Screening for Toxoplasma in Pregnancy

Joynson, D. H. M.; Payne, Rudolph

doi:10.1016/s0140-6736(88)92443-9

Cited by 30 publications

(20 citation statements)

References 6 publications

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“…Much of the current debate centres upon the prevention of congenital infection and the merits of introducing a programme in the UK to monitor pregnant women for primary T. gondii infection [6][7][8][9][10][11]. Any assessment of the public-health significance of the infection will depend upon detailed epidemiological information with which to estimate accurately the magnitude of the problem of human toxoplasmosis in the community and the present risk of infection in women of childbearing age [12].…”

Section: Introductionmentioning

confidence: 99%

Longitudinal study of toxoplasma seroprevalence in South Yorkshire

1992

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SUMMARYSerum samples collected from individuals of a wide range of ages in South Yorkshire between 1969 and 1990 provided the basis for a longitudinal seroprevalence survey of Toxoplasma gondii antibodies. Sera numbering 3868 were screened for T. gondii specific antibodies using a commercial latex agglutination test. The resultant temporal series of serological profiles revealed a rise, with age, in seroprevalence, the rate of which showed a decrease through time. A plateau of around 40-50% prevalence was attained by the 41-to 45-year age-class in 1969 which was not approached until the 66-to 70-year class in the 1988-90 data set. This trend for decline in seroprevalence was confirmed by statistical analysis for the age range 21-60 years. These results may be indicative of a decrease in the rate of toxoplasma exposure in this study community over the 20-year period. The survey of 1988-90 provides a base-line profile of present-day seroprevalence in which 11 % of individuals in the age range 16-45 years (roughly corresponding to the childbearing age-range) show evidence of past infection. The representative nature of the serum collection and public-health implications of these results are discussed.

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Section: Introductionmentioning

confidence: 99%

Longitudinal study of toxoplasma seroprevalence in South Yorkshire

1992

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“…The potential advantages of screening for toxoplasmosis in pregnancy, in order to prevent congenital toxoplasmosis, have been widely debated in several countries [1][2][3][4][5][6][7]. The foetus is only at risk following a primary maternal infection during pregnancy.…”

Section: Introductionmentioning

confidence: 99%

“…While the presence of toxoplasma-specific IgG on recall following an initial negative test can provide evidence of seroconversion in pregnancy, an infection that occurs after conception but before the first antenatal visit can only be identified by tests sensitive to recent infection, such as toxoplasma-specific IgM. The use of such tests in prenatal screening programmes has been recommended by several experts [2,9]. Tests for IgG-avidity [10] or toxoplasma-specific IgA [11], which may also be able to discriminate recent from past infection, have also been proposed.…”

Section: Introductionmentioning

confidence: 99%

Evaluating the sensitivity and predictive value of tests of recent infection: toxoplasmosis in pregnancy

Ades

1991

Epidemiol. Infect.

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SUMMARYThe diagnosis of maternal infection in early pregnancy depends on tests which are sensitive to recent infection, such as specific IgM. Two types of test are considered: those where the response persists for a period following infection and then declines, such as IgM, and those whose response increases with time since infection, such as IgG-avidity. However, individuals vary in their response to infection, and it may not always be possible to determine whether an infection occurred during pregnancy or before it. Mathematical methods are developed to evaluate the performance of these tests, and are applied to the diagnosis of toxoplasmosis in pregnancy. It is shown that, based on existing information, tests of recent infection are unlikely to be both sensitive and predictive. More data on these tests are required, before they can be reliably used to determine whether infection has occurred during pregnancy or before it.

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“…The incidence of congenital toxoplasmosis is approximately 2 per 1000 in much of Europe and America [8,38,61,52,58] although the disease may be much commoner in France [22].…”

Section: Detection Of Infected Individualsmentioning

confidence: 99%

Recent developments in the prevention and treatment of congenital toxoplasmosis

Dutton

1989

Int Ophthalmol

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The manifestations of congenital toxoplasmosis vary considerably in degree, characteristics and time of onset. Options for prevention of the disease include the appropriate disposal of cat litter and the avoidance of ingestion of both contaminated food and undercooked meat by pregnant women. Immunisation of the domestic cat population is a consideration for the future. Alternatively, immunisation of sero-negative pregnant women awaits the introduction of an effective and safe reagent. Current treatment modalities are not universally effective and new drugs are the subject of active development and research. Screening of pregnant women or perhaps newborn infants are potential options but the cost effectivity has yet to be established in many countries and the results of treatment during pregnancy and early childhood are encouraging but are as yet unproven. The majority of patients with congenital toxoplasmosis eventually develop toxoplasmic retinochoroiditis. Current treatment options for this condition are outlined. Acquired immune deficiency syndrome (AIDS) may, in some cases, represent a recrudescence of congenital intracerebral infection. Current treatment strategies for this condition are discussed.

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Screening for Toxoplasma in Pregnancy

Cited by 30 publications

References 6 publications

Longitudinal study of toxoplasma seroprevalence in South Yorkshire

Longitudinal study of toxoplasma seroprevalence in South Yorkshire

Evaluating the sensitivity and predictive value of tests of recent infection: toxoplasmosis in pregnancy

Recent developments in the prevention and treatment of congenital toxoplasmosis

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