Clinical aspects of congenital microcephaly syndrome by Zika virus in a rehabilitation center for patients with microcephaly

Almeida, Kelson James; Martins, Augusto César Beserra; Almendra, Isadora Costa Coelho Gayoso e; Meneses, Gabriel Medina Sobreira de; Sampaio, Thales Daniel de Oliveira; Campêlo, José da Cruz Moura; Bor-Seng-Shu, Edson

doi:10.1590/1806-9282.65.10.1249

Cited by 8 publications

(21 citation statements)

References 5 publications

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“…† Reported CZS cases are those that meet predefined international diagnostic criteria based on clinical symptoms. Current evidence suggests that these symptoms will persist throughout life; therefore, all of the CZS patients included in this analysis are assumed to have some degree of chronic or permanent disability [28,58,62].…”

Section: Resultsmentioning

confidence: 99%

Measuring the global burden of chikungunya and Zika viruses: A systematic review

Puntasecca¹,

King²,

LaBeaud³

2021

PLoS Negl Trop Dis

119

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Throughout the last decade, chikungunya virus (CHIKV) and Zika virus (ZIKV) infections have spread globally, causing a spectrum of disease that ranges from self-limited febrile illness to permanent severe disability, congenital anomalies, and early death. Nevertheless, estimates of their aggregate health impact are absent from the literature and are currently omitted from the Global Burden of Disease (GBD) reports. We systematically reviewed published literature and surveillance records to evaluate the global burden caused by CHIKV and ZIKV between 2010 and 2019, to calculate estimates of their disability-adjusted life year (DALY) impact. Extracted data on acute, chronic, and perinatal outcomes were used to create annualized DALY estimates, following techniques outlined in the GBD framework. This study is registered with PROSPERO (CRD42020192502). Of 7,877 studies identified, 916 were screened in detail, and 21 were selected for inclusion. Available data indicate that CHIKV and ZIKV caused the average yearly loss of over 106,000 and 44,000 DALYs, respectively, between 2010 and 2019. Both viruses caused substantially more burden in the Americas than in any other World Health Organization (WHO) region. This unequal distribution is likely due to a combination of limited active surveillance reporting in other regions and the lack of immunity that left the previously unexposed populations of the Americas susceptible to severe outbreaks during the last decade. Long-term rheumatic sequelae provided the largest DALY component for CHIKV, whereas congenital Zika syndrome (CZS) contributed most significantly for ZIKV. Acute symptoms and early mortality accounted for relatively less of the overall burden. Suboptimal reporting and inconsistent diagnostics limit precision when determining arbovirus incidence and frequency of complications. Despite these limitations, it is clear from our assessment that CHIKV and ZIKV represent a significant cause of morbidity that is not included in current disease burden reports. These results suggest that transmission-blocking strategies, including vector control and vaccine development, remain crucial priorities in reducing global disease burden through prevention of potentially devastating arboviral outbreaks.

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Section: Resultsmentioning

confidence: 99%

Measuring the global burden of chikungunya and Zika viruses: A systematic review

Puntasecca¹,

King²,

LaBeaud³

2021

PLoS Negl Trop Dis

119

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“…The remaining 15 studies [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] were critically analyzed and the information of interest was extracted. Among the selected studies, 13 [8][9][10][11][12][15][16][17][18][19][20][21][22] are articles published in specialized journals, and 2 are theses from Brazilian public universities (Universidade Federal de Pernambuco 13 and Universidade Federal Fluminense 14 ). One study 17 was not included in the meta-analysis because it used the same patients of the study 16 with different follow-up times.…”

