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Celik T, Gokcen C, Aytas O, Ozcelik A, Celik M, Coban N. The prevalence of anti-Toxoplasma gondii antibodies in stutterers is higher than in the control group. Folia Parasitol (Praha) 2015; 62. [DOI: 10.14411/fp.2015.066] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 12/15/2015] [Indexed: 01/06/2023]
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Valentini P, Buonsenso D, Barone G, Serranti D, Calzedda R, Ceccarelli M, Speziale D, Ricci R, Masini L. Spiramycin/cotrimoxazole versus pyrimethamine/sulfonamide and spiramycin alone for the treatment of toxoplasmosis in pregnancy. J Perinatol 2015; 35:90-4. [PMID: 25211284 DOI: 10.1038/jp.2014.161] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Revised: 07/16/2014] [Accepted: 07/25/2014] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To compare the effectiviness of spiramycin/cotrimoxazole (Sp/C) versus pyrimethamine/sulfonamide (Pyr/Sul) and spiramycin alone (Spy) on mother-to-child transmission of toxoplasmosis infection in pregnancy. STUDY DESIGN Retrospective study of pregnant women evaluated for suspected toxoplasmosis between 1992 and 2011. RESULT A total of 120 mothers and their 123 newborns were included. Prenatal treatment consisted of spiramycin in 43 mothers (35%), spiramycin/cotrimoxazole in 70 (56.9%) and pyrimethamine/sulfonamide in 10 (8.1%). A trend toward reduction in toxoplasmosis transmission was found when Sp/C was compared with Pyr/Sul and particularly with Spy alone (P=0.014). In particular, Spy increased the risk of congenital infection when compared with Sp/C (odds ratio (OR) 4.368; 95% CI: 1.253 to 15.219), but there was no significant reduction when Sp/C was compared with Pyr/Sul (OR 1.83; 95% CI: 0.184 to 18.274). CONCLUSION The treatment based on Sp/C has significant efficacy in reducing maternal-fetal transmission of Toxoplasma gondii when compared with Pyr/Sul and particularly to Spy. Randomized controlled trials would be required.
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Affiliation(s)
- P Valentini
- Department of Pediatrics, Catholic University of the Sacred Heart, A. Gemelli Hospital, Rome, Italy
| | - D Buonsenso
- Department of Pediatrics, Catholic University of the Sacred Heart, A. Gemelli Hospital, Rome, Italy
| | - G Barone
- Department of Pediatrics, Catholic University of the Sacred Heart, A. Gemelli Hospital, Rome, Italy
| | - D Serranti
- Department of Pediatrics, Meyer Pediatric Hospital, Florence, Italy
| | - R Calzedda
- Department of Pediatrics, Catholic University of the Sacred Heart, A. Gemelli Hospital, Rome, Italy
| | - M Ceccarelli
- Department of Pediatrics, Catholic University of the Sacred Heart, A. Gemelli Hospital, Rome, Italy
| | - D Speziale
- Department of Microbiology, Catholic University of Sacred Heart, A. Gemelli Hospital, Rome, Italy
| | - R Ricci
- Department of Microbiology, Catholic University of Sacred Heart, A. Gemelli Hospital, Rome, Italy
| | - L Masini
- Department of Obstetrics and Gynecology, Catholic University of Sacred Heart, A. Gemelli Hospital, Rome, Italy
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Liu X, Zhou X, Lackaff J. Incremental Validity in the Clinical Assessment of Early Childhood Development. JOURNAL OF PSYCHOEDUCATIONAL ASSESSMENT 2013. [DOI: 10.1177/0734282912473457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The authors demonstrate the increment of clinical validity in early childhood assessment of physical impairment (PI), developmental delay (DD), and autism (AUT) using multiple standardized developmental screening measures such as performance measures and parent and teacher rating scales. Hierarchical regression and sensitivity/specificity analyses were used to identify the differential impact of each domain the scales measure. Significant findings include (a) self-help domains in either parent or teacher questionnaires are more significant contributors than social-emotional domains to early detection, (b) performance measures are stronger predictors than parent or teacher questionnaires in detecting physical impairment or developmental delay, and (c) parent questionnaires measuring self-help skills are a stronger predictor of autism than performance measures. These results support the combined use of parent and teacher rating scales and provide important implications in choosing instruments for different developmental disorders when time and resources are limited.
