Why prevent, diagnose and treat congenital toxoplasmosis?

被引:115
作者
McLeod, Rima [1 ,2 ,3 ]
Kieffer, Francois [4 ]
Sautter, Mari [1 ,2 ,3 ]
Hosten, Tiffany [1 ,2 ,3 ]
Pelloux, Herve [5 ]
机构
[1] Univ Chicago, Comm Immunol, Dept Ophthalmol & Visual Sci, The Coll, Chicago, IL 60637 USA
[2] Univ Chicago, Comm Genet, Dept Ophthalmol & Visual Sci, The Coll, Chicago, IL 60637 USA
[3] Univ Chicago, Comm Mol Med, Dept Ophthalmol & Visual Sci, The Coll, Chicago, IL 60637 USA
[4] Inst Puericulture, Paris, France
[5] CNRS UJF, Inst Jean Roget, CHU Grenoble, Dept Agents Infect,Lab Adaptat & Pathogenie Micro, Grenoble, France
来源
MEMORIAS DO INSTITUTO OSWALDO CRUZ | 2009年 / 104卷 / 02期
关键词
congenital toxoplasmosis; prevention; treatment; POLYMERASE-CHAIN-REACTION; TO-CHILD TRANSMISSION; INFANTS AGED 0; PRENATAL TREATMENT; OCULAR TOXOPLASMOSIS; GONDII INFECTION; FOLLOW-UP; INTRACRANIAL CALCIFICATIONS; ANTIMICROBIAL AGENTS; HOMOGENEOUS SERIES;
D O I
10.1590/S0074-02762009000200029
中图分类号
R38 [医学寄生虫学]; Q [生物科学];
学科分类号
07 ; 0710 ; 09 ; 100103 ;
摘要
Evidence that prevention, diagnosis and treatment of toxoplasmosis is beneficial developed as follows: antiparasitic agents abrogate Toxoplasma gondii tachyzoite growth, preventing destruction of infected, cultured, mammalian cells and cure active infections in experimental animals, including primates. They treat active infections in persons who are immune-compromised, limit destruction of retina by replicating parasites and thereby treat ocular toxoplasmosis and treat active infection in the fetus and infant. Outcomes of untreated congenital toxoplasmosis include adverse ocular and neurologic sequelae described in different countries and decades. Better outcomes are associated with treatment of infected infants throughout their first year of life. Shorter intervals between diagnosis and treatment in utero improve outcomes. A French approach for diagnosis and treatment of congenital toxoplasmosis in the fetus and infant can prevent toxoplasmosis and limit adverse sequelae. In addition, new data demonstrate that this French approach results in favorable outcomes with some early gestation infections. A standardized approach to diagnosis and treatment during gestation has not yet been applied generally in the USA. Nonetheless, a small, similar experience confirms that this French approach is feasible, safe, and results in favorable outcomes in the National Collaborative Chicago-based Congenital Toxoplasmosis Study cohort. Prompt diagnosis, prevention and treatment reduce adverse sequelae of congenital toxoplasmosis.
引用
收藏
页码:320 / 344
页数:25
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