{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T13:57:56Z","timestamp":1787234276582,"version":"build-2736575974"},"reference-count":93,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2024,5,7]],"date-time":"2024-05-07T00:00:00Z","timestamp":1715040000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior\u2014CAPES","award":["001"],"award-info":[{"award-number":["001"]}]},{"name":"Vice-dire\u00e7\u00e3o de Pesquisa e Inova\u00e7\u00e3o\u2014ENSP\/Fiocruz","award":["001"],"award-info":[{"award-number":["001"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["TropicalMed"],"abstract":"<jats:p>Brazil reported 18,282 suspected congenital Zika syndrome (CZS) cases up to 2018 and accounts for 61.4% of the total reported Zika cases in the Americas in the period. To detect high-risk areas for children with CZS in the city of Rio de Janeiro, we used cluster detection and thematic maps. We analyzed data using a Poisson model in Satscan 10.1.3 software. We also analyzed the records of children with CZS from 2015 to 2016 to describe the clinical and epidemiological maternal and child profile, as well as live births in 2016 and the social development index (SDI) by neighborhood. In 2015 and 2016, the incidence rates of CZS were 8.84 and 46.96 per 100,000 live births in the city, respectively. Severe congenital findings such as microcephaly and brain damage, osteoarticular impairment, ocular abnormalities, and hearing loss were observed in 47 children. The spatial distribution of CZS was concentrated in the north and west zones in heterogeneous neighborhoods. The neighborhoods with the highest occurrence of CZS cases were found to have the worst SDIs. Stascan detected three spatial clusters in the north zone, where the SDI is lower. The clusters presented high relative risks for CZS (7.86, 1.46, and 2.08), although they were not statistically significant. Our findings highlight a higher occurrence of CZS in areas with less favorable socioeconomic conditions.<\/jats:p>","DOI":"10.3390\/tropicalmed9050105","type":"journal-article","created":{"date-parts":[[2024,5,7]],"date-time":"2024-05-07T03:37:42Z","timestamp":1715053062000},"page":"105","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["High-Risk Areas for Congenital Zika Syndrome in Rio de Janeiro: Spatial Cluster Detection"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5460-8316","authenticated-orcid":false,"given":"Danielle Amaral de","family":"Freitas","sequence":"first","affiliation":[{"name":"Escola Nacional de Sa\u00fade P\u00fablica, Funda\u00e7\u00e3o Oswaldo Cruz, Rua Leopoldo Bulh\u00f5es, Rio de Janeiro 1480, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9380-3387","authenticated-orcid":false,"given":"Mayumi Duarte","family":"Wakimoto","sequence":"additional","affiliation":[{"name":"Instituto Nacional de Infectologia Evandro Chagas, Funda\u00e7\u00e3o Oswaldo Cruz, Av. Brasil, Rio de Janeiro 4365, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5085-0685","authenticated-orcid":false,"given":"S\u00f3nia","family":"Dias","sequence":"additional","affiliation":[{"name":"National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center (CHRC), REAL, NOVA University of Lisbon, Avenida Padre Cruz, 1600-560 Lisboa, Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2387-6999","authenticated-orcid":false,"given":"Reinaldo","family":"Souza-Santos","sequence":"additional","affiliation":[{"name":"Escola Nacional de Sa\u00fade P\u00fablica, Funda\u00e7\u00e3o Oswaldo Cruz, Rua Leopoldo Bulh\u00f5es, Rio de Janeiro 1480, RJ, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,5,7]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Gardner, L.M., B\u00f3ta, A., Gangavarapu, K., Kraemer, M.U.G., and Grubaugh, N.D. (2018). Inferring the Risk Factors behind the Geographical Spread and Transmission of Zika in the Americas. PLoS Negl. Trop. Dis., 12.","DOI":"10.1371\/journal.pntd.0006194"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1128\/CMR.00072-15","article-title":"Zika Virus","volume":"29","author":"Musso","year":"2016","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1016\/j.amjmed.2016.02.027","article-title":"Re-Emergence of Zika Virus: A Review on Pathogenesis, Clinical Manifestations, Diagnosis, Treatment, and Prevention","volume":"129","author":"Shuaib","year":"2016","journal-title":"Am. J. Med."