Long-term developmental outcomes of children with congenital Zika syndrome
Fernanda J P Marques1, Lani Tran2,3, Youssef A Kousa2,3,4,5
1SARAH Network Rehabilitation Hospitals, Rio de Janeiro, Rio de Janeiro, Brazil. fernandajpmarques@gmail.com.
Insights
Eight years post-epidemic, children with Congenital Zika Syndrome (CZS) face severe developmental and functional challenges, including mobility and vision impairments. Continued specialized care is crucial for their quality of life.
Area of Science:
- Neurology
- Developmental Pediatrics
- Public Health
Background:
- Ongoing health challenges persist for children with Congenital Zika Syndrome (CZS) and their families eight years after Brazilian epidemics.
- Prenatal exposure to Zika virus can cause significant brain injury, leading to long-term developmental issues.
Purpose of the Study:
- To characterize the impact of virally induced prenatal brain injury on the development and functional outcomes of children with CZS.
- To assess long-term clinical and functional characteristics in a cohort of children diagnosed with CZS.
Main Methods:
- A cross-sectional study was conducted on a consecutive series of children diagnosed with CZS.
- Validated neurodevelopmental assessments were used to evaluate gross motor function, manual ability, communication, eating/drinking, and visual function.
- The Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), Communication Function Classification System (CFCS), Eating and Drinking Ability Classification System (EDACS), and Visual Function Classification System (VFCS) were utilized.
Main Results:
- The study included 60 children with CZS, noting high rates of comorbidities like epilepsy (90.0%) and undernutrition (38.3%).
- Severe functional limitations were prevalent: 86.7% at Level V in GMFCS, 85.0% in MACS, and 68.3% in CFCS.
- Significant challenges were observed in eating/drinking (68.3% dysphagia, 31.7% tube feeding dependence) and vision (38.3% at VFCS Level IV).
Conclusions:
- Congenital Zika Syndrome is linked to severe functional impairments and comorbidities, negatively affecting child development and quality of life.
- Persistent challenges in mobility, vision, and feeding highlight the ongoing needs of children with CZS.
- These findings underscore the necessity for sustained support and specialized medical care for affected children.
Background:
Eight years after the epidemics in Brazil, children with congenital Zika syndrome (CZS) and their families confront ongoing health challenges.
Objective:
This study aims to characterize how virally induced prenatal brain injury impacts development and functional outcomes among children diagnosed with CZS.
Methods:
We performed a cross-sectional study of a consecutive series of children diagnosed with CZS. Using validated neurodevelopmental assessments, we evaluated gross motor function, manual ability, communication, eating and drinking, and visual function.
Results:
Sixty children (29 males, and 31 females) met the inclusion criteria for the study. Comorbidities such as epilepsy (90.0%) and undernutrition (38.3%), along with clinical conditions including dysphagia (68.3%) and dependence on tube feeding (31.7%), were observed. Our results demonstrate a majority of children at level V - the most severe level within a five-tier system - in the Gross Motor Function (86.7%), Manual Ability (85.0%), Communication Function (68.3%), Eating and Drinking Ability (40.0%) Classification Systems, and level IV in the Visual Function Classification System (38.3%).
Conclusion:
CZS is associated with severe functional impairments and comorbidities, adversely impacting child development and quality of life. These findings reveal persistent challenges affecting the functioning of children with CZS, underscoring the need for continued support and specialized care.
Impact:
This study aimed to characterize the long-term clinical and functional characteristics of a subset of children with Congenital Zika Syndrome (CZS). We found that eight years after the Brazilian Zika epidemic, this subset of children with CZS continues to demonstrate major functional limitations impacting mobility, vision, and the ability to eat and drink. Our analysis documented a very high level of disability in several key functional classification systems. Notably, applying a new instrument for visual ability among children diagnosed with cerebral palsy, we found that more than 60% of the study group have poor or very poor visual function.
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