先天寨卡病毒感染范式:衣橱里有什么?叙述性回顾

M. Mirambo, L. Matemba, M. Majigo, S. Mshana
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引用次数: 3

摘要

背景:妊娠期寨卡病毒感染最近与先天性小头畸形和其他严重神经管缺陷有关。然而,确诊病例的规模和这些异常的范围尚未得到广泛记录。本次审查的重点是在可能病例中实验室确诊的先天性寨卡病毒病例的数量,并描述据称由寨卡病毒引起的先天性异常的模式,这些信息将为该领域的进一步研究提供信息。方法:利用在线电子数据库(PubMed/MEDLINE、POPLINE、Embase、Google Scholar和Web of Knowledge)检索有关先天性寨卡病毒感染的英文文献。使用的搜索词是“寨卡”、“怀孕”、“年份”、“小头畸形”、“婴儿”、“儿童”、“新生儿”、“胎儿”、“神经管缺陷”和“中枢神经系统表现”的不同组合。纳入2015年1月至2016年12月期间报告病例或病例系列的所有文章。将数据输入Microsoft Excel数据库并进行分析,以获得确诊病例的比例和异常模式。结果:共有24篇文章(11篇病例系列,9篇病例报告和4篇其他文章)被纳入本综述。这些文章报告了919例疑似先天性寨卡病毒感染的病例,不论有无小头畸形。其中884例(96.2%)患有小头畸形。在884例小头畸形中,783例(88.6%)接受了寨卡病毒感染检测,216例(27.6%;95%可信区间(24.5%至30.8%)被确认为寨卡病毒阳性。除了小头畸形,在调查的442例病例中,报告的其他常见异常包括脑组织钙化(n=240, 54.3%)、脑室肿大(n=93, 20.8%)、小脑发育不全(n=52, 11.7%)和眼部表现(n=46, 10.4%)。结论:根据现有文献,妊娠期寨卡病毒感染可能导致小头畸形以外的多种后果。需要在寨卡流行地区,特别是在非洲开展更多的流行病学研究,以确定寨卡病毒在导致先天性神经缺陷方面的作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Congenital Zika Virus Infection Paradigm: What is in the Wardrobe? A Narrative Review
Background: Zika virus infection during pregnancy has been recently associated with congenital microcephaly and other severe neural tube defects. However, the magnitude of confirmed cases and the scope of these anomalies have not been extensively documented. This review focuses on the magnitude of laboratory-confirmed congenital Zika virus cases among probable cases and describing the patterns of congenital anomalies allegedly caused by the Zika virus, information which will inform further research in this area. Methods: We conducted a literature search for English-language articles about congenital Zika virus infection using online electronic databases (PubMed/MEDLINE, POPLINE, Embase, Google Scholar, and Web of Knowledge). The search terms used were, “zika”, “pregnancy”, [year], “microcephaly”, “infants”, “children”, “neonates”, “foetuses”, “neural tube defect”, and “CNS manifestations” in different combinations. All articles reporting cases or case series between January 2015 and December 2016 were included. Data were entered into a Microsoft Excel database and analysed to obtain proportions of the confirmed cases and patterns of anomalies. Results: A total of 24 articles (11 case series, 9 case reports, and 4 others) were found to be eligible and included in this review. These articles reported 919 cases, with or without microcephaly, presumed to have congenital Zika virus infection. Of these cases, 884 (96.2%) had microcephaly. Of the 884 cases of microcephaly, 783 (88.6%) were tested for Zika virus infection, and 216 (27.6%; 95% confidence interval, 24.5% to 30.8%) were confirmed to be Zika virus-positive. In addition to microcephaly, other common abnormalities reported – out of 442 cases investigated – were calcifications of brain tissue (n=240, 54.3%), ventriculomegaly (n=93, 20.8%), cerebellar hypoplasia (n=52, 11.7%), and ocular manifestations (n=46, 10.4%). Conclusion: Based on the available literature, Zika virus infection during pregnancy might lead to a wide array of outcomes other than microcephaly. There is a need for more epidemiological studies in Zika-endemic areas, particularly in Africa, to ascertain the role of Zika virus in causing congenital neurological defects.
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