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1.
Artigo em Inglês | MEDLINE | ID: mdl-34200607

RESUMO

Makkah city, Kingdom of Saudi Arabia (KSA), contains many of the world's mosquito vectors of parasitic and arboviral disease and is the site of the Hajj mass gathering. As such there is a risk of exportation and globalization of vector-borne viruses, including the re-emerging Zika virus (ZIKV). There was international concern regarding the introduction of ZIKV to KSA and potential international spread of the virus following the 2016 Hajj which took place few days after the Rio summer Olympics at the height of the ZIKV pandemic. We aimed to detect flaviviruses, including ZIKV, circulating among mosquito hosts in the city of Makkah during and post the 2016 Hajj pilgrimage. Mosquitos (adults and larvae) were sampled from 15 sites in Makkah city during and post the 2016 Hajj and identified to species by morphological keys. Mosquitos were pooled according to date of collection, location, and species. A Pan-Flaviviruses RT-PCR assay that enables identification of 51 flaviviruses species and three tentative species was used to detect flavivirus RNA directly from mosquito homogenates. Between the 10 September and 6 October 2016, 9412 female mosquitos were collected. Of these, 81.3% were Aedes aegypti, 18.6% were Culex species, and 0.1% were Anopheles species. Of the total 493 mosquito pools generated, 242 (49%) were positive by the Pan-Flaviviruses primer set. Sequence analysis revealed that none of the mosquitos carried a pathogenic flavivirus, including ZIKV, but were infected with a novel insect-specific flavivirus. We found no pathogenic flaviviruses circulating in Makkah city during and post the 2016 Hajj and no evidence of introduction of ZIKV through the pilgrimage. Enhanced vector-borne diseases surveillance, prevention, and control are crucial in KSA especially during international mass gatherings such as the annual Hajj to prevent outbreaks and the spread of viruses with epidemic and pandemic potentials.


Assuntos
Aedes , Flavivirus , Infecção por Zika virus , Zika virus , Animais , Feminino , Flavivirus/genética , Mosquitos Vetores , Arábia Saudita/epidemiologia , Zika virus/genética , Infecção por Zika virus/epidemiologia
2.
Artigo em Inglês | MEDLINE | ID: mdl-34204166

RESUMO

Surveillance and control activities for virus-transmitting mosquitoes have primarily focused on dwellings. There is little information about viral circulation in heavily trafficked places such as schools. We collected and analyzed data to assess the presence and prevalence of dengue, chikungunya, and Zika viruses in mosquitoes, and measured Aedes indices in schools in Medellín (Colombia) between 2016-2018. In 43.27% of 2632 visits we collected Aedes adults, creating 883 pools analyzed by RT-PCR. 14.27% of pools yielded positive for dengue or Zika (infection rates of 1.75-296.29 for Aedes aegypti). Ae. aegypti was more abundant and had a higher infection rate for all studied diseases. Aedes indices varied over time. There was no association between Aedes abundance and mosquito infection rates, but the latter did correlate with cases of arboviral disease and climate. Results suggest schools are important sources of arbovirus and health agencies should include these sites in surveillance programs; it is essential to know the source for arboviral diseases transmission and the identification of the most population groups exposed to these diseases to research and developing new strategies.


Assuntos
Vírus da Dengue , Dengue , Infecção por Zika virus , Zika virus , Animais , Colômbia , Dengue/epidemiologia , Mosquitos Vetores , Instituições Acadêmicas , Infecção por Zika virus/epidemiologia
3.
Gac Med Mex ; 157(2): 187-193, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34270541

RESUMO

In American countries, simultaneously with the coronavirus disease 2019 (COVID-19) pandemic, epidemics caused by different arboviruses (dengue, chikungunya and Zika viruses) are occurring. In Mexico, several of the strategies to control the Aedes aegypti mosquito, which transmits arboviruses, involve the interaction of health personnel with the community. Due to the COVID-19 pandemic, social distancing and home confinement measures have been implemented. To obey these measures and avoid the risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission, the National Center for Preventive Programs and Disease Control (CENAPRECE) has presented the vector control strategy in the scenario of simultaneous dengue and COVID-19 transmission in Mexico. In this work, we mention the routine comprehensive mosquito control measures and describe the adaptations that have been made. Furthermore, we discuss the relevance of medical personnel training and supervision, especially focusing on the similarity of symptoms between both pathologies.


