This study describes the characteristics of 31 children with congenital toxoplasmosis children admitted to the University Hospital of Londrina, Southern Brazil, from 2000 to 2010. In total, 23 (85.2%) of the mothers received prenatal care but only four (13.0%) were treated for toxoplasmosis. Birth weight was <2500g in 37.9% of the infants. During the first month of life, physical examination was normal in 34.5%, and for those with clinical signs and symptoms, the main manifestations were hepatomegaly and/or splenomegaly (62.1%), jaundice (13.8%), and microcephaly (6.9%). During ophthalmic examination, 74.2% of the children exhibited injuries, 58.1% chorioretinitis, 32.3% strabismus, 19.4% microphthalmia, and 16.2% vitreitis. Anti-Toxoplasma gondii IgM antibodies were detected in 48.3% of the children. Imaging brain evaluation was normal in 44.8%; brain calcifications, hydrocephaly, or both conditions were observed in 27.6%, 10.3%, and 17.2%, respectively, of the patients. Patients with cerebrospinal fluid protein≥200mg/dL presented more brain calcifications (p=0.0325). Other sequelae were visual impairment (55.2% of the cases), developmental delay (31.0%), motor deficit (13.8%), convulsion (27.5%), and attention deficit (10.3%). All patients were treated with sulfadiazine, pyrimethamine, and folinic acid, and 55.2% of them exhibited adverse effects. The results demonstrate the significance of the early diagnosis and treatment of toxoplasmosis during pregnancy to reduce congenital toxoplasmosis and its consequences.
Introduction:The aim of this study was to investigate the knowledge of toxoplasmosis among professionals and pregnant women in the public health services in Paraná, Brazil. Methods: A cross-sectional observational and transversal study of 80 health professionals (44 nurses and 36 physicians) and 330 pregnant women [111 immunoglobulin M (IgM)-and IgG-non-reactive and 219 IgG-reactive] was conducted in 2010. An epidemiological data questionnaire was administered to the professionals and to the pregnant women, and a questionnaire about the clinical aspects and laboratory diagnosis of toxoplasmosis was administered to the professionals. Results: The participants frequently provided correct responses about prophylactic measures. Regarding the clinical and laboratory aspects, the physicians provided more correct responses and discussed toxoplasmosis with the pregnant women. The professionals had diffi culty interpreting the avidity test results, and the physicians stated that they referred pregnant women with high-risk pregnancies to a county reference center. Of the professionals, 53 (91.4%) reported that they instructed women during prenatal care, but only 54 (48.6%) at-risk pregnant women and 99 (45.2%) women who were not at risk reported receiving information about preventive measures. The physicians provided verbal instructions to 120 (78.4%) women, although instructional materials were available in the county. The pregnant women generally lacked knowledge about preventive measures for congenital toxoplasmosis, but the at-risk pregnant women tended to respond correctly. Conclusions: This study provides data to direct public health policies regarding the importance of updating the knowledge of primary care professionals. Mechanisms should be developed to increase public knowledge because prophylactic strategies are important for preventing congenital toxoplasmosis.
Toxoplasma gondii is a protozoan that has great genetic diversity and is prevalent worldwide. In 2018, an outbreak of toxoplasmosis occurred in Santa Maria, Brazil, which was considered the largest outbreak ever described in the world. This paper describes the isolation and molecular characterization of Toxoplasma gondii from the placenta of two pregnant women with acute toxoplasmosis who had live births and were receiving treatment for toxoplasmosis during the outbreak. For this, placental tissue samples from two patients underwent isolation by mice bioassay, conventional PCR and genotyping using PCR-RFLP with twelve markers. Both samples were positive in isolation in mice. The isolate was lethal to mice, suggesting high virulence. In addition, the samples were positive in conventional PCR and isolates submitted to PCR-RFLP genotyping presented an atypical genotype, which had never been described before. This research contributes to the elucidation of this great outbreak in Brazil.
Rev. Bras. Parasitol. Vet., 17, 1, 12-15 (2008) (Brazil. J. Vet. Parasitol.) RESUMOA toxoplasmose possui ampla distribuição geográfica e elevada prevalência sorológica entre seres humanos e animais. A forma adquirida é, na maioria dos casos, leve ou assintomática, entretanto, em aproximadamente 15% dos casos pode-se desenvolver a forma ocular. O objetivo deste trabalho foi relacionar algumas variáveis à ocorrência de anticorpos IgG antiToxoplasma gondii em escolares do ensino fundamental de Jataizinho (PR). Foram analisadas amostras de sangue de 276 crianças testadas pela reação de imunofluorescência indireta (IFI) onde 128 (46,4%) foram positivas. A análise das variá-veis revelou que a presença de gato doméstico foi um importante fator associado à infecção pelo T. gondii (OR= 3.45;) assim como crianças que relataram algum tipo de alteração visual (OR= 3.19;).
ResumoAs leishmanioses são antropozoonoses que envolvem diversas espécies de Leishmania e hospedeiros, tendo apresentações clínicas variáveis e consideradas de grande importância para a saúde pública. Este artigo descreve um caso de leishmaniose canina causada por Leishmania amazonensis, proveniente da cidade de Cambé, Paraná -Brasil. Este estado é considerado endêmico para a leishmaniose tegumentar americana (LTA) em humanos, porém este é o primeiro relato em cão na região, provocado pela L. amazonensis. A caracterização taxonômica da Leishmania foi realizada através da técnica multilocus enzyme electrophoresis (MLEE). Os sinais clínicos foram similares aos observados na leishmaniose visceral como poliartrite e emagrecimento progressivo. Conclui-se que a poliartrite quando relacionada à leishmaniose não pode ser considerada um sinal clínico associado somente a L. chagasi, tendo em vista que a L. amazonensis também tem esta como uma das suas formas de apresentação. A LTA torna-se um diagnóstico diferencial de poliartrite em cães. Palavras-chave: Canis familiaris, leishmaniose visceral, poliartrite AbstractLeishmaniasis are antropozoonoses involving various species of Leishmania and hosts, with variable clinical presentations and considered of great importance to public health. This article describes a case of canine leishmaniasis caused by Leishmania amazonensis, from the town of Cambé, Paraná state, Brazil. This state is considered endemic for American cutaneous leishmaniasis (ACL) in humans, but this is the first report in a dog in the region, caused by L. amazonensis. The taxonomic characterization of Leishmania was performed by multilocus enzyme electrophoresis technique (MLEE). Clinical signs were similar to those observed in visceral leishmaniasis as polyarthritis and progressive weight loss. It is concluded that the related polyarthritis when related to leishmaniasis, cannot be considered a clinical sign associated only with L. chagasi in view of the L. amazonensis also has this as one of its presentations. The LTA becomes a differential diagnosis of polyarthritis in dogs.
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