#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.

—–

Association of #Infants Exposed to Prenatal #Zika Virus #Infection With Their Clinical, #Neurologic, and Developmental Status Evaluated via the #GMA #Tool (JAMA Netw Open., abstract)

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

JAMA Netw Open. 2019 Jan 4;2(1):e187235. doi: 10.1001/jamanetworkopen.2018.7235.

Association of Infants Exposed to Prenatal Zika Virus Infection With Their Clinical, Neurologic, and Developmental Status Evaluated via the General Movement Assessment Tool.

Einspieler C1, Utsch F2, Brasil P3, Panvequio Aizawa CY4, Peyton C5,6, Hydee Hasue R4, Françoso Genovesi F4, Damasceno L3, Moreira ME7, Adachi K8, Marschik PB1,9,10, Nielsen-Saines K8; GM Zika Working Group.

Author information: 1 Interdisciplinary Developmental Neuroscience-iDN, Medical University of Graz, Graz, Austria. 2 Rede SARAH de Hospitais de Reabilitação, Reabilitação Infantil, Belo Horizonte, Brazil. 3 Laboratorio de Doenças Febris Agudas, Instituto Nacional de Infectologia Evandro Chagas (INI), Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, Brazil. 4 Department of Physical Therapy, Communication Sciences & Disorders, and Occupational Therapy, Faculty of Medicine, University of São Paulo, São Paulo, Brazil. 5 Department of Physical Therapy and Human Movement Science, Northwestern University, Chicago, Illinois. 6 Department of Pediatrics, University of Chicago, Chicago, Illinois. 7 Department of Pediatrics, Instituto Fernandes Figueira, Fiocruz, Rio de Janeiro, Brazil. 8 Division of Pediatric Infectious Diseases, Department of Pediatrics, David Geffen School of Medicine, University of California, Los Angeles. 9 Interdisciplinary Developmental Neuroscience-iDN, Department of Child and Adolescent Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany. 10 Center of Neurodevelopmental Disorders (KIND), Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden.

 

Abstract

IMPORTANCE:

There is an urgent need to assess neurodevelopment in Zika virus (ZIKV)-exposed infants.

OBJECTIVES:

To perform general movement assessment (GMA) at 9 to 20 weeks’ postterm age and to evaluate whether the findings are associated with neurodevelopmental outcomes at age 12 months in infants prenatally exposed to acute maternal illness with rash in Brazil during the ZIKV outbreak and in age-matched controls.

DESIGN, SETTING, AND PARTICIPANTS:

In this cohort study, infants prenatally exposed to acute maternal illness with rash were recruited at medical institutions in Rio de Janeiro and Belo Horizonte, Brazil, from February 1, 2016, to April 30, 2017, while infants without any exposure to maternal illness originated from the Graz University Audiovisual Research Database for the Interdisciplinary Analysis of Neurodevelopment. Participants were 444 infants, including 76 infants without congenital microcephaly, 35 infants with microcephaly, and 333 neurotypical children matched for sex, gestational age at birth, and age at GMA.

MAIN OUTCOMES AND MEASURES:

General movement assessment performed at 9 to 20 weeks’ postterm age, with negative predictive value, positive predictive value, sensitivity, and specificity generated, as well as clinical, neurologic, and developmental status (Bayley Scales of Infant and Toddler Development, Third Edition [Bayley-III] scores) at age 12 months. Motor Optimality Scores were generated based on the overall quality of the motor repertoire. Adverse outcomes were defined as a Bayley-III score less than 2 SD in at least 1 domain, a score less than 1 SD in at least 2 domains, and/or atypical neurologic findings.

RESULTS:

A total of 444 infants were enrolled, including 111 children prenatally exposed to a maternal illness with rash and 333 children without any prenatal exposure to maternal illness (57.7% male and mean [SD] age, 14 [2] weeks for both groups); 82.1% (46 of 56) of ZIKV-exposed infants without congenital microcephaly were healthy at age 12 months. Forty-four of 46 infants were correctly identified by GMA at 3 months, with a negative predictive value of 94% (95% CI, 85%-97%). Seven of 10 ZIKV-exposed children without microcephaly with adverse neurodevelopmental outcomes were identified by GMA. The GMA positive predictive value was 78% (95% CI, 46%-94%), sensitivity was 70% (95% CI, 35%-93%), specificity was 96% (95% CI, 85%-99%), and accuracy was 91% (95% CI, 80%-97%). Children with microcephaly had bilateral spastic cerebral palsy; none had normal movements. The Motor Optimality Score differentiated outcomes: the median Motor Optimality Score was 23 (interquartile range [IQR], 21-26) in children with normal development, 12 (IQR, 8-19) in children with adverse outcomes, and 5 (IQR, 5-6) in children with microcephaly, a significant difference (P = .001).

