Prevalence and clinical profile of microcephaly in South America pre-Zika, 2005-14: prevalence and case-control study.
Prevalence and clinical profile of microcephaly in South America pre-Zika, 2005-14: prevalence and case-control study.
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DOI：
10.1136/bmj.j5018
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发表时间：
2017-11-21
期刊：
影响因子：
--
通讯作者：
Castilla EE
中科院分区：
文献类型：
--
作者：
Orioli IM;Dolk H;Lopez-Camelo JS;Mattos D;Poletta FA;Dutra MG;Carvalho FM;Castilla EE
目的描述2015年寨卡疫情开始之前的2005-14年期间南美洲小头畸形的患病率和临床谱，作为寨卡疫情蔓延和未来可能出现的其他感染原因的未来监测基线。 设计流行病学和病例对照研究。 数据来源ECLAMC（拉丁美洲先天性畸形合作研究）数据库来自10个南美国家的107家医院，2005年至2014年。关于小头畸形病例、每个病例4个非畸形对照组和所有住院分娩的数据（所有住院分娩为基于医院的患病率，城市内居民为基于人口的患病率）。2010-14年，头围数据可用，并与共生图进行比较。 结果共登记小头畸形病例552例，医院患病率为4.4/10000（95%可信区间4.1 ~ 4.9），人群患病率为3.0/10000（2.7 ~ 3.4）。不同国家之间、不同地区之间和国家内不同医院之间的患病率差异很大。32%（n=175）的病例是产前诊断的; 29%（n=159）是围产期死亡。23%（n=128）与诊断的遗传综合征相关，34%（n=189）多畸形而无综合征诊断，12%（n=65）与相关神经畸形相关，26%（n=145）仅为小头畸形。此外，3.8%（n=21）有STORCH（梅毒、弓形体病、其他包括HIV、风疹、巨细胞病毒和单纯疱疹）感染诊断，2.0%（n=11）的父母有血缘关系。2010- 2014年，184/235例病例的头围测量结果显示，45%（n=82）的头围低于平均值3个标准差以上，24%（n=44）的头围低于平均值3个标准差至2个标准差之间，32%（n=58）的头围大于-2个标准差。 根据南美洲每年近700万新生儿的数据推算，在2015年寨卡疫情开始之前，估计每年有2000-2500例新生儿被诊断为小头畸形症。临床医生使用的不仅仅是简单的指标来诊断小头畸形。地方性感染是导致小头畸形的重要原因。
Objective To describe the prevalence and clinical spectrum of microcephaly in South America for the period 2005-14, before the start of the Zika epidemic in 2015, as a baseline for future surveillance as the Zika epidemic spreads and as other infectious causes may emerge in future. Design Prevalence and case-control study. Data sources ECLAMC (Latin American Collaborative Study of Congenital Malformations) database derived from 107 hospitals in 10 South American countries, 2005 to 2014. Data on microcephaly cases, four non-malformed controls per case, and all hospital births (all births for hospital based prevalence, resident within municipality for population based prevalence). For 2010-14, head circumference data were available and compared with Intergrowth charts. Results 552 microcephaly cases were registered, giving a hospital based prevalence of 4.4 (95% confidence interval 4.1 to 4.9) per 10 000 births and a population based prevalence of 3.0 (2.7 to 3.4) per 10 000. Prevalence varied significantly between countries and between regions and hospitals within countries. Thirty two per cent (n=175) of cases were prenatally diagnosed; 29% (n=159) were perinatal deaths. Twenty three per cent (n=128) were associated with a diagnosed genetic syndrome, 34% (n=189) polymalformed without a syndrome diagnosis, 12% (n=65) with associated neural malformations, and 26% (n=145) microcephaly only. In addition, 3.8% (n=21) had a STORCH (syphilis, toxoplasmosis, other including HIV, rubella, cytomegalovirus, and herpes simplex) infection diagnosis and 2.0% (n=11) had consanguineous parents. Head circumference measurements available for 184/235 cases in 2010-14 showed 45% (n=82) more than 3 SD below the mean, 24% (n=44) between 3 SD and 2 SD below the mean, and 32% (n=58) larger than −2 SD. Conclusion Extrapolated to the nearly 7 million annual births in South America, an estimated 2000-2500 microcephaly cases were diagnosed among births each year before the Zika epidemic began in 2015. Clinicians are using more than simple metrics to make microcephaly diagnoses. Endemic infections are important enduring causes of microcephaly.
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DOI：
10.1016/s0140-6736(14)60539-0
发表时间：
2015-06-06
期刊：
Lancet (London, England)
影响因子：
--
作者：
Lambert N;Strebel P;Orenstein W;Icenogle J;Poland GA
通讯作者：
Poland GA
DOI：
10.1056/nejmoa1602412
发表时间：
2016-12-15
期刊：
The New England journal of medicine
影响因子：
--
作者：
Brasil P;Pereira JP Jr;Moreira ME;Ribeiro Nogueira RM;Damasceno L;Wakimoto M;Rabello RS;Valderramos SG;Halai UA;Salles TS;Zin AA;Horovitz D;Daltro P;Boechat M;Raja Gabaglia C;Carvalho de Sequeira P;Pilotto JH;Medialdea-Carrera R;Cotrim da Cunha D;Abreu de Carvalho LM;Pone M;Machado Siqueira A;Calvet GA;Rodrigues Baião AE;Neves ES;Nassar de Carvalho PR;Hasue RH;Marschik PB;Einspieler C;Janzen C;Cherry JD;Bispo de Filippis AM;Nielsen-Saines K
通讯作者：
Nielsen-Saines K
影响因子：
2.4
作者：
Fenton TR;Kim JH
通讯作者：
Kim JH
影响因子：
168.9
作者：
Franca, Giovanny V. A.;Schuler-Faccini, Lavinia;Victora, Cesar G.
通讯作者：
Victora, Cesar G.
DOI：
10.3390/children4060047
发表时间：
2017-06-09
期刊：
Children (Basel, Switzerland)
影响因子：
--
作者：
Hanzlik E;Gigante J
通讯作者：
Gigante J