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Salomè S, Malesci R, Delle Cave V, Amitrano A, Gammella R, Fanelli F, Capone E, Capasso L, Fetoni AR, Raimondi F. Congenital toxoplasmosis and audiological outcome: from a case series to a suggestion of patient-based schedule. Front Pediatr 2024; 11:1297208. [PMID: 38239593 PMCID: PMC10794333 DOI: 10.3389/fped.2023.1297208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/11/2023] [Indexed: 01/22/2024] Open
Abstract
Introduction Sensorineural hearing loss (SNHL) has been suggested to be possibly related to congenital toxoplasmosis (CT), although its prevalence varies from 0% to 26%. This variance appears to be dependent especially on early timing of treatment. However, the available data are based on outdated studies conducted on small groups of patients that lack homogeneity. Therefore, to establish evidence-based guidelines for audiologic monitoring in CT, we conducted a comprehensive evaluation of a large case series over a long period of time. Patients and methods This is a single-center, retrospective cohort that enrolled all infants and children who were exposed in utero to Toxoplasma gondii and/or congenitally infected between September 1980 and December 2022. They underwent standard serial audiological evaluations to detect possible SNHL at an early stage. The first evaluation was performed during the initial assessment to define the onset of congenital toxoplasmosis, with another evaluation conducted at least at 12 months of life. Results We collected data from 1,712 patients, and 183 (10.7%) were diagnosed with CT. Among these cases, 78 children (42.6%) presented with symptomatic CT at the onset, exhibiting ocular findings (21.1%), clinical cerebral manifestations (6.1%), and/or abnormal findings on neuroimaging (35.5%). Therapy was administrated at the onset in 164 patients (89.6%) with 115 of them starting treatment prior to 2.5 months of age (0-388, median 32.00 ± 92.352 days of life). Only one patient presented with SNHL at the onset, but this was apparently unrelated to CT. The median number of audiological assessments was 2.2 ± 1.543 (2-10). No patients developed any grade of delayed hearing loss, both in treated and untreated groups. The median age at last audiological evaluation was 2.3 ± 2.18 years (1-8), although the median follow-up period was 12.4 years (±6.3), ranging from 1 to 27 years. Conclusions Based on these data, it appears that SNHL may be less frequent in CT than previously assumed. We recommend conducting an audiological assessment at the onset (within the first 2.5 months of life) to comprehensively define the type of CT onset, and then conducting another evaluation within 9 months of life.
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Affiliation(s)
- S. Salomè
- Division of Neonatology, Department of Translational Medical Sciences, University of Naples “Federico II”, Naples, Italy
| | - R. Malesci
- Unit of Audiology, Department of Neurosciences, Reproductive and Odontostomatologic Sciences, University of Naples “Federico II”, Naples, Italy
| | - V. Delle Cave
- Division of Neonatology, Department of Translational Medical Sciences, University of Naples “Federico II”, Naples, Italy
| | - A. Amitrano
- Division of Neonatology, Department of Translational Medical Sciences, University of Naples “Federico II”, Naples, Italy
| | - R. Gammella
- Division of Neonatology, Department of Translational Medical Sciences, University of Naples “Federico II”, Naples, Italy
| | - F. Fanelli
- Division of Neonatology, Department of Translational Medical Sciences, University of Naples “Federico II”, Naples, Italy
| | - E. Capone
- Division of Neonatology, Department of Translational Medical Sciences, University of Naples “Federico II”, Naples, Italy
| | - L. Capasso
- Division of Neonatology, Department of Translational Medical Sciences, University of Naples “Federico II”, Naples, Italy
| | - A. R. Fetoni
- Unit of Audiology, Department of Neurosciences, Reproductive and Odontostomatologic Sciences, University of Naples “Federico II”, Naples, Italy
| | - F. Raimondi
- Division of Neonatology, Department of Translational Medical Sciences, University of Naples “Federico II”, Naples, Italy
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Ferreira L, Sanfins MD, Pinto JD, Skarzynski PH, Skarżyńska MB, Vieira Biaggio EP. Congenital toxoplasmosis and auditory disorders: a literature review. Front Psychol 2024; 14:1286211. [PMID: 38298366 PMCID: PMC10828674 DOI: 10.3389/fpsyg.2023.1286211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 11/13/2023] [Indexed: 02/02/2024] Open
Abstract
