Comparison of Oropharyngeal Dysphagia in Brazilian Children with Prenatal Exposure to Zika Virus, With and Without Microcephaly.

This was a cross-sectional comparison, so it cannot show that Zika exposure or microcephaly caused the swallowing differences. The clinical swallowing assessment has not been standardized or validated specifically for congenital Zika infection. The evaluator may have been influenced by caregiver information before the clinical assessment, although the authors say the protocol was objective. Only the oral and pharyngeal phases were assessed, so esophageal swallowing problems were not measured. Moderate and severe dysphagia were grouped together in some comparisons because numbers were low. The study did not test treatment or swallowing outcomes over time, so it cannot say what intervention helps.

Funders listed include H2020 European Institute of Innovation and Technology, Wellcome Trust and the UK Department for International Development, Medical Research Council on behalf of the Newton Fund and Wellcome Trust, Fundação de Amparo à Ciência e Tecnologia do Estado de Pernambuco, Fundação Coordenação de Projetos, Pesquisas e Estudos Tecnológicos, Wellcome Trust Research Enrichment in Epidemic Situations, Conselho Nacional de Desenvolvimento Científico e Tecnológico, Secretaria de Vigilância em Saúde/Ministério da Saúde de Brasil, and Departamento de Ciência e Tecnologia. The supplied text does not state author conflicts of interest.

Do not assume that Zika-exposed children without microcephaly have no swallowing problem. The clinical swallowing assessment found OPD in 8.6% of them, with oral-phase signs such as food escaping the mouth in 8.6% and food stasis in 3.4%.