Epidemiological and clinical profile of microcephaly cases
Abstract
Objective: To describe the epidemiological and clinical profile of microcephaly cases in Recife, Pernambuco.
Method: This was a cross-sectional, quantitative study developed at a reference hospital for cases of microcephaly. Data were collected in August 2016 from the FormSUS system. All confirmed cases of microcephaly in the period from August 2015 to July 2016 were included, making up 180 cases. Data were analyzed using descriptive statistics and the chi-square and Fisher's exact tests.
Results: The majority of cases occurred in October and November 2015, with 55 (30.56%) and 52 (28.89%) cases, respectively. Serology for the Zika virus was reagent for 79 (43.89%) of the infants. The most prevalent symptom during gestation was exanthema 105 (57.3%). Furthermore, 150 (83.33%) of the children were born at full term, 78 (43.33%) presented percentiles between 10 and 50 in relation to weight and gestational age and 108 (60%) had -3 standard deviations in the comparison of head circumference with gestational age, thus considered to indicate severe microcephaly.
Conclusions: It is necessary to guarantee comprehensive and specialized care for these children. Epidemiological and entomological surveillance and more effective control actions in the fight against the vector are necessary.
Downloads
References
Weaver SC, Costa F, Garcia-Blanco MA, Ko AI, Ribeiro GS, Saade G, et al. Zika virus: history, emergence, biology, and prospects for control. Antiviral Res. [Internet] 2016 [cited 2016 Nov 20]; 130:69–80. Available from: https://doi.org/10.1016/j.antiviral.2016.03.010.
Oliveira Melo AS, Malinger G, Ximenes R, Szejnfeld PO, Alves Sampaio S, Bispo de Filippis AM. Zika virus intrauterine infection causes fetal brain abnormality and microcephaly: tip of the iceberg? Ultrasound Obstet Gynecol. [Internet] 2016 [cited 2016 Nov 20]; 47:6-7. Available from: http://onlinelibrary.wiley.com/doi/10.1002/uog.15831/epdf.
Mlakar J, Korva M, Tul N, Popović M, Poljšak-Prijatelj M, Mraz J, et al. Zika virus associated with microcephaly. N Engl J Med [Internet] 2016 [cited 2016 Nov 20]; 374:951-8. Available from: http://www.nejm.org/doi/full/10.1056/NEJMoa1600651#t=article.
Campos GS, Bandeira AC, Sardi SI. Zika virus outbreak, Bahia, Brazil. Emerg Infect Dis. [Internet] 2015 [cited 2016 Nov 20]; 21:1885-6. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4593454/.
Dupont-Rouzeyrol M, O’Connor O, Calvez E, Daures M, John M, Grangeon JP, et al. Co-infection with Zika and dengue viruses in 2 patients, New Caledonia, 2014. Emerg Infect Dis. [Internet] 2015 [cited 2016 Nov 20]; 21:381-382. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4593454/
Baronti C, Piorkowski G, Charrel RN, Boubis L, Leparc-Goffart I, de Lamballierie X. Complete sequence of Zika virus from a French Polynesia outbreak in 2013. Genome Announc [Internet] 2014 [cited 2016 Nov 20]; 2(3):e00500-14. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4047448/pdf/e00500-14.pdf
Ioos S, Mallet HP, Leparc Goffart I, Gauthier V, Cardoso T, Herida M. Current Zika virus epidemiology and recent epidemics. Med Mal Infect [Internet] 2014 [cited 2016 Nov 20]; 44:302-7. Available from: https://www.ncbi.nlm.nih.gov/pubmed/25001879
Oliveira CS, Vasconcelos PFC. Microcephaly and Zika virus. J Pediatr (Rio J) [Internet] 2016 [cited 2016 Nov 20]; 92(2):103–5. Available from: http://www.scielo.br/pdf/jped/v92n2/pt_0021-7557-jped-92-02-0103.pdf
Esposito DLA, Moraes JB, Fonseca BAL. Current priorities in the Zica response. Immonology [Internet] 2017 Nov [cited in 17 december 2018];135 (4): 435-442 Available from: https://onlinelibrary.wiley.com/doi/full/10.1111/imm.12878.