Assuntos
Aedes/virologia , Infecções por Arbovirus/epidemiologia , COVID-19/epidemiologia , Monitoramento Epidemiológico , Controle de Mosquitos/métodos , Pandemias , Animais , Infecções por Arbovirus/prevenção & controle , COVID-19/prevenção & controle , Febre de Chikungunya/epidemiologia , Febre de Chikungunya/prevenção & controle , Dengue/epidemiologia , Dengue/prevenção & controle , Promoção da Saúde , Humanos , Disseminação de Informação , Distanciamento Físico , Infecção por Zika virus/epidemiologia
4.
Cien Saude Colet ; 26(6): 2271-2280, 2021.
Artigo em Português | MEDLINE | ID: mdl-34231737

RESUMO

In 2015, there was an epidemic of microcephaly in Brazil that was associated with infection by the Zika virus. The condition of these children obliged the parents to embark on a quest in search of treatment. The scope of this study was to establish the therapeutic itinerary pursued in healthcare sectors by parents and/or caregivers of children with microcephaly due to the Zika virus. It involved qualitative research, conducted at a Center of Reference on Neurodevelopment between April 2017 and February 2018, with parents and/or caregivers of children with microcephaly caused by the Zika virus. The sample complied with the criteria of saturation. Twenty semi-structured interviews were conducted, recorded, and transcribed, and content analysis was applied. The results revealed disorientation and uncertainties in the search for care in the health sector. The most sought-after sector was the professional sector, followed by the informal sector. The information conveyed in the media and social networks, which constitute part of the informal sector, helped to clarify the significance of microcephaly and the Zika virus and assisted in the search for treatment. Care in the healthcare network was marked by difficulties and, faced with a new and emergency situation, the route between diagnosis and treatment was arduous.


Assuntos
Microcefalia , Complicações Infecciosas na Gravidez , Infecção por Zika virus , Zika virus , Brasil/epidemiologia , Criança , Feminino , Humanos , Microcefalia/epidemiologia , Gravidez , Infecção por Zika virus/complicações , Infecção por Zika virus/epidemiologia
5.
J Glob Health ; 11: 05012, 2021 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-34221359

RESUMO

Background: Strategic planning is critical for successful pandemic management. This study aimed to identify and review the scope and analytic depth of situation analyses conducted to understand their utility, and capture the documented macro-level factors impacting pandemic management. Methods: To synthesise this disparate body of literature, we adopted a two-step search and review process. A systematic search of the literature was conducted to identify all studies since 2000, that have 1) employed a situation analysis; and 2) examined contextual factors influencing pandemic management. The included studies are analysed using a seven-domain systems approach from the discipline of strategic management. Results: Nineteen studies were included in the final review ranging from single country (6) to regional, multi-country studies (13). Fourteen studies had a single disease focus, with 5 studies evaluating responses to one or more of COVID-19, Severe Acute Respiratory Syndrome (SARS), Middle East Respiratory Syndrome (MERS), Influenza A (H1N1), Ebola virus disease, and Zika virus disease pandemics. Six studies examined a single domain from political, economic, sociological, technological, ecological or wider industry (PESTELI), 5 studies examined two to four domains, and 8 studies examined five or more domains. Methods employed were predominantly literature reviews. The recommendations focus predominantly on addressing inhibitors in the sociological and technological domains with few recommendations articulated in the political domain. Overall, the legislative domain is least represented. Conclusions: Ex-post analysis using the seven-domain strategic management framework provides further opportunities for a planned systematic response to pandemics which remains critical as the current COVID-19 pandemic evolves.


Assuntos
COVID-19 , Controle de Doenças Transmissíveis , Influenza Humana , Pandemias/prevenção & controle , Infecção por Zika virus , COVID-19/epidemiologia , COVID-19/prevenção & controle , Humanos , Vírus da Influenza A Subtipo H1N1 , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , SARS-CoV-2 , Zika virus , Infecção por Zika virus/epidemiologia , Infecção por Zika virus/prevenção & controle
6.
Rev Bras Enferm ; 74(3): e20200122, 2021.
Artigo em Inglês, Português | MEDLINE | ID: mdl-34133677

