Toxoplasmosis and Pregnancy: Assessment of Disease Burden and Detection Strategies
Keywords:
Congenital toxoplasmosis, Parasitic infection, Pregnancy and fetal health, Prenatal diagnosis, Prevention and treatmentAbstract
Introduction: Toxoplasmosis is one of the most common parasitic zoonoses worldwide and is associated with an increase in perinatal morbidity and mortality. There are various diagnostic tests, both serological and molecular, that facilitate the diagnosis of primary infection. It is estimated that between 1 and 2 cases occur worldwide per 1,000 live births, which suggests that in Ecuador, by 2023, between 172 and 344 cases could have occurred, most of them being underdiagnosed. Objective: To analyze the effectiveness of a previously published screening strategy and evaluate its feasibility in pregnant women in Ecuador. Method: A comprehensive review of the scientific literature was conducted, including studies on prevalence, screening, and cost-effectiveness. Results: Prenatal screening is considered an intervention with the potential to significantly improve perinatal health outcomes, supported by favorable long-term economic evaluations. In addition, the convenience of implementing this strategy in Ecuador is discussed. Conclusion: Its implementation would allow for early treatment, which could represent a key step to reduce the burden of congenital toxoplasmosis in Ecuador.
References
1. Adane T, Getawa S. Cytomegalovirus seroprevalence among blood donors: a systematic review and meta-analysis. J Int Med Res. 2021;49(8):3000605211034656. doi:10.1177/03000605211034656.
2. Agut H, Bonnafous P, Gautheret-Dejean A. Laboratory and clinical aspects of human herpesvirus 6 infections. Clin Microbiol Rev. 2015;28(2):313-35. doi:10.1128/CMR.00122-14.
3. Behnke MS, Khan A, Wootton JC, Dubey JP, Tang K, Sibley LD. Virulence differences in Toxoplasma mediated by amplification of a family of polymorphic pseudokinases. Proc Natl Acad Sci U S A. 2011;108(23):9631-6. doi:10.1073/pnas.1015338108.
4. Binquet C, Lejeune C, Seror V, Peyron F, Bertaux AC, Scemama O, et al. The cost-effectiveness of neonatal versus prenatal screening for congenital toxoplasmosis. PLoS One. 2019;14(9):e0221709. doi:10.1371/journal.pone.0221709.
5. Binquet C, Sawers L, Wallon M, Mandelbrot L, Villena I, Stillwaggon E, et al. Prevention of congenital toxoplasmosis in France using prenatal screening: a decision-analytic economic model. PLoS One. 2022;17(11):e0273781. doi:10.1371/journal.pone.0273781.
6. Bollani L, Auriti C, Achille C, Garofoli F, De Rose DU, Meroni V, et al. Congenital toxoplasmosis: the state of the art. Front Pediatr. 2022;10:894573. doi:10.3389/fped.2022.894573.
7. Boyer KM, Holfels E, Roizen N, Swisher C, Mack D, Remington J, et al. Risk factors for Toxoplasma gondii infection in mothers of infants with congenital toxoplasmosis: implications for prenatal management and screening. Am J Obstet Gynecol. 2005;192(2):564-71. doi:10.1016/j.ajog.2004.07.031.
8. CDC. Toxoplasmosis - Prevention & Control [Internet]. 2024. Available from: https://www.cdc.gov/parasites/toxoplasmosis/prevent.html
9. Contreras MC, Schenone H, Salinas P, Sandoval L, Rojas A, Villarroel F, et al. Seroepidemiology of human toxoplasmosis in Chile. Rev Inst Med Trop São Paulo. 1996;38:431-5. doi:10.1590/S0036-46651996000600008.
10. Dunn D, Wallon M, Peyron F, Petersen E, Peckham C, Gilbert R. Mother-to-child transmission of toxoplasmosis: risk estimates for clinical counselling. Lancet. 1999;353(9167):1829-33. doi:10.1016/S0140-6736(98)08220-8.
11. Elbez-Rubinstein A, Ajzenberg D, Dardé M, Cohen R, Dumètre A, Yera H, et al. Congenital toxoplasmosis and reinfection during pregnancy: case report, strain characterization, experimental model of reinfection, and review. J Infect Dis. 2009;199(2):280-5. doi:10.1086/595793.
12. Espinoza-Rojas J, López-Mora E, Dabanch-Peña J, Cruz-Choappa R. Recomendaciones para el diagnóstico y tratamiento de la infección por Toxoplasma gondii. Rev Chilena Infectol. 2022;39(2):132-7. doi:10.4067/S0716-10182022000200132.