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Freitas, D.A., Souza-Santos, R., Carvalho, L.M.A., Barros, W.B., Neves, L.M., Brasil, P., and Wakimoto, M.D. (2020). Congenital Zika Syndrome: A Systematic Review. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0242367"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1356","DOI":"10.1016\/S1473-3099(16)30318-8","article-title":"Association between Zika Virus Infection and Microcephaly in Brazil, January to May, 2016: Preliminary Report of a Case-Control Study","volume":"16","author":"Rodrigues","year":"2016","journal-title":"Lancet Infect. Dis."},{"key":"ref_6","unstructured":"Minist\u00e9rio da Sa\u00fade (2013). Aten\u00e7\u00e3o Ao Pr\u00e9-Natal de Baixo Risco. (Cadernos de Aten\u00e7\u00e3o B\u00e1sica, N\u00b0 32)."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1203\/00006450-197108000-00144","article-title":"The ToRCH Complex-Perinatal Infections Associated with Toxoplasma and Rubella, Cytomegol- and Herpes Simplex Viruses","volume":"5","author":"Nahmias","year":"1971","journal-title":"Pediatr. Res."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"729","DOI":"10.1002\/uog.17404","article-title":"Association between Zika Virus and Fetopathy: A Prospective Cohort Study in French Guiana","volume":"49","author":"Pomar","year":"2017","journal-title":"Ultrasound Obstet. Gynecol. Off. J. Int. Soc. Ultrasound Obstet. Gynecol."},{"key":"ref_9","unstructured":"WHO (2024, April 10). Zika Cases and Congenital Syndrome Associated with Zika Virus Reported by Countries and Territories in the Americas, 2015\u20132018: Cumulative Cases\u2014Data as of 4 January 2018\u2014PAHO\/WHO|Pan American Health Organization. Available online: https:\/\/www.paho.org\/en\/node\/60231."},{"key":"ref_10","unstructured":"Brasil (2023, April 04). Boletim Epidemiol\u00f3gico No 5: Situa\u00e7\u00e3o Epidemiol\u00f3gica Da S\u00edndrome Cong\u00eanita Associada \u00e0 Infec\u00e7\u00e3o Pelo V\u00edrus Zika: Brasil, 2015 a 2022, Available online: http:\/\/plataforma.saude.gov.br\/anomalias-congenitas\/boletim-epidemiologico-SVSA-05-2023.pdf."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Duttine, A., Smythe, T., Ribiero Calheiro de S\u00e1, M., Ferrite, S., Zuurmond, M., Moreira, M.E., Collins, A., Milner, K., and Kuper, H. (2020). Congenital Zika Syndrome\u2014Assessing the Need for a Family Support Programme in Brazil. Int. J. Environ. Res. Public. Health, 17.","DOI":"10.3390\/ijerph17103559"},{"key":"ref_12","doi-asserted-by":"crossref","unstructured":"Campos, M.C., Dombrowski, J.G., Phelan, J., Marinho, C.R.F., Hibberd, M., Clark, T.G., and Campino, S. (2018). Zika Might Not Be Acting Alone: Using an Ecological Study Approach to Investigate Potential Co-Acting Risk Factors for an Unusual Pattern of Microcephaly in Brazil. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0201452"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"155","DOI":"10.17267\/2238-2704rpf.v8i2.1865","article-title":"Aspectos socioecon\u00f4micos dos genitores de crian\u00e7as com microcefalia relacionada ao Zika v\u00edrus","volume":"8","year":"2018","journal-title":"Rev. Pesqui. Em Fisioter."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1177\/0033354918777256","article-title":"Geography of Microcephaly in the Zika Era: A Study of Newborn Distribution and Socio-Environmental Indicators in Recife, Brazil, 2015\u20132016","volume":"133","author":"Souza","year":"2018","journal-title":"Public Health Rep."