Epidemiological profile of gestational and congenital toxoplasmosis cases arising out of the population outbreak
DOI:
https://doi.org/10.15448/1980-6108.2021.1.40108Keywords:
toxoplasmosis congenital, pregnancy, epidemiologyAbstract
Objective: To trace the epidemiological profile of cases of gestational and congenital toxoplasmosis reported in the city of Santa Maria - RS, resulting from the outbreak that occurred in 2018 and to investigate the association between maternal variables and the baby’s diagnosis.
Method: Cases reported between March 2018 and March 2019 were retrospectively evaluated. The baby’s diagnosis and maternal variables were analyzed using descriptive statistics and chi-square test.
Results: During the study period, 206 cases of gestational toxoplasmosis were reported, of which 74 were confirmed as a recent infection. Vertical transmission was confirmed in 27% of cases. There was a higher frequency of transmission in pregnant women who were diagnosed in the third trimester of pregnancy (p = 0.001) and who did not undergo treatment during pregnancy (p <0.001).
Conclusion: The occurrence of congenital toxoplasmosis is associated with late diagnosis, in the last trimester of pregnancy, and consequent lack of adequate treatment. In addition, there was a high prevalence of children infected by vertical transmission due to the outbreak, which reinforces the importance of prenatal care and attention to the need for adequate treatment and care during the development of infected children.
Downloads
References
Guy EC. Toxoplasmosis. Medicine (Baltimore). 2014;42(1):31-3.
Kaye A. Toxoplasmosis: Diagnosis, Treatment, and Prevention in Congenitally Exposed Infants. J Pediatr Health Care. 2011;25(6):355-64. https://doi.org/10.1016/j.pedhc.2010.04.008
Kravetz JD, Federman DG. Toxoplasmosis in pregnancy. Am J Med. 2005;118:212-6. https://doi.org/10.1016/j.amjmed.2004.08.023
Singh S. Congenital toxoplasmosis: Clinical features, outcomes, treatment, and prevention. Trop Parasitol. 2016;6(2):113-22. https://doi.org/10.4103/2229-5070.190813
Montoya JG, Liesenfeld O. Toxoplasmosis. Lancet. 2004;363:1965-76. https://doi.org/10.1016/s0140-6736(04)16412-x
Câmara JT, da Silva MG, de Castro AM. Prevalência de toxoplasmose em gestantes atendidas em dois centros de referência em uma cidade do Nordeste, Brasil. Rev Bras Ginecol Obstet. 2015;37(2):64-70. https://doi.org/10.1590/SO100-720320150005115
Varella IS, Wagner MB, Darela AC, Nunes LM, Müller RW. Prevalência de soropositividade para toxoplasmose em gestantes. J Pediatr (Rio J). 2003;79(1):69-74. https://doi.org/10.1590/S0021-75572003000100012
Spalding SM, Amendoeira MRR, Ribeiro LC, Silveira C, Garcia AP, Camilo-Coura L. Estudo prospectivo de gestantes e seus bebês com risco de transmissão de toxoplasmose congênita em município do Rio Grande do Sul. Rev Soc Bras Med Trop. 2003;36(4):483-91. https://doi.org/10.1590/S0037-86822003000400009
Neto EC, Amorim F, Lago EG. Estimation of the regional distribution of congenital toxoplasmosis in Brazil from the results of neonatal screening [Internet]. Sci Med (Porto Alegre). 2010 [citado 2021 Jul 10];20(1):64-70. Disponível em: https://revistaseletronicas.pucrs.br/ojs/index.php/scientiamedica/article/view/5983/4877
Maldonado YA, Read JS. Diagnosis, Treatment, and Prevention of Congenital Toxoplasmosis in the United States. Pediatrics. 2017;139(2):e20163860. https://doi.org/10.1542/peds.2016-3860
Rio Grande do Sul. Secretaria de Saúde. Alerta Epidemiológico. Toxoplasmose [Internet]. 2018 [citado 2021 Jul 10]. Disponível em: https://saude.rs.gov.br/upload/arquivos/carga20180752/25125245-09144313-09-05-18-alerta-toxoplamose.pdf
