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Cited by 29Mosquito-borne diseases and controlVirology and Viral DiseasesInfectious Encephalopathies and Encephalitis

The DOI matches its Crossref record; 280 of the 284 references it cites were found in a registry or an index.

Zika virus infection as a cause of congenital brain abnormalities and Guillain-Barre syndrome: a living systematic review

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Counotte, Michel Jacques, Meili, Kaspar Walter, Taghavi, Katayoun, Calvet, Guilherme, Sejvar, James, Low, Nicola·2019·F1000Research
DOI 10.12688/f1000research.19918.1PMC PMC6852328
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Abstract

Background: The Zika virus (ZIKV) caused a large outbreak in the Americas leading to the declaration of a Public Health Emergency of International Concern in February 2016. A causal relation between infection and adverse congenital outcomes such as microcephaly was declared by the World Health Organization (WHO) informed by a systematic review structured according to a framework of ten dimensions of causality, based on the work of Bradford Hill. Subsequently, the evidence has continued to accumulate, which we incorporate in regular updates of the original work, rendering it a living systematic review. Methods: We present an update of our living systematic review on the causal relation between ZIKV infection and adverse congenital outcomes and between ZIKV and GBS for four dimensions of causality: strength of association, dose-response, specificity, and consistency. We assess the evidence published between January 18, 2017 and July 1, 2019. Results: We found that the strength of association between ZIKV infection and adverse outcomes from case-control studies differs according to whether exposure to ZIKV is assessed in the mother (OR 3.8, 95% CI: 1.7-8.7, I 2 =19.8%) or the foetus/infant (OR 37.4, 95% CI: 11.0-127.1, I 2 =0%). In cohort studies, the risk of congenital abnormalities was 3.5 times higher after ZIKV infection (95% CI: 0.9-13.5, I 2 =0%). The strength of association between ZIKV infection and GBS was higher in studies that enrolled controls from hospital (OR: 55.8, 95% CI: 17.2-181.7, I 2 =0%) than in studies that enrolled controls at random from the same community or household (OR: 2.0, 95% CI: 0.8-5.4, I 2 =74.6%). In case-control studies, selection of controls from hospitals could have biased results. Conclusions: The conclusions that ZIKV infection causes adverse congenital outcomes and GBS are reinforced with the evidence published between January 18, 2017 and July 1, 2019.

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Figure 1. For congenital abnormalities due to ZIKV, exposure assessment in mother-infant pairs can be performed in the mother or the foetus or infant. The latest and previous versions of this figure are available as extended data 16.
Figure 1. For congenital abnormalities due to ZIKV, exposure assessment in mother-infant pairs can be performed in the mother or the foetus or infant. The latest and previous versions of this figure are available as extended data 16.CC BY · PubMed Central
Figure 2. Map of the epidemiological studies that report on adverse congenital outcomes (blue) or Guillain-Barré syndrome (red) associated with Zika virus exposure. The size of the points correspond with the number of exposed individuals with the adverse outcome, according to the definitions used in the publications. The latest and previous versions of this figure are available as extended data 16.
Figure 2. Map of the epidemiological studies that report on adverse congenital outcomes (blue) or Guillain-Barré syndrome (red) associated with Zika virus exposure. The size of the points correspond with the number of exposed individuals with the adverse outcome, according to the definitions used in the publications. The latest and previous versions of this figure are available as extended data 16.CC BY · PubMed Central
Figure 3. PRISMA flow-chart of publications retrieved, screened and included between January 18, 2017 and July 1, 2019. Adapted from: Moher et al. (2009) 18. The latest and previous versions of this figure are available as extended data 16.
Figure 3. PRISMA flow-chart of publications retrieved, screened and included between January 18, 2017 and July 1, 2019. Adapted from: Moher et al. (2009) 18. The latest and previous versions of this figure are available as extended data 16.CC BY · PubMed Central
Figure 4. Forest plot and meta-analysis of case-control studies reporting on ZIKV infection assessed in mothers ( A) and in infants ( B) and adverse congenital outcomes (microcephaly, congenital malformations, central nervous system abnormalities). The odds ratio from the five case-control studies that assess exposure in mothers combined is 3.8 (95% CI: 1.7-8.7, tau 2=2.37, I 2=19.8%); the odds ratio for the studies that assess exposure in infants is 37.4 (95% CI: 11.0-127.1, tau 2=0, I 2=0%). The odds ratios are plotted on the log scale. Abbreviations: CSF, cerebrospinal fluid, PRNT, plaque reduction neutralisation test; RE, random effects; RT-PCR, reverse transcription polymerase chain reaction. The latest and previous versions of this figure are available as extended data 16.
Figure 4. Forest plot and meta-analysis of case-control studies reporting on ZIKV infection assessed in mothers ( A) and in infants ( B) and adverse congenital outcomes (microcephaly, congenital malformations, central nervous system abnormalities). The odds ratio from the five case-control studies that assess exposure in mothers combined is 3.8 (95% CI: 1.7-8.7, tau 2=2.37, I 2=19.8%); the odds ratio for the studies that assess exposure in infants is 37.4 (95% CI: 11.0-127.1, tau 2=0, I 2=0%). The odds ratios are plotted on the log scale. Abbreviations: CSF, cerebrospinal fluid, PRNT, plaque reduction neutralisation test; RE, random effects; RT-PCR, reverse transcription polymerase chain reaction. The latest and previous versions of this figure are available as extended data 16.CC BY · PubMed Central
Figure 5. Forest plot and meta-analysis of cohort studies reporting on ZIKV infection and adverse congenital outcomes. The risk ratio from the random effects model is 3.5 (95% CI: 0.9-13.5, tau2=0,I 2=0%). The risk ratios are provided on the log scale. Abbreviations: ZIKV, Zika virus; PRNT, plaque reduction neutralisation test; RE, random effects; RT-PCR, Reverse transcription polymerase chain reaction. The latest and previous versions of this figure are available as extended data.
Figure 5. Forest plot and meta-analysis of cohort studies reporting on ZIKV infection and adverse congenital outcomes. The risk ratio from the random effects model is 3.5 (95% CI: 0.9-13.5, tau2=0,I 2=0%). The risk ratios are provided on the log scale. Abbreviations: ZIKV, Zika virus; PRNT, plaque reduction neutralisation test; RE, random effects; RT-PCR, Reverse transcription polymerase chain reaction. The latest and previous versions of this figure are available as extended data.CC BY · PubMed Central
Figure 6. Forest plot of six included case-control studies and their exposure assessment. Odds ratios (ORs) are shown on the log-scale. The meta-analysis is stratified by the selection of controls: Hospital controls, or community/household controls. Most similar exposure assessment measures are compared (IgM 256, 258, 259, 277, recent flavivirus infection 255, or IgM and/or RT-PCR 257). OR: 7.0 [95% CI: 1.7-28.8, tau2=2.78, I 2=78.3%]. ORs from studies marked with an asterisk (*) are matched ORs, unmarked studies provided crude ORs. The latest and previous versions of this figure are available as extended data 16.
Figure 6. Forest plot of six included case-control studies and their exposure assessment. Odds ratios (ORs) are shown on the log-scale. The meta-analysis is stratified by the selection of controls: Hospital controls, or community/household controls. Most similar exposure assessment measures are compared (IgM 256, 258, 259, 277, recent flavivirus infection 255, or IgM and/or RT-PCR 257). OR: 7.0 [95% CI: 1.7-28.8, tau2=2.78, I 2=78.3%]. ORs from studies marked with an asterisk (*) are matched ORs, unmarked studies provided crude ORs. The latest and previous versions of this figure are available as extended data 16.CC BY · PubMed Central

