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Microcefalia e alterações do sistema nervoso central relacionadas à infecção congênita pelo vírus Zika e outras etiologias infecciosas no estado do Rio de Janeiro: estudo transversal, 2015 a 2017
OBJECTIVE. To describe the clinical and epidemiological profile of cases with confirmed microcephaly or central nervous system (CNS) findings associated with congenital Zika virus infection and other infectious etiologies in the state of Rio de Janeiro, Brazil, from November 2015 to July 2017. METHO...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Organización Panamericana de la Salud
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7609916/ https://www.ncbi.nlm.nih.gov/pubmed/33165406 http://dx.doi.org/10.26633/RPSP.2020.151 |
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author | Escosteguy, Claudia Caminha Medronho, Renata Escosteguy Rodrigues, Renata Coelho da Silva, Lucas Dalsenter Romano de Oliveira, Bruna Andrade Machado, Fernanda Beatriz Costa, Yuri Sousa de Carvalho Cardoso, Silvia Cristina da Cunha, Antonio José Ledo Alves Medronho, Roberto de Andrade |
author_facet | Escosteguy, Claudia Caminha Medronho, Renata Escosteguy Rodrigues, Renata Coelho da Silva, Lucas Dalsenter Romano de Oliveira, Bruna Andrade Machado, Fernanda Beatriz Costa, Yuri Sousa de Carvalho Cardoso, Silvia Cristina da Cunha, Antonio José Ledo Alves Medronho, Roberto de Andrade |
author_sort | Escosteguy, Claudia Caminha |
collection | PubMed |
description | OBJECTIVE. To describe the clinical and epidemiological profile of cases with confirmed microcephaly or central nervous system (CNS) findings associated with congenital Zika virus infection and other infectious etiologies in the state of Rio de Janeiro, Brazil, from November 2015 to July 2017. METHOD. A cross-sectional study was performed with 298 cases (as defined by the Ministry of Health) communicated to the Rio de Janeiro State Department of Health in the study period. Demographic, epidemiological, clinical, radiological, and laboratory variables were assessed. Descriptive bivariate and multivariable logistic regression analysis was used to determine the association between specific factors and death outcome. RESULTS. The median age of mothers was 24 years; 30.9% reported fever and 64.8% reported a rash during pregnancy. The median head circumference at birth was 29 cm, and median birth weight was 2 635 g. An etiological diagnosis of congenital Zika was made in 46.0%, whereas 13.8% were diagnosed with syphilis, toxoplasmosis, rubella, cytomegalovirus, and herpes simplex infections (STORCH), with predominance of syphilis, and 40.3% had an unspecified infectious agent. CNS findings other than microcephaly were observed in 88.3%, especially intracranial calcifications, ventriculomegaly, and brain atrophy. Overall lethality was 7.0% — 19.0% in laboratory confirmed Zika cases and 22.2% in toxoplasmosis cases. Multivariable analysis revealed birth weight as the main predictor of death. CONCLUSIONS. Despite the Zika epidemic, 13.8% of the studied cases were diagnosed with STORCH. The lethality and high frequency of neurological findings beyond microcephaly reflect severe infection, with impact on families and health care system. |
format | Online Article Text |
id | pubmed-7609916 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Organización Panamericana de la Salud |
record_format | MEDLINE/PubMed |
spelling | pubmed-76099162020-11-06 Microcefalia e alterações do sistema nervoso central relacionadas à infecção congênita pelo vírus Zika e outras etiologias infecciosas no estado do Rio de Janeiro: estudo transversal, 2015 a 2017 Escosteguy, Claudia Caminha Medronho, Renata Escosteguy Rodrigues, Renata Coelho da Silva, Lucas Dalsenter Romano de Oliveira, Bruna Andrade Machado, Fernanda Beatriz Costa, Yuri Sousa de Carvalho Cardoso, Silvia Cristina da Cunha, Antonio José Ledo Alves Medronho, Roberto de Andrade Rev Panam Salud Publica Artigo Original OBJECTIVE. To describe the clinical and epidemiological profile of cases with confirmed microcephaly or central nervous system (CNS) findings associated with congenital Zika virus infection and other infectious etiologies in the state of Rio de Janeiro, Brazil, from