“…In Maceió, a region with fewer resources, when RT-PCR testing was not available, the history of maternal ZIKV infection was determined based on established epidemiologic criteria: presence of symptoms during pregnancy (e.g., rash, fever, headache, myalgia, edema, skin pruritus, red eyes), residing in an area linked to ZIKV, negative test results for other infections (syphilis, toxoplasmosis, rubella, cytomegalovirus, and herpes simplex, dengue, chikungunya). These criteria have been successfully used in other clinical studies (Fandiño-Cárdenas et al 2018; Gomes et al 2023) to identify children with prenatal ZIKV exposure. In the present sample, PCR confirmation was available for 12 children.…”