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"de Souza, W.V., de Albuquerque, M.d.F.P.M., Vazquez, E., Bezerra, L.C.A., da Cruz Gouveia Mendes, A., Lyra, T.M., de Araujo, T.V.B., de Oliveira, A.L.S., Braga, M.C., and de Alencar Ximenes, R.A. (2018). Microcephaly Epidemic Related to the Zika Virus and Living Conditions in Recife, Northeast Brazil. BMC Public Health, 18.","DOI":"10.1186\/s12889-018-5039-z"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1002\/ijgo.13049","article-title":"Analysis of the Spatial Distribution of Cases of Zika Virus Infection and Congenital Zika Virus Syndrome in a State in the Southeastern Region of Brazil: Sociodemographic Factors and Implications for Public Health","volume":"148","author":"Mocelin","year":"2020","journal-title":"Int. J. Gynaecol. Obstet. Off. Organ Int. Fed. Gynaecol. Obstet."},{"key":"ref_17","unstructured":"IBGE (2024, April 15). IBGE Cidades\u2014Panorama Do Rio de Janeiro\/Rio de Janeiro, Available online: https:\/\/cidades.ibge.gov.br\/brasil\/rj\/rio-de-janeiro\/panorama."},{"key":"ref_18","unstructured":"(2017, November 19). Minist\u00e9rio da Sa\u00fade Orienta\u00e7\u00f5es Integradas de Vigil\u00e2ncia e Aten\u00e7\u00e3o \u00e0 Sa\u00fade No \u00c2mbito da Emerg\u00eancia de Sa\u00fade P\u00fablica de Import\u00e2ncia Nacional, Available online: http:\/\/portalarquivos.saude.gov.br\/images\/pdf\/2016\/dezembro\/12\/orientacoes-integradas-vigilancia-atencao.pdf."},{"key":"ref_19","unstructured":"Minist\u00e9rio da Sa\u00fade (2016). Protocolo de Vigil\u00e2ncia e Resposta \u00e0 Ocorr\u00eancia de Microcefalia Relacionada \u00e0 Infec\u00e7\u00e3o Pelo V\u00edrus Zika."},{"key":"ref_20","unstructured":"(2020, March 17). The Global Health Network INTERGROWTH-21st Applications and Calculators\u2014INTERGROWTH-21st. Available online: https:\/\/intergrowth21.tghn.org\/intergrowth-21st-applications\/."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1016\/S0140-6736(14)60932-6","article-title":"International Standards for Newborn Weight, Length, and Head Circumference by Gestational Age and Sex: The Newborn Cross-Sectional Study of the INTERGROWTH-21st Project","volume":"384","author":"Villar","year":"2014","journal-title":"Lancet"},{"key":"ref_22","unstructured":"Kulldorff, M. (2018, April 18). SaTScanTM Manual Do Usu\u00e1rio. Available online: https:\/\/www.satscan.org\/SaTScan_TM_Manual_do_Usu%C3%A1rio_v9.4_Portugues.pdf."},{"key":"ref_23","unstructured":"Kulldorff, M. (2020, July 30). SaTScanTM User Guide. Available online: https:\/\/www.satscan.org\/cgi-bin\/satscan\/register.pl\/SaTScan_Users_Guide.pdf?todo=process_userguide_download."},{"key":"ref_24","unstructured":"(2020, February 22). IPP N\u00famero de Nascidos Vivos, Segundo a Idade da M\u00e3e, \u00c1reas de Planejamento (AP) e Regi\u00f5es Administrativas (RA) de Resid\u00eancia no Munic\u00edpio do Rio de Janeiro, 2002\/2006-2017. Available online: https:\/\/www.data.rio\/documents\/8a0fb5d7ecf04c6eae26a619863871c6\/about."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e190019","DOI":"10.1590\/1980-549720190019","article-title":"Varredura espa\u00e7o-temporal para identifica\u00e7\u00e3o de \u00e1reas de risco para hospitaliza\u00e7\u00e3o de crian\u00e7as por asma em Mato Grosso","volume":"22","author":"Souza","year":"2019","journal-title":"Rev. Bras. Epidemiol."},{"key":"ref_26","unstructured":"IPP (2020, February 17). \u00cdndice de Desenvolvimento Social. Available online: https:\/\/www.data.rio\/documents\/fa85ddc76a524380ad7fc60e3006ee97\/about."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e00248118","DOI":"10.1590\/0102-311x00248118","article-title":"Definition of Persistent Areas with Increased Dengue Risk by Detecting Clusters in Populations with Differing Mobility and Immunity in Rio de Janeiro, Brazil","volume":"35","author":"Santos","year":"2019","journal-title":"Cad. Sa\u00fade P\u00fablica"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"147","DOI":"10.17267\/2238-2704rpf.v8i2.1799","article-title":"An\u00e1lise do desenvolvimento neuropsicomotor em crian\u00e7as com s\u00edndrome p\u00f3s\u2013zika v\u00edrus: Um estudo transversal","volume":"8","year":"2018","journal-title":"Rev. Pesqui. Em Fisioter."