Export file:


  • RIS(for EndNote,Reference Manager,ProCite)
  • BibTex
  • Text


  • Citation Only
  • Citation and Abstract

Zika virus knowledge and attitudes in Ecuador

1 Office of Rural and Underserved Programs, Ohio University Heritage College of Osteopathic Medicine, Athens, OH, United States
2 Infectious and Tropical Disease Institute, Department of Biomedical Sciences, Heritage College of Osteopathic Medicine, Athens OH, United States
3 Department of Social and Public Health, College of Health Sciences and Professions, Ohio University, Athens OH, United States
4 Center for Research on Health in Latin America, School of Biological Sciences, Pontifical Catholic University of Ecuador, Quito, Ecuador

Since its discovery in 1947 in Uganda, ZIKV has spread to 61 countries with a total of 229,238 confirmed human cases worldwide. Specifically, Ecuador has recorded 3,058 confirmed cases and 7 confirmed cases of congenital syndrome associated with ZIKV. Using the Health Belief Model (HBM), this pilot study was conducted to assess Zika virus-related knowledge and attitudes among adults in Ecuador. The survey data were collected in public places in rural and urban areas of Ecuador in May 2016. Seven items measured ZIKV knowledge and 23 items measured attitudes toward ZIKV. A total of 181 Ecuadorians participated in this study. The average age of the sample was 33.4. With respect to ZIKV knowledge, the majority of the participants had heard of ZIKV (n = 162, 89.5%). More males reported first hearing of ZIKV on the internet (p = 0.02), more rural individuals reported knowing someone diagnosed with ZIKV (p = 0.02), more primary school educated individuals reported hearing about ZIKV first from their doctor/nurse (p = 0.03), and more high school graduates correctly identified that ZIKV could be transmitted from mother to child (p = 0.03). As for the HBM constructs, there was a statistically significant difference between gender and cues to action (p = 0.04), with males having a statistically significant lower mean on the cues to action items compared to females. There were also statistically significant differences between those categorized as having “adequate” knowledge compared to “low” knowledge on the benefits construct (p = 0.04) and the perceived severity construct (p = 0.03). There is a clear need for education about the transmission and prevention of ZIKV. High levels of self-efficacy for prevention behaviors for ZIKV combined with low perceived barriers in this community set the stage for effective educational interventions or health promotion campaigns that can ameliorate the knowledge deficits surrounding transmission and prevention.
  Article Metrics


1. Dick G, Kitchen SF, Haddow AJ (1952) Zika virus. Isolations and serological specificity. Trans R Soc Trop Med Hyg 46: 509–520.    

2. World Health Organization, Zika Virus Fact Sheet, 2016. Available from: http://www.who.int/mediacentre/factsheets/zika/en/.

3. World Health Organization. Situation Report: Zika virus, Microcephaly, Guillain-Barré syndrome, 2017. Available from: http://apps.who.int/iris/bitstream/10665/254714/1/zikasitrep10Mar17-eng.pdf?ua=1.

4. Pan American Health Organization. Zika Cases and Congenital Syndrome Associates with Zika Virus Reported by Countries and Territories in the Americas, 2015–2017 Cumulative cases, 2017. Available from: http://www.paho.org/hq/index.php?option=com_content&view=article&id=12390&Itemid=42090&lang=en.

5. Pan American Health Organization. Regional Zika Epidemiological Update (Americas), 2017. Available from: http://www.paho.org/hq/index.php?option=com_content&view=article&id=11599%3Aregional-zika-epidemiological-update-americas&catid=8424%3Acontents&Itemid=41691&lang=en.

6. Pan American Health Organization. Zika-Epidemiological Report Ecuador, 2017. Available from: http://www.paho.org/hq/index.php?option=com_docman&task=doc_view&gid=35027&Itemid=270&lang=en.

7. European Centre for Disease Prevention and Control. Zika virus infection: Factsheet for health professionals, 2016. Available from: https://ecdc.europa.eu/en/zika-virus-infection/facts/factsheet.

8. Ioos S, Mallet HP, Leparc GI, et al. (2014) Current Zika virus epidemiology and recent epidemics. Med Mal Infect 44: 302–307.    

9. Foy BD, Kobylinski KC, Foy JLC, et al. (2011) Probable Non–Vector-borne Transmission of Zika Virus, Colorado, USA. Emerg Infect Dis 17: 880–882.    

10. Sotelo JR, Sotelo AB, Sotelo F, et al. (2017) Persistence of Zika Virus in breast milk after infection in late stage of pregnancy. Emerg Infect Dis 23: 854–856.

