Reference Citation Analysis: Find an Article, Find a Category, Find a Journal, Find a Scholar

Download

Total Articles

4
(from Reference Citation Analysis)

Article PDFs (1)

Cited by > 0 (3)

Searched Name

Christina M Winfield

Ranked By

Results Analysis

Year Published Analysis
Article Type Analysis
Publication Title Analysis
Category Analysis

Results Analysis

Indexed Articles

Year Published

Show more Refine

Article Type

Show more Refine

Article Statistics

Refine

MESH Headings

Show more Refine

First Author

Show more Refine

First Author Affiliations

Show more Refine

Authors

Show more Refine

Publication Titles

Show more Refine

Grant Agencies

Show more Refine

Countries/Regions

Show more Refine

Affiliations

Show more Refine

Corresponding Author Affiliations

Show more Refine

Category

Show more Refine

Number

Citation Analysis

Holman EJ, Winfield CM, Borkowf CB, Kauerauf J, Baur C, Ahmed S, Funk M, Pinsoneault A, Barnes A, Hutcherson H, Oberholtzer Z, Carter B, Ruth LJ, Thomas ES. Evaluation of Serial Testing After Exposure to COVID-19 in Early Care and Education Facilities, Illinois, March-May 2022. Public Health Rep 2023:333549231173014. [PMID: 37178058 PMCID: PMC10185474 DOI: 10.1177/00333549231173014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/15/2023] Open

Mercado-Reyes M, Gilboa SM, Valencia D, Daza M, Tong VT, Galang RR, Winfield CM, Godfred-Cato S, Benavides M, Villanueva JM, Thomas JD, Daniels J, Zaki S, Reagan-Steiner S, Bhatnagar J, Schiffer J, Steward-Clark E, Ricaldi JN, Osorio J, Sancken CL, Pardo L, Tinker SC, Anderson KN, Rico A, Burkel VK, Hojnacki J, Delahoy MJ, González M, Osorio MB, Moore CA, Honein MA, Ospina Martinez ML. Pregnancy, Birth, Infant, and Early Childhood Neurodevelopmental Outcomes among a Cohort of Women with Symptoms of Zika Virus Disease during Pregnancy in Three Surveillance Sites, Project Vigilancia de Embarazadas con Zika (VEZ), Colombia, 2016-2018. Trop Med Infect Dis 2021;6:183. [PMID: 34698287 PMCID: PMC8544689 DOI: 10.3390/tropicalmed6040183] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Revised: 09/18/2021] [Accepted: 10/07/2021] [Indexed: 01/16/2023] Open

Abstract

Project Vigilancia de Embarazadas con Zika (VEZ), an intensified surveillance of pregnant women with symptoms of the Zika virus disease (ZVD) in Colombia, aimed to evaluate the relationship between symptoms of ZVD during pregnancy and adverse pregnancy, birth, and infant outcomes and early childhood neurodevelopmental outcomes. During May-November 2016, pregnant women in three Colombian cities who were reported with symptoms of ZVD to the national surveillance system, or with symptoms of ZVD visiting participating clinics, were enrolled in Project VEZ. Data from maternal and pediatric (up to two years of age) medical records were abstracted. Available maternal specimens were tested for the presence of the Zika virus ribonucleic acid and/or anti-Zika virus immunoglobulin antibodies. Of 1213 enrolled pregnant women with symptoms of ZVD, 1180 had a known pregnancy outcome. Results of the Zika virus laboratory testing were available for 569 (48.2%) pregnancies with a known pregnancy outcome though testing timing varied and was often distal to the timing of symptoms; 254 (21.5% of the whole cohort; 44.6% of those with testing results) were confirmed or presumptive positive for the Zika virus infection. Of pregnancies with a known outcome, 50 (4.2%) fetuses/infants had Zika-associated brain or eye defects, which included microcephaly at birth. Early childhood adverse neurodevelopmental outcomes were more common among those with Zika-associated birth defects than among those without and more common among those with laboratory evidence of a Zika virus infection compared with the full cohort. The proportion of fetuses/infants with any Zika-associated brain or eye defect was consistent with the proportion seen in other studies. Enhancements to Colombia's existing national surveillance enabled the assessment of adverse outcomes associated with ZVD in pregnancy.

