Toxoplasmosis: an examination of knowledge among health professionals and pregnant women in a municipality of the State of Paraná

Knowledge Gaps and Educational Opportunities in Congenital Toxoplasmosis: A Narrative Review of Brazilian and Global Perspectives

Congenital toxoplasmosis is a parasitic disease caused by the transmission of the protozoan Toxoplasma gondii during pregnancy that can potentially cause severe consequences for the fetus or neonates. The disease disproportionately impacts the global population and is generally correlated with the Human Development Index. Despite its prevalence, there are knowledge gaps among pregnant women and healthcare providers regarding the prevention, diagnosis, and treatment of this condition. This narrative review aimed to examine the current state of knowledge of toxoplasmosis among both groups, with a focus on exploring the Brazilian and global perspectives and highlighting opportunities for enhancing education and communication. A search was conducted across five databases, and 60 studies were selected (23 in Brazil and 37 worldwide). Quantitative analysis revealed that general knowledge of toxoplasmosis among pregnant women is notably poor, with 66% of Brazilian women and 72% of women worldwide lacking sufficient understanding. Among those with some knowledge, the most recognized association is with cats (46% in Brazil and 38% worldwide), followed by raw or undercooked meat (27% in Brazil and 25% worldwide), and improperly sanitized vegetables or water (15% in Brazil and 21% worldwide). Similarly, gaps in knowledge were found among healthcare providers. Difficulty with IgG avidity test interpretation is higher in Brazil (43%) compared to worldwide (18%). The most recognized association is with cats (66% in Brazil and 74% worldwide), followed by raw or undercooked meat (49% in Brazil and 70% worldwide), and improperly sanitized vegetables or water (31% in Brazil and 32% worldwide). These findings emphasize the need for tailored local and global public health educational initiatives to enhance knowledge of toxoplasmosis among pregnant women and healthcare providers.

Knowledge and practices of toxoplasmosis among healthcare workers at two large referral hospitals in Zambia: Implications on the One Health Approach

INTRODUCTION

Assessing the knowledge and practices of healthcare workers regarding Toxoplasma gondii infection, diagnosis, treatment, and control is crucial for developing an effective management strategy.

METHODS

A cross-sectional study was conducted among 175 healthcare workers at Ndola Teaching Hospital and Namwala District Hospital in Zambia from September 2021 to April 2022.

RESULTS

More than half (57.1%) of the respondents were males. Overall, 46(26.3%) and 68 (38.9%) respondents reported good knowledge and practices, respectively. Respondents with a higher number of years of experience (AOR = 0.86, 95% CI: 0.77-0.97), who were nurses than clinicians (AOR = 0.17, 95% CI: 0.007-0.41) and working at Ndola teaching hospital than Namwala hospital (AOR = 0.34, 95% CI:0.13-0.89) were less likely to have good knowledge. Respondents with a degree qualification than a diploma (AOR = 3.04, 95% CI: 1.09-8.47) were more likely to have good knowledge. Respondents from Ndola teaching hospital than Namwala hospital (AOR = 0.40, 95% CI: 0.17-0.92) were less likely to have good practices.

CONCLUSION

Our study revealed that healthcare workers had low levels of knowledge and poor practices, which could have negative implications for the management of toxoplasmosis. To improve their knowledge and practices, continuous medical education in Toxoplasma related aspects is recommended for in-service healthcare workers.

Toxoplasmosis and knowledge: what do the Italian women know about?

Toxoplasmosis is a worldwide zoonotic infectious disease caused by Toxoplasma gondii. This infection is estimated to affect about a third of the world's population. The aim of this study was to evaluate the knowledge of Italian women about toxoplasmosis and its forms of transmission, clinical manifestations, diagnosis and prevention through two different modalities (e-research and traditional research). In a cross-sectional study, 808 Italian women were interviewed, using a self-administered questionnaire, through two different modalities: an e-research or web survey and a traditional paper research and 84% reported to have heard about toxoplasmosis, but from most of the sample, it resulted that the knowledge of the protozoan disease was superficial and incomplete.The assessment of the dimensionality related to the toxoplasmosis knowledge's instrument showed that the scale is composed by two stable and reliable factors which explain 58.6% of the variance: (a) the basic knowledge (α = 0.83), which explains the 45.2% of the variance and (b) the specialist knowledge (α = 0.71), which explains the 13.4% of the variance. The variance and the multiple linear regression data analysis showed significant predictors of correct basic knowledge of toxoplasmosis: the highest age, the highest degree of study, to have previously contracted illness or to know someone who had contracted it, to be working or to be housewives. In conclusion, this study showed limited awareness of toxoplasmosis and suggested the implementation of effective education and learning programs. The results also showed that online data collection, in academic research, might be a valid alternative to more traditional (paper-and-pencil) surveys.

Characterization of prenatal healthcare for implementation of congenital toxoplasmosis surveillance program: cross-sectional study

BACKGROUND

Prenatal toxoplasmosis remains a neglected disease worldwide and few government programs focusing on its prevention are available. Success in these programs has been extensively reported in the literature, yet the strategies used for their implementation, as a model for such actions in different communities, have not been described.

