RESUMEN
INTRODUCTION: The Zika virus (ZIKV) is an arbovirus isolated for the first time in 1947 and transmitted to humans by the Aedes aegypti mosquito. In Brasil, it was first detected in May 2015. Since then, ZIKV has been identified as the etiological agent of acute exanthematous disease in Brasil, and Neuropediatricians of the Recife warned about an epidemic of microcephaly, and the Brazilian Ministry of Health confirmed the association between ZIKV and Congenital malformations and neurological syndromes. The eye, as an extension of the developing brain, has been examined in patients with microcephaly and maternal history of ZIKV infection. METHODS: Twenty newborn patients with microcephaly, whose mothers had presumed Zika virus during pregnancy, were analyzed through medical records. The nonparametric chi-square statistic was used to verify the association between head circumference and ocular alteration at a significance level of 0.0001. RESULTS: The significance of P = 0.000 in the value of non-parametric chi-square statistics was lower than the value of α = 0.0001, demonstrating that, at a level of 0.0001, there is an association between head circumference and ocular alteration. CONCLUSION: Although the knowledge of the natural evolution of the disease is still scarce, the current evidence is strong enough to establish a causal relationship between ZIKV infection during pregnancy and the increased incidence of the microcephaly and serious eye alterations that lead to the severe lower vision of these children.
Asunto(s)
Cefalometría , Oftalmopatías/virología , Microcefalia/virología , Infección por el Virus Zika/complicaciones , Brasil , Oftalmopatías/patología , Femenino , Cabeza/patología , Humanos , Lactante , Masculino , Microcefalia/patología , Valores de ReferenciaRESUMEN
SUMMARY INTRODUCTION: The Zika virus (ZIKV) is an arbovirus isolated for the first time in 1947 and transmitted to humans by the Aedes aegypti mosquito. In Brasil, it was first detected in May 2015. Since then, ZIKV has been identified as the etiological agent of acute exanthematous disease in Brasil, and Neuropediatricians of the Recife warned about an epidemic of microcephaly, and the Brazilian Ministry of Health confirmed the association between ZIKV and Congenital malformations and neurological syndromes. The eye, as an extension of the developing brain, has been examined in patients with microcephaly and maternal history of ZIKV infection. METHODS: Twenty newborn patients with microcephaly, whose mothers had presumed Zika virus during pregnancy, were analyzed through medical records. The nonparametric chi-square statistic was used to verify the association between head circumference and ocular alteration at a significance level of 0.0001. RESULTS: The significance of P = 0.000 in the value of non-parametric chi-square statistics was lower than the value of α = 0.0001, demonstrating that, at a level of 0.0001, there is an association between head circumference and ocular alteration. CONCLUSION: Although the knowledge of the natural evolution of the disease is still scarce, the current evidence is strong enough to establish a causal relationship between ZIKV infection during pregnancy and the increased incidence of the microcephaly and serious eye alterations that lead to the severe lower vision of these children.
RESUMO: INTRODUÇÃO: O vírus Zika (ZIKV) é um arbovírus isolado pela primeira vez no ano de 1947, sendo transmitido para o homem pelo mosquito Aedes aegypti. No Brasil foi detectado pela primeira vez em maio de 2015. Desde então, ZIKV foi identificado como o agente etiológico da doença exantemática aguda no Brasil, e neuropediatras do Recife deram o sinal de alerta sobre uma epidemia de microcefalia, tendo o Ministério da Saúde do Brasil confirmado a associação entre ZIKV e malformações congênitas e síndromes neurológicas. O olho, sendo uma extensão do cérebro em desenvolvimento, tem sido examinado em pacientes com microcefalia e história materna de infecção por ZIKV. MÉTODO: Foram analisados, por meio de prontuário médico, 20 pacientes recém-nascidos, portadores de microcefalia, cujas mães tiveram presumidamente Zika vírus durante a gestação. A estatística não paramétrica Qui-Quadrado foi utilizada para verificar a associação entre perímetro cefálico e alteração ocular, no nível de significância de 0,0001. RESULTADOS: A significância de P=0,000 no valor da estatística não paramétrica de Qui-Quadrado foi menor do que o valor de α = 0,0001, demonstrando que podemos afirmar que, em um nível de 0,0001, há uma associação entre o perímetro cefálico e a alteração ocular. CONCLUSÃO: Apesar de ainda serem escassos os conhecimentos sobre a evolução natural da doença, as evidências atuais são fortes o suficiente para estabelecermos a relação causal entre a infecção pelo ZIKV durante a gravidez e o aumento da frequência da microcefalia e alterações oculares graves que levam à baixa severa da visão dessas crianças.