Incidence of Symptomatic Congenital Toxoplasmosis During Ten Years in a Brazilian Hospital

Background: Population seroprevalence and rates of mother-to-child transmission are important in determining the incidence of congenital toxoplasmosis. (CT) Mother-to-child transmission depends on the timing of acute maternal infection and treatment during pregnancy. The incidence of CT varies widely across geographic regions, ranging from 1 to 10 cases per 10,000 live births. The incidence of symptomatic disease varies from 0.15 to 0.34 cases per 10,000. Methods: This is a review of patients treated at a pediatric CT clinic at a university hospital in the south of Brazil, from 2004 to 2014. Results: The annual incidence of CT varied from 0 to 14 cases per 10,000 live births, with a mean incidence of 6 cases per 10,000 during the 10 years studied (CI 95%: 3.02–8.91). The incidence of symptomatic CT varied from 0 to 9 cases per 10,000 live births, with a mean incidence of 5 per 10,000 (CI 95%: 2.44–6.94). There were 5 (14.3%) asymptomatic cases. The main findings were retinochoroiditis (54%), intracranial calcifications (37.5%) and altered cerebrospinal fluid (37.5%). Conclusions: The incidence of CT and the rate of symptomatic cases were in accordance with the previous data from other studies in Brazil, being significantly higher than in previous North American and European studies.

[1]  A. Prusa,et al.  The Austrian Toxoplasmosis Register, 1992-2008. , 2015, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[2]  I. Navarro,et al.  Congenital toxoplasmosis in a reference center of Paraná, Southern Brazil , 2014, The Brazilian journal of infectious diseases : an official publication of the Brazilian Society of Infectious Diseases.

[3]  J. Nadol,et al.  Otopathology in Congenital Toxoplasmosis , 2013, Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology.

[4]  D. Capdevielle,et al.  Toxoplasma gondii : un rôle potentiel dans la genèse de troubles psychiatriques. Une revue systématique de la littérature , 2013 .

[5]  R. Gurgel,et al.  Birth prevalence and characteristics of congenital toxoplasmosis in Sergipe, North‐east Brazil , 2012, Tropical medicine & international health : TM & IH.

[6]  J. Kei,et al.  Monitoring for Postnatal Hearing Loss Using Risk Factors: A Systematic Literature Review , 2012, Ear and hearing.

[7]  J. Montoya,et al.  Toxoplasmosis in the fetus and newborn: an update on prevalence, diagnosis and treatment , 2012, Expert review of anti-infective therapy.

[8]  R. McLeod,et al.  Severe Congenital Toxoplasmosis in the United States: Clinical and Serologic Findings in Untreated Infants , 2011, The Pediatric infectious disease journal.

[9]  I. Villena,et al.  Congenital toxoplasmosis in France in 2007: first results from a national surveillance system. , 2010, Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin.

[10]  J. Prandota.  Neuropathological changes and clinical features of autism spectrum disorder participants are similar to that reported in congenital and chronic cerebral toxoplasmosis in humans and mice , 2010 .

[11]  J. Prandota.  Autism Spectrum Disorders May Be Due to Cerebral Toxoplasmosis Associated with Chronic Neuroinflammation Causing Persistent Hypercytokinemia that Resulted in an Increased Lipid Peroxidation, Oxidative Stress, and Depressed Metabolism of Endogenous and Exogenous Substances. , 2010 .

[12]  Alan S. Brown,et al.  Prenatal infection and schizophrenia: a review of epidemiologic and translational studies. , 2010, The American journal of psychiatry.

[13]  W. Caiaffa,et al.  Congenital toxoplasmosis in southeastern Brazil: results of early ophthalmologic examination of a large cohort of neonates. , 2009, Ophthalmology.

[14]  E. Massad,et al.  Seroepidemiology of Toxoplasma infection in a metropolitan region of Brazil , 2009, Epidemiology and Infection.

