Prevalence of microcephaly: the Latin American Network of Congenital Malformations 2010–2017

Abstract

ObjectiveThe Latin American Network of Congenital Malformations: ReLAMC was established in 2017 to provide accurate congenital anomaly surveillance. This study used data from ReLAMC registries to quantify the prevalence of microcephaly from 2010 to 2017 (before, during and after the Zika virus epidemic).DesignNine ReLAMC congenital anomaly registries provided case-level data or aggregate data for any live births, still births or terminations of pregnancy with microcephaly. Births to pregnant women infected with Zika virus first occurred in Brazil in 2015, and in the remaining registry areas in 2016 with the exception of Chile that did not experience Zika virus. Therefore the prevalence of microcephaly for 2010–2014 and individual years 2015, 2016 and 2017 was estimated using multilevel random effect Poisson models. Clinical classification and characteristics of the cases were compared pre and post Zika for all centres providing individual case-level data.ResultsThe prevalence of microcephaly for all registries excluding Brazil was 2.3 per 10 000 (95% CI 2.0 to 2.6) for 2010–2014 rising to 5.4 (95% CI 4.8 to 6.0) in 2016 and 5.9 (95% CI 5.3 to 6.6) in 2017. Brazil had a prevalence of 0.6 per 10 000 (95% CI 0.5 to 0.6) in 2010–2014, rising to 5.8 (95% CI 5.6 to 6.1) in 2015, 8.0 (95% CI 7.6 to 8.3) in 2016 and then falling in 2017. Only 29 out of 687 cases of microcephaly were reported as congenital Zika syndrome in countries excluding Brazil.ConclusionsThe prevalence of microcephaly was influenced both by Zika causing congenital Zika syndrome and by increased reporting awareness.

Craniofacial and dental features in children aged 3–5 years with congenital Zika syndrome

“…Our study has some methodological and sample size limitations, partly due to circumstances inherent to the difficulty of studying CZS children of short age with learning and functional disabilities [ 5 ]. Despite these limitations, we provide here new clinical knowledge on CZS and also confirm previous reports [ 25 , 36 ].…”

“…CZS is characterized by a wide spectrum of complications, including microcephaly, brainstem malfunction, motor and sensory dysfunction, muscles hypertonia, hemiparesis, dyskinesia, dystonia, arthrogryposis and dysphagia. Microcephaly and breastfeeding dysphagia, epilepsy, primitive reflex and involuntary tremors are considered early signs of CZS [ 4 , 5 ]. ZIKV infection during early embryogenesis seems to be worse than late infection during pregnancy, when foetus is already formed.…”

Assessing the role of Ndel1 oligopeptidase activity in congenital Zika syndrome: Potential predictor of congenital syndrome endophenotype and treatment response

“…The Latin American Network of Congenital Malformations (ReLAMC) was established in 2017, following the Summer Olympics Game hosted in Brazil in 2016, to provide accurate surveillance of congenital anomalies. Since then, the prevalence of microcephaly in Brazil increased from 0.6 per 10 000 (95% CI 0.5–0.6) in 2010–2014 to 5.8 (95% CI 5.6–6.1) in 2015, and 8.0 (95% CI 7.6–8.3) in 2016, showing a clear increase in the incidence of microcephaly and birth defects among women giving birth in Brazil, and with an abrupt decrease only in 2017 (Morris et al, 2021). The economic burden of CZS over 10 years was reported to be high, with incremental economic burden in Brazil of about US$69.4 million and US$129.0 million from the household and government perspective, respectively (Fernandes et al, 2022).…”

Neurodevelopment in Children Exposed to Zika in utero: Clinical and Molecular Aspects

“…In late 2015, however, the consequences of prenatal infection by the Zika virus were suspected based on the occurrence of a cluster of children born with microcephaly in Northeast Brazil (França et al, 2016;Schuler-Faccini et al, 2016). The associaton between congenital zika infection and microcephaly was soon confirmed (Rasmussen et al, 2016) and the increase in congenital microcephaly cases followed outbreaks of zika infection outbreaks in other Latin American countries (Morris et al, 2021).…”