Dados do Trabalho


Título

HEALTH-RELATED QUALITY OF LIFE IN CHILDREN WITH CEREBRAL PALSY ASSOCIATED WITH CONGENITAL ZIKA INFECTION

Introdução

Six years ago, Brazil faced an unprecedented Zika virus (ZIKV) epidemic, followed by the emergence of a new nosological category diagnosis: congenital Zika syndrome (CZS). CZS encompasses the spectrum of symptoms observed in infants who are exposed to ZIKV in the uterus, that may affect children’s overall growth, global development, and well-being over time. Due to its intense neurotropism and consequent severe brain malformations, ZIKV was responsible for the emergence of a generation of children with neurological disorders that may impose severe lifelong limitations and lifetime needs for these mchildren and their families. The association between CZS and severe forms of cerebral palsy (CP) has been already documented. According to the World Health Organization (WHO), QOL can be defined as a broad ranging concept.

Objetivo

To describe the health-related quality of life (QOL) in children with cerebral palsy (CP) associated with congenital Zika infection.

Método

Cross-sectional study of a consecutive series of children, followed in a referral multicentric rehabilitation network in Brazil. We invited the caregivers to respond to the Brazilian version of the Caregiver Priorities & Child Health Index of Life with Disabilities (CPCHILDTM) questionnaire. Statistical analysis was performed with the Statistical Package for the Social Sciences (SPSS) 26.0™. We used absolute and relative frequencies for categorical variables and mean and standard deviation for continuous variables.

Resultados

The sample consisted of 193 children, at mean age of 50.3±7.6 months. We observed a predominance of children with cerebral palsy (CP) with Gross Motor Function Classification System (GMFCS) level V (93.7%). Epilepsy (88.4%) was the most common comorbidity. CPCHILDTM mean scores were activities of daily living (ADL)/personal care 43.2±12.6; positioning, transferring and mobility 33.7±16.5; comfort and emotions 84.4±15.2; communication and social interaction (CoSI) 48.2±24.3; health 70.9±17.1; and overall quality of life (OQOL) 72.1±17.1. Total score was 54.8±11.3.

Conclusão

The quality of life (QOL) scores were very similar to other populations with cerebral palsy (CP). The activities of positioning, transferring and mobility had the greatest impact on health-related quality of life (QOL). Rehabilitation strategies and public policies should prioritize aspects related to mobility for this population.

