Spatiotemporal Analysis of the Population Risk of Congenital Microcephaly in Pernambuco State, Brazil
by
Neal D. E. Alexander 1,*
, Wayner V. Souza 2, Laura C. Rodrigues 1, Cynthia Braga 2, André Sá 2, Luciana Caroline Albuquerque Bezerra 3 and Celina Maria Turchi Martelli 2
on behalf of the Microcephaly Epidemic Research Group (MERG)
Neal D. E. Alexander 1,*, Wayner V. Souza 2, Laura C. Rodrigues 1, Cynthia Braga 2, André Sá 2, Luciana Caroline Albuquerque Bezerra 3 and Celina Maria Turchi Martelli 2
on behalf of the Microcephaly Epidemic Research Group (MERG)
1
Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
2
Centro de Pesquisas Aggeu Magalhães, Fundação Oswaldo Cruz, Recife PE 50740-465, Brazil
3
State Health Department of Pernambuco, Recife PE 50751-530, Brazil
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2020, 17(3), 700; https://doi.org/10.3390/ijerph17030700
Received: 23 November 2019 / Revised: 10 January 2020 / Accepted: 15 January 2020 / Published: 21 January 2020
Since an outbreak in Brazil, which started in 2015, Zika has been recognized as an important cause of microcephaly. The highest burden of this outbreak was in northeast Brazil, including the state of Pernambuco. The prevalence of congenital microcephaly in Pernambuco state was estimated from the RESP (Registro de Eventos em Saúde Pública) surveillance system, from August 2015 to August 2016 inclusive. The denominators were estimated at the municipality level from official demographic data. Microcephaly was defined as a neonatal head circumference below the 3rd percentile of the Intergrowth standards. Smoothed maps of the prevalence of microcephaly were obtained from a Bayesian model which was conditional autoregressive (CAR) in space, and first order autoregressive in time. A total of 742 cases were identified. Additionally, high and early occurrences were identified in the Recife Metropolitan Region, on the coast, and in a north–south band about 300 km inland. Over a substantial part of the state, the overall prevalence, aggregating over the study period, was above 0.5%. The reasons for the high occurrence in the inland area remain unclear.
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Keywords:
congenital microcephaly; Zika; Brazil; arbovirus
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MDPI and ACS Style
Alexander, N.D.E.; Souza, W.V.; Rodrigues, L.C.; Braga, C.; Sá, A.; Albuquerque Bezerra, L.C.; Turchi Martelli, C.M., on behalf of the Microcephaly Epidemic Research Group (MERG); Spatiotemporal Analysis of the Population Risk of Congenital Microcephaly in Pernambuco State, Brazil. Int. J. Environ. Res. Public Health 2020, 17, 700.
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