Congenital toxoplasmosis is a potentially severe infection and its prevention is most often based on serological screening in pregnant women. Many cases could be prevented by simple precautions during pregnancy. Aiming to assess the knowledge about toxoplasmosis among professionals working in antenatal care in a high prevalent region, a questionnaire was administered to 118 obstetric nurses and physicians attending at primary care units and hospitals. The questionnaire was self-completed and included questions on diagnosis, clinical issues, and prevention. Only 44% of total answers were corrected. Lower scores were observed among those with over 10 years of graduation, working in primary care units, and nurses. Errors were mainly observed in questions of prevention and diagnosis. As congenital toxoplasmosis is a mother-to-child (MTC) transmitted disease, early diagnosis and treatment can prevent serious and irreversible fetal damage. Thus, doctors and nurses who provide prenatal care must be appropriately trained on prophylactic, diagnostic, and clinical aspects of toxoplasmosis. The authors suggest that measures should be taken for continuing education regarding toxoplasmosis in pregnancy.
Introduction: A single nucleotide polymorphism (SNP) in the gene encoding gamma interferon influences its production and is associated with severity of infectious diseases. This study aimed to evaluate the association of IFNγ+874T/A SNP with duration of disease, morbidity, and development of retinochoroiditis in acute toxoplasmosis. Methods: A case-control study was conducted among 30 patients and 90 controls. Results: Although statistical associations were not confirmed, A-allele was more common among retinochoroiditis cases and prolonged illness, while T-allele was more frequent in severe disease. Conclusions: Despite few cases, the results could indicate a relation between IFNγ+874T/A single nucleotide polymorphism and clinical manifestations of toxoplasmosis.
Aims:To evaluate the difficulties met in the care of pregnant women with toxoplasmosis diagnosis in antenatal care services. Methods: Longitudinal prospective study with 262 pregnant women referred to the Toxoplasmosis Clinic at Instituto de Pesquisa Clínica Evandro Chagas-Fundação Oswaldo Cruz, between January 2005 and July 2009. Results: Most women (91.2%) were in the second and third trimesters of pregnancy, and 81.3% were referred by public health services. The average delay was 113.4 days in the collection of the first sample for serological tests in antenatal care, 52.1 days for referral and 160.6 days in starting treatment. Younger women (P=0.03) and those from the public health system were referred later (P<0.05). Treatment was initiated at the origin for only 16% of the pregnant women, and 5% of these did not receive the recommended dose of spiramycin. At the Reference Center there was a low rate of confirmation of the serological tests performed in the health services of origin. It was found that 12.6% of pregnant women with an initial diagnosis of acute toxoplasmosis were susceptible to infection by Toxoplasma gondii. These tests were considered false positives. Conclusions: This study highlights the difficulties met in the management of pregnant women with toxoplasmosis in the antenatal care, including the quality of diagnostic tests and the need for greater emphasis on continuing education of health professionals.
Acute acquired toxoplasmosis is considered a self-limited mononucleosis-like disease that rarely requires treatment. We report an unusual severe case of disseminated toxoplasmosis complicated with meningitis and pneumonia in a previously 41-year-old healthy Brazilian man. Toxoplasmosis should be included in the differential diagnosis of acute febrile diseases due to the non-specific clinical symptoms and the possibility of severe outcome.
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