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Microcephaly Outcomes among Zika Virus–Infected Pregnant Women in Honduras

Jackeline Alger Departamento de Laboratorio Clínico, Hospital Escuela, Tegucigalpa, Honduras;
Instituto de Enfermedades Infecciosas y Parasitología Antonio Vidal, Tegucigalpa, Honduras;
Unidad de Investigación Científica, Facultad de Ciencias Médicas, Universidad Nacional Autónoma de Honduras (UNAH), Tegucigalpa, Honduras;

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Pierre Buekens Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana;

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Maria Luisa Cafferata Instituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina;
Unidad de Investigación Clínica y Epidemiológica, Montevideo, Uruguay;

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Zulma Alvarez Unidad de Vigilancia de la Salud, Región Sanitaria Metropolitana del Distrito Central (RSMDC), Secretaría de Salud de Honduras, Tegucigalpa, Honduras;

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Mabel Berrueta Instituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina;

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Harry Bock Dirección General, RSMDC, Secretaría de Salud de Honduras, Tegucigalpa, Honduras;

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Carolina Bustillo Departamento de Ginecología y Obstetricia, Hospital Escuela, Tegucigalpa, Honduras;
Departamento de Ginecología y Obstetricia, Facultad de Ciencias Médicas, UNAH, Tegucigalpa, Honduras;

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Alejandra Calderón Centro de Salud Alonso Suazo, RSMDC, Secretaría de Salud de Honduras, Tegucigalpa, Honduras;

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Allison Callejas Servicio de Neonatología, Departamento de Pediatría, Hospital Escuela, Tegucigalpa, Honduras;

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Mario Castillo Servicio de Neonatología, Departamento de Pediatría, Hospital Escuela, Tegucigalpa, Honduras;

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Alvaro Ciganda Unidad de Investigación Clínica y Epidemiológica, Montevideo, Uruguay;

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Jenny Fúnes Servicio de Neonatología, Departamento de Pediatría, Hospital Escuela, Tegucigalpa, Honduras;
Departamento de Pediatría, Facultad de Ciencias Médicas, UNAH, Tegucigalpa, Honduras;

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Jorge García Departamento de Laboratorio Clínico, Hospital Escuela, Tegucigalpa, Honduras;
Instituto de Enfermedades Infecciosas y Parasitología Antonio Vidal, Tegucigalpa, Honduras;

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Kimberly García Centro de Investigaciones Genéticas, Instituto de Investigaciones en Microbiología, Facultad de Ciencias, UNAH, Tegucigalpa, Honduras;

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Luz Gibbons Instituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina;

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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, Georgia;

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Emily W. Harville Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana;

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Gustavo Hernández Departamento de Pediatría, Hospital de Especialidades San Felipe, Tegucigalpa, Honduras;

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Raquel López Instituto de Enfermedades Infecciosas y Parasitología Antonio Vidal, Tegucigalpa, Honduras;

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Wendy López Departamento de Laboratorio Clínico, Hospital Escuela, Tegucigalpa, Honduras;
Instituto de Enfermedades Infecciosas y Parasitología Antonio Vidal, Tegucigalpa, Honduras;

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Ivette Lorenzana Centro de Investigaciones Genéticas, Instituto de Investigaciones en Microbiología, Facultad de Ciencias, UNAH, Tegucigalpa, Honduras;

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Marco Tulio Luque Servicio de Infectología, Departamento de Pediatría, Hospital Escuela, Tegucigalpa, Honduras;

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Carlos Maldonado Servicio de Oftalmología, Departamento de Pediatría, Hospital Escuela, Tegucigalpa, Honduras;

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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, Georgia;

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Carlos Ochoa Servicio de Maternidad, Hospital de Especialidades San Felipe, Tegucigalpa, Honduras;

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Leda Parham Centro de Investigaciones Genéticas, Instituto de Investigaciones en Microbiología, Facultad de Ciencias, UNAH, Tegucigalpa, Honduras;
Escuela de Microbiología, Facultad de Ciencias, UNAH, Tegucigalpa, Honduras;

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Karla Pastrana Departamento de Ginecología y Obstetricia, Hospital Escuela, Tegucigalpa, Honduras;
Departamento de Ginecología y Obstetricia, Facultad de Ciencias Médicas, UNAH, Tegucigalpa, Honduras;

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Fátima Rico Departamento de Pediatría, Facultad de Ciencias Médicas, UNAH, Tegucigalpa, Honduras;
Departamento de Pediatría, Hospital Escuela, Tegucigalpa, Honduras;

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Heriberto Rodríguez Sub-Dirección, Hospital de Especialidades San Felipe, Tegucigalpa, Honduras;

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Candela Stella Instituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina;

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Diana Valencia Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia;

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Douglas Varela Servicio de Neurología, Departamento de Pediatría, Hospital Escuela, Tegucigalpa, Honduras;

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Dawn M. Wesson Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana;

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Concepción Zúniga Instituto de Enfermedades Infecciosas y Parasitología Antonio Vidal, Tegucigalpa, Honduras;
Departamento de Vigilancia de la Salud, Hospital Escuela, Tegucigalpa, Honduras

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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, Georgia;

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DOI:
https://doi.org/10.4269/ajtmh.20-1483
Volume/Issue:
Volume 104: Issue 5
Page(s):
1737–1740
Restricted access
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ABSTRACT

