Abstract
BackgroundA Zika virus (ZIKV) infection outbreak occurred in Brazil in 2015, accompanied by a marked increase in the number of newborns presenting with microcephaly and other neurological disorders. This characteristic set of birth defects was later termed congenital Zika syndrome (CZS). The therapeutic itinerary of mothers and children infected by ZIKV can be determined by several factors, including the relationship established with existing healthcare services. Here, we aimed to describe and analyze the extent to which children with CZS, born from 2015 to 2018 in the state of Mato Grosso do Sul, Brazil, and their mothers were treated according to the guidelines established by the Brazilian Ministry of Health.MethodsThis was a descriptive cross-sectional study that considered all children (and respective mothers) with confirmed or suspected CZS born in Mato Grosso do Sul. Children and their mothers were identified based on all suspected or confirmed cases of congenital anomalies in Mato Grosso do Sul that were reported to the Registry of Public Health Events. We analyzed data on the epidemiological profile of mother-child pairs and the care received by them. Data were summarized using statistical descriptive analysis.ResultsWe showed that most mothers were white women (57%) with low income. Among pregnant women, 73% had a diagnosis of fever caused by ZIKV infection at a primary health care institution (PHCI), but only 36% received the necessary information regarding the risk of CZS. Over a third (36%) of the mothers did not receive guidance about childcare follow-up and 73% did not receive guidance regarding the availability of social support after childbirth. Gaps in medical care were observed mainly in pregnant women treated at a PHCI. Specialized assistance for children was adequate in most cases. Psychosocial support was not made available to women throughout their therapeutic itineraries.ConclusionsHere, we identified gaps in the care of families and children with disabilities, which can have an important impact on their quality of life. Beyond protocols, practical interventions must cover all the needs that arise throughout the therapeutic itineraries not only of children but also of pregnant women and mothers.
Highlights
A Zika virus (ZIKV) infection outbreak occurred in Brazil in 2015, accompanied by a marked increase in the number of newborns presenting with microcephaly and other neurological disorders
In Brazil, all suspected or confirmed cases of congenital anomalies related to ZIKV and syphilis, toxoplasmosis, other, and rubella (STORCH) are reported to the Registry of Public Health Events (RESP) – a public health record created during ZIKV epidemic
Epidemiological profiles of mothers of children with congenital Zika syndrome (CZS) After analyzing the 71 reports found in the RESP, we identified 9 confirmed and 5 suspected cases of CZS in Mato Grosso do Sul, diagnosed between 2015 and 2018
Summary
A Zika virus (ZIKV) infection outbreak occurred in Brazil in 2015, accompanied by a marked increase in the number of newborns presenting with microcephaly and other neurological disorders. This characteristic set of birth defects was later termed congenital Zika syndrome (CZS). Fetuses exposed to ZIKV might develop multiple disorders beyond microcephaly, including hydrocephalus, extrapyramidal movements, ophthalmological abnormalities, hemiparesis, hyperexcitability, hyperirritability, arthrogryposis, and epilepsy [6, 9, 10] This set of disorders, which usually represent chronic and severe functional limitations [11], characterizes the congenital Zika syndrome (CZS) [9]
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