#Geography of #Microcephaly in the #Zika Era: A Study of #Newborn Distribution and Socio-environmental Indicators in #Recife, #Brazil, 2015-2016 (Public Health Rep., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Public Health Rep. 2018 Jul/Aug;133(4):461-471. doi: 10.1177/0033354918777256. Epub 2018 Jun 19.

Geography of Microcephaly in the Zika Era: A Study of Newborn Distribution and Socio-environmental Indicators in Recife, Brazil, 2015-2016.

Souza AI1, de Siqueira MT2, Ferreira ALCG1, de Freitas CU3, Bezerra ACV4, Ribeiro AG5, Nardocci AC5.

Author information: 1 Instituto de Medicina Integral Professor Fernando Figueira, Recife, Brazil. 2 Faculdade de Ciências Médicas, Universidade de Pernambuco, Recife, Brazil. 3 Independent Researcher, Recife, Brazil. 4 Instituto Federal de Pernambuco, Recife, Brazil. 5 Faculdade de Saúde Pública, Universidade de São Paulo, São Paulo, Brazil.

 

Abstract

OBJECTIVES:

We assessed sociodemographic and health care factors of mothers and newborns during a 2015-2016 outbreak of microcephaly in Recife, Brazil, and we analyzed the spatial distribution and incidence risk of newborns with microcephaly in relation to socio-environmental indicators.

METHODS:

We collected data from August 2015 through May 2016 from Brazil’s Live Birth Information System and Bulletin of Microcephaly Notification, and we geocoded the data by maternal residence. We constructed thematic maps of districts, according to socio-environmental and vector indicators. We identified spatial aggregates of newborns with microcephaly by using the Bernoulli model. We performed logistic regression analyses to compare the incidence risk of microcephaly within socio-environmental indicator groups.

RESULTS:

We geocoded 17 990 of 19 554 (92.0%) live births in Recife, of which 202 (1.1%) newborns were classified as having microcephaly, based on a head circumference of ≥2 standard deviations below the mean. Larger proportions of newborns with microcephaly (compared with newborns without microcephaly) were born to mothers who delivered in a public hospital, did not attend college, were aged ≤19, or were black or mixed race. A higher risk of microcephaly (incidence rate ratio [IRR] = 3.90; 95% confidence interval [CI], 1.88-8.06) occurred in districts with the lowest (vs highest) Municipal Human Development Index (ie, an index that assesses longevity, education, and income). The risk of microcephaly was significantly higher where rates of larvae density (IRR = 2.31; 95% CI, 1.19-4.50) and larvae detection (IRR = 2.04; 95% CI, 1.05-4.00) were higher and rates of sewage system (IRR = 2.20; 95% CI, 1.16-4.18) and garbage collection (IRR = 1.96; 95% CI, 0.99-3.88) were lower. Newborns with microcephaly lived predominantly in the poorest areas and in a high-risk cluster (relative risk = 1.89, P = .01) in the north.

CONCLUSIONS:

The disproportionate incidence of microcephaly in newborns in poor areas of Recife reinforces the need for government and public health authorities to formulate policies that promote social equity and support for families and their children with microcephaly.

KEYWORDS: Zika; ecological studies; environmental indicators; health inequalities; microcephaly; social indicators

PMID: 29920225 PMCID: PMC6055288 [Available on 2019-07-01] DOI:
10.1177/0033354918777256 [Indexed for MEDLINE]

Keywords: Zika Virus; Zika Congenital Syndrome; Microcephaly; Society; Brazil.

——

Advertisements

#Clinical, #Neuroimaging, and #Neurophysiological Findings in #Children with #Microcephaly Related to #Congenital #Zika Virus Infection (Int J Environ Res Public Health, abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Int J Environ Res Public Health. 2019 Jan 23;16(3). pii: E309. doi: 10.3390/ijerph16030309.

Clinical, Neuroimaging, and Neurophysiological Findings in Children with Microcephaly Related to Congenital Zika Virus Infection.

C Lage ML1, Carvalho AL2, Ventura PA3, Taguchi TB4, Fernandes AS5, Pinho SF6, Santos-Junior OT7, Ramos CL8, Nascimento-Carvalho CM9,10.