Collapse

Affiliation(s)

Marcela Mercado-Reyes Instituto Nacional de Salud, Bogotá 111321, Colombia; (M.M.-R.); (M.D.); (M.B.); (L.P.); (A.R.); (M.G.); (M.B.O.); (M.L.O.M.)
Suzanne M. Gilboa National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA; (D.V.); (V.T.T.); (C.M.W.); (S.G.-C.); (C.L.S.); (S.C.T.); (K.N.A.); (C.A.M.); (M.A.H.)
Diana Valencia National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA; (D.V.); (V.T.T.); (C.M.W.); (S.G.-C.); (C.L.S.); (S.C.T.); (K.N.A.); (C.A.M.); (M.A.H.)
Marcela Daza Instituto Nacional de Salud, Bogotá 111321, Colombia; (M.M.-R.); (M.D.); (M.B.); (L.P.); (A.R.); (M.G.); (M.B.O.); (M.L.O.M.) Research Division, Vysnova Partners, Landover, MD 20785, USA;
Van T. Tong National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA; (D.V.); (V.T.T.); (C.M.W.); (S.G.-C.); (C.L.S.); (S.C.T.); (K.N.A.); (C.A.M.); (M.A.H.)
Romeo R. Galang National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA;
Christina M. Winfield National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA; (D.V.); (V.T.T.); (C.M.W.); (S.G.-C.); (C.L.S.); (S.C.T.); (K.N.A.); (C.A.M.); (M.A.H.)
Shana Godfred-Cato National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA; (D.V.); (V.T.T.); (C.M.W.); (S.G.-C.); (C.L.S.); (S.C.T.); (K.N.A.); (C.A.M.); (M.A.H.)
Mónica Benavides Instituto Nacional de Salud, Bogotá 111321, Colombia; (M.M.-R.); (M.D.); (M.B.); (L.P.); (A.R.); (M.G.); (M.B.O.); (M.L.O.M.) Research Division, Vysnova Partners, Landover, MD 20785, USA;
Julie M. Villanueva National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA; (J.M.V.); (J.D.T.); (J.D.); (S.Z.); (S.R.-S.); (J.B.)
Jennifer D. Thomas National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA; (J.M.V.); (J.D.T.); (J.D.); (S.Z.); (S.R.-S.); (J.B.)
Jonathan Daniels National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA; (J.M.V.); (J.D.T.); (J.D.); (S.Z.); (S.R.-S.); (J.B.)
Sherif Zaki National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA; (J.M.V.); (J.D.T.); (J.D.); (S.Z.); (S.R.-S.); (J.B.)
Sarah Reagan-Steiner National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA; (J.M.V.); (J.D.T.); (J.D.); (S.Z.); (S.R.-S.); (J.B.)
Julu Bhatnagar National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA; (J.M.V.); (J.D.T.); (J.D.); (S.Z.); (S.R.-S.); (J.B.)
Jarad Schiffer National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA; (J.S.); (E.S.-C.)
Evelene Steward-Clark National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA; (J.S.); (E.S.-C.)
Jessica N. Ricaldi National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA;
Johana Osorio Research Division, Vysnova Partners, Landover, MD 20785, USA;
Christina L. Sancken National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA; (D.V.); (V.T.T.); (C.M.W.); (S.G.-C.); (C.L.S.); (S.C.T.); (K.N.A.); (C.A.M.); (M.A.H.)
Lissethe Pardo Instituto Nacional de Salud, Bogotá 111321, Colombia; (M.M.-R.); (M.D.); (M.B.); (L.P.); (A.R.); (M.G.); (M.B.O.); (M.L.O.M.)
Sarah C. Tinker National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA; (D.V.); (V.T.T.); (C.M.W.); (S.G.-C.); (C.L.S.); (S.C.T.); (K.N.A.); (C.A.M.); (M.A.H.)
Kayla N. Anderson National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA; (D.V.); (V.T.T.); (C.M.W.); (S.G.-C.); (C.L.S.); (S.C.T.); (K.N.A.); (C.A.M.); (M.A.H.)
Angelica Rico Instituto Nacional de Salud, Bogotá 111321, Colombia; (M.M.-R.); (M.D.); (M.B.); (L.P.); (A.R.); (M.G.); (M.B.O.); (M.L.O.M.)
Veronica K. Burkel Eagle Medical Services, LLC, San Antonio, TX 78248, USA;
Jacob Hojnacki Oak Ridge Institute for Science and Education, Oak Ridge, TN 37830, USA;
Miranda J. Delahoy Eagle Global Scientific, LLC, San Antonio, TX 78248, USA;
Maritza González Instituto Nacional de Salud, Bogotá 111321, Colombia; (M.M.-R.); (M.D.); (M.B.); (L.P.); (A.R.); (M.G.); (M.B.O.); (M.L.O.M.)
May B. Osorio Instituto Nacional de Salud, Bogotá 111321, Colombia; (M.M.-R.); (M.D.); (M.B.); (L.P.); (A.R.); (M.G.); (M.B.O.); (M.L.O.M.)
Cynthia A. Moore National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA; (D.V.); (V.T.T.); (C.M.W.); (S.G.-C.); (C.L.S.); (S.C.T.); (K.N.A.); (C.A.M.); (M.A.H.)
Margaret A. Honein National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA 30329, USA; (D.V.); (V.T.T.); (C.M.W.); (S.G.-C.); (C.L.S.); (S.C.T.); (K.N.A.); (C.A.M.); (M.A.H.)
Martha Lucia Ospina Martinez Instituto Nacional de Salud, Bogotá 111321, Colombia; (M.M.-R.); (M.D.); (M.B.); (L.P.); (A.R.); (M.G.); (M.B.O.); (M.L.O.M.)

