Triagem pelo teste do pezinho para diagnóstico precoce da infecção congênita para toxoplasmose em três unidades de saúde pública da região metropolitana de Goiânia, Goiás
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2016-06-16
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Universidade Federal de Goiás
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Toxoplasma gondii is a protozoan which presents a high worldwide prevalence. This parasite is able to pass the placental barrier which results in fetal infection with severe sequelae. The diagnostics of the congenital infection is complex and should be performed precociously. The newborn screening detects several diseases in the newborns (NB) and the implantation of the toxoplasmosis detection in this set of exams enables the precocious detection of this disease. Therefore the aim of this study was to perform the toxoplasmosis serologic triage (IgM and IgG) in blood collected in filter paper; to evaluate and compare the sensitivity of serologic analysis from peripheric blood collected in filter paper; to perform confirmatory serologic tests (IgM and IgG) and complementary (PCR) to confirm the NB with serologic indication of congenital toxoplasmosis and to speed the precocious diagnostics of congenital toxoplasmosis in NB blood. At the moment of the newborn screening blood collection a second sample of blood was collected in filter paper from NB attended in Clinics Hospital from the Federal University of Goias, Maternity Hospital Dona Iris both located in Goiania, Goias, and Cais Nova Era located in Aparecida de Goiania, Goias. These samples were processed and ELISA test was performed. The NB which presented results with absorbance titers equal or higher than 3.0 were submitted to a new peripheric blood collection alongside with the blood collection from their mothers and the PCR technique was performed as to confirm the congenital infection. A total of 949 blood samples were collected in filter paper and 432 (45.52%) were IgG positive while 1 (0.10%) was IgM positive. In the IgG positive NB (432/949) which presented ELISA titers ≥ 3.0; 104 pairs of peripheric blood were analyzed. From these 104 samples of peripheric blood, 5 pairs (4.80%) presented IgG and IgM negative results, four (3.84%) presented discrepant results, i.e., NB sample negative and mother sample IgG positive, in 95 pairs (91.34%) there were accordant results with both IgG positives. The PCR technique was performed in the 95 samples of IgG positive children and was possible to detect the parasite’s DNA in one sample of NB peripheric blood. Therefore these results show that the inclusion of the toxoplasmosis serologic test in the newborn screening, which is already performed in SUS to detect other diseases, demonstrated to be effective in the precocious detection of T. gondii infected NB. We highlight that succeed in the infected NB triage several criteria should be taken into account and that a greater sampling should be performed as to ratify these results.
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STORCHILO, H. R. Triagem pelo teste do pezinho para diagnóstico precoce da infecção congênita para toxoplasmose em três unidades de saúde pública da região metropolitana de Goiânia, Goiás. 2016. 61 f. Dissertação (Mestrado em Biologia da Relação Parasito-Hospedeiro) - Universidade Federal de Goiás, Goiânia, 2016.