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Abedi B, Akbari M, Azadi D, Habibi D, Khodashenas S, Shariatmadari F. Toxoplasmosis infection in newborn: A systematic review and meta-analysis. Adv Biomed Res 2022; 11:75. [DOI: 10.4103/abr.abr_24_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 07/06/2021] [Accepted: 07/25/2021] [Indexed: 11/04/2022] Open
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Dubey JP, Murata FHA, Cerqueira-Cézar CK, Kwok OCH, Villena I. Congenital toxoplasmosis in humans: an update of worldwide rate of congenital infections. Parasitology 2021; 148:1406-1416. [PMID: 34254575 PMCID: PMC11010219 DOI: 10.1017/s0031182021001013] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 06/08/2021] [Accepted: 06/08/2021] [Indexed: 11/07/2022]
Abstract
The morbidity due to congenital toxoplasmosis in humans is very high. Most of these infected children are likely to develop symptoms of clinical toxoplasmosis. Sequelae in fetus resulting from Toxoplasma gondii infections in women who become infected with this parasite during pregnancy can be devastating and enormous efforts are directed in some countries to prevent these consequences. Here, an update on congenital toxoplasmosis in humans, especially the rate of congenital infections in humans worldwide, is provided. Although several countries have surveillance programmes, most information on the rate of congenital transmission is from France and Brazil. Because of compulsory national screening programme in France to detect and treat women with recently acquired T. gondii infection with anti-toxoplasma therapy, the rate of congenital transmission and the severity of disease in children are declining. Infections by this parasite are widely prevalent in Brazil. The severity of clinical toxoplasmosis in Brazilian children is very high and may be associated with the genetic characteristics of T. gondii isolates prevailing in animals and humans in Brazil. Virtually little or no information is available on this topic from China, India and other countries in Asia.
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Affiliation(s)
- J. P. Dubey
- United States Department of Agriculture, Agricultural Research Service, Animal Parasitic Diseases Laboratory, Beltsville Agricultural Research Center, Building 1001, Beltsville, MD20705-2350, USA
| | - F. H. A. Murata
- United States Department of Agriculture, Agricultural Research Service, Animal Parasitic Diseases Laboratory, Beltsville Agricultural Research Center, Building 1001, Beltsville, MD20705-2350, USA
| | - C. K. Cerqueira-Cézar
- United States Department of Agriculture, Agricultural Research Service, Animal Parasitic Diseases Laboratory, Beltsville Agricultural Research Center, Building 1001, Beltsville, MD20705-2350, USA
| | - O. C. H. Kwok
- United States Department of Agriculture, Agricultural Research Service, Animal Parasitic Diseases Laboratory, Beltsville Agricultural Research Center, Building 1001, Beltsville, MD20705-2350, USA
| | - I. Villena
- Parasitology, Mycology Laboratory, National Reference Centre for Toxoplasmosis, Toxoplasma Biological Resources Centre, CHU Reims and University Reims Champagne Ardenne ESCAPE EA7510, 51097, Reims, France
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Storchilo HR, Teixeira GM, Moreira ALE, Gomes TC, Borges CL, de Castro AM. Identification of Biomarkers for Diagnosis and Prognosis of Congenital and Acute Toxoplasmosis. J Infect Dis 2021; 223:1965-1972. [PMID: 32995873 DOI: 10.1093/infdis/jiaa613] [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: 08/12/2020] [Accepted: 09/25/2020] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The diagnosis of congenital toxoplasmosis can be inconclusive in many cases. Despite the several serological tests developed, the literature on biomarkers that can assist in the diagnosis of congenital an acute toxoplasmosis is limited. The objective of this study was to analyze the immunoreactive profile of Toxoplasma gondii protein bands with the potential to be biomarkers for diagnosis and prognosis of congenital and acute toxoplasmosis. METHODS Peripheral blood samples from women of childbearing age and/or pregnant women diagnosed with acquired toxoplasmosis as well as from congenitally infected children were selected and submitted to immunoblotting for analysis of the immunoreactive bands profile by immunoglobulin G (IgG) antibodies. RESULTS When comparing the immunoreactive bands profile for antibodies present in samples from different groups and subgroups, the 150, 18.5, and 16.96-kDa bands were more immunoreactive with the antibodies present in serum samples from the acquired infection group. The 343, 189, 150, 75, and 42-kDa bands showed more chance to be detected by the symptomatic congenital infection subgroup samples, while the 61, 50, and 16.96-kDa bands were significantly immunoreactive with the acute infection subgroup samples. CONCLUSIONS The identification of these potential biomarkers can assist in early diagnosis and treatment of congenital toxoplasmosis.