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Citations

Cites

Research works printed but not linked: 8

  1. D Saulino, 2017, The first zika-related infant mortality in the United States: An autopsy case report., Laboratory Investigation., 97, 10A
  2. M De Fatima Viana Vasco Aragao, 2018, Congenital Zika Syndrome: Comparison of brain CT scan with postmortem histological sections from the same subjects., Neuroradiology., 60, 367-8
  3. M Cano, 2018, Zika virus infection in Hospital del Niño 'Dr José Renán Esquivel' (Panamá): Case Review since the introduction in Latin America., Pediátr Panamá., 47, 15-9
  4. A Collier, 2018, Maternal Immune Response to Zika Virus., Reproductive Sciences., 25, 163a-4a
  5. R Caixeta, 2018, Vertical transmission of zika virus and perinatal microcephaly., Int J Gynaecol Obstet., 143, 725, 10.1002/ijgo.12583 · DOI
  6. M Jones, 2018, Multidisciplinary approach to Guillain-Barre Syndrome and neurologic injuries after zika virus., J Spinal Cord Med., 41, 588
  7. A Ali, 2017, Zik-V outbreak and Guillain-Barre syndrome in Jamaica., Neurology., 88
  8. M Dourado, 2017, High Incidence of Guillain-Barre Syndrome after Zika Virus Infection in the State Rio Grande Do Norte, in Northeast Brazil., J Peripher Nerv Syst., 22, 275-6

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Metadata

Authors
Counotte, M. J., Meili, K. W., Taghavi, K., Calvet, G., Sejvar, J., & Low, N.
Affiliations
  • University of Bern (CH)
  • Instituto Nacional de Infectologia Evandro Chagas (BR)
  • Centers for Disease Control and Prevention (US)
Corresponding author
  • Counotte, Michel Jacques
  • Low, Nicola
ORCID
Venue
F1000Research
Publisher
F1000 Research Ltd
Published
2019-08-14
Volume
8
Pages
1433
ISSN
2046-1402 (ISSN-L)
DOI
10.12688/f1000research.19918.1
PMC
PMC6852328
OpenAlex
W3033655606
Cited by
29
References
284
Citations by year
2026: 3 · 2025: 5 · 2024: 3 · 2023: 2 · 2022: 1 · 2021: 6 · 2020: 7 · 2019: 1
FWCI
0.61
Type
journal article
Language
en
Open access
Licence
Locations
  • F1000Research (publishedVersion, cc-by)
  • Americanae (AECID Library) (publishedVersion, other-oa)
  • Arca - Repositório Institucional da Fiocruz (publishedVersion, other-oa)
  • Bern Open Repository and Information System (University of Bern) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • LA Referencia (Red Federada de Repositorios Institucionales de Publicaciones Científicas) (submittedVersion, other-oa)
  • Open Access CRIS of the University of Bern
Funders
Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (320030_170069)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Mosquito-borne diseases and control
  • Health Sciences › Medicine › Epidemiology › Virology and Viral Diseases
  • Health Sciences › Medicine › Infectious Diseases › Infectious Encephalopathies and Encephalitis
Keywords
Zika virus infection, congenital brain malformation, Guillain-Barré syndrome, microcephaly, causal inference, Bradford Hill criteria, associative strength, dose-response relationship, specificity, consistency, maternal infection, fetal infection, control selection bias

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