1
|
Felín MS, Wang K, Raggi C, Moreira A, Pandey A, Grose A, Caballero Z, Rengifo-Herrera C, Ramirez M, Moossazadeh D, Castro C, Montalvo JLS, Leahy K, Zhou Y, Clouser FA, Siddiqui M, Leong N, Goodall P, Michalowski M, Ismail M, Christmas M, Schrantz S, Norero X, Estripeaut D, Ellis D, Ashi K, Dovgin S, Dixon A, Li X, Begeman I, Heichman S, Lykins J, Villalobos-Cerrud D, Fabrega L, Mendivil C, Quijada MR, Fernández-Pirla S, de La Guardia V, Wong D, de LadrónGuevara M, Flores C, Borace J, García A, Caballero N, de Saez MTM, Politis M, Ross S, Dogra M, Dhamsania V, Graves N, Kirchberg M, Mathur K, Aue A, Restrepo CM, Llanes A, Guzman G, Rebollon A, Boyer K, Heydemann P, Noble AG, Swisher C, Rabiah P, Withers S, Hull T, Su C, Blair M, Latkany P, Mui E, Vasconcelos-Santos DV, Villareal A, Perez A, Galvis CAN, Montes MV, Perez NIC, Ramirez M, Chittenden C, Wang E, Garcia-López LL, Muñoz-Ortiz J, Rivera-Valdivia N, Bohorquez-Granados MC, de-la-Torre GC, Padrieu G, Hernandez JDV, Celis-Giraldo D, Acosta Dávila JA, Torres E, Oquendo MM, Arteaga-Rivera JY, Nicolae D, Rzhetsky A, Roizen N, Stillwaggon E, Sawers L, Peyron F, Wallon M, Chapey E, Levigne P, Charter C, De Frias M, Montoya J, Press C, Ramirez R, Contopoulos-Ioannidis D, Maldonado Y, Liesenfeld O, Gomez C, Wheeler K, Holfels E, Frim D, McLone D, Penn R, Cohen W, Zehar S, McAuley J, Limonne D, Houze S, Abraham S, Piarroux R, Tesic V, Beavis K, Abeleda A, Sautter M, El Mansouri B, El Bachir A, Amarir F, El Bissati K, de-la-Torre A, Britton G, Motta J, Ortega-Barria E, Romero IL, Meier P, Grigg M, Gómez-Marín J, Kosagisharaf JR, Llorens XS, Reyes O, McLeod R. Building Programs to Eradicate Toxoplasmosis Part III: Epidemiology and Risk Factors. Curr Pediatr Rep 2022; 10:109-124. [PMID: 37744780 PMCID: PMC10516319 DOI: 10.1007/s40124-022-00265-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/29/2022] [Indexed: 11/25/2022]
Abstract
Purpose of Review Review comprehensive data on rates of toxoplasmosis in Panama and Colombia. Recent Findings Samples and data sets from Panama and Colombia, that facilitated estimates regarding seroprevalence of antibodies to Toxoplasma and risk factors, were reviewed. Summary Screening maps, seroprevalence maps, and risk factor mathematical models were devised based on these data. Studies in Ciudad de Panamá estimated seroprevalence at between 22 and 44%. Consistent relationships were found between higher prevalence rates and factors such as poverty and proximity to water sources. Prenatal screening rates for anti-Toxoplasma antibodies were variable, despite existence of a screening law. Heat maps showed a correlation between proximity to bodies of water and overall Toxoplasma seroprevalence. Spatial epidemiological maps and mathematical models identify specific regions that could most benefit from comprehensive, preventive healthcare campaigns related to congenital toxoplasmosis and Toxoplasma infection.