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Lima, G.P., Rozenbaum, D., Pimentel, C., Frota, A.C.C., Vivacqua, D., Machado, E.S., Sztajnbok, F., Abreu, T., Soares, R.A., and Hofer, C.B. (2019). Factors Associated with the Development of Congenital Zika Syndrome: A Case-Control Study. BMC Infect. Dis., 19.","DOI":"10.1186\/s12879-019-3908-4"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2321","DOI":"10.1056\/NEJMoa1602412","article-title":"Zika Virus Infection in Pregnant Women in Rio de Janeiro","volume":"375","author":"Brasil","year":"2016","journal-title":"N. Engl. J. Med."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1001\/jama.2016.19006","article-title":"Birth Defects Among Fetuses and Infants of US Women With Evidence of Possible Zika Virus Infection During Pregnancy","volume":"317","author":"Honein","year":"2017","journal-title":"JAMA"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"847","DOI":"10.1001\/jamapediatrics.2017.1474","article-title":"Screening Criteria for Ophthalmic Manifestations of Congenital Zika Virus Infection","volume":"171","author":"Zin","year":"2017","journal-title":"JAMA Pediatr."},{"key":"ref_33","unstructured":"Secretaria Municipal de Sa\u00fade do Rio de Janeiro (2023). Boletim Epidemiol\u00f3gico: S\u00edfilis no Munic\u00edpio do Rio de Janeiro\u20142023, Prefeitura do Rio de Janeiro. [1st ed.]."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1016\/j.bjid.2020.08.005","article-title":"Clinical and Laboratory Findings of Acute Zika Virus Infection in Patients from Salvador during the First Brazilian Epidemic","volume":"24","author":"Bandeira","year":"2020","journal-title":"Braz. J. Infect. Dis."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"537","DOI":"10.1056\/NEJMoa1911023","article-title":"Zika Virus Disease and Pregnancy Outcomes in Colombia","volume":"383","author":"Ospina","year":"2020","journal-title":"N. Engl. J. Med."},{"key":"ref_36","unstructured":"IPP (2024, April 15). Nascidos vivos Residentes no Munic\u00edpio do Rio de Janeiro Segundo a Dura\u00e7\u00e3o da Gravidez, Percentual de Prematuridade por \u00c1reas de Planejamento (AP) e Regi\u00f5es Administrativas (RA) de Resid\u00eancia 2002\/2006-2017. Available online: https:\/\/www.data.rio\/documents\/31780b02ef7447f9b645c7583dc3b2b3\/about."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"219","DOI":"10.15585\/mmwr.mm6608a4","article-title":"Baseline Prevalence of Birth Defects Associated with Congenital Zika Virus Infection\u2014Massachusetts, North Carolina, and Atlanta, Georgia, 2013\u20132014","volume":"66","author":"Cragan","year":"2017","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1093\/cid\/ciw324","article-title":"Clinical and Imaging Findings in an Infant With Zika Embryopathy","volume":"63","author":"Culjat","year":"2016","journal-title":"Clin. Infect. Dis."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1001\/jamaophthalmol.2016.0267","article-title":"Ocular Findings in Infants with Microcephaly Associated with Presumed Zika Virus Congenital Infection in Salvador, Brazil","volume":"134","author":"Prazeres","year":"2016","journal-title":"JAMA Ophthalmol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1002\/ajmg.a.38170","article-title":"The Phenotypic Spectrum of Congenital Zika Syndrome","volume":"173","author":"Feitosa","year":"2017","journal-title":"Am. J. Med. Genet. A"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1016\/S0140-6736(16)30883-2","article-title":"Pathology of Congenital Zika Syndrome in Brazil: A Case Series","volume":"388","author":"Martines","year":"2016","journal-title":"Lancet"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"1302","DOI":"10.1093\/cid\/cix166","article-title":"Lessons Learned at the Epicenter of Brazil\u2019s Congenital Zika Epidemic: Evidence From 87 Confirmed Cases","volume":"64","author":"Meneses","year":"2017","journal-title":"Clin. Infect. Dis."