CONCLUSIONS AND RELEVANCE:

This study suggests that although a large proportion of ZIKV-exposed infants without microcephaly develop normally, many do not. The GMA should be incorporated into routine infant assessments to enable early entry into targeted treatment programs.

PMID: 30657537 DOI: 10.1001/jamanetworkopen.2018.7235

Keywords: Zika Virus; Zika Congenital Infection; Zika Congenital Syndrome; Neurology.

——

#Zika virus #infection at mid- #gestation results in #fetal #cerebral cortical injury and fetal death in the olive baboon (PLoS Pathogens, abstract)

[Source: PLoS Pathogens, full page: (LINK). Abstract, edited.]

OPEN ACCESS /  PEER-REVIEWED / RESEARCH ARTICLE

Zika virus infection at mid-gestation results in fetal cerebral cortical injury and fetal death in the olive baboon

Sunam Gurung, Nicole Reuter, Alisha Preno, Jamie Dubaut, Hugh Nadeau, Kimberly Hyatt, Krista Singleton, Ashley Martin, W. Tony Parks, James F. Papin, Dean A. Myers

Published: January 18, 2019 / DOI: https://doi.org/10.1371/journal.ppat.1007507 / This is an uncorrected proof.

 

Abstract

Zika virus (ZIKV) infection during pregnancy in humans is associated with an increased incidence of congenital anomalies including microcephaly as well as fetal death and miscarriage and collectively has been referred to as Congenital Zika Syndrome (CZS). Animal models for ZIKV infection in pregnancy have been developed including mice and non-human primates (NHPs). In macaques, fetal CZS outcomes from maternal ZIKV infection range from none to significant. In the present study we develop the olive baboon (Papio anubis), as a model for vertical transfer of ZIKV during pregnancy. Four mid-gestation, timed-pregnant baboons were inoculated with the French Polynesian ZIKV isolate (104 ffu). This study specifically focused on the acute phase of vertical transfer. Dams were terminated at 7 days post infection (dpi; n = 1), 14 dpi (n = 2) and 21 dpi (n = 1). All dams exhibited mild to moderate rash and conjunctivitis. Viremia peaked at 5–7 dpi with only one of three dams remaining mildly viremic at 14 dpi. An anti-ZIKV IgM response was observed by 14 dpi in all three dams studied to this stage, and two dams developed a neutralizing IgG response by either 14 dpi or 21 dpi, the latter included transfer of the IgG to the fetus (cord blood). A systemic inflammatory response (increased IL2, IL6, IL7, IL15, IL16) was observed in three of four dams. Vertical transfer of ZIKV to the placenta was observed in three pregnancies (n = 2 at 14 dpi and n = 1 at 21 dpi) and ZIKV was detected in fetal tissues in two pregnancies: one associated with fetal death at ~14 dpi, and the other in a viable fetus at 21 dpi. ZIKV RNA was detected in the fetal cerebral cortex and other tissues of both of these fetuses. In the fetus studied at 21 dpi with vertical transfer of virus to the CNS, the frontal cerebral cortex exhibited notable defects in radial glia, radial glial fibers, disorganized migration of immature neurons to the cortical layers, and signs of pathology in immature oligodendrocytes. In addition, indices of pronounced neuroinflammation were observed including astrogliosis, increased microglia and IL6 expression. Of interest, in one fetus examined at 14 dpi without detection of ZIKV RNA in brain and other fetal tissues, increased neuroinflammation (IL6 and microglia) was observed in the cortex. Although the placenta of the 14 dpi dam with fetal death showed considerable pathology, only minor pathology was noted in the other three placentas. ZIKV was detected immunohistochemically in two placentas (14 dpi) and one placenta at 21 dpi but not at 7 dpi. This is the first study to examine the early events of vertical transfer of ZIKV in a NHP infected at mid-gestation. The baboon thus represents an additional NHP as a model for ZIKV induced brain pathologies to contrast and compare to humans as well as other NHPs.

