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Tipo do documento: Artigo
Título: Congenital toxoplasmosis and prenatal care state programs
Autor: Avelino, Mariza Martins
Amaral, Waldemar Naves do
Rodrigues, Isolina Maria Xavier
Rassi, Alan Ricardo
Gomes, Maria B. F.
Costa, Tatiane Luiza da
Castro, Ana aria de
Abstract: Background: Control programs have been executed in an attempt to reduce vertical transmission and the severity of congenital infection in regions with a high incidence of toxoplasmosis in pregnant women. We aimed to evaluate whether treatment of pregnant women with spiramycin associated with a lack of monitoring for toxoplasmosis seroconversion affects the prognosis of patients. Methods: We performed a prospective cohort study with 246 newborns (NB) at risk for congenital toxoplasmosis in Goiânia (Brazil) between October 2003 and October 2011. We analyzed the efficacy of maternal treatment with spiramycin. Results: A total of 40.7% (66/162) of the neonates were born seriously infected. Vertical transmission associated with reactivation during pregnancy occurred in 5.5% (9/162) of the NB, with one showing severe infection (systemic). The presence of specific immunoglobulins (fetal IgM and NB IgA) suggested the worst prognosis. Treatment of pregnant women by spiramycin resulted in reduced vertical transmission. When infected pregnant women did not undergo proper treatment, the risk of severe infection (neural-optical) in NB was significantly increased. Fetal IgM was associated with ocular impairment in 48.0% (12/25) of the fetuses and neonatal IgA-specific was related to the neuro-ophthalmologic and systemic forms of the disease. When acute toxoplasmosis was identified in the postpartum period, a lack of monitoring of seronegative pregnant women resulted in a higher risk of severe congenital infection. Conclusion: Treatment of pregnant women with spiramycin reduces the possibility of transmission of infection to the fetus. However, a lack of proper treatment is associated with the onset of the neural-optical form of congenital infection. Primary preventive measures should be increased for all pregnant women during the prenatal period and secondary prophylaxis through surveillance of seroconversion in seronegative pregnant woman should be introduced to reduce the severity of congenital infection in the environment.
Palavras-chave: Congenital toxoplasmosis
País: Gra-bretanha
Unidade acadêmica: Instituto de Patologia Tropical e Saúde Pública - IPTSP (RG)
Citação: AVELINO, Mariza M.; AMARAL, Waldemar N.; RODRIGUES, Isolina M. X.; RASSI, Alan R.; GOMES, Maria B. F.; COSTA, Tatiane L.; CASTRO, Ana M. Congenital toxoplasmosis and prenatal care state programs. BMC Infectious Diseases, London, v. 14, n. 33, p. 1-10, 2014.
Tipo de acesso: Acesso Aberto
Identificador do documento: 10.1186/1471-2334-14-33
Identificador do documento: 10.1186/1471-2334-14-33
Data de publicação: 2014
Aparece nas coleções:IPTSP - Artigos publicados em periódicos

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