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1265","DOI":"10.1111\/1471-0528.14072","article-title":"Microcephaly Associated with Maternal Zika Virus Infection","volume":"123","author":"Moron","year":"2016","journal-title":"BJOG Int. J. Obstet. Gynaecol."},{"key":"ref_44","first-page":"23","article-title":"Zika y defecto del tubo neural","volume":"45","author":"Reyes","year":"2016","journal-title":"Pedi\u00e1tr Panam\u00e1"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"633.e5","DOI":"10.1016\/j.cmi.2019.02.008","article-title":"Pregnancy Outcomes after Maternal Zika Virus Infection in a Non-Endemic Region: Prospective Cohort Study","volume":"25","author":"Suy","year":"2019","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"520","DOI":"10.1016\/S1473-3099(17)30102-0","article-title":"Analysis of Blood from Zika Virus-Infected Fetuses: A Prospective Case Series","volume":"17","author":"Schaub","year":"2017","journal-title":"Lancet Infect. Dis."},{"key":"ref_47","first-page":"i3899","article-title":"Congenital Zika Syndrome with Arthrogryposis: Retrospective Case Series Study","volume":"354","author":"Lins","year":"2016","journal-title":"Br. Med. J."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"1343","DOI":"10.15585\/mmwr.mm6547e2","article-title":"Description of 13 Infants Born During October 2015-January 2016 With Congenital Zika Virus Infection Without Microcephaly at Birth\u2014Brazil","volume":"65","author":"Pessoa","year":"2016","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1590\/0004-282x20170066","article-title":"Discordant Clinical Outcomes of Congenital Zika Virus Infection in Twin Pregnancies","volume":"75","author":"Rolim","year":"2017","journal-title":"Arq. Neuropsiquiatr."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1016\/j.jaapos.2017.04.003","article-title":"Visual Impairment in Children with Congenital Zika Syndrome","volume":"21","author":"Ventura","year":"2017","journal-title":"J. AAPOS"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1002\/uog.15901","article-title":"Intrauterine Zika Virus Infection and Microcephaly: Correlation of Perinatal Imaging and Three-Dimensional Virtual Physical Models","volume":"47","author":"Werner","year":"2016","journal-title":"Ultrasound Obstet. Gynecol. Off. J. Int. Soc. Ultrasound Obstet. Gynecol."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"100104","DOI":"10.1016\/j.dialog.2023.100104","article-title":"Perinatal Characteristics and Longer-Term Outcomes in Brazilian Children with Confirmed or Suspected Congenital Zika Infection: ZIKAction Paediatric Registry","volume":"2","author":"Lage","year":"2023","journal-title":"Dialogues Health"},{"key":"ref_53","first-page":"i1901","article-title":"Clinical Features and Neuroimaging (CT and MRI) Findings in Presumed Zika Virus Related Congenital Infection and Microcephaly: Retrospective Case Series Study","volume":"353","author":"Coeli","year":"2016","journal-title":"BMJ Online"},{"key":"ref_54","unstructured":"Bastos, L.F.C.S. (2017, October 23). OPAS\/OMS Brasil\u2014OMS Declara Fim de Emerg\u00eancia de Sa\u00fade P\u00fablica Internacional, Mas Diz Que Resposta Ao Zika e Suas Consequ\u00eancias Deve Continuar|OPAS\/OMS. Available online: http:\/\/www.paho.org\/bra\/index.php?option=com_content&view=article&id=5297:oms-declara-fim-de-emergencia-de-saude-publica-internacional-mas-diz-que-resposta-ao-zika-e-suas-consequencias-deve-continuar&Itemid=812."