Feeding modifications and additional primary caregiver support for infants exposed to Zika virus or diagnosed with congenital Zika syndrome: a rapid review of the evidence

Abstract

Objective Infants exposed to Zika virus (ZIKV) or diagnosed with congenital Zika syndrome (CZVS) may present dysphagia, regurgitation and other feeding difficulties. They may require special feeding practices to minimise the risk of mortality, morbidity and developmental problems. Improving knowledge, skills and behaviours of caregivers may preserve health, maximise development and promote quality of life among affected infants. We reviewed intervention studies of modified feeding practices and additional primary caregiver support to improve outcomes among infants 0 to 12 months of age exposed to ZIKV or diagnosed with CZVS. Methods Rapid review and meta‐analysis. We searched PubMed/MEDLINE and contacted experts. The search is current to 18 July 2020. We planned a meta‐analysis using fixed‐effect models; if unfeasible, we intended to summarise studies narratively. We planned to assess risk of bias of included studies and quality of evidence using Cochrane guidance. Results We identified 42 records for title and abstract screening; 14 were eligible for full‐text assessment. Among these, no intervention studies were found. Eight observational studies reported on the nutritional status, feeding practices and outcomes among infants affected by ZIKV or diagnosed with CZVS. They are presented and discussed to provide a basis for future research. Conclusions While no intervention studies were found, evidence from eight observational studies highlights the need for early nutrition interventions and caregiver support among infants affected by ZIKV or diagnosed with CZSV. More research is needed to assess whether modifications of feeding practices and provision of additional primary caregiver support will impact outcomes of interest.

Causes of death in children with congenital Zika syndrome in Brazil, 2015 to 2018: A nationwide record linkage study

“…For example, the ability of the children with CZS to feed may be impaired by oral motor dysfunction, dysphagia, regurgitation, as well as oral morphological abnormalities [20]. Frequent choking can lead to bronchoaspiration of food and saliva and resultant pneumonia [24,25]. In addition seizures, common in CZS [26], can result in bronchoaspiration of gastric contents and lead to pneumonia or, ultimately, respiratory failure.…”

Rapid reviews methods series: assessing the appropriateness of conducting a rapid review

“…Urgent decision-making: RRs are valuable when policy-makers, healthcare providers or public health authorities face urgent decisions, such as responding to disease outbreaks, natural disasters or emerging health threats and need evidence to inform immediate actions 33 34. RRs can also guide clinical care decisions by synthesising available evidence for healthcare professionals requiring evidence for time-sensitive direct patient care decisions 35 36…”