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Microcephaly epidemic in Brazil: An earlier chapter - 28/04/21

Doi : 10.1016/j.medmal.2020.10.024 
A. Medeiros Figueiredo a, b, , P. Sanchez-Villegas c, d, D. Cristina Moreira Marculino Figueiredo e, J. Sousa Soares de Araujo a, A. Daponte-Codina c, d
a Health Promotion Department, Universidade Federal da Paraíba, Campus I, Jardim Universitário, S/N, 58051-900 Castelo Branco, João Pessoa–Paraíba State, Brazil 
b Health Sciences Postgraduate Program, Universidade Federal do Rio Grande do Norte, Natal, Brazil 
c CIBER of Epidemiology and Public Health (CIBERESP), avenue Monforte-de-Lemos, 3-5, Pabellón 11, Planta 0, 28029 Madrid, Spain 
d Andalusian Observatory on Environment and Health (OSMAN), Escuela Andaluza de Salud Pública, Cuesta del Observatorio 4, Campus Universitario de Cartuja, 18080 Granada, Spain 
e Department of Statistics, Postgraduate program in decision and health models, Universidade Federal da Paraíba, Campus I, Jardim Universitário, S/N, 58033-455 Conj. Pres. Castelo Branco III, João Pessoa–Paraíba State, Brazil 

Corresponding author at: Health Promotion Department, Universidade Federal da Paraíba, Campus I, Jardim Universitário, S/N, 58051-900 Castelo Branco, João Pessoa–Paraíba State, Brazil.Health Promotion Department, Universidade Federal da Paraíba, Campus I, Jardim Universitário, S/NCastelo Branco, João Pessoa–Paraíba State58051-900Brazil

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Highlights

The first cases of Zika virus infection and microcephaly in Brazil were reported in 2015. A retrospective study in French Polynesia showed similar results and reinforced the hypothesis of association.
Phylogenetic analyses indicate that Zika virus may have reached Northeast Brazil between the 3rd quarter of 2013 and the 1st half of 2014.
This report is based on the measurement of the head circumference of 62,298 newborns from 2014 to 2017. Premature, newborns of mothers under 20 years of age and those born in 2014 and 2015 had a higher risk of microcephaly.
This study presents evidence that the increase in the incidence of microcephaly has occurred since 2014. Knowledge about the beginning of the transmission of Zika virus is important in qualifying the processes of epidemiological surveillance and increasing the capacity to face new epidemics worldwide.

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Abstract

Objective

Identify risk factors for microcephaly and evaluate historical trends of microcephaly and arboviruses to recognize patterns and anomalies that indicate the beginning of the microcephaly epidemic associated with Zika infection.

Methods

The head circumferences of 62,298 newborns was analyzed to identify cases of microcephaly between 2014 and 2017. We compared the groups of newborns with normal head circumferences and those with microcephaly to identify risk factors. A time series with the incidences of microcephaly was analyzed to assess the appearance of anomalous values in order to identify the beginning of the microcephaly epidemic. Data on the incidence of dengue fever was used to develop a control chart, aiming to identify changes in incidence and seasonality that could suggest the circulation of a new arbovirus.

Findings

Premature newborns, children of mothers under 20 years of age and those born in 2014 and 2015 had a higher risk of microcephaly. Three quarters with anomalous incidences of microcephaly were identified, the first in 2014 and the others in 2015. The dengue fever epidemic curve in 2013 shows persistence of high incidences in atypical periods, suggesting the entry of a new virus in the 3rd and 4th quarters.

Conclusions

These findings represent epidemiological evidence of the existence of cases of Zika virus between the 2nd quarter of 2013 and the beginning of 2014. The results add new elements to understanding the Zika virus epidemic in the Americas.

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Keywords : Microcephaly, ZIKV, Virus Epidemics, Epidemic, Cross-sectional Study


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Vol 51 - N° 3

P. 260-265 - mai 2021 Retour au numéro
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