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Affiliation(s)
- Heloisa Ribeiro Storchilo
- Department of Biosciences and Technology - Parasitology sector, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Giulianne Monteiro Teixeira
- Department of Biosciences and Technology - Parasitology sector, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - André Luís Elias Moreira
- Department of Biochemistry and Molecular Biology, Instituto de Ciências Biológicas, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Taynara Cristina Gomes
- Department of Biosciences and Technology - Parasitology sector, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Clayton Luiz Borges
- Department of Biochemistry and Molecular Biology, Instituto de Ciências Biológicas, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
| | - Ana Maria de Castro
- Department of Biosciences and Technology - Parasitology sector, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiânia, Goiás, Brazil
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Lago EG, Endres MM, Scheeren MFDC, Fiori HH. Ocular Outcome of Brazilian Patients With Congenital Toxoplasmosis. Pediatr Infect Dis J 2021; 40:e21-e27. [PMID: 33060522 DOI: 10.1097/inf.0000000000002931] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Retinochoroiditis is the most frequent manifestation of congenital toxoplasmosis. We aimed to describe the ocular outcome and factors that may influence the visual prognosis of these patients. METHODS Cohort of patients with confirmed congenital toxoplasmosis seen between 1996 and 2017 in Porto Alegre, southern Brazil. RESULTS Seventy-seven patients were included, of which 65 (85.5%) were identified by routine screening. Median age at the end of the follow-up was 10 years (minimum 2, maximum 25). Retinochoroiditis was present in 55 patients (71.4%). New retinochoroidal lesions developed after the first year of life in 77.8% of the patients who began treatment after the fourth month of life, compared with 35.2% among those treated before 4 months of life (relative risk = 0.45, 95% confidence intervals: 0.27-0.75, P = 0.02) and 33.3% among those treated before 2 months of life (relative risk = 0.42, 95% confidence intervals: 0.25-0.72, P = 0.01). There was a peak incidence of new retinochoroidal lesions between 4 and 5 years and another peak between 9 and 14 years, the latter only among girls. Thirty-four patients with retinochoroiditis were followed up for 10 years or more, and the school performance was appropriate in 28 (82.4%). CONCLUSIONS The high incidence of new retinochoroidal lesions during the follow-up period indicates the importance of long-term follow-up of patients with congenital toxoplasmosis. Initiating treatment within the first 4 months of life, especially within the first 2 months, was a protective factor against the later development of retinochoroiditis. Despite the usual favorable prognosis, the high morbidity of congenital toxoplasmosis in Brazil was confirmed.
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Affiliation(s)
- Eleonor Gastal Lago
- From the Neonatology Division, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre/RS, Brazil
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Mandelbrot L. Congenital toxoplasmosis: What is the evidence for chemoprophylaxis to prevent fetal infection? Prenat Diagn 2020; 40:1693-1702. [PMID: 32453454 DOI: 10.1002/pd.5758] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 05/02/2020] [Accepted: 05/23/2020] [Indexed: 12/25/2022]
Abstract
Although prenatal diagnosis and prenatal and neonatal therapy of congenital toxoplasmosis are available, there is controversy concerning the effectiveness of prophylaxis to prevent placental transmission. Experimental, parasitological, and clinical data suggest a "window of opportunity" following maternal infection. Among medications active against Toxoplasma gondii, mainly spiramycin (Spy) and pyrimethamine + sulfonamide combinations (P-S) have been evaluated. Results from observational studies suffered treatment bias, since prescriptions differed according to the gestational age at seroconversion, which is the major risk factor for transmission, and many lacked precise timing. Some large retrospective studies found no difference in transmission according to prophylactic treatment, but transmission was lower when treatment started promptly after maternal seroconversion. A few recent studies adjusting for timing of infection observed lower transmission in case of P-S than other or no prophylaxis. In the only randomized controlled trial, transmission was lower with P-S than S (18.5% vs 30%, P = .147); this association was strengthened when the treatment was started within 3 weeks of seroconversion, and the incidence of fetal cerebral ultrasound signs was significantly reduced in the P-S group. Rapid initiation of prophylactic therapy following maternal infection, which is usually asymptomatic, requires systematic screening for maternal seroconversion during pregnancy.
