Descriptive study of suspected congenital Zika syndrome cases during the 2015-2016 epidemic in Brazil

Abstract INTRODUCTION: Clinical and epidemiological data on suspected congenital Zika syndrome (CZS) cases from southern Mato Grosso (MT) in Brazil during the Zika virus (ZIKV) outbreak in 2015-2016 were evaluated. METHODS: This is a descriptive case series study of newborns whose mothers were suspected cases of ZIKV infections during their pregnancies. The medical records of all the suspected CZS cases (mothers and newborns) treated by the specialized ambulatory service from June 2015 to August 2016 were analyzed. RESULTS: Twenty suspected CZS cases were included in these analyses. They were categorized into four groups based on the clinical and laboratory findings: confirmed cases (n=1), highly probable cases (n=13), moderately probable cases (n=5), and somewhat probable cases (n=1). The mothers tested negative for STORCH (syphilis, toxoplasmosis, other infections, rubella, cytomegalovirus infection, and herpes simplex) and other important congenital infections; however, specific ZIKV tests were not performed during the study period. Microcephaly was observed in the majority of these newborns, and all the patients showed altered cranial computed tomography image findings. Extracranial abnormalities such as arthrogryposis, and otological and ophthalmological manifestations were also observed. CONCLUSIONS: Although ZIKV was not confirmed to cause the congenital malformations, this study demonstrated that the clinical and epidemiological findings associated with a STORCH exclusion strengthened the CZS diagnosis. The suspected cases in MT occurred simultaneously with the first CZS cases reported in Brazil, suggesting ZIKV circulation in the study region during the same period.

Microcefalia e dinâmica familiar: a percepção do pai frente à deficiência do filho / Microcefalia y dinámica familiar: la percepción del padre frente a la discapacidad del hijo / Microcephaly and family dynamics: fathers' perceptions of their children's disability

Resumo: A família é um dos pilares da vida psicológica dos indivíduos, influenciando os padrões de comportamento, o sentimento de pertencimento social e a saúde psíquica. Tal estrutura pode ser abalada quando há um membro com microcefalia associada ao Zika vírus, que ocorre quando o menino apresenta perímetro cefálico igual ou inferior a 31,9cm, e a menina, igual ou inferior a 31,5cm. Esta pesquisa visa analisar o impacto do diagnóstico de microcefalia do bebê na função paterna. Para tanto, foram realizadas entrevistas com cinco pais de crianças com microcefalia em três municípios do interior da Paraíba, Brasil. Os instrumentos foram questionário e entrevista semiestruturada gravada, submetida à análise temático-categorial. Todos os pais entrevistados participam da rotina dos filhos, sendo esse envolvimento "condicionado" pelo trabalho, bem como pela severidade da deficiência. Alguns aspectos são comuns, como reação ao diagnóstico e preocupações.

Resumen: La familia es uno de los pilares de la vida psicológica de los individuos, influenciando patrones de comportamiento, sentimiento de pertenencia social y salud psíquica. Esta estructura puede desmoronarse cuando existe un miembro con microcefalia, asociada al virus Zika, que se produce cuando el niño presenta un perímetro cefálico igual o inferior a 31,9cm, y la niña, igual o inferior a 31,5cm. El objetivo de esta investigación es analizar el impacto del diagnóstico de microcefalia del bebé en el desempeño paterno. Para tal fin, se realizaron entrevistas a cinco padres de niños con microcefalia en tres municipios del interior de Paraíba, Brasil. Los instrumentos fueron: cuestionario y entrevista semiestructurada grabada, sometida a un análisis categorial temático. Todos los padres entrevistados participaron en la rutina de los hijos, encontrándose su implicación "condicionada" por el trabajo, así como por el grado de severidad de la discapacidad. Algunos aspectos son comunes como la reacción al diagnóstico y las preocupaciones.

Abstract: The family is a key pillar in an individual's psychological life, influencing behavior patterns, feelings of social belonging, and emotional health. The family structure can be shaken by the arrival of an infant with microcephaly associated with the Zika virus, defined in newborn boys as head circumference less than or equal to 31.9cm and in newborn girls as less than or equal to 31.5cm. The study analyzes the impact of an infant's diagnosis of microcephaly on the paternal function. Interviews were held with five fathers of children with microcephaly from three communities in rural Paraíba State, Brazil. The instruments were a questionnaire and semi-structured interview that was taped and submitted to thematic and categorial analysis. All five fathers were participating in the routine care of their children, with this involvement "conditioned" by their work as well as by the disability's severity. Some aspects were common to all five fathers, such as their reaction to the diagnosis and their concerns.