Referências

1. Moore CA, Staples JE, Dobyns WB, Pessoa A, Ventura CV, Fonseca EB, et al. Characterizing the pattern of anomalies
in congenital Zika syndrome for pediatric clinicians. JAMA Pediatr. 2017;171:288-95. https://doi.org/10.1001/ jamapediatrics.2016.3982
2. Wheeler AC. Development of infants with congenital Zika syndrome: what do we know and what can we expect? Pediatrics. 2018;141 Suppl 2:S154-60. https://doi.org/10.1542/peds.2017-2038D
3. Melo AS, Aguiar RS, Amorim MM, Arruda MB, Melo F, Ribeiro ST, et al. Congenital Zika virus infection: beyond neonatal
microcephaly. JAMA Neurol. 2016;73:1407-16. https://doi.org/10.1001/jamaneurol.2016.3720
4. Marques FJ, Teixeira MC, Barra RR, Lima FM, Dias BL, Pupe C, et al. Children born with congenital Zika syndrome display
atypical gross motor development and a higher risk for cerebral palsy. J Child Neurol. 2019;34:81-5. https://doi.org/10.1177/0883073818811234
5. Carvalho AL, Ventura P, Taguchi T, Brandi I, Brites C, Lucena R. Cerebral palsy in children with congenital Zika syndrome:
a 2-year neurodevelopmental follow-up. J Child Neurol. 2020;35:202-7. https://doi.org/10.1177/0883073819885724
6. Rosenbaum P, Paneth N, Leviton A, Goldstein M, Bax M, Damiano D, et al. A report: the definition and classification
of cerebral palsy April 2006. Dev Med Child Neurol Suppl. 2007;109:8-14. PMID: 17370477
7. Power R, King C, Muhit M, Heanoy E, Galea C, Jones C, et al. Health-related quality of life of children and adolescents
with cerebral palsy in low-and middle-income countries: a systematic review. Dev Med Child Neurol. 2018;60:469-79.
https://doi.org/10.1111/dmcn.13681
8. The World Health Organization Quality of Life assessment (WHOQOL): position paper from the World Health Organization. Soc Sci Med. 1995;41:1403-9. https://doi.org/10.1016/0277-9536(95)00112-k
9. Narayanan UG, Fehlings D, Weir S, Knights S, Kiran S, Campbell K. Initial development and validation of the Caregiver
Priorities and Child Health Index of Life with Disabilities (CPCHILD). Dev Med Child Neurol. 2006;48:804-12. https://doi.org/10.1017/S0012162206001745
10. Pellegrino LA, Ortolan EV, Magalhães CS, Viana AA, Narayanan UG. Brazilian Portuguese translation and cross-cultural
adaptation of the “Caregiver Priorities and Child Health Index of Life with Disabilities” (CPCHILD©) questionnaire. BMC Pediatr.
2014;14:30. https://doi.org/10.1186/1471-2431-14-30
11. Palisano R, Rosenbaum P, Walter S, Russell D, Wood E, Galuppi B. Development and reliability of a system to classify gross motor function in children with cerebral palsy. Dev Med Child Neurol. 1997;39:214-23. https://doi.org/10.1111/j.1469-8749.1997.tb07414.x
12. Novak I, Morgan C, Adde L, Blackman J, Boyd RN, BrunstromHernandez J, et al. Early, accurate diagnosis and early intervention in cerebral palsy: advances in diagnosis and treatment. JAMA Pediatr. 2017;171:897-907. https://doi.
org/10.1001/jamapediatrics.2017.1689
13. Aragao MF, van der Linden V, Brainer-Lima AM, Coeli RR, Rocha MA, Silva PS, et al. Clinical features and neuroimaging (CT
and MRI) findings in presumed Zika virus related congenital infection and microcephaly: retrospective case series study.
BMJ. 2016;353:i1901. https://doi.org/10.1136/bmj.i1901
14. Davis E, Reddihough D, Murphy N, Epstein A, Reid SM, Whitehouse A, et al. Exploring quality of life of children
with cerebral palsy and intellectual disability: what are the important domains of life? Child Care Health Dev. 2017;43:854-60. https://doi.org/10.1111/cch.12501
15. Odding E, Roebroeck ME, Stam HJ. The epidemiology of cerebral palsy: incidence, impairments, and risk factors. Disabil Rehabil. 2006;28:183-91. https://doi.org/10.1080/09638280500158422
16. Peiter PC, Pereira RS, Moreira MC, Nascimento M, Tavares MF, Franco VC, et al. Zika epidemic and microcephaly in Brazil: challenges for access to health care and promotion in three epidemic areas. PLoS One. 2020;15:e0235010. https://doi.org/10.1371/journal.pone.0235010
17. Santos-Pinto CD, Soares-Marangoni DA, Ferrari FP, Ajalla ME, Venancio FA, Rosa TS, et al. Health demands and care of
children with congenital Zika syndrome and their mothers in a Brazilian state. BMC Public Health. 2020;20:762. https://doi.org/10.1186/s12889-020-08880-6
18. Carvalho A, Sales HF, Ventura P, Gnoatto-Medeiros M, Brites C, Lucena R. The neurodevelopmental spectrum of congenital Zika infection: a scoping review. Dev Med Child Neurol. 2020;62:1356-62. https://doi.org/10.1111/dmcn.14675

Palavras Chave

Zika virus infection; Cerebral palsy; quality of life

Área

Paralisia cerebral

Autores

LAURA JACOME DE MELO PEREIRA, ALESSANDRA LEMOS CARVALHO, FERNANDA JORDAO PINTO MARQUES, FABIANA BARRETO UTSCH MATOS, CINTHIA RAMOS DINIZ SILVA, CAROLINA ALVES REZENDE ALCÂNTARA, LILIAN GLEICE DE SENA COSTA, ANDREA NAKAMURA SALINAS