Neurodevelopmental delays arising from in utero exposure to Zika virus in Salvador, Brazil

Abstract

The World Health Organization (WHO) Clean Care is Safer Care global programme is based around a change model. It fosters partnerships and coordinates activities as set out in its programme plan. By May 2016, more than 140 of the 194 United Nations' member states had pledged their support to implement actions to reduce healthcare-associated infections, corresponding to 95% coverage of the world population.The finalized WHO Guideline on Hand Hygiene in Healthcare was launched in 2009 alongside a field-tested and validated multimodal improvement strategy. The strategy comprises five critical components: 1) system change; 2) healthcare workers' training and education; 3) evaluation and performance feedback; 4) reminders in the workplace; and 5) promotion of an institutional safety climate.WHO has over this time coordinated more than 50 national campaigns and importantly launched the global annual healthcare worker call to action; the SAVE LIVES: Clean Your Hands campaign to maintain a profile on hand hygiene action at the point of care.Reasons for the success of Clean Care is Safer Care will be reviewed, including those possibly associated with a positive influence on infection rates and patient safety.

Neurodevelopment outcomes in infants born to women with Zika virus infection during pregnancy in Mexico

“…All standardized MSEL mean scores were lower (e.g., poorer development) among infants with ZIKV exposure in utero, compared to their unexposed peers, suggesting that infection exposure may result in undiscriminated impact of early infant ND. These results are in line with research from Brazil (Cabral et al, 2018; Nielsen‐Saines et al, 2019) and Colombia (Mulkey et al, 2020), suggesting that asymptomatic infants whose mothers were infected with Zika in pregnancy may be at risk of delayed neurodevelopment. Because wider and a more differentiated range of cognitive abilities can only be examined as children grow and develop these skills, MSEL results reported here should be interpreted as preliminary and confirmed through prospective follow‐up of this cohort.…”

“…Because wider and a more differentiated range of cognitive abilities can only be examined as children grow and develop these skills, MSEL results reported here should be interpreted as preliminary and confirmed through prospective follow‐up of this cohort. In contrast with previous studies (Cabral et al, 2018; Nielsen‐Saines et al, 2019; Peçanha et al, 2020) assessing neurodevelopment outcomes using standardized tests, we added a group of infants born to mothers without medical history of ZIKV infection during pregnancy as comparison group to provide a more meaningful interpretation of MSEL scores that are typically standardized with American norms. Our results, along with previous findings, raise the concern that exposure to ZIKV in utero could be associated with a spectrum of fetal brain injuries beyond microcephaly and emphasizes the need to assess early child ND in all who had a suspected or confirmed exposure in the womb as to avoid undiagnosed ND and behavioral problems that could significantly hinder the child's future social and educational performance.…”

“…Most of the available literature is from Brazil, and these studies report below‐average ND scores in the Bayley Scales of Infant Development II (BSID‐II; Cabral et al, 2018; Faiçal et al, 2019; Nielsen‐Saines et al, 2019; Peçanha et al, 2020) in the first 2 years of life among infants exposed to ZIKV in utero. Mulkey et al (2020) reported an increased risk for abnormal neurodevelopmental outcomes in the first 18 months of life among infants in Colombia.…”

Neurodevelopment of Nonmicrocephalic Children, After 18 Months of Life, Exposed Prenatally to Zika Virus

“…These results are reassuring in relation to the development of children whose mothers were infected during pregnancy. Comparatively, the preliminary study by Cabral et al 15 evaluated 18 nonmicrocephalic children (mean age of 19 months), also with the same instrument, and found delays in 33% of them in the cognitive domain, 26% in the language domain, and 13.3% on the motor domain. Einspieler et al 28 also evaluated, using Bayley III, the neurodevelopmental outcomes of 56 children prenatally exposed to Zika virus without microcephaly at 12 months.…”

“…Investigations have been carried out regarding the development of children with congenital Zika syndrome. 12 -19…”