},{"key":"ref_55","doi-asserted-by":"crossref","unstructured":"Braga, J.U., Bressan, C., Dalvi, A.P.R., Calvet, G.A., Daumas, R.P., Rodrigues, N., Wakimoto, M., Nogueira, R.M.R., Nielsen-Saines, K., and Brito, C. (2017). Accuracy of Zika Virus Disease Case Definition during Simultaneous Dengue and Chikungunya Epidemics. PLoS ONE, 12.","DOI":"10.1371\/journal.pone.0179725"},{"key":"ref_56","first-page":"151","article-title":"Complications Associated with Zika Virus Infection: A Systematic Review Study","volume":"24","author":"Faluyi","year":"2016","journal-title":"Am. Sci. Res. J. Eng. Technol. Sci."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1126\/science.aaf5036","article-title":"Zika Virus in the Americas: Early Epidemiological and Genetic Findings","volume":"352","author":"Faria","year":"2016","journal-title":"Science"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"1253","DOI":"10.3201\/eid2308.170354","article-title":"Characteristics of Dysphagia in Infants with Microcephaly Caused by Congenital Zika Virus Infection, Brazil, 2015","volume":"23","author":"Leal","year":"2017","journal-title":"Emerg. Infect. Dis."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"701","DOI":"10.5123\/S1679-49742016000400004","article-title":"Microcefalia no Brasil: Preval\u00eancia e caracteriza\u00e7\u00e3o dos casos a partir do Sistema de Informa\u00e7\u00f5es sobre Nascidos Vivos (Sinasc), 2000\u20132015","volume":"25","author":"Marinho","year":"2016","journal-title":"Epidemiol. Serv. Sa\u00fade"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"O595","DOI":"10.1111\/1469-0691.12707","article-title":"Rapid Spread of Emerging Zika Virus in the Pacific Area","volume":"20","author":"Musso","year":"2014","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_61","unstructured":"WHO (2019, October 01). Zika Virus. Available online: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/zika-virus."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"1045","DOI":"10.3174\/ajnr.A5125","article-title":"Spectrum of Spinal Cord, Spinal Root, and Brain MRI Abnormalities in Congenital Zika Syndrome with and without Arthrogryposis","volume":"38","author":"Holanda","year":"2017","journal-title":"Am. J. Neuroradiol."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1097\/AOG.0000000000002105","article-title":"Serial Head and Brain Imaging of 17 Fetuses With Confirmed Zika Virus Infection in Colombia, South America","volume":"130","author":"Reefhuis","year":"2017","journal-title":"Obstet. Gynecol."},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"30261","DOI":"10.2807\/1560-7917.ES.2016.21.24.30261","article-title":"Confirmed Case of Zika Virus Congenital Infection, Spain, March 2016","volume":"21","author":"Perez","year":"2016","journal-title":"Eurosurveillance"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1001\/jamaneurol.2018.3553","article-title":"Association of Severe Hydrocephalus With Congenital Zika Syndrome","volume":"76","author":"Petribu","year":"2019","journal-title":"JAMA Neurol."},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Hamanaka, T., Ribeiro, C.T.M., Pone, S., Gomes, S.C., Nielsen-Saines, K., Brickley, E.B., Moreira, M.E., and Pone, M. (2022). Longitudinal Follow-Up of Gross Motor Function in Children with Congenital Zika Virus Syndrome from a Cohort in Rio de Janeiro, Brazil. Viruses, 14.","DOI":"10.3390\/v14061173"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"e009600","DOI":"10.1136\/bmjgh-2022-009600","article-title":"Socioeconomic Risk Markers of Congenital Zika Syndrome: A Nationwide, Registry-Based Study in Brazil","volume":"7","author":"Fernandes","year":"2022","journal-title":"BMJ Glob. Health"},{"key":"ref_68","doi-asserted-by":"crossref","unstructured":"Mattos, A.M., Rastely-Junior, V.N., Pires, M.M., Aguilar, J.P., Lessa, M.S.A., Regis, C., Wanderley, M., Leony, J., Bouzon, J., and Ballalai, V. (2023). Predictors of Neurodevelopment in Microcephaly Associated with Congenital Zika Syndrome: A Prospective Study. Child. Basel Switz., 10.","DOI":"10.3390\/children10121831"},{"key":"ref_69","first-page":"1425","article-title":"de Congenital zika syndrome and family impacts: An integrative