Clinical and epidemiological aspects of microcephaly in the state of Piauí, northeastern Brazil, 2015-2016.

Autor:	Almeida IMLM; Centro Regional de Referência Regional em Microcefalia/Governo do Estado do Piauí, Teresina, PI, Brazil., Ramos CV; Centro Regional de Referência Regional em Microcefalia/Governo do Estado do Piauí, Teresina, PI, Brazil., Rodrigues DC; Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil., Sousa AC; Centro Regional de Referência Regional em Microcefalia/Governo do Estado do Piauí, Teresina, PI, Brazil., Nascimento MLCAPCD; Centro Regional de Referência Regional em Microcefalia/Governo do Estado do Piauí, Teresina, PI, Brazil., Silva MVBD; Centro Regional de Referência Regional em Microcefalia/Governo do Estado do Piauí, Teresina, PI, Brazil., Batista FMA; Centro Regional de Referência Regional em Microcefalia/Governo do Estado do Piauí, Teresina, PI, Brazil., Santos JPD; Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil; Escritório Regional Fiocruz Piauí, Teresina, PI, Brazil., Oliveira RS; Universidade Federal Rio de Janeiro, Rio de Janeiro, RJ, Brazil., Soares FAF; Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil., Xavier SCDC; Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil., Carvalho-Costa FA; Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil; Escritório Regional Fiocruz Piauí, Teresina, PI, Brazil. Electronic address: guaratiba@ioc.fiocruz.br.
Jazyk:	angličtina
Zdroj:	Jornal de pediatria [J Pediatr (Rio J)] 2019 Jul - Aug; Vol. 95 (4), pp. 466-474. Date of Electronic Publication: 2018 Jun 29.
DOI:	10.1016/j.jped.2018.04.013
Abstrakt:	Objectives: To describe aspects of the microcephaly epidemic in the state of Piauí. Methods: All cases of congenital microcephaly confirmed in the state between 2015 and 2016 were included (n=100). Investigation forms of the Regional Reference Center for Microcephaly were reviewed. Discarded cases (n=63) were used as a comparison group. Results: In October, November, and December 2015 incidence rates reached 4.46, 6.33 and 3.86/1000 live births, respectively; 44 cases were reported in the state capital. Among the mothers of confirmed and discarded cases, the frequency of skin rash during pregnancy was 50/97 (51.5%) and 8/51 (15.7%), respectively (p<0.001); 33 confirmed cases (35.9%) had a head circumference z-score between -2 and -3, 23 (25%) between -3 and -4, and 8 (8.7%) had a z-score of less than -4. Head computer tomography scans revealed calcifications in 78/95 (82.1%) cases. Lissencephaly, hydrocephalus and agenesis of the corpus callosum were also frequently observed. Ophthalmic findings included retinal pigment epithelium rarefaction and atrophy. Absence of otoacoustic emissions was observed in 21/70 cases. One newborn also presented lower limb muscle atrophy. There were no significant differences in vaccination rates for influenza, diphtheria-tetanus-acellular pertussis, and hepatitis B in either group. Conclusions: The state of Piauí, like others in the northeastern region, faced an epidemic of congenital microcephaly between 2015 and 2016, presumably related to congenital Zika virus infection, more intense in the capital. Current challenges include the improvement of vector control, basic research, scaling-up of diagnostic tools for pre-natal screening of Zika virus, vaccines, and health care for affected children. (Copyright © 2018. Published by Elsevier Editora Ltda.)
Databáze:	MEDLINE
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