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Affiliation(s)
- Laurent Mandelbrot
- Service de Gynécologie-Obstétrique, Assistance Publique-Hôpitaux de Paris Nord Université de Paris, Hôpital Louis Mourier, Colombes, France.,Inserm IAME 1137, Université de Paris, Paris, France
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Soares Rodrigues Costa B, Pontes do Nascimento L, Vítor de Paiva Amorim M, Barreto Gomes AP, Mafra Veríssimo L. Stability of extemporaneous sulfadiazine oral suspensions from commercially available tablets for treatment of congenital toxoplasmosis. Trop Med Int Health 2019; 25:364-372. [PMID: 31802579 DOI: 10.1111/tmi.13354] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To determine the physicochemical and microbiological stability of sulfadiazine suspensions (100 mg/mL) in simple syrup (A) and sorbitol (B) formulations prepared from commercially available tablets. METHODS An ultra-performance liquid chromatographic assay was developed and validated to determine the chemical stability of sulfadiazine. Three samples were prepared and stored at 5 and 25 °C and assayed at 0, 7, 14 and 30 days. Physical parameters (appearance, pH, particle size and viscosity) were also monitored. Microbiological examination was performed through the suitable counting method. RESULTS The formulations presented a sulfadiazine concentration of around 95% at the beginning at both temperatures. There was some variation in pH, viscosity and particle size distribution over time. The samples met the pharmacopoeia criteria of microbiological quality over 30 days, but only sulfadiazine formulated in syrup stored at 25 °C was suitable for use after one week. CONCLUSION The sulfadiazine suspension in simple syrup was chosen as the most suitable formulation because it demonstrated stability for 14 days at room temperature, providing an alternative liquid dosage form of sulfadiazine for congenital toxoplasmosis treatment.
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Affiliation(s)
- Brunna Soares Rodrigues Costa
- Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Norte, Natal, Brasil.,Núcleo de Pesquisa em Alimentos e Medicamentos, Universidade Federal do Rio Grande do Norte, Natal, Brasil
| | | | | | - Ana Paula Barreto Gomes
- Programa de Pós-Graduação em Ciências Farmacêuticas, Universidade Federal do Rio Grande do Norte, Natal, Brasil.,Departamento de Farmácia, Universidade Federal do Rio Grande do Norte, Natal, Brasil
| | - Lourena Mafra Veríssimo
- Núcleo de Pesquisa em Alimentos e Medicamentos, Universidade Federal do Rio Grande do Norte, Natal, Brasil.,Departamento de Farmácia, Universidade Federal do Rio Grande do Norte, Natal, Brasil
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Venancio FA, Bernal MEQ, Ramos MDCDBV, Chaves NR, Hendges MV, de Souza MMR, de Medeiros MJ, Pinto CDBS, Falcão de Oliveira E. Congenital Zika Syndrome in a Brazil-Paraguay-Bolivia border region: Clinical features of cases diagnosed between 2015 and 2018. PLoS One 2019; 14:e0223408. [PMID: 31584972 PMCID: PMC6777783 DOI: 10.1371/journal.pone.0223408] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 09/21/2019] [Indexed: 02/02/2023] Open
Abstract
Congenital Zika Syndrome (CZS) is a unique pattern of congenital abnormalities found in fetuses and neonates infected with the Zika virus (ZIKV). Here, we clinically identify and characterize infants with CZS between 2015 and 2018 in Mato Grosso do Sul, Brazil-a border area with Paraguay and Bolivia. This cross-sectional study, based on primary and secondary data, tracks the cases registered in the Brazilian Public Health Reporting System through the following stages: (1) preliminary data analysis, (2) identification of the congenital syndrome cases, (3) etiologic classification of the cases, (4) active search, and (5) clinical assessment. Of the 72 investigated cases, 16 were probable cases of CZS. Of these, it was only possible to clinically assess 11 infants. Considering the 16 probable cases of CZS, nine were classified as confirmed cases, and five as potential cases of the syndrome. Regarding clinical features, brain palsy was identified in all analyzed infants. Moreover, microcephaly and pseudobulbar syndrome were found in eight infants, and hydrocephalus was found in three individuals. In addition to these conditions, seven children were malnourished. Our study may provide significant insights for other researches that aim to elucidate CZS and its clinical and populational consequences.