review","volume":"28","author":"Lyra","year":"2023","journal-title":"Cienc. Saude Coletiva"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"3679","DOI":"10.1590\/1413-81232022279.02972022","article-title":"Healthcare for Children with Congenital Zika Syndrome: Analysis of Access to Social Rights","volume":"27","author":"Cardoso","year":"2022","journal-title":"Ci\u00eanc. Sa\u00fade Coletiva"},{"key":"ref_71","doi-asserted-by":"crossref","unstructured":"Peiter, P.C., Pereira, R.D.S., Nunes Moreira, M.C., Nascimento, M., Tavares, M.D.F.L., Franco, V.D.C., Carvajal Cort\u00eas, J.J., Campos, D.D.S., and Barcellos, C. (2020). Zika Epidemic and Microcephaly in Brazil: Challenges for Access to Health Care and Promotion in Three Epidemic Areas. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0235010"},{"key":"ref_72","first-page":"861","article-title":"Primary care in the context of the Zika epidemic and congenital Zika syndrome in the state of Pernambuco, Brazil: Context, bond and care","volume":"27","author":"Miranda","year":"2022","journal-title":"Cienc. Saude Coletiva"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"e20190105","DOI":"10.1590\/0037-8682-0105-2019","article-title":"Descriptive Study of Suspected Congenital Zika Syndrome Cases during the 2015\u20132016 Epidemic in Brazil","volume":"52","author":"Roma","year":"2019","journal-title":"Rev. Soc. Bras. Med. Trop."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"e00032020","DOI":"10.1590\/0102-311x00032020","article-title":"The Vulnerabilities of Lives: Zika, Women and Children in Alagoas State, Brazil","volume":"36","author":"Ambrogi","year":"2021","journal-title":"Cad. Saude Publica"},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"396","DOI":"10.1177\/1010539518769809","article-title":"Spatiotemporal Distribution and Geospatial Diffusion Patterns of 2013 Dengue Outbreak in Jhapa District, Nepal","volume":"30","author":"Acharya","year":"2018","journal-title":"Asia Pac. J. Public Health"},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1016\/j.actatropica.2019.01.020","article-title":"Simultaneous Circulation of Arboviruses and Other Congenital Infections in Pregnant Women in Rio de Janeiro, Brazil","volume":"192","author":"Carvalho","year":"2019","journal-title":"Acta Trop."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"e62","DOI":"10.1590\/s1678-9946201860062","article-title":"Spatial Analysis of Probable Cases of Dengue Fever, Chikungunya Fever and Zika Virus Infections in Maranhao State, Brazil","volume":"60","author":"Costa","year":"2018","journal-title":"Rev. Inst. Med. Trop. S\u00e3o Paulo"},{"key":"ref_78","doi-asserted-by":"crossref","unstructured":"Freitas, L.P., Cruz, O.G., Lowe, R., and S\u00e1 Carvalho, M. (2019). Space\u2013Time Dynamics of a Triple Epidemic: Dengue, Chikungunya and Zika Clusters in the City of Rio de Janeiro. Proc. R. Soc. B Biol. Sci., 286.","DOI":"10.1101\/521591"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1093\/heapol\/czz059","article-title":"Access to Healthcare for Children with Congenital Zika Syndrome in Brazil: Perspectives of Mothers and Health Professionals","volume":"34","author":"Albuquerque","year":"2019","journal-title":"Health Policy Plan."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1590\/1414-462x201900030237","article-title":"Necessidades de crian\u00e7as com s\u00edndrome cong\u00eanita pelo Zika v\u00edrus no contexto domiciliar","volume":"27","author":"Duarte","year":"2019","journal-title":"Cad. Sa\u00fade Coletiva"},{"key":"ref_81","first-page":"e24","article-title":"Congenital Zika syndrome: Sociodemographic profile of mothersSindrome congenito por el virus del Zika: Perfil sociodemografico de las madres","volume":"43","author":"Freitas","year":"2019","journal-title":"Rev. Panam. Salud Publica Pan Am. J. Public Health"},{"key":"ref_82","doi-asserted-by":"crossref","unstructured":"Mendes, A.G. (2020, February 16). Enfrentando