Congenital Toxoplasmosis in Tunisia: Prenatal and Neonatal Diagnosis and Postnatal Follow-up of 35 Cases

Abstract

Congenital toxoplasmosis (CT) results from transplacental passage of to the fetus during acute maternal infection. Our study aims to report clinical and biological patterns of 35 cases of CT diagnosed at the department of the Parasitology of the Pasteur Institute of Tunis and to access the performance of prenatal and early postnatal diagnosis techniques. Serological screening of maternal infection was performed by Immunoglobulin (Ig) M and IgG detection and IgG avidity determination. Prenatal diagnosis was based on both DNA detection in the amniotic fluid and monthly ultrasound examinations. polymerase chain reaction analysis on amniotic fluid, performed only in 15 cases, detected 's DNA in five cases (33.3%). Ultrasound examination did not reveal any morphological abnormalities. Thirty newborns had serological criteria of infection. Congenital toxoplasmosis diagnosis was confirmed in 23 cases (76.6%) by immunoblot. Among the 35 born-infants, five (14.3%) were symptomatic: three had chorioretinitis at the first clinical ocular examination, one had neurological symptoms (seizures) with positive parasite DNA in cerebral spinal fluid, and one had both ophthalmological and neurological damages- chorioretinitis and intracranial calcifications in the computed tomography scan. Thirty-four of 35 infected children were treated with pyrimethamine-sulfadiazine combination. Four (11.7%) of the treated infants showed abnormal hematological values because of the treatment side effect. Serological rebound was observed in seven infants. A screening program and a diagnostic algorithm in pregnant women should be implemented in Tunisia to improve the follow-up of seronegative ones and to prevent CT cases.

First isolation and molecular characterization of Toxoplasma gondii strains from human congenital toxoplasmosis cases in Monastir, Tunisia

“…In fact, a positive rate of 0.04% has been found (16/40,566). However, in North of Tunisia Boudaoura et al 35 www.nature.com/scientificreports www.nature.com/scientificreports/ At concluding remarks, this study presents the first report of T. gondii strains isolation in Tunisia from human AF samples. Also, all isolates were belonging to type II genotype.…”

Seroepidemiology of Toxoplasma gondii Among Pregnant Women Attending Antenatal Care in Northwest Ethiopia

“… 6 , 7 Moreover, the infection of pregnant women results in miscarriage or congenital infection that causes hydrocephalus, blindness, foetal death, neurological damage/intracranial calcification and retinochoroiditis. 3 , 8 , 9 Recent reports have also reported that toxoplasmosis is a possible risk factor for personality shifts and increased likelihood of reduced intelligence or schizophrenia. 10 Hence, early serological screening for toxoplasmosis in pregnant women is imperative.…”

Prospective evalution of pregnant women with suspected acute toxoplasmosis treated in a reference prenatal care clinic at a university teaching hospital in Southern Brazil

“…Similarly, Boudaouara et al . 36 found no morphological abnormalities in ultrasound examinations of foetuses with congenital toxoplasmosis.…”

“…Although fetal ultrasound analyses are routinely used as an additional diagnostic instrument to detect vertical transmission and to perform the foetal follow-up, only one case of foetal death revealed previous alterations. Similarly, Boudaouara et al 36 found no morphological abnormalities in ultrasound examinations of foetuses with congenital toxoplasmosis.…”