative analysis, global burden of disease study 2023
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