Javed F, Manzoor KN, Ali M, Haq IU, Khan AA, Zaib A, Manzoor S. Zika virus: what we need to know? J Basic Microbiol. 2018 Nov; 58(1): 3-16.
Göertz GP, Abbo SR, Fros JJ, Pijlman GP. Functional RNA during Zika vírus infection. Virus research 2018 Aug; 254: 41-53.
Krauer F, Riesen M, Reveiz L, Oladapo OD, Martínez-Veja R, Porgo TV et al. Zika virus Infection as a cause of Congenital Brain Abnormalities and Guillain-Barré Syndrome: Sistematic Review. Plos Med [internet] 2017 Jan[cited in 17 december 2018]; 1-27 Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5207634/.
Organização mundial da saúde. Microcephaly. [Internet] 2016 2007 [cited 2016 Jun 14]; Available from: http://who.int/mediacentre/factsheets/microcephaly/en/
Pryor HB, Thelander H. Abnormally small head size and intellect in children. J Pediatr [Internet] 1968 [cited 2016 Nov 20]; 73:593–598. Available from: http://www.jpeds.com/article/S0022-3476(68)80275-6/pdf
Coronado R, Ruíz AM, Arjonilla JG, Roig-Quilis M. Concordancia entre una función de crecimiento del perímetro cefálico y la discapacidad intelectual em relación con la etiología de la microcefalia. An Pediatr (Barc). [Internet] 2015 [cited 2016 Nov 20]; 83(2):109-116. Available from: http://www.analesdepediatria.org/es-pdf-S1695403314005311
Brasil. Centro de Operações de Emergências em Saúde Pública Sobre Microcefalias - COES – MICROCEFALIAS. Monitoramento dos Casos de Microcefalia no Brasil. Informe epidemiológico nº 37 – Semana Epidemiológica (SE) 30/2016 (24/07/2016 a 30/07/2016). Brasília; 2016. Disponível em: http://combateaedes.saude.gov.br/images/sala-de-situacao/informe_microcefalia_epidemiologico37.pdf
Pernambuco. Secretaria Estadual de Saúde de Pernambuco. Secretaria Executiva de Vigilância em Saúde. Protocolo Clínico e Epidemiológico para investigação de casos de microcefalia no estado de Pernambuco. Versão N° 02; 2015. Disponível em: http://portal.saude.pe.gov.br/sites/portal.saude.pe.gov.br/files/protocolo_microcefalia_versao02.pdf
Nunes ML, Carlini CR, Marinowic D, Neto FK, Fiori HH, Scotta MC, et al. Microcephaly and Zika virus: a clinical and epidemiological analysis of the current outbreak in Brazil. J Pediatr (Rio J) [Internet] 2016 [cited 2016 Nov 20]; 92(3):230–240. Available from: https://doi.org/10.1016/j.jped.2016.02.009
Noronha Ld, Zanluca C, Azevedo ML, Luz KG, Santos CN. Zika virus damages the human placental barrier and presents marked fetal neurotropism. Mem Inst Oswaldo Cruz [Internet] 2016 [cited 2016 Nov 20]; 111(5):287–293. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4878297/pdf/0074-0276-mioc-111-5-0287.pdf
Araújo TVB, Ximenes RAA, Filho DBM, Rodrigues LC, Souza WV, Montarroyos UR, Melo APL, et al. Association between microcephaly, Zika virus infection, and other risk factors in Brazil: final report of a case-control study. Lancet Infect Dis [Internet] 2018 [cited 2018 Jul 22]; 18:328–36. Available from: https://www.thelancet.com/pdfs/journals/laninf/PIIS1473-3099(17)30727-2.pdf
Duffy MR, Chen TH, Hancock WT, Powers AM, Kool JL, Lanciotti RS, et al. Zika virus outbreak on Yap Island, Federated States of Micronesia. N Engl J Med [Internet] 2009 [cited 2016 Nov 20]; 360:2536-43. Available from: http://www.nejm.org/doi/pdf/10.1056/NEJMoa0805715
Brasil P, Pereira JP Jr, Raja Gabaglia C, Nogueira RMR, Damasceno L, Wakimoto M, et al. Zika virus infection in pregnant women in Rio de Janeiro — preliminary report. N Engl J Med. [Internet] 2016 [cited 2016 Nov 20]; 24(375): 2321-34. Available from: http://www.nejm.org/doi/pdf/10.1056/NEJMoa1602412