RESUMO

OBJECTIVES: to classify the degree of dependence on nursing care required by children with Congenital Zika Syndrome during hospitalization and to analyze their complexity. METHODS: this is a descriptive, observational and quantitative study carried out in a pediatric ward of a public hospital in Rio de Janeiro. Data were collected from hospitalization records between June 2017 and April 2018. RESULTS: 54% of the population studied showed a degree of dependence equivalent to semi-intensive care. On 37.5% of hospitalization days, patients required non-invasive or invasive mechanical ventilation; 31.5% had spontaneous breathing requiring airway clearance by aspiration and/or oxygen therapy. CONCLUSION: Congenital Zika Syndrome represents a challenge for health professionals due to its uniqueness. In this study, it is expressed by demands for complex and continuous care in hospitalization and in preparation for discharge, requiring semi-intensive nursing care.


Assuntos
Cuidados de Enfermagem , Infecção por Zika virus , Zika virus , Brasil , Criança , Hospitalização , Humanos , Respiração Artificial , Infecção por Zika virus/complicações , Infecção por Zika virus/epidemiologia
7.
BMC Public Health ; 21(1): 1199, 2021 06 23.
Artigo em Inglês | MEDLINE | ID: mdl-34162338

RESUMO

BACKGROUND: Zika virus (ZIKV) infection caused outbreak in Brazil, in 2015 and 2016. Disorganized urban growth, facilitates the concentration of numerous susceptible and infected individuals. It is useful to understand the mechanisms that can favor the increase in ZIKV incidence, such as areas with wide socioeconomic and environmental diversity. Therefore, the study analyzed the spatial distribution of ZIKV in the city of Rio de Janeiro, Brazil, in 2015 and 2016, and associations between the incidence per 1000 inhabitants and socio-environmental factors. METHODS: The census tracts were used as the analytical units reported ZIKV cases among the city's inhabitants. Local Empirical Bayesian method was used to control the incidence rates' instability effect. The spatial autocorrelation was verified with Moran's Index and local indicators of spatial association (LISA). Spearman correlation matrix was used to indicate possible collinearity. The Ordinary Least Squares (OLS), Spatial Lag Model (SAR), and Spatial Error Model (CAR) were used to analyze the relationship between ZIKV and socio-environmental factors. RESULTS: The SAR model exhibited the best parameters: R2 = 0.44, Log-likelihood = - 7482, Akaike Information Criterion (AIC) = 14,980. In this model, mean income between 1 and 2 minimum wages was possible risk factors for Zika occurrence in the localities. Household conditions related to adequate water supply and the existence of public sewage disposal were associated with lower ZIKV cumulative incidence, suggesting possible protective factors against the occurrence of ZIKV in the localities. The presence of the Family Health Strategy in the census tracts was positively associated with the ZIKV cumulative incidence. However, the results show that mean income less than 1 minimum wage were negatively associated with higher ZIKV cumulative incidence. CONCLUSION: The results demonstrate the importance of socio-environmental variables in the dynamics of ZIKV transmission and the relevance for the development of control strategies.


Assuntos
Infecção por Zika virus , Zika virus , Teorema de Bayes , Brasil/epidemiologia , Cidades , Saúde da Família , Humanos , Infecção por Zika virus/epidemiologia
8.
BMC Med Res Methodol ; 21(1): 120, 2021 06 08.
Artigo em Inglês | MEDLINE | ID: mdl-34103009

RESUMO

BACKGROUND: Pandemic events often trigger a surge of clinical trial activity aimed at rapidly evaluating therapeutic or preventative interventions. Ensuring rapid public access to the complete and unbiased trial record is particularly critical for pandemic research given the urgent associated public health needs. The World Health Organization (WHO) established standards requiring posting of results to a registry within 12 months of trial completion and publication in a peer reviewed journal within 24 months of completion, though compliance with these requirements among pandemic trials is unknown. METHODS: This cross-sectional analysis characterizes availability of results in trial registries and publications among registered trials performed during the 2009 H1N1 influenza, 2014 Ebola, and 2016 Zika pandemics. We searched trial registries to identify clinical trials testing interventions related to these pandemics, and determined the time elapsed between trial completion and availability of results in the registry. We also performed a comprehensive search of MEDLINE via PubMed, Google Scholar, and EMBASE to identify corresponding peer reviewed publications. The primary outcome was the compliance with either of the WHO's established standards for sharing clinical trial results. Secondary outcomes included compliance with both standards, and assessing the time elapsed between trial completion and public availability of results. RESULTS: Three hundred thirty-three trials met eligibility criteria, including 261 H1N1 influenza trials, 60 Ebola trials, and 12 Zika trials. Of these, 139 (42%) either had results available in the trial registry within 12 months of study completion or had results available in a peer-reviewed publication within 24 months. Five trials (2%) met both standards. No results were available in either a registry or publication for 59 trials (18%). Among trials with registered results, a median of 42 months (IQR 16-76 months) elapsed between trial completion and results posting. For published trials, the median elapsed time between completion and publication was 21 months (IQR 9-34 months). Results were available within 24 months of study completion in either the trial registry or a peer reviewed publication for 166 trials (50%). CONCLUSIONS: Very few trials performed during prior pandemic events met established standards for the timely public dissemination of trial results.


