A Birth Cohort Follow-Up Study on Congenital Zika Virus Infection in Vietnam
Michiko Toizumi1, Cuong Nguyen Vu2, Hai Thi Huynh2
1Department of Pediatric Infectious Diseases, Institute of Tropical Medicine, Nagasaki University, Nagasaki 852-8523, Japan.
Insights
Children with congenital Zika virus (ZIKV) infection showed near-typical development and no brain or eye abnormalities by preschool age. Longer follow-up is recommended for congenital Zika virus (ZIKV) infected children.
Area of Science:
- Pediatrics
- Neurology
- Infectious Diseases
Background:
- Congenital Zika virus (ZIKV) infection (CZI) can impact child development.
- Longitudinal assessment of neurodevelopmental and sensory outcomes in CZI is crucial.
Purpose of the Study:
- To evaluate the development, sensory status, and brain structure of children with CZI at early childhood stages.
- To identify potential long-term effects of ZIKV exposure in utero.
Main Methods:
- Assessed 12 children with CZI using developmental (ASQ-3, ASQ:SE-2), autism screening, auditory (AABR), and vision (SVS) tests.
- Performed brain CT and MRI, alongside detailed ophthalmological examinations.
- Followed children from 23-25.5 months to 51-62 months of age.
Main Results:
- Most children demonstrated age-appropriate development, passing auditory and vision screenings.
- Minor developmental delays were noted in specific domains (communication, motor skills) in a few children.
- Brain imaging revealed no significant abnormalities, except for cerebellar hypoplasia in a child with Down syndrome.
Conclusions:
- Children with CZI generally exhibit near-typical development and no major brain or eye abnormalities by preschool age.
- Early detection and intervention remain important for CZI cases.
- Continued, careful long-term follow-up is essential for monitoring CZI outcomes.
Abstract:
We assessed the development, sensory status, and brain structure of children with congenital Zika virus (ZIKV) infection (CZI) at two years and preschool age. CZI was defined as either ZIKV RNA detection or positive ZIKV IgM and neutralization test in the cord or neonatal blood. Twelve children with CZI born in 2017-2018 in Vietnam, including one with Down syndrome, were assessed at 23-25.5 months of age, using Ages and Stages Questionnaire (ASQ-3), ASQ:Social-Emotional (ASQ:SE-2), Modified Checklist for Autism in Toddlers, automated auditory brainstem response (AABR), and Spot Vision Screener (SVS). They underwent brain CT and MRI. They had detailed ophthalmological examinations, ASQ-3, and ASQ:SE-2 at 51-62 months of age. None had birthweight or head circumference z-score < -3 except for the one with Down syndrome. All tests passed AABR (n = 10). No ophthalmological problems were detected by SVS (n = 10) and detailed examinations (n = 6), except for a girl's astigmatism. Communication and problem-solving domains in a boy at 24 months, gross-motor area in a boy, and gross-motor and fine-motor areas in another boy at 59-61 months were in the referral zone. Brain CT (n = 8) and MRI (n = 6) revealed no abnormalities in the cerebrum, cerebellum, or brainstem other than cerebellar hypoplasia with Down syndrome. The CZI children were almost age-appropriately developed with no brain or eye abnormalities. Careful and longer follow-up is necessary for children with CZI.