13. Furui Y, Satake M, Hoshi Y, Uchida S, Suzuki K, Tadokoro K, et al. Cytomegalovirus seroprevalence in Japanese blood donors and high detection frequency of CMV DNA in elderly donors. Transfusion. 2013;53(10):2190-7. doi:10.1111/trf.12390.
14. Garweg JG, Kieffer F, Mandelbrot L, Peyron F, Wallon M. Long-term outcomes in children with congenital toxoplasmosis: a systematic review. Pathogens. 2022;11(10):1187. doi:10.3390/pathogens11101187.
15. Gómez Marín JE. Toxoplasmosis: un problema de salud pública en Colombia. Rev Salud Pública. 2002;4:7-10.
16. Hampton MM. Congenital toxoplasmosis: a review. Neonatal Netw. 2015;34(5):274-8. doi:10.1891/0730-0832.34.5.274.
17. Instituto de Salud Pública de Chile. Boletín de vigilancia de laboratorios sobre agentes parasitarios transmitidos por alimentos. 2012–2016. Available from: https://www.ispch.cl/sites/default/files/BoletinETAS-14052018A%20(2).pdf
18. Jeannel D, Niel G, Costagliola D, Danis M, Traore BM. Epidemiology of toxoplasmosis among pregnant women in the Paris area. Int J Epidemiol. 1988;17(3):595-602. doi:10.1093/ije/17.3.595.
19. Jones JL. Toxoplasma gondii infection in the United States: seroprevalence and risk factors. Am J Epidemiol. 2001;154(4):357-65. doi:10.1093/aje/154.4.357.
20. Kowalzik F, Hitzler W, Runkel S, Marron M. Seroprevalence and seroconversion of cytomegalovirus in German blood donors. Clin Lab. 2020;66(4). doi:10.7754/Clin.Lab.2019.190901.
21. Lancini DV, Faddy HM, Flower RL, Hogan C. Cytomegalovirus disease in immunocompetent adults. Med J Aust. 2014;201(10):578-80. doi:10.5694/mja14.00183.
22. Lancini DV, Faddy HM, Ismay S, Chesneau S, Hogan C, Flower RL. Cytomegalovirus in Australian blood donors. Transfusion. 2016;56(6 Pt 2):1616-21. doi:10.1111/trf.13459.
23. Mengjiao L, Yushan X, Yan L, Dawei C, Xiaojun Z, Yongjun W, et al. Prevalence of transfusion-transmitted infections in hospitalized patients and blood donors. Infect Dis Now. 2024;54(2):104861. doi:10.1016/j.idnow.2024.104861.
24. Mimica F, Muñoz-Zanzi C, Torres M, Padilla O. Toxoplasmosis, zoonosis parasitaria prevalente en Chile: recuento y desafíos. Rev Chilena Infectol. 2015;32(5):541-9. doi:10.4067/S0716-10182015000600008.
25. Molan A, Nosaka K, Hunter M, Wang W. Global status of Toxoplasma gondii infection: systematic review and prevalence snapshots. Trop Biomed. 2019;36(4):898-925.
26. Muñoz-Zanzi CA, Fry P, Lesina B, Hill D. Toxoplasma gondii oocyst-specific antibodies and source of infection. Emerg Infect Dis. 2010;16(10):1591-3. doi:10.3201/eid1610.091674.
27. Muñoz-Zanzi C, Campbell C, Berg S. Seroepidemiology of toxoplasmosis in rural and urban communities from Los Ríos Region, Chile. Infect Ecol Epidemiol. 2016;6:30597. doi:10.3402/iee.v6.30597.
28. Neghme A, Thiermann E, Pino F, Christen R, Agosin M. Toxoplasmosis humana en Chile. Bol Enf Parasit Chilenas. 1952;7:6-8.
29. Oliveira JRF, Varallo FR, Jirón M, Ferreira IML, Lopes VD, Leira L. Descripción del consumo de psicofármacos en atención primaria. Cad Saude Publica. 2021;37(1):e00060520. doi:10.1590/0102-311X00060520.
30. OMS. Cytomegalovirus / toxoplasmosis / prevención en salud (según fuente institucional). Available from: https://www.who.int/
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Sapiens in Health Sciences
This work is licensed under a Creative Commons Attribution 4.0 International License.
Articles published in this journal are available under the Creative Commons Attribution 4.0 International (CC BY 4.0) licence. This licence authorises third parties to download, copy, distribute, adapt and reuse the contents, including for commercial purposes, provided that credit is given to the original author of the work.