Collapse

Ospina ML, Tong VT, Gonzalez M, Valencia D, Mercado M, Gilboa SM, Rodriguez AJ, Tinker SC, Rico A, Winfield CM, Pardo L, Thomas JD, Avila G, Villanueva JM, Gomez S, Jamieson DJ, Prieto F, Meaney-Delman D, Pacheco O, Honein MA. Zika Virus Disease and Pregnancy Outcomes in Colombia. N Engl J Med 2020;383:537-545. [PMID: 32757522 PMCID: PMC7480270 DOI: 10.1056/nejmoa1911023] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]

Abstract

BACKGROUND

In 2015 and 2016, Colombia had a widespread outbreak of Zika virus. Data from two national population-based surveillance systems for symptomatic Zika virus disease (ZVD) and birth defects provided complementary information on the effect of the Zika virus outbreak on pregnancies and infant outcomes.

METHODS

We collected national surveillance data regarding cases of pregnant women with ZVD that were reported during the period from June 2015 through July 2016. The presence of Zika virus RNA was identified in a subgroup of these women on real-time reverse-transcriptase-polymerase-chain-reaction (rRT-PCR) assay. Brain or eye defects in infants and fetuses and other adverse pregnancy outcomes were identified among the women who had laboratory-confirmed ZVD and for whom data were available regarding pregnancy outcomes. We compared the nationwide prevalence of brain and eye defects during the outbreak with the prevalence both before and after the outbreak period.

RESULTS

Of 18,117 pregnant women with ZVD, the presence of Zika virus was confirmed in 5926 (33%) on rRT-PCR. Of the 5673 pregnancies with laboratory-confirmed ZVD for which outcomes had been reported, 93 infants or fetuses (2%) had brain or eye defects. The incidence of brain or eye defects was higher among pregnancies in which the mother had an onset of ZVD symptoms in the first trimester than in those with an onset during the second or third trimester (3% vs. 1%). A total of 172 of 5673 pregnancies (3%) resulted in pregnancy loss; after the exclusion of pregnancies affected by birth defects, 409 of 5426 (8%) resulted in preterm birth and 333 of 5426 (6%) in low birth weight. The prevalence of brain or eye defects during the outbreak was 13 per 10,000 live births, as compared with a prevalence of 8 per 10,000 live births before the outbreak and 11 per 10,000 live births after the outbreak.

CONCLUSIONS

In pregnant women with laboratory-confirmed ZVD, brain or eye defects in infants or fetuses were more common during the Zika virus outbreak than during the periods immediately before and after the outbreak. The frequency of such defects was increased among women with a symptom onset early in pregnancy. (Funded by the Colombian Instituto Nacional de Salud and the Centers for Disease Control and Prevention.).