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Affiliation(s)
- Xin Liu
- Pearson, Bloomington, MN, USA
- Data Recognition Corporation, Maple Grove, MN, USA
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Eballe AO, Ellong A, Zoua MEA, Bella LA, Ngeufack S, Kouam JM, Melong J. Cerebral and ocular congenital toxoplasmosis complicated by West syndrome. Clin Ophthalmol 2010; 4:861-4. [PMID: 20714363 PMCID: PMC2921293 DOI: 10.2147/opth.s11565] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2010] [Indexed: 11/28/2022] Open
Abstract
We report a case of a child who presented cerebral and ocular congenital toxoplasmosis associated with West syndrome. He was seen and followed-up in the in patients pediatric and ophthalmologic units at the Gyneco-Obstetric and Pediatric Hospital of Yaoundé in Cameroon between July 2008 and February 2010.
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Affiliation(s)
- André Omgbwa Eballe
- Faculty of Medicine and Pharmaceutical Sciences, University of Douala, Cameroon.
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Chêne G, Thiébaut R. Options for clinical trials of pre and post-natal treatments for congenital toxoplasmosis. Mem Inst Oswaldo Cruz 2010; 104:299-304. [PMID: 19430657 DOI: 10.1590/s0074-02762009000200025] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2008] [Accepted: 02/06/2009] [Indexed: 11/21/2022] Open
Abstract
Clinical trials comparing different drug regimens and strategies for the treatment of congenital toxoplasmosis and its clinical manifestations in the liveborn child in different clinical settings should aim at formally evaluating the net benefit of existing treatments and at developing new therapeutic options. Currently, there is no ideal drug for congenital toxoplasmosis; future research should focus on the screening of new active drugs and on their pre-clinical and early clinical development, with a focus on pharmacokinetic/dynamic studies and teratogenicity. For the prenatal treatment of congenital toxoplasmosis, a trial comparing spiramycine to pyrimethamine-sulphadiazine and placebo would allow a formal estimation of the effect of both drugs in infected pregnant women. In newborn children, the net benefit of pyrimethamine-sulphadiazine should also be formally assessed. These trials will be implemented in settings where prenatal screening for Toxoplasma gondii is currently implemented. Trials should be carefully designed to allow for translation to other settings and modelling tools like cost-effectiveness analysis should be used to provide clinicians and founders with the best available evidence to establish recommendations.
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Affiliation(s)
- Geneviève Chêne
- INSERM U897 Epidemiology and Biostatistics, Bordeaux School of Public Health, Bordeaux University, Bordeaux, France.
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McLeod R, Kieffer F, Sautter M, Hosten T, Pelloux H. Why prevent, diagnose and treat congenital toxoplasmosis? Mem Inst Oswaldo Cruz 2009; 104:320-44. [PMID: 19430661 PMCID: PMC2735102 DOI: 10.1590/s0074-02762009000200029] [Citation(s) in RCA: 109] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2008] [Accepted: 10/20/2008] [Indexed: 11/21/2022] Open
Abstract
Evidence that prevention, diagnosis and treatment of toxoplasmosis is beneficial developed as follows: anti-parasitic agents abrogate Toxoplasma gondii tachyzoite growth, preventing destruction of infected, cultured, mammalian cells and cure active infections in experimental animals, including primates. They treat active infections in persons who are immune-compromised, limit destruction of retina by replicating parasites and thereby treat ocular toxoplasmosis and treat active infection in the fetus and infant. Outcomes of untreated congenital toxoplasmosis include adverse ocular and neurologic sequelae described in different countries and decades. Better outcomes are associated with treatment of infected infants throughout their first year of life. Shorter intervals between diagnosis and treatment in utero improve outcomes. A French approach for diagnosis and treatment of congenital toxoplasmosis in the fetus and infant can prevent toxoplasmosis and limit adverse sequelae. In addition, new data demonstrate that this French approach results in favorable outcomes with some early gestation infections. A standardized approach to diagnosis and treatment during gestation has not yet been applied generally in the USA. Nonetheless, a small, similar experience confirms that this French approach is feasible, safe, and results in favorable outcomes in the National Collaborative Chicago-based Congenital Toxoplasmosis Study cohort. Prompt diagnosis, prevention and treatment reduce adverse sequelae of congenital toxoplasmosis.
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Affiliation(s)
- Rima McLeod
- Department of Ophthalmology and Visual Sciences, Committees on Immunology, Genetics, Molecular Medicine, The College, University of Chicago, Chicago, IL 60637, USA.
