Outcome of Treatment for Congenital Toxoplasmosis, 1981-2004: The National Collaborative Chicago-Based, Congenital Toxoplasmosis Study

Abstract

Although not all children did well with treatment, the favorable outcomes we noted indicate the importance of diagnosis and treatment of infants with congenital toxoplasmosis.

Deficiência auditiva na toxoplasmose congênita detectada pela triagem neonatal

“…Table 5 shows comparisons of three studies which encompassed hearing evaluation in children with congenital toxoplasmosis. The Chicago Study 15,20 evaluated children treated with the classical antiparasitic drugs for 12 The results observed in this study are similar to those found by Wilson et al 19 Studies with larger samples, submitted to long stand treatment (12 months), did not identify the presence of hypoacusis, concluding for a better prognosis of the treated children 20 . In the present investigation, among the 16 children properly treated, for long time and regularly, two presented hearing deficit, but only one had an important functional loss.…”

“…Long standing treatments (one year) for congenital toxoplasmosis have been associated to better children prognosis by some authors 15,20 . Among the four children in the present study, one received antiparasitic drugs for three months only (this mother, a teenager, was not interested in her child's problem) and the other was irregularly treated for 10 months (did not regularly come for visits at the ward); the most affected child and the other one with unilateral hearing loss were treated during 12 months.…”

“…This study was approved by the COEP-UFMG (ETIC 157/01) and we honored the standards established for research with human beings, according to resolution 196/96 from CONEP. 20 were identified with congenital toxoplasmosis, resulting in a rate of 1:1590 infected by live births. In relation to the time of diagnosis for these 20 children, six (30%) had already been identified during prenatal care (prenatal screening program implemented in BH), four (20%) were identified in the neonatal period because they had clinical manifestations suggesting the infection; and ten (50%) were identified by neonatal screening alone.…”

“…17 ; however, Wilson et al 18,19 reported unilateral or bilateral hearing loss in 5 (26%) of the 19 children with subclinical infection. Other authors have found no association between the parasites and hypoacusis, when children are treated 15,20 , and there still are doubts as to the rate at which toxoplasmosis can cause hearing deficit 13,17,21 .…”

When are we going to celebrate the centenary of the discovery of efficient treatment for congenital toxoplasmosis?

“…It should be born in mind that, at the time of some of these studies, antenatal diagnosis and ultrasound were not available. Mcleod et al (2006) reported the results of a longitudinal study and found that infants who were treated for one year after birth with pyrimethamine and sulfadiazine had better outcomes that those of children who were not treated or who were treated for one month. Recently, the same team reported on a cohort of congenitally infected children who were not treated during the first year of life.…”