Collapse

Affiliation(s)

Martha L Ospina From Instituto Nacional de Salud (M.L.O., M.G., M.M., A.J.R, A.R., L.P., G.A., S.G., F.P., O.P.), Bogota, Colombia; and the Centers for Disease Control and Prevention (V.T.T., D.V., S.M.G., S.C.T., C.M.W., J.D.T., J.M.V., D.M.D., M.A.H.) and the Department of Gynecology and Obstetrics, Emory University School of Medicine (D.J.J.), Atlanta
Van T Tong From Instituto Nacional de Salud (M.L.O., M.G., M.M., A.J.R, A.R., L.P., G.A., S.G., F.P., O.P.), Bogota, Colombia; and the Centers for Disease Control and Prevention (V.T.T., D.V., S.M.G., S.C.T., C.M.W., J.D.T., J.M.V., D.M.D., M.A.H.) and the Department of Gynecology and Obstetrics, Emory University School of Medicine (D.J.J.), Atlanta
Maritza Gonzalez From Instituto Nacional de Salud (M.L.O., M.G., M.M., A.J.R, A.R., L.P., G.A., S.G., F.P., O.P.), Bogota, Colombia; and the Centers for Disease Control and Prevention (V.T.T., D.V., S.M.G., S.C.T., C.M.W., J.D.T., J.M.V., D.M.D., M.A.H.) and the Department of Gynecology and Obstetrics, Emory University School of Medicine (D.J.J.), Atlanta
Diana Valencia From Instituto Nacional de Salud (M.L.O., M.G., M.M., A.J.R, A.R., L.P., G.A., S.G., F.P., O.P.), Bogota, Colombia; and the Centers for Disease Control and Prevention (V.T.T., D.V., S.M.G., S.C.T., C.M.W., J.D.T., J.M.V., D.M.D., M.A.H.) and the Department of Gynecology and Obstetrics, Emory University School of Medicine (D.J.J.), Atlanta
Marcela Mercado From Instituto Nacional de Salud (M.L.O., M.G., M.M., A.J.R, A.R., L.P., G.A., S.G., F.P., O.P.), Bogota, Colombia; and the Centers for Disease Control and Prevention (V.T.T., D.V., S.M.G., S.C.T., C.M.W., J.D.T., J.M.V., D.M.D., M.A.H.) and the Department of Gynecology and Obstetrics, Emory University School of Medicine (D.J.J.), Atlanta
Suzanne M Gilboa From Instituto Nacional de Salud (M.L.O., M.G., M.M., A.J.R, A.R., L.P., G.A., S.G., F.P., O.P.), Bogota, Colombia; and the Centers for Disease Control and Prevention (V.T.T., D.V., S.M.G., S.C.T., C.M.W., J.D.T., J.M.V., D.M.D., M.A.H.) and the Department of Gynecology and Obstetrics, Emory University School of Medicine (D.J.J.), Atlanta
Andrea J Rodriguez From Instituto Nacional de Salud (M.L.O., M.G., M.M., A.J.R, A.R., L.P., G.A., S.G., F.P., O.P.), Bogota, Colombia; and the Centers for Disease Control and Prevention (V.T.T., D.V., S.M.G., S.C.T., C.M.W., J.D.T., J.M.V., D.M.D., M.A.H.) and the Department of Gynecology and Obstetrics, Emory University School of Medicine (D.J.J.), Atlanta
Sarah C Tinker From Instituto Nacional de Salud (M.L.O., M.G., M.M., A.J.R, A.R., L.P., G.A., S.G., F.P., O.P.), Bogota, Colombia; and the Centers for Disease Control and Prevention (V.T.T., D.V., S.M.G., S.C.T., C.M.W., J.D.T., J.M.V., D.M.D., M.A.H.) and the Department of Gynecology and Obstetrics, Emory University School of Medicine (D.J.J.), Atlanta
Angelica Rico From Instituto Nacional de Salud (M.L.O., M.G., M.M., A.J.R, A.R., L.P., G.A., S.G., F.P., O.P.), Bogota, Colombia; and the Centers for Disease Control and Prevention (V.T.T., D.V., S.M.G., S.C.T., C.M.W., J.D.T., J.M.V., D.M.D., M.A.H.) and the Department of Gynecology and Obstetrics, Emory University School of Medicine (D.J.J.), Atlanta
Christina M Winfield From Instituto Nacional de Salud (M.L.O., M.G., M.M., A.J.R, A.R., L.P., G.A., S.G., F.P., O.P.), Bogota, Colombia; and the Centers for Disease Control and Prevention (V.T.T., D.V., S.M.G., S.C.T., C.M.W., J.D.T., J.M.V., D.M.D., M.A.H.) and the Department of Gynecology and Obstetrics, Emory University School of Medicine (D.J.J.), Atlanta