Collapse
Affiliation(s)
| | - Kanix Wang
- Institute for Genomics and Systems Biology, The University
of Chicago, Chicago, IL, USA
| | - Catalina Raggi
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
- Instituto de Investigaciones Científicas Y Servicios
de Alta Tecnología AIP (INDICASAT-AIP), Ciudad de Panamá, Panama
- Department of Pediatrics Infectious Diseases/Department of
Neonatology, Hospital del Niño Doctor José Renán Esquivel,
Ciudad de Panamá, Panama
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
- The College, The University of Chicago, Chicago, IL,
USA
- The Global Health Center, The University of Chicago,
Chicago, IL, USA
| | - Aliya Moreira
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
- The College, The University of Chicago, Chicago, IL,
USA
- The Global Health Center, The University of Chicago,
Chicago, IL, USA
| | - Abhinav Pandey
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
- The College, The University of Chicago, Chicago, IL,
USA
- The Global Health Center, The University of Chicago,
Chicago, IL, USA
| | - Andrew Grose
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
| | - Zuleima Caballero
- Instituto de Investigaciones Científicas Y Servicios
de Alta Tecnología AIP (INDICASAT-AIP), Ciudad de Panamá, Panama
| | | | - Margarita Ramirez
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
- The College, The University of Chicago, Chicago, IL,
USA
- The Global Health Center, The University of Chicago,
Chicago, IL, USA
| | - Davina Moossazadeh
- The College, The University of Chicago, Chicago, IL,
USA
- The Global Health Center, The University of Chicago,
Chicago, IL, USA
- Department of Statistics, The University of Chicago,
Chicago, IL, USA
| | - Catherine Castro
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
| | - José Luis Sanchez Montalvo
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
- The College, The University of Chicago, Chicago, IL,
USA
| | - Karen Leahy
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
| | - Ying Zhou
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
| | | | - Maryam Siddiqui
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
| | - Nicole Leong
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
| | - Perpetua Goodall
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
| | - Morgan Michalowski
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
| | - Mahmoud Ismail
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
| | - Monica Christmas
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
| | - Stephen Schrantz
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
| | - Ximena Norero
- Department of Pediatrics Infectious Diseases/Department of
Neonatology, Hospital del Niño Doctor José Renán Esquivel,
Ciudad de Panamá, Panama
| | - Dora Estripeaut
- Department of Pediatrics Infectious Diseases/Department of
Neonatology, Hospital del Niño Doctor José Renán Esquivel,
Ciudad de Panamá, Panama
| | - David Ellis
- Department of Pediatrics Infectious Diseases/Department of
Neonatology, Hospital del Niño Doctor José Renán Esquivel,
Ciudad de Panamá, Panama
| | - Kevin Ashi
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
| | - Samantha Dovgin
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
- The College, The University of Chicago, Chicago, IL,
USA
| | - Ashtyn Dixon
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
| | - Xuan Li
- Rush University Medical School/Rush University Medical
Center, Chicago, IL, USA
| | - Ian Begeman
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
| | - Sharon Heichman
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
| | - Joseph Lykins
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
| | - Delba Villalobos-Cerrud
- Instituto de Investigaciones Científicas Y Servicios
de Alta Tecnología AIP (INDICASAT-AIP), Ciudad de Panamá, Panama
| | - Lorena Fabrega
- Instituto de Investigaciones Científicas Y Servicios
de Alta Tecnología AIP (INDICASAT-AIP), Ciudad de Panamá, Panama
| | - Connie Mendivil
- Instituto de Investigaciones Científicas Y Servicios
de Alta Tecnología AIP (INDICASAT-AIP), Ciudad de Panamá, Panama
| | - Mario R. Quijada
- Instituto de Investigaciones Científicas Y Servicios
de Alta Tecnología AIP (INDICASAT-AIP), Ciudad de Panamá, Panama
| | - Silvia Fernández-Pirla
- Toxoplasmosis Programs and Initiatives in Panamá,
Ciudad de Panamá, Panama
- Academia Interamericana de Panamá, Ciudad de
Panamá, Panama
| | - Valli de La Guardia
- Instituto de Investigaciones Científicas Y Servicios
de Alta Tecnología AIP (INDICASAT-AIP), Ciudad de Panamá, Panama
| | - Digna Wong
- Instituto de Investigaciones Científicas Y Servicios
de Alta Tecnología AIP (INDICASAT-AIP), Ciudad de Panamá, Panama
| | - Mayrene de LadrónGuevara
- Instituto de Investigaciones Científicas Y Servicios
de Alta Tecnología AIP (INDICASAT-AIP), Ciudad de Panamá, Panama
| | | | | | - Anabel García
- Instituto de Investigaciones Científicas Y Servicios
de Alta Tecnología AIP (INDICASAT-AIP), Ciudad de Panamá, Panama
| | | | - Maria Theresa Moreno de Saez
- Department of Pediatrics Infectious Diseases/Department of
Neonatology, Hospital del Niño Doctor José Renán Esquivel,
Ciudad de Panamá, Panama
| | - Michael Politis
- Toxoplasmosis Programs and Initiatives in Panamá,
Ciudad de Panamá, Panama
| | - Stephanie Ross
- Rush University Medical School/Rush University Medical
