A study carried out by the Center for Data Integration and Knowledge for Health (Cidacs), of Fiocruz Bahia, followed 3,308 babies with congenital Zika syndrome up to the age of 3 years and identified a rate mortality 11 times higher than that of children without the disease. The main causes of death vary by age and among them are congenital anomalies, infectious and parasitic diseases and causes related to the central nervous system.
The study was published today (24) by the Oswaldo Cruz Foundation (Fiocruz) and published in the scientific journal The New England Journal of Medicine. This is the first survey to follow children diagnosed with the syndrome up to the third year of life and is part of the Long-Term Monitoring Platform for Zika and its Consequences, coordinated by Cidacs/Fiocruz Bahia.
To arrive at this sample of more than 3,000 children with the congenital syndrome, the data of more than 11 million newborns registered in the Live Birth Information System (Sinasc) between 2015 and 2018 were analyzed.
Congenital Zika syndrome is caused by changes in the central nervous system of babies caused when the virus infects mothers during pregnancy. The best known form of the disease is microcephaly, but there are also functional abnormalities, such as difficulty swallowing, or clinical sequelae, such as epilepsy.
Among the more than 3,000 children with the disease followed, there were 398 deaths until the age of 3 years. The researchers identified that for babies born at less than 32 weeks or less than 1.5 kg, there is no difference in mortality when children with the syndrome are compared to those without.
For children born between 32 and 36 weeks, the syndrome caused by Zika multiplies by nine the risks of dying before the age of 3 years. And for those born after 37 weeks, this risk is multiplied by 14.
The study also shows that the increased risk of dying extends throughout the life span analyzed. Up to 28 days of life, the risk is seven times higher than for children without the syndrome. Between 1 and 3 years, the possibility is 22 times greater.
One of the study’s authors, research associate at Cidacs and assistant professor at the London School of Hygiene & Tropical Medicine (LSHTM) Enny Paixão, explained to Fiocruz News Agency that such alarming figures require action after birth to help improve the survival of these children. “We need well-established postnatal protocols, including early intervention, to help reduce sequelae and improve survival,” he argues.
Another author of the work, professor at the Federal University of Bahia (UFBA) and associate researcher at Cidacs/Fiocruz Bahia Glória Teixeira, stressed the importance of increasing the availability of neonatal beds to prevent deaths from the syndromes congenital neurological.
“We observed that children died more often in places with few NICU beds. These children need rehabilitation centers: they are born with fewer neurons and with damaged neurons, but they have neurons that can be stimulated, which can improve cognition and motor processing,” he told Fiocruz de Noticias.
“It is essential to provide services and trained professionals for assistance at the local level. Health Watch executives and technicians at the three levels of management must exchange information and think about strategies to capillarize actions,” said the professor.
The researchers also draw attention to the importance of preventing infection with the zika virus, which is one of the arboviruses carried by the Aedes aegypti mosquito. One of the main preventive measures against the proliferation of the mosquito is to avoid the accumulation of calm and open water, where the insect can lay its eggs and reproduce.