Investigating Zika virus prevalence, congenital Zika syndrome and its effects on the developing human brain in Ugandan children.
Angelina Kakooza-Mwesige1, James. K. Tumwine1, Julius. K. Lutwama2, Ian Goodfellow3.
1Makerere University College of Health Sciences, Department of Paediatrics and Child Health, School of Medicine, P.O. Box 7072, Kampala, Uganda, 2UVRI/CDC Influenza Surveillance and Zoonotics Surveillance Programs, National Influenza Center, Uganda Virus Research Institute, P. O. Box 49, Entebbe, Uganda, 3University of Cambridge, Division of Virology, Lab Block Level 5 (BOX 237), Department of Pathology, Addenbrooke’s Hospital Hills Road, Cambridge, UK CB2 0QQ
Introduction:
The re-emergence of the Zika virus (ZIKV) has generated considerable alarm globally, particularly related to its potential to cause permanent neurological dysfunction in infected foetuses. Among the reported ZIKV syndromes, the congenital Zika syndrome comprises not only microcephaly and fetal brain damage, but also a range of neurodevelopmental abnormalities. To date in Uganda, the prevalence of ZIKV, associated factors, genetics, and neurodevelopmental outcomes in the children born with this infection is unknown
Objectives:
To determine the sero-prevalence of ZIKV and associated factors among pregnant women in Uganda, describe the pregnancy and child neurodevelopmental outcomes, ascertain the prevailing ZIKV genotype and determine the relation between microcephaly and in utero ZIKV infection.
Methodology:
We are in the process of recruiting and following up until delivery, 2,500 pregnant women from 16 health units with access to Lake Victoria in Wakiso district, Uganda. Women found positive for serum ZIKV IgM by IgM-capture enzyme-linked immunosorbent assay will determine the prevalence, and these will be compared to those found negative to establish the associated factors. ZIKV will be isolated from the serum samples using quantitative real-time polymerase chain reaction assays and undergo sequencing analysis to determine the genotype. Plaque-reduction neutralization testing will help differentiate ZIKV from other similar viruses. A case control design of 108 cases of microcephaly in a ratio of 1:1 will determine the association between ZIKV infection and microcephaly.
Conclusions:
Information generated by this study is exceedingly important to provide counselling to pregnant women and help protect their health and that of their babies. We will also be able to build a cohort, which could be a foundation for future in-depth and follow-up studies.
KEY WORDS: Congenital Zika syndrome, Genotype, Neurodevelopment, Uganda, Zika prevalence