 

Author summary

Zika virus is endemic in the Americas, primarily spread through mosquitos and sexual contact. Zika virus infection during pregnancy in women is associated with a variety of fetal pathologies now referred to as Congenital Zika Syndrome (CZS), with the most severe pathology being fetal microcephaly. Developing model organisms that faithfully recreate Zika infection in humans is critical for future development of treatments and preventions. In our present study, we infected Olive baboons at mid-gestation with Zika virus and studied the acute period of viremia and transfer of Zika virus to the fetus during the first three weeks after infection to better understand the timing and mechanisms of transfer of ZIKV across the placenta, leading to CZS. We observed Zika virus transfer to fetuses resulting in fetal death in one pregnancy and in a second pregnancy, significant damage to the frontal cortex of the fetal brain at a critical period of neurodevelopment in primates. Thus, the baboon provides a promising new non-human primate model to further compare and contrast the consequences of Zika virus infection in pregnancy to humans and other non-human primates.

___

Citation: Gurung S, Reuter N, Preno A, Dubaut J, Nadeau H, Hyatt K, et al. (2019) Zika virus infection at mid-gestation results in fetal cerebral cortical injury and fetal death in the olive baboon. PLoS Pathog 15(1): e1007507. https://doi.org/10.1371/journal.ppat.1007507

Editor: Carolyn B. Coyne, University of Pittsburgh, UNITED STATES

Received: October 10, 2018; Accepted: December 5, 2018; Published: January 18, 2019

Copyright: © 2019 Gurung et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Data Availability: All relevant data are within the manuscript and its Supporting Information files.

Funding: These studies were supported in part by the National Institutes of Health, NS103772 (DAM) and OD01988 (JFP). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

Competing interests: The authors have declared that no competing interests exist.

Keywords: Zika Virus; Zika Congenital Infection; Zika Congenital Syndrome; Pregnancy; Animal models.

——

Association of #Prenatal #Ultrasonographic Findings With Adverse #Neonatal Outcomes Among #Pregnant Women With Zika Virus Infection in #Brazil (JAMA Netw Open., abstract)

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

JAMA Netw Open. 2018 Dec 7;1(8):e186529. doi: 10.1001/jamanetworkopen.2018.6529.

Association of Prenatal Ultrasonographic Findings With Adverse Neonatal Outcomes Among Pregnant Women With Zika Virus Infection in Brazil.

Pereira JP Jr1, Nielsen-Saines K2, Sperling J3, Maykin MM3, Damasceno L4, Cardozo RF1, Valle HA1, Dutra BRT1, Gama HD1, Adachi K2, Zin AA1, Tsui I5, Vasconcelos Z1, Brasil P4, Moreira ME1, Gaw SL3.

Author information: 1 Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira-Fundação Oswaldo Cruz, Rio de Janeiro, Brazil. 2 Division of Pediatric Infectious Diseases, Department of Pediatrics, University of California, Los Angeles. 3 Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco. 4 Laboratorio de Doenças Febris Agudas, Instituto de Infectologia Evandro Chagas-Fundação Oswaldo Cruz, Rio de Janeiro, Brazil. 5 Jules Stein Eye Institute, Retina Division, UCLA (University of California, Los Angeles).

 

Abstract

IMPORTANCE:

Congenital Zika virus infection causes a spectrum of adverse birth outcomes, including severe birth defects of the central nervous system. The association of prenatal ultrasonographic findings with adverse neonatal outcomes, beyond structural anomalies such as microcephaly, has not been described to date.

OBJECTIVE:

To determine whether prenatal ultrasonographic examination results are associated with abnormal neonatal outcomes in Zika virus-affected pregnancies.

DESIGN, SETTING, AND PARTICIPANTS:

A prospective cohort study conducted at a single regional referral center in Rio de Janeiro, Brazil, from September 1, 2015, to May 31, 2016, among 92 pregnant women diagnosed during pregnancy with Zika virus infection by reverse-transcription polymerase chain reaction, who underwent subsequent prenatal ultrasonographic and neonatal evaluation.