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Affiliation(s)
- Fabio Antonio Venancio
- Programa de Pós-Graduação em Doenças Infecciosas e Parasitárias, Universidade Federal de Mato Grosso do Sul, Campo Grande, Brasil
| | | | | | - Neuma Rocha Chaves
- Coordenadoria de Vigilância Epidemiológica, Secretaria Municipal de Saúde Pública de Campo Grande, Campo Grande, Brasil
| | | | | | | | | | - Everton Falcão de Oliveira
- Programa de Pós-Graduação em Doenças Infecciosas e Parasitárias, Universidade Federal de Mato Grosso do Sul, Campo Grande, Brasil
- Instituto Integrado de Saúde, Universidade Federal de Mato Grosso do Sul, Campo Grande, Brasil
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Bolais PF, Vignoles P, Pereira PF, Keim R, Aroussi A, Ismail K, Dardé ML, Amendoeira MR, Mercier A. Toxoplasma gondii survey in cats from two environments of the city of Rio de Janeiro, Brazil by Modified Agglutination Test on sera and filter-paper. Parasit Vectors 2017; 10:88. [PMID: 28212681 PMCID: PMC5316176 DOI: 10.1186/s13071-017-2017-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 02/07/2017] [Indexed: 11/10/2022] Open
Abstract
Background Toxoplasma gondii is a protozoan with a worldwide distribution, in warm-blood animals, including humans. Local conditions and environmental disturbances may influence transmission dynamics of a zoonotic agent. This study evaluates the epidemiology of T. gondii based on toxoplasmosis prevalence in two populations of cats living in distinct urbanization conditions in Rio de Janeiro, Brazil. Methods Among 372 domestic cats sampled, 265 were from a public shelter located downtown Rio and 107 from a relatively preserved wild environment in a residential area. Sera and eluates from dried blood spots were tested for detection of IgG antibodies against T. gondii by modified agglutination test (MAT). Results Antibodies to T. gondii were detected in 32/265 (12.08%) animals from the public shelter and in 4/107 (3.74%) cats from the residential area. Identical results were observed for sera and eluates. Conclusions Filter paper provides a reliable accurate alternative storage option when conditions of sample collection and transportation in the field are unfavorable. The significantly lower prevalence in the residential area is discussed in terms of environmental, biological and behavioral features.
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Affiliation(s)
- Paula F Bolais
- Univ. Limoges, INSERM UMR-S 1094 Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, 2 Rue du Dr. Marcland, Limoges, 87025, France. .,Toxoplasmosis and other Protozoosis Laboratory of Oswaldo Cruz Institute, Av. Brasil 4365, Rio de Janeiro, 21045-900, Brazil.
| | - Philippe Vignoles
- Univ. Limoges, INSERM UMR-S 1094 Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, 2 Rue du Dr. Marcland, Limoges, 87025, France
| | - Pamela F Pereira
- Toxoplasmosis and other Protozoosis Laboratory of Oswaldo Cruz Institute, Av. Brasil 4365, Rio de Janeiro, 21045-900, Brazil
| | - Rafael Keim
- Quatro Elementos Veterinary Medicine and Environmental consulting, Rua Coronel Moreira Cesar, 211 Bl. 2/502, Niteroi, 24.230-052, Brazil
| | - Abdelkrim Aroussi
- Univ. Limoges, INSERM UMR-S 1094 Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, 2 Rue du Dr. Marcland, Limoges, 87025, France
| | - Khadja Ismail
- Univ. Limoges, INSERM UMR-S 1094 Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, 2 Rue du Dr. Marcland, Limoges, 87025, France
| | - Marie-Laure Dardé
- Univ. Limoges, INSERM UMR-S 1094 Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, 2 Rue du Dr. Marcland, Limoges, 87025, France
| | - Maria Regina Amendoeira
- Toxoplasmosis and other Protozoosis Laboratory of Oswaldo Cruz Institute, Av. Brasil 4365, Rio de Janeiro, 21045-900, Brazil
| | - Aurélien Mercier
- Univ. Limoges, INSERM UMR-S 1094 Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, 2 Rue du Dr. Marcland, Limoges, 87025, France
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