OBJECTIVE

To describe the aspects of prenatal care strategies in 13 municipalities within the regional healthcare unit of Araçatuba, in the northwestern region of the state of São Paulo in 2017, focusing on congenital toxoplasmosis.

DESIGN AND SETTING

Descriptive study on prenatal healthcare within the Brazilian National Health System, in 13 participating municipalities.

METHODS

Data on serological tests, referral clinics, notifications, healthcare strategies, health education and drugs for infected children were requested through a questionnaire that was sent via e-mail to people responsible for healthcare services in these municipalities.

RESULTS

Major differences relating to diagnoses, reference outpatient clinics, notifications, health education and healthcare and drugs for infected children were reported among the prenatal strategies of these 13 municipal healthcare services.

CONCLUSION

The lack of standardized prenatal strategy in the study area may compromise the prevention of infection. However, our identification of each aspect of prenatal care corroborates the need to implement a healthcare surveillance program relating to congenital toxoplasmosis.

Prospective evalution of pregnant women with suspected acute toxoplasmosis treated in a reference prenatal care clinic at a university teaching hospital in Southern Brazil

Infection by the protozoan Toxoplasma gondii during pregnancy demands greater attention from the health authorities due to the risk of placental transmission, which can have devastating consequences to the foetus and newborn. This study was conducted in a high-risk prenatal care outpatient clinic of a university teaching hospital. Pregnant women screened for specific IgM and IgG anti -T. gondii, attended from January 2009 to August 2018 were included. From 530 suspected patients, 218 were followed up and they presented positive IgM and IgG anti- T. gondii. From these patients, 83 (38.0%) had low IgG avidity, 39 (18%) seroconverted in the second or third trimester of pregnancy, 19 (8.7%) had no avidity test, 69 (31.6%) had high IgG avidity after 16 weeks of gestation, five had recurrent chorioretinitis (2.2%) and three (1.3%) were seropositive to HIV. Complementary diagnoses were made in 30/48 (62.5%) of the patients revealing the presence of specific IgA antibodies raised to T. gondii; 3/63 (4.8%) peripheral blood samples and 1/57 (1.8%) amniotic fluid sample. There were eight foetal deaths, one case of neonatal hepatomegaly and one case of T. gondii DNA detected in a peripheral blood sample. Of the 139 newborn deliveries at the teaching hospital, there was a 38% loss of follow-up. The prevalence of congenital toxoplasmosis was 1.2 cases/1,000 live births in this study area, according to the retrospective survey of cases. Prenatal treatment may have helped to reduce the risk of vertical transmission.

Ocular Lesions in Congenital Toxoplasmosis in Santa Isabel do Ivaí, Paraná, Brazil

We verified clinical and psychopedagogic aspects of congenital cases with ocular sequelae, 13 years after toxoplasmosis outbreak in Santa Isabel do Ivaí, and current seroprevalence of this zoonosis in pregnant women. Audiologic and ophthalmologic evaluations were performed in congenital cases, in addition to collection of clinical and psychopedagogic data. In pregnant women, current seroprevalence was observed. Among affected teenagers, 2 of 5 are behind in school grade, and 4 of 5 reported learning difficulties, requiring psychopedagogic monitoring, as well as ocular complaints. We observed predominance of small, scarred, dispersed, type II chorioretinal lesions (hypopigmented halo and hyperpigmented central area), and 1 case of ocular relapse. All patients presented normal audiologic assessment. Among 131 pregnant women, 62 (47.3%) were seronegative and 39 (29.8%) were IgG reactive. Only 1 reported acquiring infection during the outbreak. This is one of the few studies in Brazil showing the outcome of congenital toxoplasmosis, a decade after infection, in one of the world's largest outbreaks.

Knowledge and perceptions on toxoplasmosis among pregnant women and nurses who provide prenatal in primary care

BACKGROUND

Toxoplasmosis is an infection that affects almost a third of the world population. In adults, it is often asymptomatic, although having important manifestation in children- infected by placental transmission. The prenatal is an important moment, requiring actions in women's care during pregnancy, in order to prevent diseases that could compromise the mother and the child's life.

METHODS

This is a descriptive study of qualitative approach aimed to understand the perception of nurses and pregnant women about toxoplasmosis during primary - prenatal care. The study was conducted in five selected primary health care units, in the municipality of São Luis - MA. The sample consisted of 15 nurses working in nursing consultation and 15 pregnant women attended in prenatal care. For data collection, a semi-structured questionnaire and an interview guide covering issues related to knowledge and conduct on toxoplasmosis were used. For analysis, the content analysis technique was used.

RESULTS

The answers were transcribed, organized and grouped thematically, where the following categories emerged: knowledge about examination requests; knowledge about toxoplasmosis; guidance during prenatal consultation; knowledge of nurses about the avidity test; procedures and guidelines on reagent cases. Pregnant women showed unawareness about toxoplasmosis and its effects. Nurses, although having basic knowledge about the subject, showed little applicability regarding pregnant women's guidance.

CONCLUSION

The nurse plays an important role in educational activities regarding pregnant women, contributing to the quality of prenatal care. Pregnant women were shown to have some knowledge about toxoplasmosis, although they said they did not have assurance about prevention.