Characterizing Disabilities in Preschool Aged Children with Congenital Zika Virus Syndrome with the ICF Model
Laura Cristina Machado Ribeiro de Souza1, Carla Trevisan Martins Ribeiro1, Tatiana Hamanaka1
1National Institute of Women, Children and Adolescents Health Fernandes Figueira, Oswaldo Cruz, Foundation (IFF-Fiocruz), Avenida Rui Barbosa, 716, Flamengo, Rio de Janeiro 22250-020, Brazil.
Insights
Congenital Zika Syndrome (CZS) causes severe, widespread disabilities in children, impacting cognition, speech, and motor skills. This study highlights the critical need for comprehensive health planning and support for affected children.
Area of Science:
- Pediatrics
- Neurology
- Public Health
Background:
- Congenital Zika Syndrome (CZS) presents significant challenges for child development and requires thorough understanding for effective health planning.
- The biopsychosocial model, through the International Classification of Functioning, Disability and Health (ICF), offers a framework to assess these complex disabilities.
Purpose of the Study:
- To describe the functioning and disabilities in children over 3 years old with CZS.
- To characterize disabilities using the ICF framework based on clinical and motor development evaluations.
Main Methods:
- A cohort study was conducted with 50 children diagnosed with CZS, aged over 3 years.
- Disability assessment involved clinical evaluations and motor development assessments, analyzed within the ICF model.
Main Results:
- Nearly all children (94%) exhibited severe impairment, with 92% having microcephaly and universal central nervous system imaging abnormalities.
- Common issues included cognitive impairment (92%), muscle tone problems (90%), and speech deficits (94%).
- Movement limitations were pervasive (80-94%), especially in postural transfers and displacements. Environmental factors like access to health services were noted.
Conclusions:
- Children with CZS experience profound and persistent disabilities beyond age 3, particularly affecting motor function.
- ICF-based assessments are valuable for evaluating health domains and informing interventions for CZS.
- This research underscores the long-term impact of CZS and the necessity for tailored support systems.
Abstract:
Understanding functioning and disabilities in children with Congenital Zika Syndrome (CZS) is essential for health planning. We describe disabilities present in children with CZS followed in a reference hospital in Rio de Janeiro, Brazil, based on the biopsychosocial model of the International Classification of Functioning, Disability and Health (ICF). This was a cohort study of children >3 years of age with CZS. Disability was characterized through outcomes related to ICF components assessed via clinical and motor development evaluations. Among 50 children, with a median age of 40 months, 47 (94%) presented with severe impairment and 46 (92%) had microcephaly. Damage to the head and neck was found in most children, with abnormal central nervous system imaging universally present. Most children had cognitive impairment (92%), muscle tone problems (90%), and speech deficits (94%). We found movement limitations in all categories but more pervasively (80−94%), in postural transfers and displacements. The main environmental factors identified in the ICF model were the use of products or substances for personal consumption and access to health services. Children with CZS have extremely high rates of disability beyond aged 3 years, particularly regarding motor activity. ICF-based models can contribute to the assessment of health domains.
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