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Microcephaly Outcomes among Zika Virus–Infected Pregnant Women in Honduras

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  • 1 Departamento de Laboratorio Clínico, Hospital Escuela, Tegucigalpa, Honduras;
  • 2 Instituto de Enfermedades Infecciosas y Parasitología Antonio Vidal, Tegucigalpa, Honduras;
  • 3 Unidad de Investigación Científica, Facultad de Ciencias Médicas, Universidad Nacional Autónoma de Honduras (UNAH), Tegucigalpa, Honduras;
  • 4 Department of Epidemiology, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana;
  • 5 Instituto de Efectividad Clínica y Sanitaria, Buenos Aires, Argentina;
  • 6 Unidad de Investigación Clínica y Epidemiológica, Montevideo, Uruguay;
  • 7 Unidad de Vigilancia de la Salud, Región Sanitaria Metropolitana del Distrito Central (RSMDC), Secretaría de Salud de Honduras, Tegucigalpa, Honduras;
  • 8 Dirección General, RSMDC, Secretaría de Salud de Honduras, Tegucigalpa, Honduras;
  • 9 Departamento de Ginecología y Obstetricia, Hospital Escuela, Tegucigalpa, Honduras;
  • 10 Departamento de Ginecología y Obstetricia, Facultad de Ciencias Médicas, UNAH, Tegucigalpa, Honduras;
  • 11 Centro de Salud Alonso Suazo, RSMDC, Secretaría de Salud de Honduras, Tegucigalpa, Honduras;
  • 12 Servicio de Neonatología, Departamento de Pediatría, Hospital Escuela, Tegucigalpa, Honduras;
  • 13 Departamento de Pediatría, Facultad de Ciencias Médicas, UNAH, Tegucigalpa, Honduras;
  • 14 Centro de Investigaciones Genéticas, Instituto de Investigaciones en Microbiología, Facultad de Ciencias, UNAH, Tegucigalpa, Honduras;
  • 15 Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia;
  • 16 Departamento de Pediatría, Hospital de Especialidades San Felipe, Tegucigalpa, Honduras;
  • 17 Servicio de Infectología, Departamento de Pediatría, Hospital Escuela, Tegucigalpa, Honduras;
  • 18 Servicio de Oftalmología, Departamento de Pediatría, Hospital Escuela, Tegucigalpa, Honduras;
  • 19 Servicio de Maternidad, Hospital de Especialidades San Felipe, Tegucigalpa, Honduras;
  • 20 Escuela de Microbiología, Facultad de Ciencias, UNAH, Tegucigalpa, Honduras;
  • 21 Departamento de Pediatría, Hospital Escuela, Tegucigalpa, Honduras;
  • 22 Sub-Dirección, Hospital de Especialidades San Felipe, Tegucigalpa, Honduras;
  • 23 Servicio de Neurología, Departamento de Pediatría, Hospital Escuela, Tegucigalpa, Honduras;
  • 24 Department of Tropical Medicine, Tulane School of Public Health and Tropical Medicine, New Orleans, Louisiana;
  • 25 Departamento de Vigilancia de la Salud, Hospital Escuela, Tegucigalpa, Honduras

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.

    • Supplementary Materials

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.

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