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https://www.arca.fiocruz.br/handle/icict/31375
CONGENITAL BRAIN ABNORMALITIES DURING A ZIKA VIRUS EPIDEMIC IN SALVADOR, BRAZIL, APRIL 2015 TO JULY 2016
Microcefalia
Anomalia
Infecção
Gravidez
Epidemiologia
Perímetro cefálico
Nascidos vivos
Brasil
Malformações congenitas
Microcephaly
Abnormalities
Infection
Pregnancy
Epidemiology
Circumference screening
Live births
Brazil
Congenital malformations
Author
Affilliation
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Salvador, BA, Brasil.
Secretaria Municipal de Saúde de Salvador. Salvador, BA, Brasil.
Secretaria Municipal de Saúde de Salvador. Salvador, BA, Brasil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Salvador, BA, Brasil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Emory University. Atlanta, United States.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Salvador, BA, Brasil.
Boston Children’s Hospital. Boston, United States / Massachusetts General Hospital. Boston, United States / Harvard Medical School. Boston, United States.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Salvador, BA, Brasil.
Secretaria Municipal de Saúde de Salvador. Salvador, BA, Brasil.
Secretaria Municipal de Saúde de Salvador. Salvador, BA, Brasil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Salvador, BA, Brasil.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Emory University. Atlanta, United States.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Salvador, BA, Brasil.
Boston Children’s Hospital. Boston, United States / Massachusetts General Hospital. Boston, United States / Harvard Medical School. Boston, United States.
Fundação Oswaldo Cruz. Instituto Gonçalo Moniz. Salvador, BA, Brasil / Universidade Federal da Bahia. Salvador, BA, Brasil.
Abstract
North-eastern Brazil was the region most
affected by the outbreak of congenital Zika syndrome
that followed the 2015 Zika virus (ZIKV) epidemics,
with thousands of suspected microcephaly cases
reported to the health authorities, mostly between
late 2015 and early 2016. Aim: To describe clinical
and epidemiological aspects of the outbreak of congenital
brain abnormalities (CBAs) and to evaluate
the accuracy of different head circumference screening
criteria in predicting CBAs. Method: Between April
2015 and July 2016, the Centers for Information and
Epidemiologic Surveillance of Salvador, Brazil investigated
the reported cases suspected of microcephaly
and, based on intracranial imaging studies, confirmed
or excluded a diagnosis of CBA. Sensitivity, specificity
and positive and negative predictive values of different
head circumference screening criteria in predicting
CBAs were calculated. Results: Of the 365 investigated
cases, 166 (45.5%) had confirmed CBAs. The most
common findings were intracranial calcifications and
ventriculomegaly in 143 (86.1%) and 111 (66.9%) of
the 166 CBA cases, respectively. Prevalence of CBAs
peaked in December 2015 (2.24 cases/100 live births).
Cases of CBAs were significantly more likely to have
been born preterm and to mothers who had clinical
manifestations of arboviral infection during pregnancy.
None of the head circumference screening criteria performed
optimally in predicting CBAs. Conclusion: This
study highlights the magnitude of neurological consequences
of the ZIKV epidemic and the limitations of
head circumference in accurately identifying children
with CBA. Gestational symptoms compatible with ZIKV
infection should be combined with imaging studies
for efficient detection of suspect CBAs during ZIKV
epidemics.
Keywords in Portuguese
Zika virusMicrocefalia
Anomalia
Infecção
Gravidez
Epidemiologia
Perímetro cefálico
Nascidos vivos
Brasil
Malformações congenitas
Keywords
Zika virusMicrocephaly
Abnormalities
Infection
Pregnancy
Epidemiology
Circumference screening
Live births
Brazil
Congenital malformations
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