Assuntos
Doença pelo Vírus Ebola , Vírus da Influenza A Subtipo H1N1 , Infecção por Zika virus , Zika virus , Estudos Transversais , Humanos , Editoração , Sistema de Registros , Infecção por Zika virus/epidemiologia , Infecção por Zika virus/terapia
9.
Int J Pediatr Otorhinolaryngol ; 147: 110801, 2021 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34147906

RESUMO

BACKGROUND: Identification of the factors that could potentially lead to congenital hearing loss is of paramount importance, as early detection of congenital hearing loss and intervention could prevent developmental delays in speech, language development as well as childhood cognitive impairment. Hitherto, intrauterine exposure to Zika virus has emerged as a cause of various fetal malformations, including cases of congenital hearing loss. The aim of this systematic review is to investigate the association between intrauterine exposure to Zika virus and hearing loss in children. METHODS: A systematic literature search was conducted to the databases PubMed, Cochrane library, Scopus, ClinicalTrials.gov, SciELO and Lilacs in order to identify studies that examine the association between prenatally Zika exposure and hearing loss within the first few years of life. Studies were eligible for inclusion, if solely objective methods for hearing evaluation of patients such as otoacoustic emissions (OAEs) and/or auditory brainstem response (ABR) were used, in children who intrauterine exposed to the Zika virus. RESULTS: Thirteen studies were included, which included 1275 children who are prenatally exposed to Zika virus. In 852 of the cases an objective hearing evaluation was performed using either OAEs or ABR. 709 children were tested with ABR and 79 had a failed outcome. 143 children were tested with OAEs whilst of these, 30 had a failed outcome. Altered OAEs ranged from 8.7% to 30.2%, while altered ABR ranged from 0% to 19.9%. The initial sample includes 428 children with microcephaly, while 5 of the studies comprise microcephaly to the inclusion criteria. CONCLUSION: It seems to be a possible association between prenatal Zika virus exposure and hearing loss in children during the first years of their life. It is of great importance that in future studies possible confounding factors, like microcephaly, will be appropriately controlled. Additionally, the follow-up period of monitoring hearing loss in children should be prolonged in order to identify potential late onset hearing problems caused by intrauterine exposure to Zika virus.


Assuntos
Perda Auditiva , Microcefalia , Complicações Infecciosas na Gravidez , Infecção por Zika virus , Zika virus , Criança , Feminino , Perda Auditiva/diagnóstico , Perda Auditiva/epidemiologia , Perda Auditiva/etiologia , Humanos , Microcefalia/epidemiologia , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/epidemiologia , Infecção por Zika virus/complicações , Infecção por Zika virus/diagnóstico , Infecção por Zika virus/epidemiologia
10.
BMJ Glob Health ; 6(6)2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-34117012

RESUMO

Zika virus (ZIKV) is a vectorborne infectious agent of global public health significance due to its potential to cause severe teratogenic outcomes. The question of whether health systems should consider adopting screening programmes for ZIKV infections during pregnancy warrants consideration. In this analysis, we apply the Wilson-Jungner framework to appraise the potential utility of a prenatal ZIKV screening programme, outline potential screening strategies within the case-finding pathway, and consider other epidemiological factors that may influence the planning of such a screening programme. Our evaluation of a potential prenatal ZIKV screening programme highlights factors affirming its usefulness, including the importance of Congenital Zika Syndrome as a public health problem and the existence of analogous congenital prenatal screening programmes for STORCH agents (syphilis, toxoplasmosis, others (eg, human immunodeficiency virus, varicella-zoster virus, parvovirus B19), rubella, cytomegalovirus, and herpes simplex virus). However, our assessment also reveals key barriers to implementation, such as the need for more accurate diagnostic tests, effective antiviral treatments, increased social service capacity, and surveillance. Given that the reemergence of ZIKV is likely, we provide a guiding framework for policymakers and public health leaders that can be further elaborated and adapted to different contexts in order to reduce the burden of adverse ZIKV-related birth outcomes during future outbreaks.


