The Zika Virus Individual Participant Data Consortium: A Global Initiative to Estimate the Effects of Exposure to Zika Virus during Pregnancy on Adverse Fetal, Infant, and Child Health Outcomes

Abstract

This commentary describes the creation of the Zika Virus Individual Participant Data Consortium, a global collaboration to address outstanding questions in Zika virus (ZIKV) epidemiology through conducting an individual participant data meta-analysis (IPD-MA). The aims of the IPD-MA are to (1) estimate the absolute and relative risks of miscarriage, fetal loss, and short- and long-term sequelae of fetal exposure; (2) identify and quantify the relative importance of different sources of heterogeneity (e.g., immune profiles, concurrent flavivirus infection) for the risk of adverse fetal, infant, and child outcomes among infants exposed to ZIKV in utero; and (3) develop and validate a prognostic model for the early identification of high-risk pregnancies and inform communication between health care providers and their patients and public health interventions (e.g., vector control strategies, antenatal care, and family planning programs). By leveraging data from a diversity of populations across the world, the IPD-MA will provide a more precise estimate of the risk of adverse ZIKV-related outcomes within clinically relevant subgroups and a quantitative assessment of the generalizability of these estimates across populations and settings. The ZIKV IPD Consortium effort is indicative of the growing recognition that data sharing is a central component of global health security and outbreak response.

Keywords: Zika virus; congenital Zika syndrome; data sharing; emerging pathogen; individual participant data meta-analysis; microcephaly; prediction model; prognostic model.

Figure 1

Distribution of monthly Zika virus (ZIKV) cases and Zika virus-related longitudinal studies of pregnant women and their infants and children. Vertical axis shows the total number of monthly reported ZIKV cases for countries/regions listed (6-month moving average of raw data extracted from PAHO PLISA Health Information Platform for the Americas, 2 November 2019). Each of the 42 colored circles represents a participating study with color corresponding to country/region and circle size corresponding to the number of pregnant women enrolled in the study. The horizontal colored lines indicate the time period during which a participating study recruited pregnant women. Ten studies missing information on number of pregnant women enrolled are excluded from the graph. * French Territories include Guadeloupe, Martinique, and French Guiana.