11. Rather IA, Lone JB, Bajpai VK, et al. (2017) Zika Virus infection during pregnancy and congenital abnormalities. Front Microbiol 8: 581.

12. Krauer F, Riesen M, Reveiz L, et al. (2017) Zika Virus infection as a cause of congenital brain abnormalities and Guillain–Barré Syndrome: Systematic review. PLoS Med 14: e1002203.    

13. Marrs C, Olson G, Saade G, et al. (2016) Zika Virus and pregnancy: A review of the literature and clinical considerations. Am J Perinatol 33: 625–639.    

14. World Health Organization. Zika Causality Statement. 7 September 2016. Available from: http://www.who.int/emergencies/zika-virus/causality/en/.

15. Garcia Serpa Osorio-de-Castro C, Silva Miranda E, Machado de Freitas C, et al. (2017) The Zika Virus outbreak in Brazil: Knowledge gaps and challenges for risk reduction. Am J Public Health 6: 960–965.

16. Rosenstock IM, Strecher VJ, Becker MH (1988) Social learning theory and the Health Belief Model. Health Educ Q 15: 175–183.    

17. Glanz K, Lewis FM, Rimer BK (1997) Health behavior and health education: Theory, research, and practice. San Francisco, CA, US: Jossey-Bass, 460.

18. Stretcher V, Rosenstock I (1997) The Health Belief Model. In: Health Behaviour and Health Education: Theory, Research and Practice. San Francisco, CA, US: Jossey-Bass.

19. Sabogal-Roman JA, Murillo-Garcıa DR, Yepes-Echeverri MC, et al. (2015) Healthcare students and workers' knowledge about transmission, epidemiology and symptoms of Zika fever in four cities of Colombia. Travel Med Infect Dis 14: 52–54.

20. Gupta N, Randhawa RK, Thakar S, et al. (2016) Knowledge regarding Zika virus infection among dental practitioners of Tricity area (Chandigarh, Panchkula and Mohali), India. Niger Postgrad Med J 23: 33–37.

21. Michael GC, Aliyu I, Grema BA, et al. (2017) Knowledge of Zika virus disease among reproductive-age women attending a general outpatient clinic in Northern Nigeria. S Afr Fam Pract 59: 148–153.

22. Cheema S, Maisonneuve P, Weber I, et al. (2017) Knowledge and perceptions about Zika virus in a Middle East country. BMC Infect Dis 17: 524.    

23. Whittemore K, Tate A, Illescas A, et al. (2017) Zika virus knowledge among pregnant women who were in areas with active transmission. Emerg Infect Dis 23: 164–166.    

24. World Health Organization. Knowledge, Attitudes and Practice surveys Zika virus disease and potential complications. Available from: http://www.who.int/csr/resources/publications/zika/kap-surveys/en/.

25. Office of Management and Budget. 2010 OMB Metro Standards, FR Notice June 28, 2010 - 06282010_metro_standards-Complete. 2010. Available from: https://obamawhitehouse.archives.gov/sites/default/files/omb/assets/fedreg_2010/06282010_metro_standards-Complete.pdf.

26. IBM Corp. IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp.

27. NORC. The Zika virus: gaps in Americans' knowledge and support for government action. University of Chicago; 2016 Sep, 1–12.

28. Correspondent HSR. Pope suggests contraception can be condoned in Zika crisis. The Guardian. 2016 Feb 18. Available from: https://www.theguardian.com/world/2016/feb/18/pope-suggests-contraception-can-be-condoned-in-zika-crisis.

29. Cost of Living in Ecuador. Available from: https://www.numbeo.com/cost-of-living/country_result.jsp?country=Ecuador.

30. Priddy FH, Cheng AC, Salazar LF, et al. (2006) Racial and ethnic differences in knowledge and willingness to participate in HIV vaccine trials in an urban population in the Southeastern US. Int J STD AIDS 17: 99–102.    

31. Roberts KJ, Newman PA, Duan N, et al. (2005) HIV vaccine knowledge and beliefs among communities at elevated risk: conspiracies, questions and confusion. J Natl Med Assoc 97: 1662–1671.

32. Clarke VA, Lovegrove H, Williams A, et al. (2000) Unrealistic optimism and the Health Belief Model. J Behav Med 23: 367–376.    

© 2018 the Author(s), licensee AIMS Press. This is an open access article distributed under the terms of the Creative Commons Attribution Licese (http://creativecommons.org/licenses/by/4.0)

Download full text in PDF

Export Citation

Article outline

Show full outline
Copyright © AIMS Press All Rights Reserved