Assuntos
Epidemias , Viroses , Infecção por Zika virus , Zika virus , Feminino , Humanos , Gravidez , Diagnóstico Pré-Natal , Viroses/epidemiologia , Infecção por Zika virus/diagnóstico , Infecção por Zika virus/epidemiologia , Infecção por Zika virus/prevenção & controle
11.
Nat Commun ; 12(1): 2619, 2021 05 11.
Artigo em Inglês | MEDLINE | ID: mdl-33976183

RESUMO

After the Zika virus (ZIKV) epidemic in the Americas in 2016, both Zika and dengue incidence declined to record lows in many countries in 2017-2018, but in 2019 dengue resurged in Brazil, causing ~2.1 million cases. In this study we use epidemiological, climatological and genomic data to investigate dengue dynamics in recent years in Brazil. First, we estimate dengue virus force of infection (FOI) and model mosquito-borne transmission suitability since the early 2000s. Our estimates reveal that DENV transmission was low in 2017-2018, despite conditions being suitable for viral spread. Our study also shows a marked decline in dengue susceptibility between 2002 and 2019, which could explain the synchronous decline of dengue in the country, partially as a result of protective immunity from prior ZIKV and/or DENV infections. Furthermore, we performed phylogeographic analyses using 69 newly sequenced genomes of dengue virus serotype 1 and 2 from Brazil, and found that the outbreaks in 2018-2019 were caused by local DENV lineages that persisted for 5-10 years, circulating cryptically before and after the Zika epidemic. We hypothesize that DENV lineages may circulate at low transmission levels for many years, until local conditions are suitable for higher transmission, when they cause major outbreaks.


Assuntos
Vírus da Dengue/imunologia , Dengue/epidemiologia , Suscetibilidade a Doenças/imunologia , Epidemias/estatística & dados numéricos , Infecção por Zika virus/imunologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Anticorpos Antivirais/imunologia , Brasil/epidemiologia , Criança , Pré-Escolar , Dengue/imunologia , Dengue/transmissão , Dengue/virologia , Vírus da Dengue/genética , Vírus da Dengue/isolamento & purificação , Epidemias/prevenção & controle , Monitoramento Epidemiológico , Feminino , Genoma Viral/genética , Humanos , Imunidade Heteróloga , Incidência , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Tipagem Molecular , Mosquitos Vetores/virologia , Filogeografia , Sorotipagem , Adulto Jovem , Zika virus/imunologia , Infecção por Zika virus/epidemiologia
12.
Rev Esp Salud Publica ; 952021 May 10.
Artigo em Espanhol | MEDLINE | ID: mdl-33967267

RESUMO

OBJECTIVE: Environmental management of imported arboviruses such as dengue (DENV), Zika (ZIKV) or Chikungunya (CHIKV) is a task of great significance for Public Health since the arrival and establishment of the competent vector Aedes albopictus (Asian tiger mosquito) in numerous cities of our country. There are recent examples of autochthonous transmission of some of these arboviruses in Spain probably linked to undetected and / or unmanaged imported cases. METHODS: Vector management interventions were carried out in the city of Valencia (Spain) by the Health Service of the Valencia City Council between 2016 and 2018. These actions took place within the framework of a coordination protocol established with the Health authorities of the Valencia regional government. RESULTS: A total of 21 arbovirus cases were reported and led to entomological surveillance and vector control interventions in the city of Valencia: 8 DENV, 7 CHIKV and 6 ZIKV. In 8 of these 21 cases (38%) the presence of Ae. Albopictus was detected within the risk zones established for each case. CONCLUSIONS: Vector surveillance and control strategies associated with imported cases of arboviruses, provide accurate information on the environmental risks of amplification of these viruses and also allow reducing these risks through population control of vectors. Due to the short duration of the viremic phases, these interventions should be carried out as quickly as possible in order to reduce the hypothetical contact between the infected person and vector as much as possible.


