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- Title
Clinical and epidemiological aspects of microcephaly in the state of Piauí, northeastern Brazil, 2015-2016.
- Authors
Lopes Moreira de Almeida, Isabel Marlúcia; Viana Ramos, Carmen; Carvalho Rodrigues, Danielle; de Sousa, Amanda Carvalho; Cristina Alcântara Paz Carvalho do Nascimento, Maria de Lourdes Cristina Alcântara Paz Carvalho do Nascimento a; da Silva, Marcos Vilhena Bittencourt; Batista, Francisca Miriane Araújo; dos Santos, Jéssica Pereira; de Oliveira, Roselane Sampaio; de Freitas Soares, Filipe Augusto; das Chagas Xavier, Samanta Cristina; Carvalho-Costa, Filipe Anibal
- Abstract
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.
- Subjects
MICROCEPHALY; EPIDEMIOLOGICAL research; SKIN inflammation; ZIKA virus infections; COMPUTED tomography
- Publication
Jornal de Pediatria, 2019, Vol 95, Issue 4, p466
- ISSN
0021-7557
- Publication type
Article
- DOI
10.1016/j.jped.2018.04.013