Toxoplasmose crônica em gestantes. Avaliação da prevalência, fatores de risco e acompanhamento de um grupo de recém-nascidos em Goiânia – Goiás

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2013-03-07

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Universidade Federal de Goiás

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Toxoplasma gondii causes a parasitosis with wide distribution in nature and high prevalence in the human population, in the form of asymptomatic infection. When a pregnant woman if infects, can occur the passage of parasites through the placenta, causing an infection that varies in severity, depending on the season in which occurred the fetal disease. The fetus may die in function of the infectious process, or staying with serious sequelae (ocular or brain), but may be asymptomatic at birth, which does not necessarily imply in benign progression of the disease, because the changes may appear throughout their development. The objective of this study was to make an evaluation of serological survey on chronically infected mothers and their newborns to check the possibility of the occurrence of congenital toxoplasmosis. Blood samples were collected from 230 mothers and their newborns, originated from two public hospitals of Goiânia (GO), in the period from 2010 to 2011. The samples were submitted to techniques of IFAT and ELISA for identification of specific antibody anti- T. gondii. In addition to the testing of Avidity of IgG in 133 of these samples. In 32 samples of sera of RN was performed to search for antibodies of the IgA class and 42 blood samples from newborns were submitted to the technique of PCR for identification of the parasite by having their serologic titers higher than their mothers or have low avidity of IgG. It was found that 68.1% (188/230) of the samples had specific antibodies of the IgG class which corresponds to 51.9% among pregnant women treated at the Hospital das Clinicas (HC) in 2010, and 42.3% among pregnant women of Maternidade Nossa Senhora de Lourdes in 2011. Not if identified antibodies of the IgM and IgA in the blood of any of RN studied and it was also not possible the encounter of the parasite between RN by PCR. 14.8% (34/230) of women examined had their results of IgG negative despite having positive result in serological screening test, thus constituting the false-positive test. Despite of the results in this group of pregnant women and newborns have not shown that the congenital toxoplasmosis can happen so important in pregnant women chronically infected, during the project, was diagnosed with a case of a pregnant woman chronically infected by T.gondii, with eight months of pregnancy that had its fetus infected congenitally, causing fetal death. Were detected high titers of antibodies of the IgG class, presence of IgM and high avidity of IgG, suggesting that treat of resurgence of protozoal infection. This finding points to the importance of the advice of primary prevention measures for all pregnant women, regardless of their immune status against the parasite.

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AVELAR, Juliana Boaventura. Toxoplasmose crônica em gestantes. Avaliação da prevalência, fatores de risco e acompanhamento de um grupo de recém-nascidos em Goiânia – Goiás. 2013. 90 f. Tese (Doutorado em Medicina Tropical e Saúde Publica) - Universidade Federal de Goiás, Goiânia, 2013.