Document Detail


Feasibility of neonatal screening for toxoplasma infection in the absence of prenatal treatment. Danish Congenital Toxoplasmosis Study Group .
MedLine Citation:
PMID:  10359408     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The best method for prevention and control of congenital toxoplasma infection is uncertain. Prenatal screening is done in Austria and France, but the effect of treatment during pregnancy is not well documented. The aim of our study was to find out the maternofetal transmission rate and outcome in infants born to mothers who were not treated during pregnancy. METHODS: We analysed 89873 eluates from phenylketonuria (PKU) cards from neonates and paired first-trimester serum samples from the mothers for specific IgG antibodies to Toxoplasma gondii. Children born to mothers who seroconverted during pregnancy were followed-up clinically and serologically to 12 months of age. In addition, 21144 PKU cards were analysed for toxoplasma-specific IgM antibodies during the last 12 months of the study. FINDINGS: In 24989 (27.8%) cases both the PKU eluate and the first-trimester samples were IgG positive, which indicates previous maternal infection. 139 of the 64884 seronegative women acquired toxoplasma infection during pregnancy and gave birth to 141 infants (two sets of twins). 27 of these children were diagnosed with congenital toxoplasma infection. The transmission rate was 19.4% (95% CI 13.2-27.0). Clinical signs and symptoms were found in four (15%) of the 27 children. The additional analysis for toxoplasma-specific IgM antibodies from the PKU card identified seven of nine children with congenital toxoplasma infection. The false-positive rate for the IgM test was 0.19 per 1000, and no false-negatives were found. INTERPRETATION: The risks of transmission of infection and of disease in the infant are low in an area with a low risk of toxoplasma infection. A neonatal screening programme based on detection of toxoplasma-specific IgM antibodies alone will identify between 70% and 80% of cases of congenital toxoplasmosis.
Authors:
M Lebech; O Andersen; N C Christensen; J Hertel; H E Nielsen; B Peitersen; C Rechnitzer; S O Larsen; B Nørgaard-Pedersen; E Petersen
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Lancet     Volume:  353     ISSN:  0140-6736     ISO Abbreviation:  Lancet     Publication Date:  1999 May 
Date Detail:
Created Date:  1999-06-24     Completed Date:  1999-06-24     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  2985213R     Medline TA:  Lancet     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  1834-7     Citation Subset:  AIM; IM    
Affiliation:
Laboratory of Parasitology, Statens Serum Institut, Copenhagen, Denmark.
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Specimen Collection
Denmark / epidemiology
Feasibility Studies
Female
Humans
Infant, Newborn
Infectious Disease Transmission, Vertical / statistics & numerical data
Neonatal Screening* / methods
Phenylketonurias / epidemiology
Pregnancy
Pregnancy Complications, Parasitic / epidemiology
Prevalence
Risk Assessment
Toxoplasmosis / epidemiology,  transmission
Toxoplasmosis, Congenital / diagnosis,  epidemiology*,  prevention & control
Comments/Corrections
Comment In:
Lancet. 1999 Jun 5;353(9168):1899-900   [PMID:  10371564 ]
Lancet. 1999 Sep 18;354(9183):1030-1   [PMID:  10501387 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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