Jenum PA, Stray-Pedersen B, Gunderser A-G. Improved Diagnosis of Primary Toxoplasma gondii Infection in Early Pregnancy by Determination of Antitoxoplasma Immunoglobulin G Avidity. J Clin Microbiol. 1997;35(8):1972-7. https://doi.org/10.1128/jcm.35.8.1972-1977.1997
Figueiró-Filho EA, Lopes AHA, Senefonte FR de A, de Souza Júnior VG, Botelho CA, Figueiredo MS, et al. Toxoplasmose aguda: estudo da freqüência, taxa de transmissão vertical e relação entre os testes diagnósticos materno-fetais em gestantes em estado da Região Centro-Oeste do Brasil. Rev Bras Ginecol Obstet. 2005;27(8):442-9. https://doi.org/10.1590/S0100-72032005000800002
Avelar JB, da Silva MG, Rezende HHA, Storchilo HR, do Amaral WN, Xavier IR, et al. Epidemiological factors associated with Toxoplasma gondii infection in postpartum women treated in the public healthcare system of Goiânia, State of Goiás, Brazil. Rev Soc Bras Med Trop. 2018;51(1):57-62. https://doi.org/10.1590/0037-8682-0112-2017
Kapperud G, Jenum PA, Stray-pedersen B, Melby KK, Eskild A, Eng J. Risk Factors for Toxoplasma gondii Infection in Pregnancy: Results of a Prospective Case- Control Study in Norway. Am J Epidemiol. 1996;144(4):405-12. https://doi.org/10.1093/oxfordjournals.aje.a008942
Walcher DL, Comparsi B, Pedroso D. Toxoplasmose gestacional: uma revisão. RBAC. 2017;49(4):323-7. https://dx.doi.org/10.21877/2448-3877.201600273
Federação Brasileira das Associações de Ginecologia e Obstetrícia (FEBRASGO) Manual de Gestação de Alto Risco [Internet]. 2011 [citado 2021 Jul 10]; 220 p. disponível em: http://www.as.saude.ms.gov.br/wp-content/uploads/2019/08/manual-de-gesta%c3%87%c3%83ode-alto-risco-2011.pdf
Dunn D, Wallon M, Peyron F, Petersen E, Peckham C, Gilbert R. Mother-to-child transmission of toxoplasmosis: risk estimates for clinical counselling. Lancet. 1999;353(9167):1829-33. https://doi.org/10.1016/S0140-6736(98)08220-8
Gomes ADO, Silva DAO, Silva NM, Barbosa BDF, Franco PS, Angeloni MB, et al. Effect of Macrophage Migration Inhibitory Factor (MIF) in Human Placental Explants Infected with Toxoplasma gondii Depends on Gestational Age. Am J Pathol. 2011;178(6):2792-801. https://doi.org/10.1016/j.ajpath.2011.02.005
Donadono V, Saccone G, Giuseppe MM, Berghella V, Migliorini S, Esposito G, et al. Incidence of toxoplasmosis in pregnancy in Campania: A population-based study on screening, treatment, and outcome. Eur J Obstet Gynecol Reprod Biol. 2019;240:316-21. https://doi.org/10.1016/j.ejogrb.2019.07.033
Paraná. Secretaria de Estado da Saúde. Caderno atenção ao pré-natal - Toxoplasmose [Internet]. Curitiba: Secretaria de Estado da Saúde [citado 2021 Jul 10]. Disponível em: http://www.sjp.pr.gov.br/wpcontent/uploads/2018/04/ANEXO-VII-toxoplasmosecong%C3%AAnita.pdf
Mandelbrot L, Winer N, Mesnard L, Berrebi A, Bory J, Ville Y, et al. Prenatal therapy with pyrimethamine + sulfadiazine vs spiramycin to reduce placental transmission of toxoplasmosis: a multicenter, randomized trial. Am J Obstet Gynecol. 2018;219:386. e1-9. https://doi.org/10.1016/j.ajog.2018.05.031
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2021 Scientia Medica
This work is licensed under a Creative Commons Attribution 4.0 International License.
Copyright
The submission of originals to Scientia Medica implies the transfer by the authors of the right for publication. Authors retain copyright and grant the journal right of first publication. If the authors wish to include the same data into another publication, they must cite Scientia Medica as the site of original publication.
Creative Commons License
Except where otherwise specified, material published in this journal is licensed under a Creative Commons Attribution 4.0 International license, which allows unrestricted use, distribution and reproduction in any medium, provided the original publication is correctly cited.
