Analysis of functional performance of infants with congenital zika syndrome: longitudinal study
DOI:
https://doi.org/10.1590/1809-2950/18001626022019Keywords:
Child Development, Zika Virus, InfantAbstract
This study aimed to longitudinally evaluate the functional performance of infants affected by Congenital Zika Syndrome (CZS). A study was carried out with infants from the Laboratório de Estudos em Pediatria of the Universidade Federal de Pernambuco and the Aliança de Mães e Famílias Raras, aged between 6 and 24 months, of both genders. The Pediatric Evaluation of Disability Inventory (PEDI) was applied to analyze functional performance in two evaluations, with a minimum of six months interval between them. Data analysis was performed using the Wilcoxon test. In the sample of 16 infants, we observed a change in the classification from normal to delay in the domains of self-care and social function, with a significant decrease in normative scores (p=0.001 and p<0.001, respectively); in the mobility, individuals initially classified with delay also presented reduction of normative scores (p=0.001), remaining in the same classification. Despite the significant increase in gross self-care scores (p=0.024) and mobility (p=0.001), infants remained classified as delayed. Caregiver care was analyzed in these evaluation, in which 100% of infants were delayed in all three domains of the PEDI, receiving maximum or full care. The main environmental modifications were those focused on the child. We concluded that infants with CZS presented significant delays in functional performance, with a slow evolution in the evaluated range.
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References
World Health Organization [Internet]. Geneva: World Health
Organization; 2016 [cited 2017 Aug 31]. WHO statement on the
first meeting of the International Health Regulations (2005)
(IHR 2005) Emergency Committee on Zika virus and observed
increase in neurological disorders and neonatal malformations.
Available from: http://www.who.int/mediacentre/news/
statements/2016/1st-emergency-committee-zika/en/
Eickmann SH, Carvalho MDCG, Ramos RC, Rocha MA, Van
Der Linden V, Silva PS. Síndrome da infecção congênita
pelo vírus Zika. Cad Saúde Pública. 2016;32(7):1-3. doi:
1590/0102-311X00047716
Kapogiannis BG, Chakhtoura N, Hazra R, Spong CY. Bridging
knowledge gaps to understand how Zika virus exposure
and infection affect child development. JAMA Pediatr.
;171(5):478. doi: 10.1001/jamapediatrics.2017.0002
Ventura CV, Maia M, Ventura BV, van der Linden V, Araujo
EB, Ramos RC, et al. Ophthalmological findings in infants
with microcephaly and presumable intra-uterus Zika
virus infection. Arq Bras Oftalmol. 2016;79(1):1-3. doi:
5935/0004-2749.20160002
Leal MC, Muniz LF, Ferreira TSA, Santos CM, Almeida LC, van
der Linden V, et al. Hearing loss in infants with microcephaly
and evidence of congenital zika virus infection – Brazil,
November 2015 – May 2016. MMWR Morb Mortal Wkly Rep.
;65(34):917-9. doi: 10.15585/mmwr.mm6534e3
Alves LV, Cruz DDCS, van der Linden AMC, Falbo AR, Mello
MJG, Paredes CE, et al. Crises epilépticas em crianças com
síndrome congênita do Zika vírus. Rev Bras Saúde Matern
Infant. 2016;16:33-7. doi: 10.1590/1806-9304201600s100003
Brasil. Ministério da Saúde. Orientações integradas de vigilância
e atenção à saúde no âmbito da emergência de saúde pública
de importância nacional: procedimentos para o monitoramento
das alterações no crescimento e desenvolvimento a partir da
gestação até a primeira infância, relacionadas à infecção pelo vírus zika e outras etiologias infeciosas dentro da capacidade
operacional do SUS. Brasília, DF: Ministério da Saúde; 2017
[cited 2019 Apr 30]. Available from: http://portalarquivos.
saude.gov.br/images/pdf/2016/12/orientacoes-integradasvigilancia-atencao.pdf
World Health Organization. Screening, assessment and
management of neonates and infants with complications
associated with zika virus exposure in utero. Geneva: World Health
Organization; 2016 [cited 2019 Apr 30]. Available from: http://www.
who.int/csr/resources/publications/zika/assessment-infants/en/
Aragao MFV, van der Linden V, Brainer-Lima AM, Ramos RC,
Rocha MA, Silva PS, et al. Clinical features and neuroimaging
(CT and MRI) findings in presumed zika virus related congenital
infection and microcephaly: retrospective case series study.
