ABSTRACT
Untreated acute toxoplasmosis among pregnant women can lead to serious sequelae among newborns, including neurological impairment and blindness. In Brazil, the risk of congenital toxoplasmosis (CTox) has not been fully evaluated. Our aim was to evaluate trends in acute toxoplasmosis prevalence from 1998-2005, the incidence of CTox and the rate of mother-to-child transmission (MTCT). A cross-sectional study was undertaken to dentify patients who fit the criteria for acute toxoplasmosis during pregnancy. Exposed newborns were included in a historical cohort, with a median follow-up time of 11 months, to establish definite diagnosis of CTox. Diagnoses for acute infection in pregnancy and CTox were based on European Research Network on Congenital Toxoplasmosis criteria. In 41,112 pregnant women, the prevalence of acute toxoplasmosis was 4.8/1,000 women. The birth prevalence of CTox was 0.6/1,000 newborns [95 percent confidence interval (CI): 0.4-0.9]. During the follow-up study, 12 additional cases were detected, increasing the CTox rate to 0.9/1,000 newborns (95 percent CI: 0.6-1.3). Among the 200 newborns exposed to Toxoplasma gondii,there were 37 babies presenting diagnostic criteria of CTox, leading to an MTCT rate of 18.5 percent (95 percent CI: 13.4-24.6 percent). The additional cases identified during follow-up reinforce the need for serological monitoring during the first year of life, even in the absence of evidence of congenital infection at birth.
Subject(s)
Animals , Female , Humans , Infant, Newborn , Pregnancy , Infectious Disease Transmission, Vertical/statistics & numerical data , Pregnancy Complications, Parasitic/epidemiology , Toxoplasmosis/epidemiology , Acute Disease , Brazil/epidemiology , Cross-Sectional Studies , Hospitals, Public , Incidence , Prevalence , Pregnancy Complications, Parasitic/diagnosis , Toxoplasmosis, Congenital/diagnosis , Toxoplasmosis, Congenital/epidemiology , Toxoplasmosis, Congenital/transmission , Toxoplasmosis/diagnosis , Toxoplasmosis/transmissionSubject(s)
Humans , Male , Female , Adult , Middle Aged , Case-Control Studies , Cross Infection/complications , Acquired Immunodeficiency Syndrome/etiology , BrazilABSTRACT
A presença insuspeitada do Vírus da Imunodeficiência Humana (HIV) em pessoas que procuram atendimiento médico é cada vez maior. É inexeqüível a realizaçäo dos testes para identificaçäo de anticorpos anti-HIV em todos os pacientes, bem como em materiais biológicos para exames. Em funçäo disto, atualmente recomenda-se que os profissionais de saúde adotem precauçöes universais quando em contato com sangue/secreçöes de qualquer paciente. Este trabalho traz as orientaçöes recentes para os profissionais da área da saúde que apresentam riscos de contrair infecçöes transmitidas pelo sangue, entre as quais, o vírus da AIDS