Lissethe Pardo From Instituto Nacional de Salud (M.L.O., M.G., M.M., A.J.R, A.R., L.P., G.A., S.G., F.P., O.P.), Bogota, Colombia; and the Centers for Disease Control and Prevention (V.T.T., D.V., S.M.G., S.C.T., C.M.W., J.D.T., J.M.V., D.M.D., M.A.H.) and the Department of Gynecology and Obstetrics, Emory University School of Medicine (D.J.J.), Atlanta
Jennifer D Thomas From Instituto Nacional de Salud (M.L.O., M.G., M.M., A.J.R, A.R., L.P., G.A., S.G., F.P., O.P.), Bogota, Colombia; and the Centers for Disease Control and Prevention (V.T.T., D.V., S.M.G., S.C.T., C.M.W., J.D.T., J.M.V., D.M.D., M.A.H.) and the Department of Gynecology and Obstetrics, Emory University School of Medicine (D.J.J.), Atlanta
Greace Avila From Instituto Nacional de Salud (M.L.O., M.G., M.M., A.J.R, A.R., L.P., G.A., S.G., F.P., O.P.), Bogota, Colombia; and the Centers for Disease Control and Prevention (V.T.T., D.V., S.M.G., S.C.T., C.M.W., J.D.T., J.M.V., D.M.D., M.A.H.) and the Department of Gynecology and Obstetrics, Emory University School of Medicine (D.J.J.), Atlanta
Julie M Villanueva From Instituto Nacional de Salud (M.L.O., M.G., M.M., A.J.R, A.R., L.P., G.A., S.G., F.P., O.P.), Bogota, Colombia; and the Centers for Disease Control and Prevention (V.T.T., D.V., S.M.G., S.C.T., C.M.W., J.D.T., J.M.V., D.M.D., M.A.H.) and the Department of Gynecology and Obstetrics, Emory University School of Medicine (D.J.J.), Atlanta
Sara Gomez From Instituto Nacional de Salud (M.L.O., M.G., M.M., A.J.R, A.R., L.P., G.A., S.G., F.P., O.P.), Bogota, Colombia; and the Centers for Disease Control and Prevention (V.T.T., D.V., S.M.G., S.C.T., C.M.W., J.D.T., J.M.V., D.M.D., M.A.H.) and the Department of Gynecology and Obstetrics, Emory University School of Medicine (D.J.J.), Atlanta
Denise J Jamieson From Instituto Nacional de Salud (M.L.O., M.G., M.M., A.J.R, A.R., L.P., G.A., S.G., F.P., O.P.), Bogota, Colombia; and the Centers for Disease Control and Prevention (V.T.T., D.V., S.M.G., S.C.T., C.M.W., J.D.T., J.M.V., D.M.D., M.A.H.) and the Department of Gynecology and Obstetrics, Emory University School of Medicine (D.J.J.), Atlanta
Franklyn Prieto From Instituto Nacional de Salud (M.L.O., M.G., M.M., A.J.R, A.R., L.P., G.A., S.G., F.P., O.P.), Bogota, Colombia; and the Centers for Disease Control and Prevention (V.T.T., D.V., S.M.G., S.C.T., C.M.W., J.D.T., J.M.V., D.M.D., M.A.H.) and the Department of Gynecology and Obstetrics, Emory University School of Medicine (D.J.J.), Atlanta
Dana Meaney-Delman From Instituto Nacional de Salud (M.L.O., M.G., M.M., A.J.R, A.R., L.P., G.A., S.G., F.P., O.P.), Bogota, Colombia; and the Centers for Disease Control and Prevention (V.T.T., D.V., S.M.G., S.C.T., C.M.W., J.D.T., J.M.V., D.M.D., M.A.H.) and the Department of Gynecology and Obstetrics, Emory University School of Medicine (D.J.J.), Atlanta
Oscar Pacheco From Instituto Nacional de Salud (M.L.O., M.G., M.M., A.J.R, A.R., L.P., G.A., S.G., F.P., O.P.), Bogota, Colombia; and the Centers for Disease Control and Prevention (V.T.T., D.V., S.M.G., S.C.T., C.M.W., J.D.T., J.M.V., D.M.D., M.A.H.) and the Department of Gynecology and Obstetrics, Emory University School of Medicine (D.J.J.), Atlanta
Margaret A Honein From Instituto Nacional de Salud (M.L.O., M.G., M.M., A.J.R, A.R., L.P., G.A., S.G., F.P., O.P.), Bogota, Colombia; and the Centers for Disease Control and Prevention (V.T.T., D.V., S.M.G., S.C.T., C.M.W., J.D.T., J.M.V., D.M.D., M.A.H.) and the Department of Gynecology and Obstetrics, Emory University School of Medicine (D.J.J.), Atlanta