[15]  Ivana S Varella,et al.  Prevalence of acute toxoplasmosis infection among 41,112 pregnant women and the mother-to-child transmission rate in a public hospital in South Brazil. , 2009, Memorias do Instituto Oswaldo Cruz.

[16]  L. Stagni,et al.  Prenatal screening for congenital toxoplasmosis in Campania: preliminary report on activities and results. , 2009, Memorias do Instituto Oswaldo Cruz.

[17]  R. Cohen,et al.  Congenital toxoplasmosis and reinfection during pregnancy: case report, strain characterization, experimental model of reinfection, and review. , 2009, The Journal of infectious diseases.

[18]  J. Montoya,et al.  Management of Toxoplasma gondii infection during pregnancy. , 2008, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[19]  J. Montoya,et al.  Prevalence of infection with Toxoplasma gondii among pregnant women in Cali, Colombia, South America. , 2008, The American journal of tropical medicine and hygiene.

[20]  F. Kieffer,et al.  Risk Factors for Retinochoroiditis During the First 2 Years of Life in Infants With Treated Congenital Toxoplasmosis , 2008, The Pediatric infectious disease journal.

[21]  E. C. Neto,et al.  Congenital toxoplasmosis: late pregnancy infections detected by neonatal screening and maternal serological testing at delivery. , 2007, Paediatric and perinatal epidemiology.

[22]  R. Gilbert,et al.  Effectiveness of prenatal treatment for congenital toxoplasmosis: a meta-analysis of individual patients' data , 2007, The Lancet.

[23]  J. Lobry,et al.  Serotyping of Toxoplasma gondii in chronically infected pregnant women: predominance of type II in Europe and types I and III in Colombia (South America). , 2006, Microbes and infection.

[24]  R. Gilbert,et al.  Symptomatic toxoplasma infection due to congenital and postnatally acquired infection , 2006, Archives of Disease in Childhood.

[25]  L. Camillo-Coura,et al.  Estudo prospectivo de gestantes e seus bebês com risco de transmissão de toxoplasmose congênita em município do Rio Grande do Sul , 2003 .

[26]  H. Pelloux,et al.  Genotype of 86 Toxoplasma gondii isolates associated with human congenital toxoplasmosis, and correlation with clinical findings. , 2002, The Journal of infectious diseases.

[27]  T. Wolańczyk,et al.  Obsessive-compulsive disorder and acquired toxoplasmosis in two children , 2001, European Child & Adolescent Psychiatry.

[28]  R. Reading.  Feasibility of neonatal screening for toxoplasma infection in the absence of prenatal treatment , 2000 .

[29]  R. Gilbert,et al.  Mother-to-child transmission of toxoplasmosis: risk estimates for clinical counselling , 1999, The Lancet.

[30]  J. Himes,et al.  A United States National Reference for Fetal Growth , 1996, Obstetrics and gynecology.

[31]  N. Zelnik,et al.  Congenital toxoplasmosis: a significant cause of neurological morbidity in Israel? , 1995, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[32]  R. Lynfield,et al.  Neonatal serologic screening and early treatment for congenital Toxoplasma gondii infection. The New England Regional Toxoplasma Working Group. , 1994, The New England journal of medicine.

[33]  J. Couvreur,et al.  Congenital toxoplasmosis. A prospective study of 378 pregnancies. , 1974, The New England journal of medicine.

[34]  J. Boulenger,et al.  [Toxoplasma gondii: a potential role in the genesis of psychiatric disorders]. , 2013, L'Encephale.

[35]  L. Kodjikian,et al.  Ocular manifestations in congenital toxoplasmosis , 2005, Graefe's Archive for Clinical and Experimental Ophthalmology.

[36]  S. Spalding,et al.  [Prospective study of pregnants and babies with risk of congenital toxoplasmosis in municipal district of Rio Grande do Sul]. , 2003, Revista da Sociedade Brasileira de Medicina Tropical.

[37]  Neonatal serologic screening and early treatment for congenital toxoplasma gondii infection , 1995 .