EXPOSURES:

Prenatal ultrasonography.

MAIN OUTCOMES AND MEASURES:

The primary outcome measure was composite adverse neonatal outcome (perinatal death, abnormal finding on neonatal examination, or abnormal finding on postnatal neuroimaging). Secondary outcomes include association of specific findings with neonatal outcomes.

RESULTS:

Of 92 mother-neonate dyads (mean [SD] maternal age, 29.4 [6.3] years), 55 (60%) had normal results and 37 (40%) had abnormal results on prenatal ultrasonographic examinations. The median gestational age at delivery was 38.6 weeks (interquartile range, 37.9-39.3). Of the 45 neonates with composite adverse outcome, 23 (51%) had normal results on prenatal ultrasonography. Eleven pregnant women (12%) had a Zika virus-associated finding that was associated with an abnormal result on neonatal examination (adjusted odds ratio [aOR], 11.6; 95% CI, 1.8-72.8), abnormal result on postnatal neuroimaging (aOR, 6.7; 95% CI, 1.1-38.9), and composite adverse neonatal outcome (aOR, 27.2; 95% CI, 2.5-296.6). Abnormal results on middle cerebral artery Doppler ultrasonography were associated with neonatal examination abnormalities (aOR, 12.8; 95% CI, 2.6-63.2), postnatal neuroimaging abnormalities (aOR, 8.8; 95% CI, 1.7-45.9), and composite adverse neonatal outcome (aOR, 20.5; 95% CI, 3.2-132.6). There were 2 perinatal deaths. Abnormal findings on prenatal ultrasonography had a sensitivity of 48.9% (95% CI, 33.7%-64.2%) and a specificity of 68.1% (95% CI, 52.9%-80.1%) for association with composite adverse neonatal outcomes. For a Zika virus-associated abnormal result on prenatal ultrasonography, the sensitivity was lower (22.2%; 95% CI, 11.2%-37.1%) but the specificity was higher (97.9%; 95% CI, 88.7%-99.9%).

CONCLUSIONS AND RELEVANCE:

Abnormal results on prenatal ultrasonography were associated with adverse outcomes in congenital Zika infection. The absence of abnormal findings on prenatal ultrasonography was not associated with a normal neonatal outcome. Comprehensive evaluation is recommended for all neonates with prenatal Zika virus exposure.

PMID: 30646333 DOI: 10.1001/jamanetworkopen.2018.6529

Keywords: Zika Virus; Zika Congenital Infection; Zika Congenital Syndrome; Pregnancy; 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.

——

The Role of #Amniocentesis in the #Diagnosis of #Congenital #Zika Syndrome (Clin Infect Dis., abstract)

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

Clin Infect Dis. 2019 Jan 8. doi: 10.1093/cid/ciz013. [Epub ahead of print]

The Role of Amniocentesis in the Diagnosis of Congenital Zika Syndrome.

Pereira JP Jr1, Maykin MM2, Vasconcelos Z1, Avvad-Portari E1, Zin AA1, Tsui I3, Brasil P4, Nielsen-Saines K5, Moreira ME1, Gaw SL2.

Author information: 1 Instituto Nacional de Sau´de da Mulher, da Crianc¸a e do Adolescente Fernandes Figueira- Fundac¸a~o Oswaldo Cruz, Rio de Janeiro, Brazil. 2 Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, San Francisco, California, USA. 3 Jules Stein Eye Institute, Retina Division, University of California, Los Angeles, Los Angeles, California, USA. 4 Laboratorio de Doenças Febris Agudas, Instituto de Infectologia Evandro Chagas-Fundac¸a~o Oswaldo Cruz, Rio de Janeiro, Brazil. 5 Division of Pediatric Infectious Diseases, Department of Pediatrics, University of California, Los Angeles, Los Angeles, California, USA.

 

Abstract

There is limited data on amniocentesis as a diagnostic tool for congenital Zika syndrome. Here we report on a prospective cohort of 16 women with suspected Zika virus infection in a highly endemic area, and discusss the role of amniocentesis in the prenatal diagnosis of fetal Zika infection.

PMID: 30624579 DOI: 10.1093/cid/ciz013

Keywords: Zika Virus; Zika Congenital Syndrome; Pregnancy.

——