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Causes of death in children with congenital Zika syndrome in Brazil, 2015 to 2018: A nationwide record linkage study.
Costa, Maria da Conceição N; Cardim, Luciana Lobato; Moore, Cynthia A; de Jesus, Eliene Dos Santos; Carvalho-Sauer, Rita; Barreto, Mauricio L; Rodrigues, Laura C; Smeeth, Liam; Schuler-Faccini, Lavínia; Brickley, Elizabeth B; Oliveira, Wanderson K; Carmo, Eduardo Hage; Pescarini, Julia Moreira; Andrade, Roberto F S; Rodrigues, Moreno M S; Veiga, Rafael V; Costa, Larissa C; França, Giovanny V A; Teixeira, Maria Gloria; Paixão, Enny S.
Afiliação
  • Costa MDCN; Center of Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil.
  • Cardim LL; Collective Health Institute, Federal University of Bahia, Salvador, Bahia, Brazil.
  • Moore CA; Center of Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil.
  • de Jesus EDS; Goldbelt Professional Services, LLC, Chesapeake, Virginia, United States of America.
  • Carvalho-Sauer R; Collective Health Institute, Federal University of Bahia, Salvador, Bahia, Brazil.
  • Barreto ML; Municipal Health Department, Department of Health Information, Salvador, Bahia, Brazil.
  • Rodrigues LC; Collective Health Institute, Federal University of Bahia, Salvador, Bahia, Brazil.
  • Smeeth L; East Regional Health Center, State Health Secretariat of Bahia, Santo Antonio de Jesus, Bahia, Brazil.
  • Schuler-Faccini L; Center of Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil.
  • Brickley EB; Collective Health Institute, Federal University of Bahia, Salvador, Bahia, Brazil.
  • Oliveira WK; Center of Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil.
  • Carmo EH; London School of Hygiene and Tropical Medicine, London, United Kingdom.
  • Pescarini JM; London School of Hygiene and Tropical Medicine, London, United Kingdom.
  • Andrade RFS; Department of Genetics, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
  • Rodrigues MMS; London School of Hygiene and Tropical Medicine, London, United Kingdom.
  • Veiga RV; Technical Directorate of Education and Research, Ministry of Defense Hospital das Armed Forces, Brasília, Distrito Federal, Brazil.
  • Costa LC; Center of Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil.
  • França GVA; Secretariat of Health Surveillance, Ministry of Health, Brasilia, Distrito Federal, Brazil.
  • Teixeira MG; Center of Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Bahia, Brazil.
  • Paixão ES; London School of Hygiene and Tropical Medicine, London, United Kingdom.
PLoS Med ; 20(2): e1004181, 2023 02.
Article em En | MEDLINE | ID: mdl-36827251
BACKGROUND: Children with congenital Zika syndrome (CZS) have severe damage to the peripheral and central nervous system (CNS), greatly increasing the risk of death. However, there is no information on the sequence of the underlying, intermediate, immediate, and contributing causes of deaths among these children. The aims of this study are describe the sequence of events leading to death of children with CZS up to 36 months of age and their probability of dying from a given cause, 2015 to 2018. METHODS AND FINDINGS: In a population-based study, we linked administrative data on live births, deaths, and cases of children with CZS from the SINASC (Live Birth Information System), the SIM (Mortality Information System), and the RESP (Public Health Event Records), respectively. Confirmed and probable cases of CZS were those that met the criteria established by the Brazilian Ministry of Health. The information on causes of death was collected from death certificates (DCs) using the World Health Organization (WHO) DC template. We estimated proportional mortality (PM%) among children with CZS and among children with non-Zika CNS congenital anomalies (CA) by 36 months of age and proportional mortality ratio by cause (PMRc). A total of 403 children with confirmed and probable CZS who died up to 36 months of age were included in the study; 81.9% were younger than 12 months of age. Multiple congenital malformations not classified elsewhere, and septicemia unspecified, with 18 (PM = 4.5%) and 17 (PM = 4.2%) deaths, respectively, were the most attested underlying causes of death. Unspecified septicemia (29 deaths and PM = 11.2%) and newborn respiratory failure (40 deaths and PM = 12.1%) were, respectively, the predominant intermediate and immediate causes of death. Fetuses and newborns affected by the mother's infectious and parasitic diseases, unspecified cerebral palsy, and unspecified severe protein-caloric malnutrition were the underlying causes with the greatest probability of death in children with CZS (PMRc from 10.0 to 17.0) when compared to the group born with non-Zika CNS anomalies. Among the intermediate and immediate causes of death, pneumonitis due to food or vomiting and unspecified seizures (PMRc = 9.5, each) and unspecified bronchopneumonia (PMRc = 5.0) were notable. As contributing causes, fetus and newborn affected by the mother's infectious and parasitic diseases (PMRc = 7.3), unspecified cerebral palsy, and newborn seizures (PMRc = 4.5, each) were more likely to lead to death in children with CZS than in the comparison group. The main limitations of this study were the use of a secondary database without additional clinical information and potential misclassification of cases and controls. CONCLUSION: The sequence of causes and circumstances involved in the deaths of the children with CZS highlights the greater vulnerability of these children to infectious and respiratory conditions compared to children with abnormalities of the CNS not related to Zika.
Assuntos

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Complicações Infecciosas na Gravidez / Paralisia Cerebral / Sepse / Zika virus / Infecção por Zika virus / Malformações do Sistema Nervoso Tipo de estudo: Etiology_studies Limite: Child / Female / Humans / Newborn / Pregnancy País/Região como assunto: America do sul / Brasil Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Complicações Infecciosas na Gravidez / Paralisia Cerebral / Sepse / Zika virus / Infecção por Zika virus / Malformações do Sistema Nervoso Tipo de estudo: Etiology_studies Limite: Child / Female / Humans / Newborn / Pregnancy País/Região como assunto: America do sul / Brasil Idioma: En Ano de publicação: 2023 Tipo de documento: Article