Uma Nova Realidade a Partir Da S\u00edndrome Cong\u00eanita Do V\u00edrus Zika: A Perspectiva Das Fam\u00edlias. Available online: http:\/\/www.cienciaesaudecoletiva.com.br\/artigos\/enfrentando-uma-nova-realidade-a-partir-da-sindrome-congenita-do-virus-zika-a-perspectiva-das-familias\/17145?id=17145.","DOI":"10.1590\/1413-812320202510.00962019"},{"key":"ref_83","doi-asserted-by":"crossref","unstructured":"Souza, M.P.A., da Natividade, M.S., Werneck, G.L., and Dos Santos, D.N. (2022). Congenital Zika Syndrome and Living Conditions in the Largest City of Northeastern Brazil. BMC Public Health, 22.","DOI":"10.1186\/s12889-022-13614-x"},{"key":"ref_84","unstructured":"Cavallieri, F. (2020, April 27). \u00cdndice de Desenvolvimento Social, Available online: https:\/\/www.rio.rj.gov.br\/dlstatic\/10112\/6165511\/4162027\/analise_ids_rio_compur.pdf."},{"key":"ref_85","unstructured":"(2020, March 22). ISP Letalidade Violenta, Available online: https:\/\/www.ispvisualizacao.rj.gov.br\/Letalidade.html."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"1839","DOI":"10.1590\/1413-81232020255.34642019","article-title":"Rela\u00e7\u00e3o dos indicadores de desigualdade social na distribui\u00e7\u00e3o espacial dos casos de Zika V\u00edrus","volume":"25","author":"Cunha","year":"2020","journal-title":"Ci\u00eanc. Sa\u00fade Coletiva"},{"key":"ref_87","doi-asserted-by":"crossref","unstructured":"Akter, R., Naish, S., Gatton, M., Bambrick, H., Hu, W., and Tong, S. (2019). Spatial and Temporal Analysis of Dengue Infections in Queensland, Australia: Recent Trend and Perspectives. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0220134"},{"key":"ref_88","doi-asserted-by":"crossref","unstructured":"Li, J., Jia, K., Liu, Y., Yuan, B., Xia, M., and Zhao, W. (2021). Spatiotemporal Distribution of Zika Virus and Its Spatially Heterogeneous Relationship with the Environment. Int. J. Environ. Res. Public. Health, 18.","DOI":"10.3390\/ijerph18010290"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"1086","DOI":"10.1111\/j.1365-3156.2012.03038.x","article-title":"Space-Time Clusters of Dengue Fever in Bangladesh","volume":"17","author":"Banu","year":"2012","journal-title":"Trop. Med. Int. Health"},{"key":"ref_90","first-page":"171","article-title":"S\u00edndrome de TORCH: Enfoque Racional Del Diagn\u00f3stico y Tratamiento Pre y Post Natal.: Recomendaciones Del Comit\u00e9 Consultivo de Infecciones Neonatales Sociedad Chilena de Infectolog\u00eda, 2016","volume":"82","author":"Delpiano","year":"2017","journal-title":"Rev. Chil. Obstet. Ginecol."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"15","DOI":"10.2223\/JPED.368","article-title":"Infec\u00e7\u00f5es cong\u00eanitas e perinatais","volume":"75","author":"Yamamoto","year":"1999","journal-title":"J. Pediatr."},{"key":"ref_92","first-page":"38","article-title":"Fortalecendo a rede de apoio de m\u00e3es no contexto da s\u00edndrome cong\u00eanita do v\u00edrus Zika: Relatos de uma interven\u00e7\u00e3o psicossocial e sist\u00eamica","volume":"26","author":"Monteiro","year":"2017","journal-title":"Nova Perspect. Sist\u00eamica"},{"key":"ref_93","first-page":"e00046316","article-title":"Zika virus and women","volume":"32","author":"Diniz","year":"2016","journal-title":"Cad. Saude Publica"}],"container-title":["Tropical Medicine and Infectious Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2414-6366\/9\/5\/105\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:40:34Z","timestamp":1760107234000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2414-6366\/9\/5\/105"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,5,7]]},"references-count":93,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024,5]]}},"alternative-id":["tropicalmed9050105"],"URL":"https:\/\/doi.org\/10.3390\/tropicalmed9050105","relation":{},"ISSN":["2414-6366"],"issn-type":[{"value":"2414-6366","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,5,7]]}}}