Assuntos
Aedes/virologia , Febre de Chikungunya/prevenção & controle , Dengue/prevenção & controle , Controle de Mosquitos , Mosquitos Vetores/virologia , Infecção por Zika virus/prevenção & controle , Animais , Febre de Chikungunya/epidemiologia , Cidades/epidemiologia , Dengue/epidemiologia , Humanos , Espanha/epidemiologia , Infecção por Zika virus/epidemiologia
13.
J R Soc Interface ; 18(178): 20210165, 2021 05.
Artigo em Inglês | MEDLINE | ID: mdl-33947225

RESUMO

When a rare pathogen emerges to cause a pandemic, it is critical to understand its dynamics and the impact of mitigation measures. We use experimental data to parametrize a temperature-dependent model of Zika virus (ZIKV) transmission dynamics and analyse the effects of temperature variability and control-related parameters on the basic reproduction number (R0) and the final epidemic size of ZIKV. Sensitivity analyses show that these two metrics are largely driven by different parameters, with the exception of temperature, which is the dominant driver of epidemic dynamics in the models. Our R0 estimate has a single optimum temperature (≈30°C), comparable to other published results (≈29°C). However, the final epidemic size is maximized across a wider temperature range, from 24 to 36°C. The models indicate that ZIKV is highly sensitive to seasonal temperature variation. For example, although the model predicts that ZIKV transmission cannot occur at a constant temperature below 23°C (≈ average annual temperature of Rio de Janeiro, Brazil), the model predicts substantial epidemics for areas with a mean temperature of 20°C if there is seasonal variation of 10°C (≈ average annual temperature of Tampa, Florida). This suggests that the geographical range of ZIKV is wider than indicated from static R0 models, underscoring the importance of climate dynamics and variation in the context of broader climate change on emerging infectious diseases.


Assuntos
Infecção por Zika virus , Zika virus , Brasil , Florida , Humanos , Mosquitos Vetores , Temperatura , Infecção por Zika virus/epidemiologia
14.
J Trop Pediatr ; 67(2)2021 05 17.
Artigo em Inglês | MEDLINE | ID: mdl-34037794

RESUMO

INTRODUCTION: In utero Zika virus (ZIKV) exposure has been related to a group of congenital structural abnormalities called the congenital Zika syndrome, which also has been related to neurodevelopment alterations even in normocephalic children. Physical growth has been less explored, and delayed growth and malnutrition have been reported. OBJECTIVE: The objective of this study is to describe the growth and neurodevelopment features of normocephalic infants born from a cohort of mothers with RT-PCR confirmed ZIKV during pregnancy in Risaralda, Colombia. METHODS: We conducted a retrospective cohort, including normocephalic children born from mothers with RT-PCR confirmed ZIKV infection during pregnancy in Risaralda, Colombia. Physical growth was measured using WHO standards, and neurodevelopment was measured with the abbreviated neurodevelopment scale 2 validated for Colombia. RESULTS: After verifying inclusion and exclusion criteria, 16 children were followed during a median time of 28 months (IQR 23-31 months); for a total of 116 visits, 87.5% (n = 14) of the patients developed a growth alteration. Five presented post-natal microcephaly, and among them, four presented malnutrition or low height. Six patients developed macrocephaly. Patients with a normal head circumference had normal neurodevelopment. Only one patient with microcephaly persisted with impairment of the neurodevelopment at the end of follow-up. All the patients with macrocephaly had normal neurodevelopment. DISCUSSION: Our study suggests that growth could be altered in infants with in utero Zika exposure. We found a high proportion of patients with overgrowth and macrocephaly. Future studies should consider endocrine follow-up of children born with in utero Zika exposure to explore these findings' possible aetiologies. CONCLUSION: We found a high proportion of growth alterations, particularly with overgrowth features and macrocephaly. Our study suggests that in addition to neurodevelopment impairment, growth could be altered in infants and children with in utero Zika exposure, even in those patients born without CZS.


