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Volume 26, Number 11—November 2020
Dispatch

Preventing Vector-Borne Transmission of Zika Virus Infection During Pregnancy, Puerto Rico, USA, 2016–20171

Katherine KortsmitComments to Author , Beatriz Salvesen von Essen, Lee Warner, Denise V. D’Angelo, Ruben A. Smith, Carrie K. Shapiro-Mendoza, Holly B. Shulman, Wanda Hernández Virella, Aspy Taraporewalla, Leslie Harrison, Sascha Ellington, Wanda D. Barfield, Denise J. Jamieson, Shanna Cox, Karen Pazol, Patricia Garcia Díaz, Beatriz Rios Herrera, and Manuel Vargas Bernal
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (K. Kortsmit, B. Salvesen von Essen, L. Warner, D.V. D’Angelo, R.A. Smith, C.K. Shapiro-Mendoza, H.B. Shulman, A. Taraporewalla, L. Harrison, S. Ellington, W.D. Barfield, S. Cox, K. Pazol); Puerto Rico Department of Health, San Juan, Puerto Rico, USA (W. Hernández Virella, P. Garcia Díaz, B. Rios Herrera, M. Vargas Bernal); Emory University School of Medicine, Atlanta (D.J. Jamieson)

Main Article

Table 2

Adjusted weighted prevalence estimates and prevalence ratios of self-reported use of personal protective measures to prevent vector-borne transmission of Zika virus during pregnancy by maternal characteristics and provider counseling, PRAMS-ZPER, Puerto Rico, USA, 2016–2017*

Maternal characteristics Wore long sleeves and long pants every day
Frequent mosquito repellent use†
2016, n = 2,238‡
2017, n = 1,365‡
2016, n = 2,241‡
2017, n = 1,375‡
aPR (95% CI)§ aPR (95% CI)§ aPR (95% CI)§ aPR (95% CI)§
Total¶
11.3
NA

7.9
NA

45.4
NA

56.9
NA
Age, y
≤19 7.8 0.46 (0.27–0.77)# 8.3 0.62 (0.35–1.08) 47.6 0.82 (0.68–0.99)# 53.3 0.87 (0.73–1.04)
20–34 11.1 0.65 (0.46–0.94)# 7.1 0.52 (0.36–0.76)# 43.5 0.75 (0.67–0.85)# 56.6 0.93 (0.84–1.03)
≥35
17.0
Referent

13.5
Referent

57.9
Referent

61.1
Referent
Education level
<HS diploma 20.2 2.03 (1.38–2.99)# 8.0 1.14 (0.63–2.08) 47.7 1.07 (0.90–1.26) 60.3 1.09 (0.93–1.27)
HS diploma 13.2 1.33 (1.01–1.73)# 10.9 1.55 (1.13–2.14)# 46.4 1.04 (0.93–1.15) 60.6 1.09 (1.00–1.20)
>HS
9.9
Referent

7.0
Referent

44.8
Referent

55.5
Referent
Marital status during pregnancy
Unmarried 10.8 0.88 (0.68–1.14) 8.6 1.31 (0.92–1.86) 45.6 1.02 (0.92–1.12) 57.4 1.03 (0.95–1.12)
Married
12.3
Referent

6.5
Referent

44.8
Referent

55.8
Referent
Prenatal WIC participation
Yes 11.2 0.93 (0.63–1.36) 8.1 1.15 (0.73–1.81) 46.6 1.29 (1.07–1.57)# 58.4 1.20 (1.07–1.35)#
No
12.1
Referent

7.0
Referent

36.0
Referent

48.5
Referent
Receipt of provider counseling on types of clothes to wear to prevent mosquito
Yes 11.3 0.99 (0.73–1.35) 8.2 1.15 (0.79–1.68) NA NA NA NA
No
11.4
Referent

7.1
Referent

NA
NA

NA
NA
Receipt of provider counseling on using mosquito repellent
Yes NA NA NA NA 46.1 1.23 (1.05–1.46)# 58.9 1.52 (1.29–1.78)#
No NA NA NA NA 37.3 Referent 38.8 Referent

*On the 2016 PRAMS-ZPER survey, women were asked about receiving counseling from a healthcare provider about using mosquito repellent on their skin only. On the 2017 PRAMS-ZPER survey, the question was expanded to ask about mosquito repellent on their skin or clothing. aPR, adjusted prevalence ratio; HS, high school; NA, not applicable; PRAMS-ZPER, Pregnancy Risk Assessment Monitoring System–Zika Postpartum Emergency Response Study; WIC, Special Supplemental Nutrition Program for Women, Infants, and Children.
†Defined as every day use in 2016 and always use in 2017. 
‡Unweighted sample size; sample size varies because of missing responses.
§Prevalence and prevalence ratio estimates adjusted for maternal age, education, marital status, prenatal WIC participation, receipt of provider counseling, infant birth month, and health district region (Aguadilla, Arecibo, Bayamon, Caguas, Fajardo, Mayaguez, Metro, or Ponce).
¶Unadjusted prevalence estimates. 
#Statistically significant result.

Main Article

1Presented in part at the 2018 CityMatCH Leadership and MCH Epidemiology Conference, Portland, Oregon, September 12–14, 2018.

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Page updated: October 19, 2020 12:07 PM EDT
Page reviewed: October 19, 2020 12:07 PM EDT
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