Association between prenatal treatment and clinical manifestations of congenital toxoplasmosis in infancy: A cohort study in 13 European centres

Gras, Luuk; Wallon, Martine; Pollak, Arnold; Cortina‐Borja, Mario; Evengård, Birgitta; Hayde, Michael; Petersen, Eskild; Gilbert, Ruth

doi:10.1080/08035250500251999

Cited by 95 publications

(77 citation statements)

References 30 publications

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“…39,40 Although none of the neonates in this study showed any detectable symptoms (100%, 27/27), with the relatively small sample size of T. gondii positive neonates, this is not significantly different from 80-90% found in the previously reported studies. 39,40 One of the limitations of this study is that detection is based on PCR and this means that it is possible that it does not represent living parasites, but parasite DNA molecules. While this has to be acknowledged, PCR is used widely as a diagnostic tool for Toxoplasma 1 and a wide range of other protozoan parasitic diseases.…”

Section: Discussioncontrasting

confidence: 64%

High frequency detection ofToxoplasma gondiiDNA in human neonatal tissue from Libya

Haq

Abushahama

Gerwash

et al. 2016

Trans R Soc Trop Med Hyg

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Background: Toxoplasma gondii is a parasite that causes significant disease in humans. Toxoplasmosis is normally asymptomatic, unless associated with congenital transmission, or in immunocompromised people. Congenital transmission generally occurs at low frequencies. In this study, we use PCR to investigate possible congenital transmission of T. gondii during pregnancy in a cohort of mothers from Libya.Methods: Two hundred and seventy two pregnant women (producing 276 neonates) were recruited to obtain umbilical cord tissue from their neonates at birth; DNA was extracted from that tissue and tested for T. gondii DNA using two specific PCR protocols based on the sag 1 and sag 3 genes.Results: Toxoplasma gondii DNA was detected in the umbilical cord DNA from 27 of the 276 neonates giving a prevalence of 9.9% (95% CI 6.8-13.9%). Compared with more commonly reported rates of congenital transmission of 0.1% of live births, this is high. There was no association of infection with unsuccessful pregnancy.Conclusions: This study shows a high frequency presence of T. gondii DNA associated with neonatal tissue at birth in this cohort of 276 neonates from Libya. Although PCR cannot detect living parasites, there is the possibility that this indicates a higher than usual frequency of congenital transmission.

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Section: Discussioncontrasting

confidence: 64%

High frequency detection ofToxoplasma gondiiDNA in human neonatal tissue from Libya

Haq

Abushahama

Gerwash

et al. 2016

Trans R Soc Trop Med Hyg

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“…Some reports have suggested that pregnant women diagnosed with acute toxoplasmosis should be treated as soon as possible to reduce the risk and severity of congenital infection , Gras et al 2005. Others have argued that there is still no treatment capable of reducing vertical transmission , Peyron et al 2000).…”

mentioning

confidence: 99%

Prevalence of acute toxoplasmosis infection among 41,112 pregnant women and the mother-to-child transmission rate in a public hospital in South Brazil

Varella

Canti

Santos

et al. 2009

Mem. Inst. Oswaldo Cruz

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“…In France, where the infection is relatively common, the surveillance system records only the lesions apparent at the time of birth, although the actual size of the damage related to congenital toxoplasmosis can only be determined with long-term follow-up of the infants. Infants born with congenital infection carry a risk of ocular lesions leading to blindness during childhood and adolescence even if they appear asymptomatic at birth (Gras et al, 2005).…”

Section: Discussionmentioning

confidence: 99%

Seroprevalence of Toxoplasma gondii and rubella among pregnant women in central Turkey

elen¹,

Sargin²,

Ccedil³

et al. 2013

Afr. J. Microbiol. Res.

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Infection with Toxoplasma gondii (T. gondii), when acquired in pregnancy, can lead to fetal infection, which may ultimately result in the loss of the fetus or in lesions involving the brain and the eyes. Rubella, when acquired in the first 12 weeks of pregnancy, is associated with a nearly 90% risk of congenital malformations. The aim of this study was to assess the seroprevalence of T. gondii and rubella among pregnant women at a tertiary referral hospital in central Turkey and to evaluate the use of our results for the prevention of congenital rubella syndrome (CRS) and congenital toxoplasmosis (CT). Data were obtained from the test results of sera collected from pregnant women during their first routine antenatal visit between 2008-2010. The results of the TORCH serology and avidity tests were evaluated. Age-specific subgroups were arranged for the rubella and T. gondii antibodies, and the distribution of seropositivity among the subgroups was assessed. Serum samples were evaluated for rubella (n=31385) and T. gondii (n=30863) IgG, IgM, and IgG avidity. The seropositivity of antibodies for T. gondii was 7869 (25.5%) and 83 (0.3%) for IgG and IgM, respectively. For rubella, the seropositivity was 29478 (93.9%) and 124 (0.4%) for IgG and IgM, respectively. In cases with both IgM and IgG, seropositivity avidity tests were performed. A high avidity of IgG antibodies was detected in 95 (76.6%) rubella cases and 30 (36.1%) T.gondii cases. Seropositivity for T. gondii increased significantly with age, while rubella seropositivity was high in all of the age-specific subgroups. In conclusion T. gondii and rubella are common causes of severe congenital infection. Widespread preventive antenatal measures and screening may help to protect against these teratogenic agents. Due to high seroprevalence of rubella, vaccination programs during childhood and preconceptional periods rather than antenatal screening appear to be more efficient for eliminating CRS. Avoidance of raw meat consumption, proper disposal of the fecal material of domestic animals, and elimination of oocysts from raw food are the main measures to prevent infection with T. gondii. Antenatal screening for toxoplasmosis is warranted, considering the low seroprevalence and serious fetal hazards of congenital infection.

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Association between prenatal treatment and clinical manifestations of congenital toxoplasmosis in infancy: A cohort study in 13 European centres

Abstract: Only early versus no prenatal treatment for intracranial lesions showed a statistically significant benefit. A large randomized controlled trial and/or meta-analysis of individual patient data from cohort studies is required to confirm these findings.

Cited by 95 publications

References 30 publications

High frequency detection ofToxoplasma gondiiDNA in human neonatal tissue from Libya

High frequency detection ofToxoplasma gondiiDNA in human neonatal tissue from Libya

Prevalence of acute toxoplasmosis infection among 41,112 pregnant women and the mother-to-child transmission rate in a public hospital in South Brazil

Seroprevalence of Toxoplasma gondii and rubella among pregnant women in central Turkey

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