Survey of European programmes for the epidemiological surveillance of congenital toxoplasmosis

Abstract

The objective of this investigation was to describe systems for the epidemiological surveillance of congenital toxoplasmosis implemented in European countries. In September 2004, a questionnaire, adapted from the evaluation criteria published by the United States Centers for Disease Control and Prevention, was sent to a panel of national correspondents in 35 countries in the European geographical area with knowledge of the epidemiological surveillance systems implemented in their countries. Where necessary, we updated the information until July 2007. Responses were received from 28 countries. Some 16 countries reported routine surveillance for toxoplasmosis. In 12 countries (Bulgaria, Cyprus, Czech Republic, England and Wales, Estonia, Ireland, Latvia, Lithuania, Malta, Poland, Scotland and Slovakia), surveillance was designed to detect only symptomatic toxoplasmosis, whether congenital or not. Four countries reported surveillance of congenital toxoplasmosis, on a regional basis in Italy and on a national basis in Denmark, France and Germany. In conclusion, epidemiological surveillance of congenital toxoplasmosis needs to be improved in order to determine the true burden of disease and to assess the effectiveness of and the need for existing prevention programmes.

Frecuencia de anticuerpos anti Toxoplasma gondii en gestantes de Cúcuta, Colombia

“…En la mayoría de los casos, la transmisión es transplacentaria, lo que se hace imprescindible el rastreo de anticuerpos frente a T.gondii como parte del control prenatal y con el propósito de detectar posible infección activa gestacional, para manejo posterior de la paciente evitando la infección fetal (8,(19)(20)(21).…”

Screening of Maternal Toxoplasmosis in Pregnancy: Laboratory Diagnostics from the Perspective of Public Health Requirements

“…annual), extensive assessment and reporting on key epidemiological data like seroprevalence, incidence of maternal infections (stratified by gestational week of diagnosis and an estimated time point of infection), incidence of fetal infections (if amniocentesis was performed), treatments, and, most importantly, the clinical outcome in the child in the long run: "The prime example of minimal available data is France …" [30], but at least France introduced some mandatory reporting in May 2007 [1] and reported some first results about congenital toxoplasmosis [10]. Even worse, Austria is still waiting for these first steps in the right direction.…”

“…Due to this news, many public health authorities and health care payment providers have withdrawn their support for screening (e.g., Denmark stopped its neonatal screening in 2007 [1] and Switzerland even voted against voluntary screening except for a surveillance project in the Basel region in 2008 [16]). Nonetheless, many limitations and biases of these studies have been discussed [8] and many toxoplasmosis experts propose important arguments in favor of the treatment concept [9,13,[17][18][19].…”

“…Austria and France) [1][2][3]. Recently, despite much international research, the efficiency of this approach in preventing toxoplasmosis in the fetus has been questioned, more on the ground of inconclusive data than on convincing study results [4][5][6][7][8].…”

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

“…Some countries, such as Austria and France, have implemented a prenatal screening programme and other European countries have issued recommendations to screen non-immune pregnant women. In Europe, 28 countries recently declared that they had a system for the surveillance of congenital toxoplasmosis that could be used either routinely or only to identify symptomatic cases (Benard et al 2008): (ii) active and well-tolerated drugs are available for control of the infection as demonstrated by the prevention and treatment of the disease in immunocompromised patients (Montoya & Liesenfeld 2004). The emergence of opportunistic infections in AIDS patients has markedly stimulated the search for new active compounds.…”