Assuntos
Microcefalia , Complicações Infecciosas na Gravidez , Infecção por Zika virus , Zika virus , Brasil , Criança , Colômbia , Feminino , Seguimentos , Humanos , Lactente , Microcefalia/epidemiologia , Mães , Gravidez , Estudos Retrospectivos , Infecção por Zika virus/complicações , Infecção por Zika virus/diagnóstico , Infecção por Zika virus/epidemiologia
15.
Am J Orthod Dentofacial Orthop ; 159(6): 816-823, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33836919

RESUMO

INTRODUCTION: The objectives of this study were to determine the prevalence of malocclusion among children with Zika virus-associated microcephaly (MZV) and to describe the most common malocclusion in this population. METHODS: This was a cross-sectional study including patients aged between 30 and 36 months diagnosed with MZV. Healthy children were randomly selected with the same sociodemographic characteristics as the control group. Information about arch-type, primate spaces, arch form, overbite, overjet, midline deviation, anterior crossbite, anterior open bite, and the posterior crossbite was recorded. The statistical analysis used descriptive analysis, Pearson chi-square test, and multivariate logistic regression. RESULTS: Forty children comprised the MZV group, and 40 comprised the control group. Our results demonstrated a significantly higher prevalence of malocclusions in children who had MZV than the control group (P <0.001). Patients with MZV were more likely to have late eruption (P <0.001), hypoplastic maxillary arch (P <0.001), hypoplastic mandibular arch (P <0.001), excessive overjet (P <0.001), and posterior crossbite (P = 0.004). CONCLUSIONS: The prevalence of malocclusion was higher among children with MZV. Late eruption, hypoplastic maxillary arch, hypoplastic mandibular arch, excessive overjet, and posterior crossbite were the most common characteristics for this population.


Assuntos
Má Oclusão , Microcefalia , Infecção por Zika virus , Zika virus , Criança , Estudos Transversais , Humanos , Má Oclusão/complicações , Má Oclusão/epidemiologia , Microcefalia/complicações , Microcefalia/epidemiologia , Prevalência , Infecção por Zika virus/complicações , Infecção por Zika virus/epidemiologia
16.
BMJ Glob Health ; 6(4)2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33849897

RESUMO

INTRODUCTION: There has been no systematic comparison of how the policy response to past infectious disease outbreaks and epidemics was funded. This study aims to collate and analyse funding for the Ebola epidemic and Zika outbreak between 2014 and 2019 in order to understand the shortcomings in funding reporting and suggest improvements. METHODS: Data were collected via a literature review and analysis of financial reporting databases, including both amounts donated and received. Funding information from three financial databases was analysed: Institute of Health Metrics and Evaluation's Development Assistance for Health database, the Georgetown Infectious Disease Atlas and the United Nations Financial Tracking Service. A systematic literature search strategy was devised and applied to seven databases: MEDLINE, EMBASE, HMIC, Global Health, Scopus, Web of Science and EconLit. Funding information was extracted from articles meeting the eligibility criteria and measures were taken to avoid double counting. Funding was collated, then amounts and purposes were compared within, and between, data sources. RESULTS: Large differences between funding reported by different data sources, and variations in format and methodology, made it difficult to arrive at precise estimates of funding amounts and purpose. Total disbursements reported by the databases ranged from $2.5 to $3.2 billion for Ebola and $150-$180 million for Zika. Total funding reported in the literature is greater than reported in databases, suggesting that databases may either miss funding, or that literature sources overreport. Databases and literature disagreed on the main purpose of funding for socioeconomic recovery versus outbreak response. One of the few consistent findings across data sources and diseases is that the USA was the largest donor. CONCLUSION: Implementation of several recommendations would enable more effective mapping and deployment of outbreak funding for response activities relating to COVID-19 and future epidemics.


Assuntos
Surtos de Doenças/economia , Doença pelo Vírus Ebola/economia , Infecção por Zika virus/economia , Ebolavirus , Doença pelo Vírus Ebola/epidemiologia , Humanos , Zika virus , Infecção por Zika virus/epidemiologia
17.
Rev Saude Publica ; 55: 15, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33909869

RESUMO

We report cognitive, language and motor neurodevelopment, assessed by the Bayley-III test, in 31 non-microcephalic children at age 3 with PCR-confirmed maternal Zika virus exposure (Rio de Janeiro, 2015-2016). Most children had average neurodevelopmental scores, however, 8 children (26%) presented delay in some domain. Language was the most affected: 7 children (22.6%) had a delay in this domain (2 presenting severe delay). Moderate delay was detected in the cognitive (3.2%) and motor (10%) domains. Maternal illness in the third trimester of pregnancy and later gestational age at birth were associated with higher Bayley-III scores. Zika-exposed children require long-term follow-up until school age.


