Conséquences d’une infection néonatale au virus du Chikungunya par transmission materno-fœtale. Évaluation neurocognitive à l’âge de 10 ans

Abstract : Introduction: Chikungunya is an arboviral infection transmitted by Aedes mosquitoes (commonly called Asian tiger mosquitoes) which has been expanding largely since its re-emergence in 2004. During an unprecedented outbreak on the Reunion Island between 2005 and 2006, paediatricians described for the first time a mother-to-child vertical transmission of the virus during childbirth. An assessment of the toddlers at the age of two years revealed that consequences were mainly neurological, suggesting a global retardation in psychomotor acquisitions subsequent to the neonatal infection. Objectives: The main objective of our study was to evaluate the neurocognitive performances of children infected by the chikungunya virus during delivery, by the age of 10 years. The secondary objectives were to identify associated neuro-sensory disorders, and to assess the children’s schooling and the use of specialized care such as speech therapy, orthoptics or psychomotor care. Methods: In 2015, we examined 21 children from the CHIMERE cohort, who got infected by chikungunya in the neonatal period, at the approximate age of 10 years. Based on EDA evaluation scale (assessing children’s cognitive and learning outcomes), children performed a variety of neurocognitive tests in comparison with a reference group of 626 children in order to track neurocognitive impairments. Results: The results showed lower performances in the infected group, inferior to -1DS on both verbal and non-verbal abilities and slightly superior to -1DS on learning skills on the EDA scale (p < 0.001). 4 children out of 21 (19%) were affected by severe encephalopathy with psychomotor retardation, and educate at special school. In addition, MR imaging performed on most affected children, allowed to localise cerebral hypo-metabolism in the frontal white matter where the coordination and language functions are regulated. Conclusion: Mother-to-child infection to the chikungunya virus has a major impact on children’s neurocognitive functions despite a great brain plasticity. Neonatologists, obstetricians and paediatricians should be on the frontline for prevention and surveillance of the arbovirus epidemics.
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Master Thesis
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Raphaëlle Sarton. Conséquences d’une infection néonatale au virus du Chikungunya par transmission materno-fœtale. Évaluation neurocognitive à l’âge de 10 ans. Sciences du Vivant [q-bio]. 2019. ⟨dumas-02112103⟩

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