Section: Study Inclusionmentioning

confidence: 99%

“…4 More recently, the hypothesis that CZS is associated with a high risk of developing early epilepsy (ie, in the first 24 months of life) has been confirmed in several studies. [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22] Indeed, children diagnosed with CZS often present recurrent and spontaneous seizures, epileptogenic changes on electroencephalography (EEG), and high irritability. 9,18,21,22 Although several studies have evaluated the epidemiology of epilepsy in children with CZS in Brazil, they are decentralized, and no effort to estimate the overall frequency of this neurological complication among patients exposed to ZIKV during pregnancy has been reported.…”

mentioning

confidence: 99%

Epilepsy in children with Congenital Zika Syndrome: A systematic review and meta‐analysis

et al. 2021

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Objectives: To estimate the overall frequency of epilepsy in children with congenital Zika syndrome (CZS) and describe the profile of seizures and the response rate to anti-epileptic treatment in this group of patients. Methods: A systematic review and meta-analysis were conducted following the Cochrane Handbook and preferred reporting items for systematic reviews and metaanalyses (PRISMA) guidelines. PubMed/MEDLINE, Scopus, Cochrane Library, SciELO, and LILACS were searched until June 23, 2020. Observational studies that evaluated the frequency of epilepsy in children diagnosed with CZS according to international criteria were included in the study. Results: Fourteen studies evaluating 903 patients diagnosed with CZS were pooled in a meta-analysis. All studies were conducted in Brazil, with reports published between 2016 and 2020, and included children diagnosed with CSZ from 0 to 40 months of age. The overall rate of epilepsy in children diagnosed with CZS was estimated at 60% (95% confidence interval [CI] 0.51-0.68). The studies included in this review show that the frequency of epilepsy in patients with CSZ varies with age, with higher rates in older children. Epileptic spasms was the primary type of seizure observed in this group, followed by focal and generalized crisis. The response rate to antiepileptic drugs was considerably low, ranging from 20% of seizure control in the first year and 30% in the second year. Significance: Children with CZS presented a high cumulative incidence of epilepsy episodes with increased severity and a low response to anti-epileptic therapy, which is associated with the extensive damage caused by the Zika virus on the cortical structures of patients. K E Y W O R D Santi-epileptic agents, congenital infection, cortical malformations, seizures, Zika virus (ZIKV) | METHODSA systematic review and meta-analysis were conducted following the Cochrane Handbook guidelines. 23 The searching, selection, extraction, and analysis of the data of interest were performed according to the Preferred Reporting Items Key points• The overall rate of epilepsy in children diagnosed with congenital Zika syndrome (CZS) was estimated at 60% (95% confidence interval [CI] 0.51-0.68) • The rate of epilepsy in children with CZS is considerably higher than that observed in congenital infections with syphilis, toxoplasmosis, other infections, rubella, cytomegalovirus infection, and herpes simplex (STORCH) pathogens • Epileptic spasms were the primary type of seizure observed in this group, followed by focal and generalized crisis • The response rate to anti-epileptic drugs was considerably low (20% of seizure control in the first year and 30% in the second year)

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“…Recent research into congenital Zika syndrome (CZS) has focused on further characterizing microcephaly, central nervous system (CNS) abnormalities, arthrogryposis, hearing loss, ophthalmological and digestive abnormalities, seizures, delayed motor/cognitive development, 1,2 and possible viral persistence 3,4 . Nevertheless, the risk to a second pregnancy in women who delivered an infant with CZS remains unknown.…”

Section: Case Mother’s Age Zika Symptoms 1st/5th Min Apgar Gestationamentioning

confidence: 99%

“…The virus appears to persist for a mean of 14 days in blood and 34 days in semen; nonetheless, this window could reach 80 and 125 days, respectively 2,3 . ZIKV displays tropism for the CNS 4 ; however, how long it can remain in the CNS or eyes is unknown.…”

Section: Case Mother’s Age Zika Symptoms 1st/5th Min Apgar Gestationamentioning

confidence: 99%

Outcomes of subsequent pregnancies following Zika virus infection: A comparative case series

Melo

Oliveira-Szejnfeld

Malinger

et al. 2020

Intl J Gynecology & Obste

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Clinical aspects of congenital microcephaly syndrome by Zika virus in a rehabilitation center for patients with microcephaly

Cited by 8 publications

References 5 publications

Measuring the global burden of chikungunya and Zika viruses: A systematic review

Measuring the global burden of chikungunya and Zika viruses: A systematic review

Epilepsy in children with Congenital Zika Syndrome: A systematic review and meta‐analysis

Outcomes of subsequent pregnancies following Zika virus infection: A comparative case series

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