Collapse

Galang RR, Avila GA, Valencia D, Daza M, Tong VT, Bermúdez AJ, Gilboa SM, Rico A, Cates J, Pacheco O, Winfield CM, Prieto F, Honein MA, Cortés LJ, Moore CA, Ospina ML. Etiology of Microcephaly and Central Nervous System Defects during the Zika Epidemic in Colombia. J Pediatr 2020;222:112-119.e3. [PMID: 32417080 PMCID: PMC7321917 DOI: 10.1016/j.jpeds.2020.02.023] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 01/06/2020] [Accepted: 02/12/2020] [Indexed: 11/21/2022]

Abstract

OBJECTIVE

To estimate the prevalence of microcephaly and central nervous system (CNS) defects during the Zika virus (ZIKV) epidemic in Colombia and proportion attributable to congenital ZIKV infection.

STUDY DESIGN

Clinical and laboratory data for cases of microcephaly and/or CNS defects reported to national surveillance between 2015 and 2017 were reviewed and classified by a panel of clinical subject matter experts. Maternal and fetal/infant biologic specimens were tested for congenital infection and chromosomal abnormalities. Infants/fetuses with microcephaly and/or CNS defects (cases) were classified into broad etiologic categories (teratogenic, genetic, multifactorial, and unknown). Cases classified as potentially attributable to congenital ZIKV infection were stratified by strength of evidence for ZIKV etiology (strong, moderate, or limited) using a novel strategy considering birth defects unique or specific to ZIKV or other infections and laboratory evidence.

RESULTS

Among 858 reported cases with sufficient information supporting a diagnosis of microcephaly or CNS defects, 503 were classified as potentially attributable to congenital ZIKV infection. Of these, the strength of evidence was considered strong in 124 (24.7%) cases; moderate in 232 (46.1%) cases; and limited in 147 (29.2%). Of the remaining, 355 (41.4%) were attributed to etiologies other than ZIKV infection (syphilis, toxoplasmosis, rubella, cytomegalovirus, herpes 1 and herpes 2 viruses only, n = 32 [3.7%]; genetic, n = 16 [1.9%]; multifactorial, n = 42 [4.9%]; unknown, n = 265 [30.9%]).

CONCLUSIONS

Fifty-eight percent of cases of microcephaly and/or CNS defects were potentially attributable to congenital ZIKV infection; however, the strength of evidence varied considerably. This surveillance protocol might serve as a model approach for investigation and etiologic classification of complex congenital conditions.

Collapse

Affiliation(s)

Romeo R Galang Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, United States.
Greace Alejandra Avila Dirección de Vigilancia y Análisis de Riesgo en Salud Pública, Instituto Nacional de Salud, Bogotá, Distrito Capital, Colombia
Diana Valencia Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, United States
Marcela Daza Vysnova Partners, Research Division, Bethesda, MD, United States
Van T Tong Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, United States
Antonio José Bermúdez Dirección de Redes en Salud Pública, Instituto Nacional de Salud, Bogotá, Distrito Capital, Colombia
Suzanne M Gilboa Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, United States
Angélica Rico Dirección de Redes en Salud Pública, Instituto Nacional de Salud, Bogotá, Distrito Capital, Colombia
Jordan Cates Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, United States
Oscar Pacheco Dirección de Vigilancia y Análisis de Riesgo en Salud Pública, Instituto Nacional de Salud, Bogotá, Distrito Capital, Colombia
Christina M Winfield Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, United States
Franklyn Prieto Dirección de Vigilancia y Análisis de Riesgo en Salud Pública, Instituto Nacional de Salud, Bogotá, Distrito Capital, Colombia
Margaret A Honein Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, United States
Liliana J Cortés Dirección de Vigilancia y Análisis de Riesgo en Salud Pública, Instituto Nacional de Salud, Bogotá, Distrito Capital, Colombia
Cynthia A Moore Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, United States
Martha L Ospina Dirección General, Instituto Nacional de Salud, Bogotá, Distrito Capital, Colombia

Collapse