Background Congenital toxoplasmosis (CT) occurs mainly by primary maternal infection during pregnancy. It is estimated that the incidence of vertical transmission to the fetus is 20% and that infected women are more likely to have a premature birth or low birth weight neonate since there is an association between CT and the rate of premature birth and low birth weight. In addition to severe neurological and ophthalmic consequences, hearing disorders such as hearing loss are also among the clinical manifestations seen in children with CT. Given the above, the objective of this study is to verify what are the auditory disorders seen in children with CT. Methods This literature review was structured according to the PRISMA statement and based on the terms of Study Target Population, Intervention, Comparison, Outcomes, and Study Types (PICOS). To obtain the studies, the following electronic databases were consulted: PubMed, Web of Science, Scopus, and Lilacs. The combined terms used for the search were: ("auditory evoked potentials" OR "hearing" OR "hearing loss") AND ("congenital toxoplasmosis"). The selection of articles was carried out independently, blindly, by two of the authors, to minimize risk of bias. Results The search in the databases identified 172 articles, after excluding duplicate articles, 105 studies were identified. From the selection made by reading the titles and abstracts, 11 studies were selected for full-text reading. A total of 94 studies were excluded. An article was selected from the list of references. Therefore, 12 studies were included in the final analysis. It was observed that a significant percentage of studies sought to study the peripheral auditory pathway, verifying the occurrence or association between hearing loss and the presence of congenital infection. Only two studies evaluated the central auditory pathway, using the Brainstem Auditory Evoked Potential (BAEP) and the Frequency Following Response (FFR). Conclusion Toxoplasmosis affects not only the peripheral areas but central areas as well. Most studies suggest this pathology as a risk factor for both peripheral and central impairment. Research has found a greater association between CT and mild to moderate hearing loss, in addition to alterations in exams such as BAEP and FFR. These data recommend that CT be reported as a global public health problem and can help assess complications and impacts of hearing disorders as a result of CT. There is a gap about studies that retract the co-occurrence between CT and other Risk Indicators for Hearing Loss (RIHL), such as prematurity, permanence in the intensive care unit, and use of ototoxic medications, lack of longitudinal studies, that accompany the development of hearing and language of children with CT, since the consequences of this infection may be late.
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Affiliation(s)
- Laís Ferreira
- Postgraduate Program in Human Communication Disorders, Department of Speech Therapy Federal University of Santa Maria, Santa Maria, Brazil
| | - Milaine Dominici Sanfins
- Department of Teleaudiology and Screening, Institute of Physiology and Pathology of Hearing, Kajetany, Poland
- Albert Einstein Institute for Teaching and Research (IIEP), São Paulo, Brazil
| | | | - Piotr Henryk Skarzynski
- Department of Teleaudiology and Screening, Institute of Physiology and Pathology of Hearing, Kajetany, Poland
- Center of Hearing and Speech Medincus, Kajetany, Poland
- Institute of Sensory Organs, Kajetany, Poland
- Marie Curie-Skłodowska University, Lublin, Lublin Voivodeship, Poland
| | - Magdalena B. Skarżyńska
- Department of Pharmacotherapy and Pharmaceutical Care, Pharmaceutical Department, Medical University of Warsaw, Warsaw, Poland
- Institute of Sensory Organs, Kajetany, Poland
- Center of Hearing and Speech, Nadarzyn, Poland
| | - Eliara Pinto Vieira Biaggio
- Postgraduate Program in Human Communication Disorders, Department of Speech Therapy Federal University of Santa Maria, Santa Maria, Brazil
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Abstract
Congenital hearing loss is the most common birth defect, estimated to affect 2-3 in every 1000 births. Currently there is no cure for hearing loss. Treatment options are limited to hearing aids for mild and moderate cases, and cochlear implants for severe and profound hearing loss. Here we provide a literature overview of the environmental and genetic causes of congenital hearing loss, common animal models and methods used for hearing research, as well as recent advances towards developing therapies to treat congenital deafness. © 2021 The Authors.