Author information: 1 Post-graduate Programme in Health Sciences, Federal University of Bahia School of Medicine, Praça XV de Novembro-Largo do Terreiro de Jesus, 40025-010 Bahia, Brazil. marylulage@hotmail.com. 2 Pediatric Rehabilitation Centre, Salvador Hospital, SARAH Network of Rehabilitation Hospitals, Avenida Tancredo Neves, Caminho das Árvores, Salvador, 41820-900 Bahia, Brazil. 13110@sarah.br. 3 Pediatric Rehabilitation Centre, Salvador Hospital, SARAH Network of Rehabilitation Hospitals, Avenida Tancredo Neves, Caminho das Árvores, Salvador, 41820-900 Bahia, Brazil. 701064@sarah.br. 4 Pediatric Rehabilitation Centre, Salvador Hospital, SARAH Network of Rehabilitation Hospitals, Avenida Tancredo Neves, Caminho das Árvores, Salvador, 41820-900 Bahia, Brazil. 11786@sarah.br. 5 Pediatric Rehabilitation Centre, Salvador Hospital, SARAH Network of Rehabilitation Hospitals, Avenida Tancredo Neves, Caminho das Árvores, Salvador, 41820-900 Bahia, Brazil. 400868@sarah.br. 6 Pediatric Rehabilitation Centre, Salvador Hospital, SARAH Network of Rehabilitation Hospitals, Avenida Tancredo Neves, Caminho das Árvores, Salvador, 41820-900 Bahia, Brazil. 701053@sarah.br. 7 Diagnostic Imaging Department, Salvador Hospital, SARAH Network of Rehabilitation Hospital, Avenida Tancredo Neves, Caminho das ÁrvoresSalvador, 41820-900 Bahia, Brazil. 700991@sarah.br. 8 Bahiana School of Medicine, Bahiana Foundation for Science Development, Dom João VI, Salvador, 40290-000 Bahia, Brazil. ccclr1@gmail.com. 9 Post-graduate Programme in Health Sciences, Federal University of Bahia School of Medicine, Praça XV de Novembro-Largo do Terreiro de Jesus, 40025-010 Bahia, Brazil. nascimentocarvalho@hotmail.com. 10 Departament of Paediatrics, Federal University of Bahia School of Medicine, Praça XV de Novembro-Largo do Terreiro de Jesus, 40025-010 Bahia, Brazil. nascimentocarvalho@hotmail.com.

 

Abstract

Zika virus (ZIKV) infection appeared in Brazil in 2015, causing an epidemic outbreak with increased rates of microcephaly and other serious birth disorders. We reviewed 102 cases of children who were diagnosed with microcephaly at birth and who had gestational exposure to ZIKV during the outbreak. We describe the clinical, neuroimaging, and neurophysiological findings. Most mothers (81%) reported symptoms of ZIKV infection, especially cutaneous rash, during the first trimester of pregnancy. The microcephaly was severe in 54.9% of the cases. All infants presented with brain malformations. The most frequent neuroimaging findings were cerebral atrophy (92.1%), ventriculomegaly (92.1%), malformation of cortical development (85.1%), and cortical⁻subcortical calcifications (80.2%). Abnormalities in neurological exams were found in 97.0% of the cases, epileptogenic activity in 56.3%, and arthrogryposis in 10.8% of the infants. The sensorineural screening suggested hearing loss in 17.3% and visual impairment in 14.1% of the infants. This group of infants who presented with microcephaly and whose mothers were exposed to ZIKV early during pregnancy showed clinical and radiological criteria for congenital ZIKV infection. A high frequency of brain abnormalities and signs of early neurological disorders were found, and epileptogenic activity and signs of sensorineural alterations were common. This suggests that microcephaly can be associated with a worst spectrum of neurological manifestations.

KEYWORDS: Zika virus; microcephaly; neuroimaging; neurologic examination

PMID: 30678125 DOI: 10.3390/ijerph16030309 Free full text

Keywords: Zika Virus; Zika Congenital Infection; Zika Congenital Syndrome; Microcephaly; Brazil.

—–

#Infants with #microcephaly due to #ZIKA virus exposure: #nutritional status and #food practices (Nutr J., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Nutr J. 2019 Jan 11;18(1):4. doi: 10.1186/s12937-019-0429-3.

