Implementation of Screening for Toxoplasma gondii Infection in Pregnancy

Paschale, Massimo De; Agrappi, Carlo; Manco, Maria Teresa; Cerulli, Teresa; Clerici, Pierangelo

doi:10.4021/jocmr2010.05.321w

Cited by 14 publications

(8 citation statements)

References 11 publications

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“…The 11 articles included in this study have been carried out in various countries in Latin America, Europe, the USA, Africa and Asia ( Figure 2 ), ( Table 2 ). More specifically, the research of De Paschale et al, 2010 ( 35 ) investigated the implementation of screening of Toxoplasma gondii infection during pregnancy. The cases studied consisted of 4.694 pregnant women who gave birth between 2006 and 2008 in Italy.…”

Section: Resultsmentioning

confidence: 99%

The Importance of Use of the On-line Databases as a Source for Systematic Review of Toxoplasmosis Screening During Pregnancy

et al. 2021

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Background: Infection with the parasite Toxoplasma gondii is a common infection in animals and humans worldwide. This infection can occur after ingestion of water or food contaminated with cat oocytes, ingestion of tissue cysts in mammalian and avian meat and congenitally. The prenatal infection can lead to Congenital Toxoplasmosis with miscarriage or stillbirth. After infection, laboratory tests are positive within 2-3 weeks and remain positive throughout life. However, testing for Toxoplasma infection during pregnancy is necessary in some countries, while in others it is not a mandatory “screening” test. Objective: The aim of this study was to review systematically the screening of toxoplasmosis in pregnancy in different countries worldwide. Methods: Cohorts, retrospective and cross-sectional studies were incorporated in our review, finally including 11 articles from an initial pool of 1532 related papers. Results: The seroprevalence of pregnant women varies from countries with low prevalence to regions with high prevalence and screening policies also differ. Most countries worldwide have control policies, while Germany and Mexico that do not have systematic screening for Toxoplasma during the prenatal period. Conclusion: Our results show that Congenital Toxoplasmosis is very rare in some countries and it is very difficult to find a balance between potential risk and benefit of a screening program. For this reason, some countries are limited to prenatal counseling to reduce CT. In addition, the reduction of major sources of contamination especially in developing countries is the most important prevention measure.

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Section: Resultsmentioning

confidence: 99%

The Importance of Use of the On-line Databases as a Source for Systematic Review of Toxoplasmosis Screening During Pregnancy

et al. 2021

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“…According to the authors, this was the first study to evaluate the compliance with the screening scheme in France. From northern Italy, adherence of less than 35% with recommended five or more screening tests was reported [ 23 ]. With regard to Austria, we are not aware of previous studies that addressed this problem.…”

Section: Discussionmentioning

confidence: 99%

“Blind periods” in screening for toxoplasmosis in pregnancy in Austria – a debate

2012

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Recent studies from Austria, France and Italy have shown that there is a poor adherence to the screening scheme for maternal Toxoplasma infections in pregnancy demonstrated by the fact that many recommended examinations are missed. This leads to undetected infections and limits our knowledge of incidence of the disease. We discuss the negative consequences of this situation on research on treatment effectiveness and the outcomes of congenital toxoplasmosis. The responsible public health institutions should assume responsibility for appropriate surveillance of the screening programme and take measures to improve screening adherence during pregnancy. Screening should start as early as possible in pregnancy and the latest test should be done at delivery. Screening schedule should allow distinguishing infections from the first, second and third trimester of pregnancy, as the risk of materno-foetal transmission and outcomes in case of foetal infections varies by time.

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“…Whether or not systematic screening of pregnant women should be implemented is certainly the most disputed issue in the field of CT. Mass screening programs have been implemented for more than 25 years at no costs for the patients in France and in Austria, with monthly or two monthly retests, respectively. They are also organized in other European countries, including Italy [ 12 ] and Slovenia [ 13 ]. Many countries, like the US, have no screening program and pregnant women are rarely tested for toxoplasmosis unless presenting with clinical signs, being at risk of infection or presenting abnormal foetal ultrasound.…”

Section: Congenital Toxoplasmosismentioning

confidence: 99%

Congenital Toxoplasmosis: A Plea for a Neglected Disease

Wallon

Peyron

2018

Pathogens

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Maternal infection by Toxoplasma gondii during pregnancy may have serious consequences for the fetus, ranging from miscarriage, central nervous system involvement, retinochoroiditis, or subclinical infection at birth with a risk of late onset of ocular diseases. As infection in pregnant women is usually symptomless, the diagnosis relies only on serological tests. Some countries like France and Austria have organized a regular serological testing of pregnant women, some others have no prenatal program of surveillance. Reasons for these discrepant attitudes are many and debatable. Among them are the efficacy of antenatal treatment and cost-effectiveness of such a program. A significant body of data demonstrated that rapid onset of treatment after maternal infection reduces the risk and severity of fetal infection. Recent cost-effectiveness studies support regular screening. This lack of consensus put both pregnant women and care providers in a difficult situation. Another reason why congenital toxoplasmosis is disregarded in some countries is the lack of precise information about its impact on the population. Precise estimations on the burden of the disease can be achieved by systematic screening that will avoid bias or underreporting of cases and provide a clear view of its outcome.

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Implementation of Screening for Toxoplasma gondii Infection in Pregnancy

Cited by 14 publications

References 11 publications

The Importance of Use of the On-line Databases as a Source for Systematic Review of Toxoplasmosis Screening During Pregnancy

The Importance of Use of the On-line Databases as a Source for Systematic Review of Toxoplasmosis Screening During Pregnancy

“Blind periods” in screening for toxoplasmosis in pregnancy in Austria – a debate

Congenital Toxoplasmosis: A Plea for a Neglected Disease

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