Growth and Development of Children with Microcephaly Associated with Congenital Zika Virus Syndrome in Brazil

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Abstract

The outbreak of Zika virus in Latin America in the period 2015–2016 has caused a sudden increase in the number of severe manifestations and reports of congenital changes in newborns in Brazil. This is the first study that evaluated and compared the growth and cognitive and motor development of children with microcephaly due to Congenital Zika Virus Syndrome (CZS) in relation to typical children. It was an observational, analytical, cross-sectional study with 8 children with CZS and 16 typical children, with a mean age of 20.5 months (±2.1), in a region of northeastern Brazil. Considering the mean, children with CZS presented extremely low performance in the motor domain and in the cognitive development domain, whereas typical children presented average performance in the cognitive and motor development domains. Children with CZS presented a mean growth rate (head circumference and weight) lower than typical children. Therefore, children with CZS are at risk for growth retardation and development compared to typical children.

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Poverty and disability in low- and middle-income countries: A systematic review

Lena Morgon Banks, Hannah Kuper, Sarah Polack (2017)

Introduction Disability and poverty are believed to operate in a cycle, with each reinforcing the other. While agreement on the existence of a link is strong, robust empirical evidence substantiating and describing this potential association is lacking. Consequently, a systematic review was undertaken to explore the relationship between disability and economic poverty, with a focus on the situation in low and middle income countries (LMICs). Methods Ten electronic databases were searched to retrieve studies of any epidemiological design, published between 1990-March 2016 with data comparing the level of poverty between people with and without disabilities in LMICs (World Bank classifications). Poverty was defined using economic measures (e.g. assets, income), while disability included both broad assessments (e.g. self-reported functional or activity limitations) and specific impairments/disorders. Data extracted included: measures of association between disability and poverty, population characteristics and study characteristics. Proportions of studies finding positive, negative, null or mixed associations between poverty and disability were then disaggregated by population and study characteristics. Results From the 15,500 records retrieved and screened, 150 studies were included in the final sample. Almost half of included studies were conducted in China, India or Brazil (n = 70, 47%). Most studies were cross-sectional in design (n = 124, 83%), focussed on specific impairment types (n = 115, 77%) and used income as the measure for economic poverty (n = 82, 55%). 122 studies (81%) found evidence of a positive association between disability and a poverty marker. This relationship persisted when results were disaggregated by gender, measure of poverty used and impairment types. By country income group at the time of data collection, the proportion of country-level analyses with a positive association increased with the rising income level, with 59% of low-income, 67% of lower-middle and 72% of upper-middle income countries finding a positive relationship. By age group, the proportion of studies reporting a positive association between disability and poverty was lowest for older adults and highest for working-age adults (69% vs. 86%). Conclusions There is strong evidence for a link between disability and poverty in LMICs and an urgent need for further research and programmatic/policy action to break the cycle.

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The Zika Virus Epidemic in Brazil: From Discovery to Future Implications

Rachel Lowe, Christovam Barcellos, Patrícia BRASIL … (2018)

The first confirmed case of Zika virus infection in the Americas was reported in Northeast Brazil in May 2015, although phylogenetic studies indicate virus introduction as early as 2013. Zika rapidly spread across Brazil and to more than 50 other countries and territories on the American continent. The Aedes aegypti mosquito is thought to be the principal vector responsible for the widespread transmission of the virus. However, sexual transmission has also been reported. The explosively emerging epidemic has had diverse impacts on population health, coinciding with cases of Guillain–Barré Syndrome and an unexpected epidemic of newborns with microcephaly and other neurological impairments. This led to Brazil declaring a national public health emergency in November 2015, followed by a similar decision by the World Health Organization three months later. While dengue virus serotypes took several decades to spread across Brazil, the Zika virus epidemic diffused within months, extending beyond the area of permanent dengue transmission, which is bound by a climatic barrier in the south and low population density areas in the north. This rapid spread was probably due to a combination of factors, including a massive susceptible population, climatic conditions conducive for the mosquito vector, alternative non-vector transmission, and a highly mobile population. The epidemic has since subsided, but many unanswered questions remain. In this article, we provide an overview of the discovery of Zika virus in Brazil, including its emergence and spread, epidemiological surveillance, vector and non-vector transmission routes, clinical complications, and socio-economic impacts. We discuss gaps in the knowledge and the challenges ahead to anticipate, prevent, and control emerging and re-emerging epidemics of arboviruses in Brazil and worldwide.

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Congenital Zika Virus Infection: Beyond Neonatal Microcephaly.

Adriana Melo, Renato de Aguiar, Melania Maria Ramos do Amorim … (2016)

Recent studies have reported an increase in the number of fetuses and neonates with microcephaly whose mothers were infected with the Zika virus (ZIKV) during pregnancy. To our knowledge, most reports to date have focused on select aspects of the maternal or fetal infection and fetal effects.

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Author and article information

Journal

Journal ID (nlm-ta): Int J Environ Res Public Health

Journal ID (iso-abbrev): Int J Environ Res Public Health

Journal ID (publisher-id): ijerph

Title: International Journal of Environmental Research and Public Health

Publisher: MDPI

ISSN (Print): 1661-7827

ISSN (Electronic): 1660-4601

Publication date (Electronic): 13 September 2018

Publication date (Print): September 2018

Volume: 15

Issue: 9

Electronic Location Identifier: 1990

Affiliations

[1 ]Collective Health PostGraduate Program, Faculty of Health Sciences of Trairi, Federal University of Rio Grande do Norte, Santa Cruz 59200-000, Brazil; thais-lorena@ 123456hotmail.com (T.L.B.d.F.); wilton.medeiros@ 123456ebserh.gov.br (W.R.M.); egmarlongo@ 123456yahoo.es (E.L.); apsilvana@ 123456gmail.com (S.A.P.)

[2 ]Ana Bezerra University Hospital , Federal University of Rio Grande do Norte, Santa Cruz 59200-000, Brazil

[3 ]Nursing Graduate Program, Federal University of Rio Grande do Norte, Natal 59072-970, Brazil; nilba.lima@ 123456hotmail.com

[4 ]Rehabilitation Sciences Postgraduate Program, Faculty of Health Sciences of Trairi, Federal University of Rio Grande do Norte, Santa Cruz 59200-000, Brazil

[5 ]Department of Physical Therapy, Federal University of Rio Grande do Norte, Natal 59072-970, Brazil

[6 ]City Hall of Touros, Department of Health, Primary Health Care, Touros 59584-000, Brazil; thamyris68@ 123456gmail.com

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[* ]Correspondence: galante@ 123456facisa.ufrn.br ; Tel.: +55-84-98110-0633

Author information

Nilba Lima de Souza https://orcid.org/0000-0002-3748-370X

Silvana Alves Pereira https://orcid.org/0000-0002-6226-2837

Klayton Galante Sousa https://orcid.org/0000-0002-7710-7522

Article

Publisher ID: ijerph-15-01990

DOI: 10.3390/ijerph15091990

PMC ID: 6164092

PubMed ID: 30216976

SO-VID: abb229b0-3a0e-4677-9192-6106137a8d3d

License:

Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ( http://creativecommons.org/licenses/by/4.0/).

History

Date received : 17 June 2018

Date accepted : 14 August 2018

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Growth and Development of Children with Microcephaly Associated with Congenital Zika Virus Syndrome in Brazil

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Most cited references 21

Poverty and disability in low- and middle-income countries: A systematic review

The Zika Virus Epidemic in Brazil: From Discovery to Future Implications

Congenital Zika Virus Infection: Beyond Neonatal Microcephaly.

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