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https://www.arca.fiocruz.br/handle/icict/57691
COMPARISON OF OROPHARYNGEAL DYSPHAGIA IN BRAZILIAN CHILDREN WITH PRENATAL EXPOSURE TO ZIKA VIRUS, WITH AND WITHOUT MICROCEPHALY
Zika virus
Zika-related microcephaly
Zika-exposed children without microcephaly
Congenital Zika syndrome
Author
Affilliation
Fundação Oswaldo Cruz, Instituto Aggeu Magalhães, Recife, Pernambuco, Brasil.
Faculdade de Ciência Médicas/ Hospital Universitário Oswaldo Cruz/ Universidade de Pernambuco, Setor NIR- ZIKA, Recife, PE, Brasil.
Faculdade de Ciência Médicas/Hospital Universitário Oswaldo Cruz/ Universidade de Pernambuco, Setor NIR- ZIKA, Recife, PE, Brazil.
Universidade Federal de Pernambuco, Av. Prof. Moraes Rego, 1235 - Cidade Universitária, Recife, Pernambuco, Brasil
London School of Hygiene and Tropical Medicine, Bloomsbury, London, UK.
Abstract
Severe brain damage associated with Zika-related microcephaly (ZRM) have been reported to result in oropharyngeal dysphagia (OPD); however, it is unknown if OPD presents in children with prenatal Zika virus (ZIKV) exposure but only mild or undetectable abnormalities. The aims of this study were: to compare the frequency and characteristics of OPD in children with ZRM and in children without microcephaly born to mothers who tested polymerase chain reaction positive (PCR+) for ZIKV during pregnancy; and to investigate the concordance of caregiver reports of OPD with the diagnosis from the clinical swallowing assessment (CSA). Between Mar/2017 and May/2018, we evaluated 116 children (n = 58 with microcephaly, n = 58 children without microcephaly born to ZIKV PCR + mothers) participating in the Microcephaly Epidemic Research Group (MERG) cohort of children born during the 2015–2016 ZIKV epidemic in Pernambuco, Brazil. To assess OPD we used: a CSA; a clinical assessment of the stomatognathic system; and a questionnaire administered to caregivers. The frequency of OPD was markedly higher in children with ZRM (79.3%) than in the exposed but normocephalic group (8.6%). The children with microcephaly also presented more frequently with anatomic and functional abnormalities in the stomatognathic system. There was a high degree of agreement between the caregiver reports of OPD and the CSA (κ = 0.92). In conclusion, our findings confirm that OPD is a feature of Congenital Zika Syndrome that primarily occurs in children with microcephaly and provide support for policies in which children are referred for rehabilitation with an OPD diagnosis based on caregiver report.
Keywords
Oropharyngeal dysphagiaZika virus
Zika-related microcephaly
Zika-exposed children without microcephaly
Congenital Zika syndrome
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