BMJ. 2016;353(i1901):1-10. doi: 10.1136/bmj.i1901
van der Linden V, Pessoa A, Dobyns W, Barkovich AJ, Ribeiro
EM, Leal MD, et al. Description of 13 infants born during october
-january 2016 with congenital zika virus infection without
microcephaly at birth – Brazil. MMWR Morb Mortal Wkl.
;65(47):1343-8. doi: 10.15585/mmwr.mm6547e2
Petribu NC, Aragão MFV, van der Linden V, Parizel P, Jungmann
P, Araújo L, et al. Follow-up brain imaging of 37 children
with congenital zika syndrome: case series study. BMJ.
;359:j4188. doi.org/10.1136/bmj.j4188
Brasil. Ministério da Saúde. Secretaria de Atenção à Saúde.
Diretrizes de estimulação precoce: crianças de zero a 3 anos
com atraso no desenvolvimento neuropsicomotor decorrente
de microcefalia. Brasília, DF: Ministério da Saúde; 2016. 123 p.
Haley SM, Coster WJ, Ludlow L, Haltiwanger J, Andrellos P.
Pediatric evaluation of disability inventory: development,
standardization and administration manual. Trustees of Boston
University Boston, MA; 1992.
Mancini MC. Inventário de avaliação pediátrica de incapacidade
(PEDI): manual da versão brasileira adaptada. Belo Horizonte:
UFMG; 2005.
Zwicker JG, Missiuna C, Harris SR, Boyd LA. Developmental
coordination disorder: a review and update. Eur J Paediatr
Neurol. 2012;16(6):573-81. doi: 10.1016/j.ejpn.2012.05.005
Lee B-H. Relationship between gross motor function and
the function, activity and participation components of the
International Classification of Functioning in children with
spastic cerebral palsy. J Phys Ther Sci. 2017;29:1732-6. doi:
1589/jpts.29.1732
Nissen S, Purssell E, Shaw K, Bailey C, Efstathiou N, Dunford
C. Impaired mobility associated with an increased likelihood
of death in children: a systematic review. J Child Heal Care.
;136749351773283. doi: 10.1177/1367493517732839
Botelho AC, Neri LV, Silva MQF, Lima TT, Santos KG, et al. Infecção
congênita presumível por Zika vírus: achados do desenvolvimento
neuropsicomotor: relato de casos. Rev Bras Saúde Matern Infant.
(1):45-50. doi.org/10.1590/1806-9304201600S100004
Ryan J, Cassidy E, Nooduyn S, O’Connell N. Exercise
interventions for cerebral palsy (Review). Cochrane Database
Syst Rev. 2017;(6):1-199. doi: 10.1002/14651858.CD011660
Alriksson-Schmidt A, Hagglund G. Pain in children and
adolescents with cerebral palsy: a population-based registry
study. Acta Paediatr. 2016;105:665-70. doi: 10.1111/apa.13368
Mancini MC, Alves, Schaper C, Figueiredo EM, Sampaio, Coelho
ZAC, et al. Gravidade da paralisia cerebral e desempenho
funcional. Rev Bras Fisioter. 2004;8(3):253-60.
Brandao MB, Gonçalves SC, Carvalho LASRP, Crepaldi PV,
Abrahão LC, Mambrini JVM, et al. Clusters of daily functioning
and classification levels: agreement of information in children
with cerebral palsy. J Pediatr Rehabil Med. 2012;5(3):151-8. doi:
3233/PRM-2012-0207
Pavão L, Silva S, Rocha C. Efeito da orientação domiciliar no
desempenho funcional de crianças com necessidades especiais.
Motricidade. 2011;7:21-9. doi: 10.6063/motricidade.7(1).117
Cury V, Mancini M, Melo A, Fonseca S, Sampaio R, Tirado M.
Efeitos do uso de órtese na mobilidade funcional de crianças
com paralisia cerebral. Rev Bras Fisioter. 2006;10(1):67-74. doi:
1590/S1413-35552006000100009
Henderson S, Skelton H, Rosenbaum P. Assistive devices for
children with functional impairments: impact on child and
caregiver function. Dev Med Child Neurol. 2008; 50(2):89-98.
doi: 10.1111/j.1469-8749.2007.02021.x
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