Infants with microcephaly due to ZIKA virus exposure: nutritional status and food practices.

Dos Santos SFM1, Soares FVM2, de Abranches AD2, da Costa ACC2, Moreira MEL2, de Matos Fonseca V2.

Author information: 1 Institution: Instituto Nacional de Saúde da Mulher, Criança e Adolescente Fernandes Figueira – Fundação Oswaldo Cruz (IFF- FIOCRUZ), Av. Rui Barbosa, 716, Rio de Janeiro, 22250-020, Brazil. samira_fernandes13@hotmail.com. 2 Institution: Instituto Nacional de Saúde da Mulher, Criança e Adolescente Fernandes Figueira – Fundação Oswaldo Cruz (IFF- FIOCRUZ), Av. Rui Barbosa, 716, Rio de Janeiro, 22250-020, Brazil.

 

Abstract

BACKGROUND:

Children with microcephaly due to vertical exposure to Zika virus are an interesting population for investigation. Highlighted among their unique aspects are those related to nutrition due to its impact on child growth and development. Knowledge about the nutrition of microcephalic infants can help mothers and caregivers provide better care. Thus, this study aimed to describe the nutritional status and feeding practices of infants with microcephaly due to Zika virus exposure at birth and 12-23 months of age.

METHODS:

This is a descriptive study developed from a cohort of patients attending a public institution of reference. A total of 65 infants attended outpatient nutrition clinics. The food practices were described using the 24-h food recall and food consumption indicators. Anthropometric measurements and consultations were made using the Child Health Handbook to obtain information on the nutritional status (weight, height and head circumference) at the time of consultation and birth.

RESULTS:

There was a significant decrease in z-scores for weight, height and head circumference (HC) from birth to the time of the consultation. However, most infants did not show weight-for-height deficits. Additionally, HC was correlated with the anthropometric indices weight-for-age, height-for-age, body mass index-for-age and weight-for-height.

CONCLUSION:

Infants exhibited a worsening of their nutritional status between birth and the time of their consultation, notably when we evaluated the indices of height and head circumference for age. The main inadequacies regarding dietary practices were low food diversity, use of ultra-processed products and low lipid intake.

KEYWORDS: Infant nutrition; Microcephaly; Nutritional status; Zika virus

PMID: 30634976 DOI: 10.1186/s12937-019-0429-3

Keywords: Zika Virus; Zika Congenital Syndrome; Microcephaly.

——

#Genome Sequences of #Zika Virus Strains Recovered from #Amniotic Fluid, #Placenta, and Fetal #Brain of a #Microcephaly Patient in #Thailand, 2017 (Microbiol Resour Announc., abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Microbiol Resour Announc. 2018 Sep 20;7(11). pii: e01020-18. doi: 10.1128/MRA.01020-18. eCollection 2018 Sep.

Genome Sequences of Zika Virus Strains Recovered from Amniotic Fluid, Placenta, and Fetal Brain of a Microcephaly Patient in Thailand, 2017.

Wongsurawat T1, Jenjaroenpun P1, Athipanyasilp N2, Kaewnapan B2, Leelahakorn N2, Angkasekwinai N3, Kantakamalakul W2, Sutthent R2, Ussery DW1,4, Horthongkham N2, Nookaew I1,4.

Author information: 1 Department of Biomedical Informatics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA. 2 Department of Microbiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkoknoi, Bangkok, Thailand. 3 Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkoknoi, Bangkok, Thailand. 4 Department of Physiology and Biophysics, College of Medicine, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA.

 

Abstract

We present here the complete genome sequences of Zika virus strains isolated from aborted fetal tissue (brain and placenta) and amniotic fluid of a microcephaly patient in Thailand in 2017. The virus genomes that were sequenced have an average length of 10,807 nucleotides.

PMID: 30533643 PMCID: PMC6256666 DOI: 10.1128/MRA.01020-18

Keywords: Zika Virus; Microcephaly; Thailand.

——

#Congenital #Zika Virus #Infection with Normal Neurodevelopmental Outcome, #Brazil (Emerg Infect Dis., abstract)

[Source: US Centers for Disease Control and Prevention (CDC), Emerging Infectious Diseases Journal, full page: (LINK). Abstract, edited.]

