Building Programs to Eradicate Toxoplasmosis Part IV: Understanding and Development of Public Health Strategies and Advances “Take a Village”

Abstract

Purpose of Review Review international efforts to build a global public health initiative focused on toxoplasmosis with spillover benefits to save lives, sight, cognition and motor function benefiting maternal and child health. Recent Findings Multiple countries’ efforts to eliminate toxoplasmosis demonstrate progress and context for this review and new work. Summary Problems with potential solutions proposed include accessibility of accurate, inexpensive diagnostic testing, pre-natal screening and facilitating tools, missed and delayed neonatal diagnosis, restricted access, high costs, delays in obtaining medicines emergently, delayed insurance pre-approvals and high medicare copays taking considerable physician time and effort, harmful shortcuts being taken in methods to prepare medicines in settings where access is restricted, reluctance to perform ventriculoperitoneal shunts promptly when needed without recognition of potential benefit, access to resources for care, especially for marginalized populations, and limited use of recent advances in management of neurologic and retinal disease which can lead to good outcomes.

Novel paradigm enables accurate monthly gestational screening to prevent congenital toxoplasmosis and more

“…Our studies, along with the earlier experience in the Palo Alto reference laboratory and collated recent results, demonstrate practical problems in the US with potential serious consequences for patient care using NRL tests [ 35 ] where the ICT can be helpful in a patient’s management. This has been confirmed in France making a total of 132 of 137 IgM and 27 of 27 IgG false positive results were corrected.…”

“…It should be emphasized again that POC tests for anti- Toxoplasma IgG and IgM, such as the ICT, are merely a first step toward diagnosis, given that IgM antibodies can persist for up to several years after acute infection. For any woman who receives a false positive IgM test result, the next step of an evaluation with other tests can involve weeks of waiting for a blood sample to be tested using technology that runs at much higher costs than the point of care test [ 1 , 2 , 6 , 7 , 27 , 33 , 35 ]. Persistence of IgM in subacute or chronic infection, results just above the cut off or more, and true seroconversion all cause positive IgM results.…”

“…Providers were given the same educational pamphlet that their patients also received. All had the opportunity to ask questions of RMc and learned about various related educational resources [ 1 – 3 , 6 , 7 , 32 – 35 , 38 , 46 ].…”

“…We collated results of all of our earlier work, both published already [ 23 – 27 , 29 – 31 , 35 ] and other separate studies ongoing at present on related topics that were published separately concurrently [ 30 ], and our current work herein. Our earlier work and some of the work presented herein was used to apply for European CE mark which was granted in October 2020.…”

“…This highly accurate test may help enable screening for acquisition of T . gondii in gestation [ 23 – 39 ], as well as being useful in other settings, and thereby contribute to saving sight, cognition, motor function and lives and improve quality of life [ 1 – 10 , 12 – 15 , 17 , 24 , 35 ].…”