Navegando por Palavras-chave "Zika Virus Infection"

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    Evolução clínica, antropométrica e nutricional de crianças com síndrome congênita do vírus Zika durante quatro anos após a epidemia
    (Universidade Federal de São Paulo (UNIFESP), 2021) Arrais, Nivia Maria Rodrigues [UNIFESP]; Pinto, Maria Isabel De Moraes [UNIFESP]; Universidade Federal de São Paulo
    Objectives: To evaluate the growth and development of children with congenital Zika virus syndrome during their first years of life and to verify predictive variables for low weight, death and behavioral changes. To establish the frequency and severity of congenital heart disease in these children and to describe two cases of type 1 diabetes mellitus. Methods: Cohort of 71 children diagnosed with probable or confirmed congenital Zika virus syndrome according to the Brazilian Ministry of Health classification and who were followed up in Natal, Rio Grande do Norte. Maternal-infant epidemiological, clinical and laboratory data and anthropometric parameters were obtained during out patient visits. The tendency of the mean z-score of head circumference and low weight and short stature free time in children with and without microcephaly at birth were evaluated. Predictive variables for death were evaluated. The Survey of Wellbeing of Young Children questionnaire assessed development, risk for altered behavior, andf amily background. Results: Children born without microcephaly presented a decrease in the head circumference growth velocity (p=0.019) and a tendency towards a decrease in the mean z-score (p<0.001). They showed greater free time to low weight (p=0.036) and to short stature (p=0.034) compared to those born with microcephaly. The comparison of the height classification using the stadiometer and the measurements of the tibia and knee-calcaneal segments in the curves ofthe W.H.O. (2006) showed a slight agreement (ƙappa=0.316, p<0.001). Assessing the nutritional diagnoses obtained from the W.H.O. curves and Brooks curves (2011), low weight and short stature were observed only in the W.H.O. curves. For nutritional classification by body mass index, agreement was slight or moderate, regardless of height used. All 52 children whose families responded to the Survey of Wellbeing of Young Children questionnaire had microcephaly and developmental delayat the time of the interview. Normocephalic babies at birth were 36 times more likely to have behavioral changes when compared to microcephalic babies (95%CI 3.82-337.92, p=0.002). Those with hearing impairment and strabismus had less risk of behavioral changes; 35% of the families reported food insecurity in the year prior to the interview and 21% of the mothers were at risk for depression. Children with arthrogryposis were seven times more likely to die than those without this condition. Seven of 51 (13.7%) children with echocardiographic assessment had mild congenital heart disease without hemodynamic repercussions. Two children (2.8%) were diagnosed with type 1 diabetes mellitus. Conclusions: Children with SCZ born normocephalic can progress to microcephaly during the first year of life, but they have longer free time from low weight and short stature when compared to those born microcephalic. The use of height estimated by segment measurements seems to be na option for daily practice after 24 months of age. Children born normocephalic had a higher risk of behavioral changes, suggesting greater social interaction and better conditions for externalizing reactions. Food insecurity and maternal depression may reflect the psychosocial vulnerability of these families. Only children with mild congenital heart disease and without hemodynamic repercussions were observed, suggesting that the cardiologic investigation should be reserved for children with clinical or neonatal screening suggestive of impairment. Two cases of type 1 diabetes mellitus were described, suggestive of a possible role of the Zika virus as na environmental factor triggering autoimmunity.