The impact of Zika virus (ZIKV) infection on pregnancies shows regional variation emphasizing the importance of studies in different geographical areas. We conducted a prospective study in Tegucigalpa, Honduras, recruiting 668 pregnant women between July 20, 2016, and December 31, 2016. We performed Trioplex real-time reverse transcriptase–PCR (rRT-PCR) in 357 serum samples taken at the first prenatal visit. The presence of ZIKV was confirmed in seven pregnancies (7/357, 2.0%). Nine babies (1.6%) had microcephaly (head circumference more than two SDs below the mean), including two (0.3%) with severe microcephaly (head circumference [HC] more than three SDs below the mean). The mothers of both babies with severe microcephaly had evidence of ZIKV infection. A positive ZIKV Trioplex rRT-PCR was associated with a 33.3% (95% CI: 4.3–77.7%) risk of HC more than three SDs below the mean.

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Author Notes

Address correspondence to Pierre Buekens, W. H. Watkins Professor of Epidemiology School of Public Health and Tropical Medicine, Tulane University, 1440 Canal St., Suite 2001, New Orleans, LA 70112. E-mail: pbuekens@tulane.edu

CDC Disclaimer: The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the CDC.

Financial support: The Zika in Pregnancy in Honduras (ZIPH) study is partially funded by Vysnova Partners SC-2018-3045-TU.

Authors’ addresses: Jackeline Alger, Jorge García, and Wendy López, Departamento de Laboratorio Clínico, Hospital Escuela Universitario, Tegucigalpa, Honduras, and Instituto de Enfermedades Infecciosas y Parasitología Antonio Vidal (IAV), Tegucigalpa, Honduras, E-mails: jackelinealger@gmail.com, jalgar62_84@yahoo.com.ar and wlopez36@hotmail.com. Pierre Buekens, Emily W. Harville, and Dawn M. Wesson, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, E-mails: pbuekens@tulane.edu, eharvill@tulane.edu, and wesson@tulane.edu. Maria Luisa Cafferata, Mabel Berrueta, Luz Gibbons, and Candela Stella, Instituto de Efectividad Clínica y Sanitaria (IECS), Buenos Aires, Argentina, E-mails: marialuisa.cafferata@gmail.com, mberrueta@iecs.org.ar, lgibbons@iecs.org.ar, and cstella@iecs.org.ar. Zulma Alvarez and Harry Bock, Región Sanitaria Metropolitana del Distrito Central, Secretaría de Salud de Honduras, Tegucigalpa, Honduras, E-mails: zulmahen@yahoo.com and hbockme@hotmail.com. Carolina Bustillo and Karla Pastrana, Departamento de Ginecología y Obstetricia, Facultad de Ciencias Médicas, UNAH, Tegucigalpa, Honduras, E-mails: mcbu1502@yahoo.com and kpastrana_2000@yahoo.com.mx. Alejandra Calderón, Centro de Salud Alonso Suazo, Región Sanitaria Metropolitana del Distrito Central, Secretaría de Salud de Honduras, Tegucigalpa, Honduras, E-mail: lilianalecalderon@gmail.com. Allison Callejas, Mario Castillo, and Jenny Fúnes, Servicio de Neonatología, Departamento de Pediatría, Hospital Escuela, Tegucigalpa, Honduras, E-mails: amariecs1981@gmail.com, mariocastillo26@yahoo.com, and jennylagosfunes@yahoo.com. Alvaro Ciganda, Unidad de Investigación Clínica y Epidemiológica, Montevideo, Uruguay, E-mail: aciganda@gmail.com. Kimberly García, Ivette Lorenzana, and Leda Parham, Facultad de Ciencias, UNAH, Tegucigalpa, Honduras, E-mails: kimfa_2010@hotmail.com, ivettelorenzana@yahoo.com, and lparham29@hotmail.com. Suzanne M. Gilboa, Cynthia A. Moore, Diana Valencia, and 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, E-mails: suz0@cdc.gov, cam0@cdc.gov, ile9@cdc.gov, and vct2@cdc.gov. Gustavo Hernández, Carlos Ochoa, Heriberto Rodríguez, Hospital de Especialidades San Felipe, Tegucigalpa, Honduras, E-mails: ghernandezbustillo@yahoo.es, caof@email.com, and mmfhrg@gmail.com. Raquel López, Instituto de Enfermedades Infecciosas y Parasitología Antonio Vidal, Tegucigalpa, Honduras, E-mail: raquelbonilla_86@hotmail.com. Marco Tulio Luque, Carlos Maldonado, Fátima Rico, Douglas Varela, Departamento de Pediatría, Hospital Escuela, Tegucigalpa, Honduras, E-mails: mtluque@yahoo.com, cmcolegiaciones@gmail.com, ricourrea7@gmail.com, and douglasvarela2068@gmail.com. Concepción Zúniga, Departamento de Vigilancia de la Salud, Hospital Escuela, Tegucigalpa, Honduras, E-mail: concepcionzuniga@gmail.com.

These authors contributed equally to this work.

Copyright:
© The American Society of Tropical Medicine and Hygiene 2021
Received:
17 Nov 2020
|
Accepted:
19 Jan 2021
|
Published Online:
15 Mar 2021
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
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