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Lennon J, Harper R, Lloyd C, Biswas S. Usefulness of post-assessment reports in a paediatric low vision clinic: a questionnaire survey of parents and education professionals. Ophthalmic Physiol Opt 2008; 28:247-52. [DOI: 10.1111/j.1475-1313.2008.00557.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Aylward GP, Verhulst SJ. Comparison of Caretaker Report and Hands-On Neurodevelopmental Screening in High-Risk Infants. Dev Neuropsychol 2008; 33:124-36. [DOI: 10.1080/87565640701884220] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Thiébaut R, Leproust S, Chêne G, Gilbert R. Effectiveness of prenatal treatment for congenital toxoplasmosis: a meta-analysis of individual patients' data. Lancet 2007; 369:115-22. [PMID: 17223474 DOI: 10.1016/s0140-6736(07)60072-5] [Citation(s) in RCA: 264] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Despite three decades of prenatal screening for congenital toxoplasmosis in some European countries, uncertainty remains about the effectiveness of prenatal treatment. METHODS We did a systematic review of cohort studies based on universal screening for congenital toxoplasmosis. We did a meta-analysis using individual patients' data to assess the effect of timing and type of prenatal treatment on mother-to-child transmission of infection and clinical manifestations before age 1 year. Analyses were adjusted for gestational age at maternal seroconversion and other covariates. FINDINGS We included 26 cohorts in the review. In 1438 treated mothers identified by prenatal screening, we found weak evidence that treatment started within 3 weeks of seroconversion reduced mother-to-child transmission compared with treatment started after 8 or more weeks (adjusted odds ratio [OR] 0.48, 95% CI 0.28-0.80; p=0.05). In 550 infected liveborn infants identified by prenatal or neonatal screening, we found no evidence that prenatal treatment significantly reduced the risk of clinical manifestations (adjusted OR for treated vs not treated 1.11, 95% CI 0.61-2.02). Increasing gestational age at seroconversion was strongly associated with increased risk of mother-to-child transmission (OR 1.15, 95% CI 1.12-1.17) and decreased risk of intracranial lesions (0.91, 0.87-0.95), but not with eye lesions (0.97, 0.93-1.00). INTERPRETATION We found weak evidence for an association between early treatment and reduced risk of congenital toxoplasmosis. Further evidence from observational studies is unlikely to change these results and would not distinguish whether the association is due to treatment or to biases caused by confounding. Only a large randomised controlled clinical trial would provide clinicians and patients with valid evidence of the potential benefit of prenatal treatment.
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Freeman K, Salt A, Prusa A, Malm G, Ferret N, Buffolano W, Schmidt D, Tan HK, Gilbert RE. Association between congenital toxoplasmosis and parent-reported developmental outcomes, concerns, and impairments, in 3 year old children. BMC Pediatr 2005; 5:23. [PMID: 16014166 PMCID: PMC1199601 DOI: 10.1186/1471-2431-5-23] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/27/2004] [Accepted: 07/13/2005] [Indexed: 11/14/2022] Open
Abstract
Background Information is lacking on the effects of congenital toxoplasmosis on development, behavior, and impairment in later childhood, as well as on parental concerns and anxiety. This information is important for counselling parents about the prognosis for an infected child and for policy decisions on screening. Methods We prospectively studied a cohort of children identified by screening for toxoplasmosis in pregnant women or neonates between 1996 and 2000 in ten European centers. At 3 years of age, parents of children with and without congenital toxoplasmosis were surveyed about their child's development, behavior, and impairment, and about parental concerns and anxiety, using a postal questionnaire. Results Parents of 178/223 (80%) infected, and 527/821 (64%) uninfected children responded. We found no evidence that impaired development or behavior were more common in infected children, or that any potential effect of congenital toxoplasmosis was masked by prenatal treatment. Parents of infected children were significantly more anxious and reported more visual problems in their children. Conclusion On average, children aged three to four years with congenital toxoplasmosis identified by screening and treated during infancy in this European setting had risks of abnormal development and behavior similar to uninfected children. Parental anxiety about infected children needs to be addressed by clinicians. Future studies with longer follow up and clinician-administered assessments may be better able to detect any subtle differences in child outcomes.
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Affiliation(s)
- Katherine Freeman
- Albert Einstein College of Medicine, Department of Epidemiology and Population Health, New York, U.S.A
| | - Alison Salt
- The Neurodisability Service, Great Ormond Street Hospital for Children and Institute of Child Health, London, UK
| | - Andrea Prusa
- Department of Pediatrics, Division of Neonatology and Intensive Care, Medical University of Vienna, Austria
| | - Gunilla Malm
- Karolinska University Hospital, Huddinge, Stockholm, Sweden
| | - Nicole Ferret
- CHU de NICE, Service Parasitologie – Mycologie, Hopital L'Archet II, BP 3079, 06202 NICE Cedex 3, France
| | - Wilma Buffolano
- Perinatal Infection Unit, Dept of Pediatrics, University of Naples Federico II, Naples, Italy
| | - Dorthe Schmidt
- Department of Parasitology, Staten Seruminstitut, Copenhagen, Denmark
| | - Hooi Kuan Tan
- Centre for Paediatric Epidemiology and Biostatistics, Institute of Child Health, London, UK
| | - Ruth E Gilbert
- Centre for Paediatric Epidemiology and Biostatistics, Institute of Child Health, London, UK
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