Birth prevalence and characteristics of congenital toxoplasmosis in Sergipe, North-east Brazil; Prévalence à la naissance et caractéristiques de la toxoplasmose congénitale à Sergipe, nord-est du Brésil; Prevalencia de nacimientos con toxoplasmosis congénita y características de la misma en Sergipe, Noreste de Brasil

• Published in: Tropical medicine & international health 2012-11, Vol.17 (11), p.1349
• Main Authors: de Melo Inagaki, Ana Dorcas, Carvalheiro, Cristina Gardonyi, Cipolotti, Rosana, Gurgel, Ricardo Queiroz, Rocha, Dayse Alves, Pinheiro, Kariny Souza, Araújo, Raquel Melo, Lima, Dorothy Ribeiro Resende, Winandy, Jacques Leon, Mussi-Pinhata, Marisa Márcia
• Format: Article
• Language: English
• Subjects: Congenital diseases; Medical screening; Newborn babies; Parasitic diseases
• ISSN: 1360-2276; 1365-3156
• DOI: 10.1111/j.1365-3156.2012.03079.x

Objectives: To estimate, by neonatal screening, the birth prevalence of congenital toxoplasmosis among live-born infants in Sergipe state, Brazil, and to investigate the clinical features of affected infants. Methods: Dried blood spot specimens obtained from 15204 neonates were assayed for the presence of anti-T. gondii IgM antibodies. Duplicate retesting was done in infants with positive and borderline results. Confirmatory testing in peripheral blood samples consisted of testing for anti-T. gondii IgG and IgM in infants and mothers. Those with possible congenital toxoplasmosis were evaluated and followed up to a median age of 20months. Congenital infection was confirmed in the presence of persisting anti-T. gondii IgG antibodies beyond 12months of age. All infants with confirmed infection were treated with pyrimethamine, sulfadiazine and folinic acid for 1year. Results: Fifty-three infants had detectable IgM in dried blood spot specimens. Confirmatory testing was reactive in 39/50, of which, 38 completed follow-up. Six of 15204 newborns were diagnosed with congenital toxoplasmosis, resulting in an estimated birth prevalence of four per 10000 [CI 95% 1.4-8.0]. Four infants (67%) showed signs of congenital toxoplasmosis in their first year of life; three (75%) had retinochoroidal scars, and one had cerebral calcifications. Two infants remained asymptomatic until 20months of age. Conclusions: The birth prevalence of congenital toxoplasmosis is high in the Brazilian state of Sergipe, with most of the infants showing ocular lesions. Preventive measures are strongly warranted.[PUBLICATION ABSTRACT]