รายงานผลการเฝ้าระวังหญิงตั้งครรภ์ติดเชื้อไวรัสซิกาและผลการคลอด ประเทศไทย พ.ศ. 2559–2563

Abstract

Backgrounds: In 2015, Brazil reported an association between Zika virus (ZIKV) infection and microcephaly. After that WHO declared that Zika infection associated with microcephaly and other neurological disorders constitutes a Public Health Emergency of International Concern (PHEIC). Since the Zika outbreaks of 2016 in Thailand, reported Zika cases have distributed throughout the country then continued to exist.
Methods: Descriptive study was conducted by reviewing the data of Zika infected surveillance in Thailand during 2016–2020. Case definition of patients include women with laboratory evidence of ZIKV infection during pregnancy and their infants should be evaluated and managed for possible adverse outcomes.
Results: A total of 213 pregnant women with ZIKV infection, the patients resided in 51 of the 77 provinces in Thailand. The incidence was highest rainy season. Symptomatic pregnant women were 65% (n = 138). The evidence of possible recent ZIKV infection, birth defects potentially related to ZIKV were identified in 186 pregnant women. There were 77% (n = 143) of infants born at full term. Pregnancy outcomes were reported in 83 of 186 completed pregnancies with maternal symptoms or exposure exclusively in the second trimester (45%), third trimesters (40%) first trimesters (14%) and missing reported (1%) respectively. Birth defects were reported for 4 of 11 pregnant symptomatic women and seven of eleven asymptomatic pregnant women. During January 1st, 2016–December 31st, 2020, we obtained 2–year reports of infants born, total 70 cases. These 4 infants birth defects and developmental disabilities, eight without microcephaly, but brain abnormalities in long–term. Two of three had microcephaly, myasthenia and seizure.
Conclusion & Recommendations: Given this situation and considering the continued expansion of ZIKV in Thailand, our focus was observing pregnant and active cases finding as soon as they detected ZIKV. Health education service for pregnant woman in antenatal care clinic. Further guidelines on monitoring neurological syndromes and the clinical management of microcephaly and/or infants born to Zika infected woman are provided herein.