Acompanhamento clínico e nutricional de uma coorte de lactentes com síndrome da Zika congênita, nascidos em Sergipe, nordeste do Brasil

• Autor(a) principal: Lopes, Aline de Siqueira Alves
• Data de Publicação: 2018
• Tipo de documento: Dissertação
• Idioma: por
• Título da fonte: Repositório Institucional da UFS
• Texto Completo: http://ri.ufs.br/jspui/handle/riufs/9390
• topic: Alimentação; Coorte; Desenvolvimento infantil; Infecção pelo zika virus; Microcefalia; Síndrome da zika congênita; Feeding; Child development; Cohort; Microcephaly; Congenital zika syndrome; Zika virus infection; CIENCIAS DA SAUDE

Introduction: At the end of 2015, zika virus became the protagonist of an epidemic of congenital anomalies never observed. The northeastern region of Brazil was the most affected. Congenital Zika Syndrome is characterized by severe microcephaly, critical brain damage, ophthalmologic, auditory, cardiac and orthopedic anomalies, as well as severe developmental delay with irritability, spasticity and convulsions. Owning to the fact that it is a new pathology, little is known about its long-term evolution, since affected children are aged around 3 years. Goal: To follow-up of a cohort of infants born with microcephaly and / or anomalies associated with congenital zika virus infection, from birth to 18 months of age, evaluating their growth, development, feeding and occurrence of associated morbidities. Methodology: This was a longitudinal, observational and descriptive study of a cohort of infants born in Sergipe during the outbreak of microcephaly and referred to two public health services. The children were followed up through 18 months of age in childcare consultations, together with expert evaluations and complementary examinations. The data was collected from August / 2017 to January / 2018 with using a research form. Statistical analyzes were carried out in R Core Team 2018 software. Results: The cohort comprised 84 children with Congenital Zika Syndrome. There was a predominance of females (53.8%) and only 9 newborns had no diagnosis of microcephaly but had other alterations compatible with Congenital Zika Syndrome. The Z scores for head circumference, weight and length remained stable over time, remaining below the expected standard for the three anthropometric indexes. The evolution of Z scores for weight / length showed a downward trend, although the average remained in the eutrophic pattern. In addition to the occurrence of other neurological impairments, such as seizures (69%), spasticity (48,8%), and irritability (64,3%), the infants presented severe developmental delays with delayed acquisition of all markers. The prevalence of exclusive breastfeeding until 6 months was law (14.3%) and a significant percentage of feeding difficulty (57,1%). This aspect reflected the delay in the introduction of complementary feeding (mean age of 7.1 months) and non-progression to the family diet in 22.6%. As to the complementary evaluation, cerebral malformations compatible with congenital Zika infection were detected in all children, ocular involvement was diagnosed in 42 infants (54.5%), and in half (50.7%) cardiac anomalies were observed. The main clinical morbidity observed was upper airways infection, followed by intestinal constipation. Conclusions: Infants with Congenital Zika Syndrome exhibited anthropometric growth impairment, as well as a severe delay in the acquisition of neuromotor development markers. It was found low prevalence of exclusive breastfeeding until 6 months, with a high frequency of feeding difficulties. There was also a significant number of infants who presented irritability, convulsion and spasticity. This study reinforces the need for specialized multiprofessional follow-up aimed at rehabilitation therapies and support to the family members involved.