Assuntos
Transtornos do Neurodesenvolvimento , Complicações Infecciosas na Gravidez , Infecção por Zika virus , Zika virus , Brasil , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Transtornos do Neurodesenvolvimento/etiologia , Gravidez , Infecção por Zika virus/epidemiologia
18.
Braz Oral Res ; 35: e043, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33909865

RESUMO

Numerous studies have reported abnormalities in the development of oral structures in congenital infections that also involve microcephaly. In this context, it is necessary to identify possible dental anomalies of shape and/or number in patients with Zika virus syndrome using radiography. The study population consisted of 35 children born with congenital ZIKV who underwent intraoral radiographic examinations for 24 consecutive months. A modified periapical technique was performed in an occlusal position for the maxilla and mandible. Categorical data were expressed as absolute and percentage frequencies and compared using Pearson's Chi-square test, with a 95% confidence interval. Of the entire sample, eight children (22.8%) had dental anomalies of shape and/or number, and four children (11.4%) presented with both anomalies, with agenesis of the upper and lower deciduous/permanent incisors and dental form modifications, such as microdontia and anomalous cusps. When we considered age and sex, there was no statistically significant difference between patients who presented with agenesis and those who presented with modifications. Children with congenital Zika virus syndrome were more likely to have dental modifications in the number and shape of their teeth, and it is essential to implement medium- to long-term monitoring to diagnose other possible alterations throughout the development of the mixed and permanent dentition, favoring their treatment.


Assuntos
Microcefalia , Anormalidades Dentárias , Infecção por Zika virus , Zika virus , Criança , Humanos , Mandíbula , Microcefalia/diagnóstico por imagem , Anormalidades Dentárias/diagnóstico por imagem , Infecção por Zika virus/complicações , Infecção por Zika virus/diagnóstico por imagem , Infecção por Zika virus/epidemiologia
19.
PLoS Negl Trop Dis ; 15(4): e0009337, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33909610

RESUMO

BACKGROUND: As the three major arthropod-borne viruses, dengue virus (DENV), chikungunya virus (CHIKV), and zika virus (ZIKV) are posing a growing threat to global public health and socioeconomic development. Our study aimed to systematically review the global seroprevalences of these arboviruses from existing publications. METHODS: Articles published between Jan 01, 2000 and Dec 31, 2019 in the databases of Embase, Pubmed and Web of Science were searched and collected. Countries or areas with known local presence of Aedes vector mosquitoes were included. Random effects model was utilized to estimate the pooled seroprevalences and the proportion of inapparent infection. RESULTS: Out of 1375, a total of 133 articles involving 176,001 subjects were included for our analysis. The pooled seroprevalences of DENV, CHIKV and ZIKV were 38%, 25% and 18%, respectively; and their corresponding proportions of inapparent infections were 80%, 40% and 50%. The South-East Asia Region had the highest seroprevalences of DENV and CHIKV, while the Region of the Americas had the highest seroprevalence of ZIKV. The seroprevalences of DENV and CHIKV were similar when comparing developed and developing countries, urban and rural areas, or among different populations. In addition, we observed a decreased global seroprevalences in the new decade (2010-2019) comparing to the decade before (2000-2009) for CHIKV. For ZIKV, the positive rates tested with the nucleic acid detection method were lower than those tested with the antibody detection method. Lastly, numerous cases of dual seropositivity for CHIKV and DENV were reported. CONCLUSIONS: Our results revealed a varied prevalence of arbovirus infections in different geographical regions and countries, and the inapparent infection accounted an unneglected portion of infections that requires more attention. This study will shed lights on our understanding of the true burden of arbovirus infections and promote appropriate vaccination in the future.


Assuntos
Aedes/virologia , Febre de Chikungunya/epidemiologia , Dengue/epidemiologia , Infecção por Zika virus/epidemiologia , Animais , Febre de Chikungunya/transmissão , Febre de Chikungunya/virologia , Vírus Chikungunya/fisiologia , Dengue/transmissão , Dengue/virologia , Vírus da Dengue/fisiologia , Saúde Global , Humanos , Mosquitos Vetores/virologia , Estudos Soroepidemiológicos , Zika virus/fisiologia , Infecção por Zika virus/transmissão , Infecção por Zika virus/virologia
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