Prenatal Management of 746 Pregnancies at Risk for Congenital Toxoplasmosis

Daffos, F.; Forestier, F.; Capella-Pavlovsky, M; Thulliez, P.; Aufrant, C; Valenti, Daniel; Cox, Wendy L.

doi:10.1056/nejm198802043180502

Cited by 462 publications

(119 citation statements)

References 5 publications

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“…In a study of 542 pregnancies in which spiramycin was given to women who seroconverted during pregnancy (388 women given treatment and 154 without treatment) the percentage of children without prenatal infection increased from 39 to 77%, and the percentage of children with severe congenital disease or intrauterine death decreased from 11 to 3% [214]. If transmission to the foetus can be documented in utero (by polymerase chain reaction (PCR) or other techniques [33]) the administration of pyrimethamine and sulfadiazine to the mother can treat the infection in utero and further decrease the severity of symptoms in infected children [216,217].…”

Section: Congenital Toxoplasmosismentioning

confidence: 99%

Toxoplasma gondii: from animals to humans

Tenter

Heckeroth

Weiss

2000

International Journal for Parasitology

3,011

2,476

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Toxoplasmosis is one of the more common parasitic zoonoses world-wide. Its causative agent, Toxoplasma gondii, is a facultatively heteroxenous, polyxenous protozoon that has developed several potential routes of transmission within and between different host species. If first contracted during pregnancy, T. gondii may be transmitted vertically by tachyzoites that are passed to the foetus via the placenta. Horizontal transmission of T. gondii may involve three lifecycle stages, i.e. ingesting infectious oocysts from the environment or ingesting tissue cysts or tachyzoites which are contained in meat or primary offal (viscera) of many different animals. Transmission may also occur via tachyzoites contained in blood products, tissue transplants, or unpasteurised milk. However, it is not known which of these routes is more important epidemiologically. In the past, the consumption of raw or undercooked meat, in particular of pigs and sheep, has been regarded as a major route of transmission to humans. However, recent studies showed that the prevalence of T. gondii in meat-producing animals decreased considerably over the past 20 years in areas with intensive farm management. For example, in several countries of the European Union prevalences of T. gondii in fattening pigs are now <1%. Considering these data it is unlikely that pork is still a major source of infection for humans in these countries. However, it is likely that the major routes of transmission are different in human populations with differences in culture and eating habits. In the Americas, recent outbreaks of acute toxoplasmosis in humans have been associated with oocyst contamination of the environment. Therefore, future epidemiological studies on T. gondii infections should consider the role of oocysts as potential sources of infection for humans, and methods to monitor these are currently being developed. This review presents recent epidemiological data on T. gondii, hypotheses on the major routes of transmission to humans in different populations, and preventive measures that may reduce the risk of contracting a primary infection during pregnancy.

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Section: Congenital Toxoplasmosismentioning

confidence: 99%

Toxoplasma gondii: from animals to humans

Tenter

Heckeroth

Weiss

2000

International Journal for Parasitology

3,011

2,476

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“…Placental contamination is a pre-requisite to congenital infection when there is maternal parasitaemia. The infected placenta then acts as a reservoir from which the parasite can spread to the foetus leading to multi-systemic disease (Daffos et al, 1988).…”

Section: Toxoplasma Gondii Genotypes and Pathologymentioning

confidence: 99%

Congenital Toxoplasmosis: A Review of its Pathology, Immune Response and Current Treatment Options.

Wellington¹,

Oladipo²,

Chimere

et al. 2010

Sierra Leone j. biomed. res.

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Toxoplasmosis, caused by the protozoan parasite Toxoplasma gondii, is one of the most common parasites of man and other warm-blooded animals. Humans are infected through contaminated food, water, and blood transfusion, organ transplantation or from mother to foetus through the placenta. Severe congenital infections occur as a result of primary T. gondii infection in early pregnancy. Transmission of T.gondii to the foetus can result in serious health problems, including mental retardation, seizures, blindness and death. Frequency of foetal infection is higher when maternal infection occurs later in pregnancy and sequelae are more severe when maternal infections occur early in the first trimester of pregnancy. The ability of the parasite to survive intracellularly largely depends on the blocking of different proapoptotic signaling cascades of the host cells. During pregnancy, however, alterations in the incidence of apoptosis are associated with abnormal placental morphology and function. Both cellular and humoral immune responses control T.gondii infection. Toxoplasma is asymptomatic, infected women can only be detected by serological testing. In many instances, congenital toxoplasmosis can be prevented by educating pregnant women and women of childbearing age about the route of transmission. The need for screening suspected cases of T. gondii will help reduce transmission to the foetus.

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“…For occurrence of congenital toxoplasmosis, the primary infection should be established during pregnancy 16 . Among women infected by T. gondii during pregnancy, 61% do not transmit the disease to the fetus, 26% of the conceptions present subclinical infection (visual/or hearing deficit, neuromotor and/or learning deficit) and in 13% there is a clinical infection (hydrocephalus or microcephaly, chorioretinitis, cerebral calcification and mental retardation) 43 .…”

Section: Introductionmentioning

confidence: 99%

Factors associated to infection by Toxoplasma gondii in pregnant women attended in Basic Health Units in the city of Rolândia, Paraná, Brazil

Dias

Lopes-Mori²,

Mitsuka‐Breganó³

et al. 2011

Rev. Inst. Med. trop. S. Paulo

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SUMMARYThe aim of the present work was to determine the prevalence of IgG and IgM anti-Toxoplasma gondii antibodies and the factors associated to the infection in pregnant women attended in Basic Health Units in Rolândia, Paraná, Brazil. The sample was divided in two groups: group I (320 pregnant women who were analyzed from July 2007 to February 2008) and group II (287 pregnant women who were analyzed from March to October 2008). In group I, it was found 53.1% of pregnant women with IgG reactive and IgM nonreactive, 1.9% with IgG and IgM reactive, 0.3% with IgG non-reactive and IgM reactive and 44.7% with IgG and IgM non-reactive. In group II, it was found 55.1% with IgG reactive and IgM non-reactive and 44.9% with IgG and IgM non-reactive. The variables associated to the presence of IgG antibodies were: residence in rural areas, pregnant women between 35-40 years old, low educational level, low family income, more than one pregnancy, drinking water which does not originate from the public water supply system and the habit of handling soil or sand. Guidance on primary prevention measures and the quarterly serological monitoring of the pregnant women in the risk group are important measures to prevent congenital toxoplasmosis.

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Prenatal Management of 746 Pregnancies at Risk for Congenital Toxoplasmosis

Cited by 462 publications

References 5 publications

Toxoplasma gondii: from animals to humans

Toxoplasma gondii: from animals to humans

Congenital Toxoplasmosis: A Review of its Pathology, Immune Response and Current Treatment Options.

Factors associated to infection by Toxoplasma gondii in pregnant women attended in Basic Health Units in the city of Rolândia, Paraná, Brazil

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