Volume 24, Number 11—November 2018 / Research Letter

Congenital Zika Virus Infection with Normal Neurodevelopmental Outcome, Brazil

Alessandra Lemos de Carvalho  , Carlos Brites, Tânia Barreto Taguchi, Suely Fernandes Pinho, Gúbio Campos, and Rita Lucena

Author affiliations: SARAH Network of Rehabilitation Hospitals, Salvador, Brazil (A.L. de Carvalho, T.B. Taguchi, S.F. Pinho); Federal University of Bahia, Salvador (C. Brites, G. Campos, R. Lucena)

 

Abstract

We describe a case of a 20-month-old girl with probable congenital Zika virus infection and normal neurodevelopment, despite microcephaly and abnormal neuroimaging. This case raises questions about early prognostic markers and draws attention to the need for investigation in suspected Zika cases, even if the child’s early neurodevelopment is normal.

Keywords: Zika Virus; Zika Congenital Syndrome; Microcephaly.

——

Can we better understand how #Zika leads to #microcephaly? A systematic review of the effects of the Zika virus on human #brain #organoids (J Infect Dis., abstract)

[Source: Journal of Infectious Diseases, full page: (LINK). Abstract, edited.]

Can we better understand how Zika leads to microcephaly? A systematic review of the effects of the Zika virus on human brain organoids

Bayu Sutarjono

The Journal of Infectious Diseases, jiy572, https://doi.org/10.1093/infdis/jiy572

Published: 26 September 2018

 

Abstract

Background

The emergence of human brain organoids represents a unique opportunity to better understand the genesis of congenital brain abnormalities, more strikingly microcephaly, caused by the Zika virus (ZIKV) infection during early pregnancy.

Methodology/Results

A systematic review was conducted to investigate how ZIKV leads to microcephaly in a novel experimental model that mimics early brain development. Studies were gathered by searching MEDLINE/Pubmed, LILACS, and LiSSa of the effects of ZIKV infection on human brain organoids. From 146 identified papers, 13 articles were selected for review. In summary, this review found that ZIKV of African, Latin American, and Asian lineages caused productive replication after 72 hours, preferentially infected neural progenitor cells over mature neurons, reduced both cell populations, and caused premature differentiation. Limited data involving only African and Latin American lineages showed a reduction in populations of proliferating cells and intermediate cells, and overall decreased viability. Furthermore, all three lineages caused heightened apoptosis and reduced organoid size.

Conclusion/Significance

This systematic review strengthened the hypothesis that ZIKV causes congenital microcephaly, as investigated in the human brain organoid model. It also demonstrated the coherence of outcomes by these studies to validate the utility of human brain organoids in future research of brain development.

Zika, organoid, microcephaly, neural progenitor cells

Issue Section: Major Article

© The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

This article is published and distributed under the terms of the Oxford University Press, Standard Journals Publication Model (https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model)

Keywords: Zika Virus; Microcephaly; Organoids.

——

Association and #birth #prevalence of #microcephaly attributable to #Zika virus infection among #infants in Paraíba, #Brazil, in 2015-16: a case-control study (Lancet Child Adolesc Health, abstract)

[Source: US National Library of Medicine, full page: (LINK). Abstract, edited.]

Lancet Child Adolesc Health. 2018 Mar;2(3):205-213. doi: 10.1016/S2352-4642(18)30020-8. Epub 2018 Jan 12.

Association and birth prevalence of microcephaly attributable to Zika virus infection among infants in Paraíba, Brazil, in 2015-16: a case-control study.

Krow-Lucal ER1, de Andrade MR2, Cananéa JNA3, Moore CA4, Leite PL5, Biggerstaff BJ6, Cabral CM2, Itoh M7, Percio J8, Wada MY8, Powers AM6, Barbosa A9, Abath RB3, Staples JE6, Coelho GE5; Paraíba Microcephaly Work Group.