Serpa LLN, Costa KVRM, Voltolini JC, Kakitani I. Variação sazonal de Aedes aegypti e Aedes albopictus no município de Potim, São Paulo. Rev Saúde Pública. [Internet] 2006 [citado 20 Nov 2016]; 40:1101-1105. Disponível em: http://www.scielo.br/pdf/rsp/v40n6/20.pdf
Vissoci JRN, Rocha TAH, Silva NC, Queiroz RCS, Thomaz EBAF, Amaral PVM et al. Zica virus infection and mycrocephaly: Evidence regarding geoespatial associations. PloS Neg Trop Des [Internet] 2018 Apr [cited in: 17 december 2018] 12(4): e0006392. Available from: https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0006392
Brasil. Ministério da Saúde. Nota Informativa Nº01/2015 – COES Microcefalias. Brasília (DF), 17 de novembro de 2015. Disponível em: http://www.cosemspa.com.br/wordpress/wp-content/uploads/2015/11/microcefalia-nota-informativa-17nov2015-c-1.pdf
Brasil. Ministério da Saúde. Protocolo de vigilância e resposta à ocorrência de microcefalia relacionada à infecção pelo vírus Zika. Brasília, 2015. Disponível em: http://portalarquivos.saude.gov.br/images/pdf/2015/dezembro/09/Microcefalia---Protocolo-de-vigil--ncia-e-resposta---vers--o-1----09dez2015-8h.pdf
Brasil. Ministério da Saúde. Protocolo de vigilância e resposta à ocorrência de microcefalia e/ou alterações do sistema nervoso central (SNC) Brasília, 2016. Disponível em: http://combateaedes.saude.gov.br/images/sala-de-situacao/Microcefalia-Protocolo-de-vigilancia-e-resposta-10mar2016-18h.pdf
Cortes MS, Rivera AM, Yepez M, Guimaraes CV, Yunes ID, Zarutskie A et al. Clinical assessment and brain findings in a cohort of mothers, fetuses and infants infected with Zika virus. Am J Obstet Gynecol [Internet] 2018 Apr [cited in 17 decmber 2018]; 218(4):440.e1-440.e36. Available from: https://www.ajog.org/article/S0002-9378(18)30013-9/fulltext
Pereira AM, Monteiro DLM, Werner E, Daltro P, Fazecas T, Guedes B et al. Zica virus and pragnancy in Brazil: what hapenned? J Turk Ger Gynecol Assoc [Internet] 2018 [cited in 17 december 2018]; 19(1): 39-47. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5838777/
Victora CG, Schuler-Faccini L, Matijasevich A, Ribeiro E, Pessoa A, Barros FC. Microcephaly in Brazil: how to interpret reported numbers? Lancet 2016 Feb;387(10019):621-4.
The works published in this magazine are subject to the following terms:
1. The Publications Service of the University of Murcia (the publisher) preserves the copyright of the published works, and encourages and allows the reuse of the works under the license for use stated in point 2.
© Servicio de Publicaciones, Universidad de Murcia, 2011 (© Publications Service, University of Murcia, 2011)
2. The works are published in the electronic edition of the journal under Creative Commons Reconocimiento-NoComercial-SinObraDerivada 3.0 España(texto legal) “ a Attribution-NonCommercial-NoDerivatives 3.0 Spain license (legal text)”. They can be copied, used, broadcasted, transmitted and publicly displayed, provided that: i) the authorship and original source of their publication (journal, publisher and URL) are cited; (ii) are not used for commercial purposes; iii) the existence and specifications of this license is mentioned.
3. Conditions of self-archiving. Authors are allowed and encouraged to electronically disseminate the pre-print (pre-reviewed ) and / or post-print (reviewed and accepted for publication) versions of their works prior to publication, as it ensures a wider circulation and dissemination which may lead to a possible increase in its mention and a higher scope among the academic community. RoMEO color: green.
