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

Toxoplasmosis

“…At present, severe neurologic or ocular involvement, or both, is observed only among infants born to women in the following patient groups: patients referred from foreign countries where screening is not performed during pregnancy (e.g., Morocco, Algeria, United Kingdom), mothers who for any reason were not screened during pregnancy, mothers who were immunodeficient, and mothers who were erroneously considered to be immune. With these exceptions, in which the clinical status may be considered abnormal (see "Chronic Maternal Toxoplasma Infection"), prenatal screening for maternal T. gondii infection during pregnancy appears to be an effective preventive measure for congenital toxoplasmosis in France, although the efficacy of this approach has not been formally tested in randomized controlled trials (see Table 31-5) [195,196].…”

“…However, it is acknowledged that the absence of evidence from controlled clinical trials is not evidence for the lack of benefit. For this reason, other authorities, including those in France [196] and in the United States [198,199]-although they agree that carefully designed studies are needed to determine the true benefit-believe that a program of screening, careful counseling, and treatment of the pregnant woman who acquires infection during pregnancy is appropriate. This is particularly true in countries such as Brazil, where the incidence of severe, symptomatic congenital toxoplasmosis appears to be much greater than in Europe and North America, perhaps reflecting the greater prevalence in Brazil of more virulent type I and atypical strains of T. gondii [200].…”

“…Although we agree that such studies would be necessary to provide incontrovertible proof of efficacy, lack of evidence for benefit from placebo-controlled trials is not evidence that postnatal treatment is of no benefit. For this reason, until such placebo-controlled data with long-term follow-up and analyses as careful as those in the NCCCTS become available, we and others [196] continue to recommend that treatment be given following the regimens described for the NCCCTS study. Ideally, in the United States and Canada, when physicians feel this may be of benefit for their patients and in understanding the natural history of this disease, consideration should be given to referring cases to the NCCCTS.…”

Congenital toxoplasmosis—a report on the Danish neonatal screening programme 1999–2007

“…the Chicago cohort, will present with more severe symptomatology (McLeod et al 2006). In general, authors have expressed an urgent need for more randomised trials regarding both pre-and neonatal treatment (Gilbert 2009;Peyron 2009). …”

Estudo da carga parasitária e dos genótipos de Toxoplasma gondii na toxoplasmose congênita

“…No entanto, quando adquirida durante a gestação assume grande importância pelo fato de poder causar malformações congênitas graves, além de abortos espontâneos e natimortos (Remington et al, 2001, Dubey, 2012 (Reikvam et al, 1976;Frenkel et al, 1997;Dubey et al, 1998;Remington et al, 2001;Montoya e Remington, 2008 (Costa et al, 2000;Calderaro et al, 2006;Cassaing et al, 2006;Okay et al, 2009, Mesquita et al, 2010 Este fato pode ser importante para alertar os obstetras sobre a possibilidade de falha terapêutica (Gilbert, 2009;Peyron, 2009 (Gilbert, 2009;Peyron, 2009 (Siqueira et al, 1985;Yano et al, 1987;Gissot et al, 2007 (Ajzenberg et al, 2004, Ferreira et al,2006Su et al, 2006;Belfort-Neto et al, 2007;Dubey et al, 2007;Su et al, 2010;Dubey et al, 2012).…”