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Affiliation(s)
- Justine M Renauld
- Department of Otolaryngology, Head & Neck Surgery, Case Western Reserve University School of Medicine, Cleveland, Ohio
| | - Martin L Basch
- Department of Otolaryngology, Head & Neck Surgery, Case Western Reserve University School of Medicine, Cleveland, Ohio.,Department of Genetics and Genome Sciences, Case Western Reserve School of Medicine, Cleveland, Ohio.,Department of Biology, Case Western Reserve University, Cleveland, Ohio.,Department of Otolaryngology, Head & Neck Surgery, University Hospitals, Cleveland, Ohio
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Bertachini ALL, Januario GC, Novi SL, Mesquita RC, Silva MAR, Andrade GMQ, de Resende LM, de Miranda DM. Hearing brain evaluated using near-infrared spectroscopy in congenital toxoplasmosis. Sci Rep 2021; 11:10135. [PMID: 33980948 PMCID: PMC8115034 DOI: 10.1038/s41598-021-89481-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 04/20/2021] [Indexed: 12/11/2022] Open
Abstract
Congenital toxoplasmosis (CT) is a known cause of hearing loss directly caused by Toxoplasma gondii. Hearing loss might result from sensory, neural, or sensorineural lesions. Early treated infants rarely develop hearing loss, but retinochoroidal lesions, intracranial calcifications and hydrocephalus are common. In this study, we aimed to evaluate the brain evoked hemodynamic responses of CT and healthy infants during four auditory stimuli: mother infant directed speech, researcher infant directed speech, mother reading and researcher recorded. Children underwent Transitionally Evoked Otoacoustic Emission Auditory Testing and Automated Brainstem Auditory Response tests with normal auditory results, but with a tendency for greater latencies in the CT group compared to the control group. We assessed brain hemodynamics with functional near-infrared spectroscopy (fNIRS) measurements from 61 infants, and we present fNIRS results as frequency maps of activation and deactivation for each stimulus. By evaluating infants in the three first months of life, we observed an individual heterogeneous brain activation pattern in response to all auditory stimuli for both groups. Each channel was activated or deactivated in less than 30% of children for all stimuli. There is a need of prospective studies to evaluate if the neurologic or auditory changes course with compromise of children outcomes.
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Affiliation(s)
- Ana Lívia Libardi Bertachini
- Department of Pediatrics, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,NUPAD - Center for Newborn Screening and Genetic Diagnostics, UFMG - Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Gabriela Cintra Januario
- Department of Pediatrics, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,NUPAD - Center for Newborn Screening and Genetic Diagnostics, UFMG - Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Sergio Luiz Novi
- "Gleb Wataghin'' Institute of Physics, University of Campinas, Campinas, Brazil
| | | | | | - Gláucia Manzan Queiroz Andrade
- Department of Pediatrics, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,NUPAD - Center for Newborn Screening and Genetic Diagnostics, UFMG - Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Luciana Macedo de Resende
- Department of Speech and Hearing Therapy, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil.,NUPAD - Center for Newborn Screening and Genetic Diagnostics, UFMG - Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Débora Marques de Miranda
- Department of Pediatrics, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil. .,Centro de Tecnologia Em Medicina Molecular, Universidade Federal de Minas Gerais, Av. Prof. Alfredo Balena 190, Santa Efigênia, Belo Horizonte, MG, 30130-100, Brazil.
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Serological and molecular rapid diagnostic tests for Toxoplasma infection in humans and animals. Eur J Clin Microbiol Infect Dis 2019; 39:19-30. [PMID: 31428897 PMCID: PMC7087738 DOI: 10.1007/s10096-019-03680-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 08/11/2019] [Indexed: 02/07/2023]
Abstract
Infection by Toxoplasma gondii is prevalent worldwide. The parasite can infect a broad spectrum of vertebrate hosts, but infection of fetuses and immunocompromised patients is of particular concern. Easy-to-perform, robust, and highly sensitive and specific methods to detect Toxoplasma infection are important for the treatment and management of patients. Rapid diagnostic methods that do not sacrifice the accuracy of the assay and give reproducible results in a short time are highly desirable. In this context, rapid diagnostic tests (RDTs), especially with point-of-care (POC) features, are promising diagnostic methods in clinical microbiology laboratories, especially in areas with minimal laboratory facilities. More advanced methods using microfluidics and sensor technology will be the future trend. In this review, we discuss serological and molecular-based rapid diagnostic tests for detecting Toxoplasma infection in humans as well as animals.
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