Long-term consequences of Zika virus infections during pregnancy for school- aged children and their families in Brazil

Using unparalleled epidemiological, administrative, and social science data continuously collected from 2015 onwards in Brazil, this collaborative proposal aims to define the prognosis and learning needs of school-aged children with prenatal exposure to Zika virus (ZIKV) and the long-term health and social impacts for families of children with Congenital Zika Syndrome (CZS). Through four linked work packages, we will: (i) define the natural history of CZS in the first 12 years of life, including the frequency of late- onset manifestations, hospitalizations, and deaths, (ii) compare neurodevelopment and learning-related outcomes in children with and without CZS, (iii) evaluate long-term consequences of CZS for families, including implications of COVID-19, and (iv) critically interrogate the experience of families engaging in research and data sharing initiatives during and after public health emergencies. To achieve these aims, we are requesting resources to perform comprehensive clinical and neurodevelopmental assessments in the Microcephaly Epidemic Research Group and ZIKAIFF Pediatric Cohorts in Pernambuco and Rio de Janeiro states, undertake a nationwide individual participant data meta-analysis of ZIKV-related clinical and neurodevelopmental outcomes among children in the Zika Brazilian Cohorts Consortium, link large- scale nationwide electronic health and social records in the CIDACS/Fiocruz Zika Platform, and conduct qualitative research with key stakeholders.