Characterizing Disabilities in Preschool Aged Children with Congenital Zika Virus Syndrome with the ICF Model
Laura Cristina Machado Ribeiro de Souza,
Carla Trevisan Martins Ribeiro,
Tatiana Hamanaka,
Luciana Castaneda Ribeiro,
Nathália Crsitina Oliveira de Souza,
Sheila Moura Pone,
Karin Nielsen-Saines,
Elizabeth B. Brickley,
Maria Elisabeth Lopes Moreira,
Marcos Vinicius da Silva Pone
Affiliations
Laura Cristina Machado Ribeiro de Souza
National Institute of Women, Children and Adolescents Health Fernandes Figueira, Oswaldo Cruz, Foundation (IFF-Fiocruz), Avenida Rui Barbosa, 716, Flamengo, Rio de Janeiro 22250-020, Brazil
Carla Trevisan Martins Ribeiro
National Institute of Women, Children and Adolescents Health Fernandes Figueira, Oswaldo Cruz, Foundation (IFF-Fiocruz), Avenida Rui Barbosa, 716, Flamengo, Rio de Janeiro 22250-020, Brazil
Tatiana Hamanaka
National Institute of Women, Children and Adolescents Health Fernandes Figueira, Oswaldo Cruz, Foundation (IFF-Fiocruz), Avenida Rui Barbosa, 716, Flamengo, Rio de Janeiro 22250-020, Brazil
Luciana Castaneda Ribeiro
Federal Institute of Rio de Janeiro (IFRJ), Rua Professor Carlos Wenceslau, 343-Realengo, Rio de Janeiro 21710-240, Brazil
Nathália Crsitina Oliveira de Souza
National Institute of Women, Children and Adolescents Health Fernandes Figueira, Oswaldo Cruz, Foundation (IFF-Fiocruz), Avenida Rui Barbosa, 716, Flamengo, Rio de Janeiro 22250-020, Brazil
Sheila Moura Pone
National Institute of Women, Children and Adolescents Health Fernandes Figueira, Oswaldo Cruz, Foundation (IFF-Fiocruz), Avenida Rui Barbosa, 716, Flamengo, Rio de Janeiro 22250-020, Brazil
Karin Nielsen-Saines
David Geffen School of Medicine, University of California, 10833 Le Conte Ave, Los Angeles, CA 90095, USA
Elizabeth B. Brickley
London School of Hygiene & Tropical Medicine, Keppel St., London WC1E 7HT, UK
Maria Elisabeth Lopes Moreira
National Institute of Women, Children and Adolescents Health Fernandes Figueira, Oswaldo Cruz, Foundation (IFF-Fiocruz), Avenida Rui Barbosa, 716, Flamengo, Rio de Janeiro 22250-020, Brazil
Marcos Vinicius da Silva Pone
National Institute of Women, Children and Adolescents Health Fernandes Figueira, Oswaldo Cruz, Foundation (IFF-Fiocruz), Avenida Rui Barbosa, 716, Flamengo, Rio de Janeiro 22250-020, Brazil
Understanding functioning and disabilities in children with Congenital Zika Syndrome (CZS) is essential for health planning. We describe disabilities present in children with CZS followed in a reference hospital in Rio de Janeiro, Brazil, based on the biopsychosocial model of the International Classification of Functioning, Disability and Health (ICF). This was a cohort study of children >3 years of age with CZS. Disability was characterized through outcomes related to ICF components assessed via clinical and motor development evaluations. Among 50 children, with a median age of 40 months, 47 (94%) presented with severe impairment and 46 (92%) had microcephaly. Damage to the head and neck was found in most children, with abnormal central nervous system imaging universally present. Most children had cognitive impairment (92%), muscle tone problems (90%), and speech deficits (94%). We found movement limitations in all categories but more pervasively (80–94%), in postural transfers and displacements. The main environmental factors identified in the ICF model were the use of products or substances for personal consumption and access to health services. Children with CZS have extremely high rates of disability beyond aged 3 years, particularly regarding motor activity. ICF-based models can contribute to the assessment of health domains.