November 2015 to July 2017. METHOD. A cross-sectional study was performed with 298 cases (as defined by the Ministry of Health) communicated to the Rio de Janeiro State Department of Health in the study period. Demographic, epidemiological, clinical, radiological, and laboratory variables were assessed. Descriptive bivariate and multivariable logistic regression analysis was used to determine the association between specific factors and death outcome. RESULTS. The median age of mothers was 24 years; 30.9% reported fever and 64.8% reported a rash during pregnancy. The median head circumference at birth was 29 cm, and median birth weight was 2 635 g. An etiological diagnosis of congenital Zika was made in 46.0%, whereas 13.8% were diagnosed with syphilis, toxoplasmosis, rubella, cytomegalovirus, and herpes simplex infections (STORCH), with predominance of syphilis, and 40.3% had an unspecified infectious agent. CNS findings other than microcephaly were observed in 88.3%, especially intracranial calcifications, ventriculomegaly, and brain atrophy. Overall lethality was 7.0% — 19.0% in laboratory confirmed Zika cases and 22.2% in toxoplasmosis cases. Multivariable analysis revealed birth weight as the main predictor of death. CONCLUSIONS. Despite the Zika epidemic, 13.8% of the studied cases were diagnosed with STORCH. The lethality and high frequency of neurological findings beyond microcephaly reflect severe infection, with impact on families and health care system. Organización Panamericana de la Salud 2020-11-02 /pmc/articles/PMC7609916/ /pubmed/33165406 http://dx.doi.org/10.26633/RPSP.2020.151 Text en https://creativecommons.org/licenses/by-nc-nd/3.0/igo/legalcode Este é um artigo de acesso aberto distribuído sob os termos da Licença Creative Commons Attribution-NonCommercial-NoDerivs 3.0 IGO, que permite o uso, distribuição e reprodução em qualquer meio, desde que o trabalho original seja devidamente citado. Não são permitidas modificações ou uso comercial dos artigos. Em qualquer reprodução do artigo, não deve haver nenhuma sugestão de que a OPAS ou o artigo avaliem qualquer organização ou produtos específicos. Não é permitido o uso do logotipo da OPAS. Este aviso deve ser preservado juntamente com o URL original do artigo. |
spellingShingle | Artigo Original Escosteguy, Claudia Caminha Medronho, Renata Escosteguy Rodrigues, Renata Coelho da Silva, Lucas Dalsenter Romano de Oliveira, Bruna Andrade Machado, Fernanda Beatriz Costa, Yuri Sousa de Carvalho Cardoso, Silvia Cristina da Cunha, Antonio José Ledo Alves Medronho, Roberto de Andrade Microcefalia e alterações do sistema nervoso central relacionadas à infecção congênita pelo vírus Zika e outras etiologias infecciosas no estado do Rio de Janeiro: estudo transversal, 2015 a 2017 |
title | Microcefalia e alterações do sistema nervoso central relacionadas à infecção congênita pelo vírus Zika e outras etiologias infecciosas no estado do Rio de Janeiro: estudo transversal, 2015 a 2017 |
title_full | Microcefalia e alterações do sistema nervoso central relacionadas à infecção congênita pelo vírus Zika e outras etiologias infecciosas no estado do Rio de Janeiro: estudo transversal, 2015 a 2017 |
title_fullStr | Microcefalia e alterações do sistema nervoso central relacionadas à infecção congênita pelo vírus Zika e outras etiologias infecciosas no estado do Rio de Janeiro: estudo transversal, 2015 a 2017 |
title_full_unstemmed | Microcefalia e alterações do sistema nervoso central relacionadas à infecção congênita pelo vírus Zika e outras etiologias infecciosas no estado do Rio de Janeiro: estudo transversal, 2015 a 2017 |
title_short | Microcefalia e alterações do sistema nervoso central relacionadas à infecção congênita pelo vírus Zika e outras etiologias infecciosas no estado do Rio de Janeiro: estudo transversal, 2015 a 2017 |
title_sort | microcefalia e alterações do sistema nervoso central relacionadas à infecção congênita pelo vírus zika e outras etiologias infecciosas no estado do rio de janeiro: estudo transversal, 2015 a 2017 |
topic | Artigo Original |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7609916/ https://www.ncbi.nlm.nih.gov/pubmed/33165406 http://dx.doi.org/10.26633/RPSP.2020.151 |
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