Please use this identifier to cite or link to this item: https://www.arca.fiocruz.br/handle/icict/19673
Title: Microcephaly in Pernambuco State, Brazil: epidemiological characteristics and evaluation of the diagnostic accuracy of cutoff points for reporting suspected cases
Other Titles: Microcefalia no Estado de Pernambuco, Brasil: características epidemiológicas e avaliação da acurácia diagnóstica dos pontos de corte adotados para notificação de caso
Microcefalia en el estado de Pernambuco, Brasil: características epidemiológicas y evaluación de la precisión diagnóstica de los puntos de corte adoptados para la notificación de casos
Authors: Souza, Wayner Vieira de
Araújo, Thalia Velho Barreto de
Albuquerque, Maria de Fátima Pessoa Militão de
Braga, Maria Cynthia
Ximenes, Ricardo Arraes de Alencar
Miranda-Filho, Demócrito de Barros
Bezerra, Luciana Caroline Albuquerque
Dimech, George Santiago
Carvalho, Patrícia Ismael de
Assunção, Romildo Siqueira de
Santos, Roselene Hans
Oliveira, Wanderson Kleber de
Rodrigues, Laura Cunha
Martelli, Celina Maria Turchi
Affilliation: Fundação Oswaldo Cruz. Instituto Aggeu Magalhães. Recife, PE, Brasil
Abstract: The increase in the number of reported cases of microcephaly in Pernambuco State, and Northeast Brazil, characterized an epidemic that led the Brazilian Ministry of Health to declare a national public health emergency. The Brazilian Ministry of Health initially defined suspected cases as newborns with gestational age (GA) ≥ 37 weeks and head circumference (HC) ≤ 33cm, but in December 2015 this cutoff was lowered to 32cm. The current study aimed to estimate the accuracy, sensitivity, and specificity of different cutoff points for HC, using ROC curves, with the Fenton and Intergrowth (2014) curves as the gold standard. The study described cases reported in Pernambuco from August 8 to November 28, 2015, according to sex and GA categories. The Fenton and Intergrowth methods provide HC growth curves according to GA and sex, and microcephaly is defined as a newborn with HC below the 3rd percentile in these distributions. Of the 684 reported cases, 599 were term or post-term neonates. For these, the analyses with ROC curves show that according to the Fenton criterion the cutoff point with the largest area under the ROC curve, with sensitivity greater than specificity, is 32cm for both sexes. Using the Intergrowth method and following the same criteria, the cutoff points are 32cm and 31.5cm for males and females, respectively. The cutoff point identified by the Fenton method (32cm) coincided with the Brazilian Ministry of Health recommendation. Adopting Intergrowth as the standard, the choice would be 32cm for males and 31.5cm for females. The study identified the need to conduct critical and on-going analyses to evaluate cutoff points, including other characteristics for microcephaly case definition.
Keywords: Brazil
Female
Gestational Age
Humans
Infant Newborn
Male
Microcephaly
Pregnancy
Pregnancy Complications, Infectious
ROC Curve
Sensitivity and Specificity
Zika virus
Zika Virus Infection
Epidemiology
keywords: Microcefalia
Brasil
Zika virus
Epidemiologia
DeCS: Zika virus
Sensibilidade e Especificidade
Infecção pelo Zika virus
Humanos
Masculino
Gravidez
Complicações Infecciosas na Gravidez
Curva ROC
Microcefalia
Recém-Nascido
Feminino
Idade Gestacional
Epidemiologia
Diagnóstico
Issue Date: 2016
Citation: SOUZA, Wayner Vieira de et al. Microcephaly in Pernambuco State, Brazil: epidemiological characteristics and evaluation of the diagnostic accuracy of cutoff points for reporting suspected cases. Cadernos de Saúde Pública, v. 32, n. 4, p. 1-7, 2016.
DOI: 10.1590/0102-311X00017216
ISSN: 1678-4464
Copyright: open access
Appears in Collections:PE - IAM - Artigos de Periódicos

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27143306 2017 sou-mic.pt.oa.pdfVersão em português180.17 kBAdobe PDFView/Open


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