Collaborators (38): Araújo E, Medeiros ELA, Brant J, Cerroni M, de Barros Moreira Beltrão H, Fantinato FFST, Lise MLZ, Ohara PM, Resende E, Saad E, de St Maurice A, Dieke A, Harrist A, Kwit N, Marlow M, Soke G, de Arruda Pessoa R, da Silva RC, Diniz RC, de Araújo Ariette MC, Lira CF, Matos S, Wanderley TMM, Silva VOC, da Silva HS, Carmo EH, Carvalho M, Lentini N, Miranda R, Boland E, Burns P, Fischer M, Ledermann J, Coronado F, Dicent-Taillepierre J, Flannery B, Macedo de Oliveira A, Arena JF.

Author information: 1 Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA; EIS Program Office, Centers for Disease Control and Prevention, Atlanta, GA, USA. 2 Epidemiologia Aplicada aos Serviços do Sistema Único de Saúde (Episus), Brasilia, Brazil. 3 Secretariat of Health, Paraíba, Brazil. 4 Division of Congenital and Developmental Disorders, Centers for Disease Control and Prevention, Atlanta, GA, USA. 5 National Dengue Control Program, Brazil Ministry of Health, Brasilia, Brazil. 6 Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA. 7 EIS Program Office, Centers for Disease Control and Prevention, Atlanta, GA, USA. 8 Epidemiologia Aplicada aos Serviços do Sistema Único de Saúde (Episus), Brasilia, Brazil; National Dengue Control Program, Brazil Ministry of Health, Brasilia, Brazil. 9 Brazil Country Office, Centers for Disease Control and Prevention, Brasilia, Brazil.

 

Abstract

BACKGROUND:

In 2015, the number of infants born with microcephaly increased in Paraíba, Brazil, after a suspected Zika virus outbreak. We did a retrospective case-control investigation to assess the association of microcephaly and Zika virus.

METHODS:

We enrolled cases reported to the national database for microcephaly and born between Aug 1, 2015, and Feb 1, 2016, on the basis of their birth head circumference and total body length. We identified controls from the national birth registry and matched them to cases by location, aiming to enrol a minimum of two controls per case. Mothers of both cases and controls were asked about demographics, exposures, and illnesses and infants were measured at a follow-up visit 1-7 months after birth. We took blood samples from mothers and infants and classified those containing Zika virus IgM and neutralising antibodies as evidence of recent infection. We calculated prevalence of microcephaly and odds ratios (ORs) using a conditional logistic regression model with maximum penalised conditional likelihood, and combined these ORs with exposure probability estimates to determine the attributable risk.

FINDINGS:

We enrolled 164 of 706 infants with complete information reported with microcephaly at birth, of whom we classified 91 (55%) as having microcephaly on the basis of their birth measurements, 36 (22%) as small, 21 (13%) as disproportionate, and 16 (10%) as not having microcephaly. 43 (26%) of the 164 infants had microcephaly at follow-up for an estimated prevalence of 5·9 per 1000 livebirths. We enrolled 114 control infants matched to the 43 infants classified as having microcephaly at follow-up. Infants with microcephaly at follow-up were more likely than control infants to be younger (OR 0·5, 95% CI 0·4-0·7), have recent Zika virus infection (21·9, 7·0-109·3), or a mother with Zika-like symptoms in the first trimester (6·2, 2·8-15·4). Once Zika virus infection and infant age were controlled for, we found no significant association between microcephaly and maternal demographics, medications, toxins, or other infections. Based on the presence of Zika virus antibodies in infants, we concluded that 35-87% of microcephaly occurring during the time of our investigation in northeast Brazil was attributable to Zika virus. We estimate 2-5 infants per 1000 livebirths in Paraíba had microcephaly attributable to Zika virus.

INTERPRETATION:

Time of exposure to Zika virus and evidence of infection in the infants were the only risk factors associated with microcephaly. This investigation has improved understanding of the outbreak of microcephaly in northeast Brazil and highlights the need to obtain multiple measurements after birth to establish if an infant has microcephaly and the need for further research to optimise testing criteria for congenital Zika virus infection.

FUNDING:

Centers for Disease Control and Prevention.

Copyright © 2018 Elsevier Ltd. All rights reserved.

PMID: 30169255 DOI: 10.1016/S2352-4642(18)30020-8

Keywords: Zika Virus; Zika Congenital Infection; Microcephaly; Brazil.

——