Center, Chicago, IL, USA
| | - Mimansa Dogra
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
| | - Vishan Dhamsania
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
- Capstone Program, Global Health Center, The University of
Chicago, Chicago, IL, USA
| | - Nicholas Graves
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
- Capstone Program, Global Health Center, The University of
Chicago, Chicago, IL, USA
| | - Marci Kirchberg
- Capstone Program, Global Health Center, The University of
Chicago, Chicago, IL, USA
- Harris School of Public Policy, The University of
Chicago, Chicago, IL, USA
| | - Kopal Mathur
- Capstone Program, Global Health Center, The University of
Chicago, Chicago, IL, USA
- Harris School of Public Policy, The University of
Chicago, Chicago, IL, USA
| | - Ashley Aue
- Harris School of Public Policy, The University of
Chicago, Chicago, IL, USA
| | - Carlos M. Restrepo
- Instituto de Investigaciones Científicas Y Servicios
de Alta Tecnología AIP (INDICASAT-AIP), Ciudad de Panamá, Panama
| | - Alejandro Llanes
- Instituto de Investigaciones Científicas Y Servicios
de Alta Tecnología AIP (INDICASAT-AIP), Ciudad de Panamá, Panama
| | - German Guzman
- Instituto de Investigaciones Científicas Y Servicios
de Alta Tecnología AIP (INDICASAT-AIP), Ciudad de Panamá, Panama
| | - Arturo Rebollon
- Sanofi Aventis de Panamá S.A, University of South
Florida, Ciudad de Panamá, Panama
| | - Kenneth Boyer
- Rush University Medical School/Rush University Medical
Center, Chicago, IL, USA
| | - Peter Heydemann
- Rush University Medical School/Rush University Medical
Center, Chicago, IL, USA
| | - A. Gwendolyn Noble
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
- Northwestern University Feinberg School of Medicine,
Chicago, IL, USA
| | - Charles Swisher
- Northwestern University Feinberg School of Medicine,
Chicago, IL, USA
| | | | - Shawn Withers
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
| | - Teri Hull
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
| | - Chunlei Su
- Department of Microbiology, The University of Tennessee,
Knoxville, TN, USA
| | - Michael Blair
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
| | - Paul Latkany
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
| | - Ernest Mui
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
| | | | - Alcibiades Villareal
- Instituto de Investigaciones Científicas Y Servicios
de Alta Tecnología AIP (INDICASAT-AIP), Ciudad de Panamá, Panama
| | - Ambar Perez
- Instituto de Investigaciones Científicas Y Servicios
de Alta Tecnología AIP (INDICASAT-AIP), Ciudad de Panamá, Panama
| | | | | | | | - Morgan Ramirez
- The College, The University of Chicago, Chicago, IL,
USA
| | - Cy Chittenden
- The College, The University of Chicago, Chicago, IL,
USA
| | - Edward Wang
- The College, The University of Chicago, Chicago, IL,
USA
| | | | - Juliana Muñoz-Ortiz
- Grupo de Investigación en Neurociencias,
Universidad del Rosario, Bogotá, Colombia
| | | | | | | | - Guillermo Padrieu
- The University of South Florida College of Public Health,
Tampa, FL, USA
| | | | - Daniel Celis-Giraldo
- Grupo de Investigación en Neurociencias,
Universidad del Rosario, Bogotá, Colombia
| | | | - Elizabeth Torres
- Grupo de Investigación en Neurociencias,
Universidad del Rosario, Bogotá, Colombia
| | | | | | - Dan Nicolae
- Department of Statistics, The University of Chicago,
Chicago, IL, USA
| | - Andrey Rzhetsky
- Institute for Genomics and Systems Biology, The University
of Chicago, Chicago, IL, USA
| | - Nancy Roizen
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
| | | | - Larry Sawers
- Department of Economics, American University, Washington,
D.C, USA
| | - Francois Peyron
- Institut Des Agents Infectieux, Hôpital de La
Croix-Rousse, Lyon, France
| | - Martine Wallon
- Institut Des Agents Infectieux, Hôpital de La
Croix-Rousse, Lyon, France
| | - Emanuelle Chapey
- Institut Des Agents Infectieux, Hôpital de La
Croix-Rousse, Lyon, France
| | - Pauline Levigne
- Institut Des Agents Infectieux, Hôpital de La
Croix-Rousse, Lyon, France
| | | | | | - Jose Montoya
- Remington Specialty Laboratory, Palo Alto, CA, USA
| | - Cindy Press
- Remington Specialty Laboratory, Palo Alto, CA, USA
| | | | - Despina Contopoulos-Ioannidis
- Department of Pediatrics, Division of Infectious
Diseases, Stanford University College of Medicine, Stanford, CA, USA
| | - Yvonne Maldonado
- Department of Pediatrics, Division of Infectious
Diseases, Stanford University College of Medicine, Stanford, CA, USA
| | | | - Carlos Gomez
- Department of Economics, Gettysburg College, Gettysburg,
PA, USA
| | - Kelsey Wheeler
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
| | - Ellen Holfels
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
| | - David Frim
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
| | - David McLone
- Northwestern University Feinberg School of Medicine,
Chicago, IL, USA
| | - Richard Penn
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
| | - William Cohen
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
| | - Samantha Zehar
- Northwestern University Feinberg School of Medicine,
Chicago, IL, USA
| | - James McAuley
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
| | | | - Sandrine Houze
- Laboratory of Parasitologie, Bichat-Claude Bernard
Hopital, Paris, France
| | - Sylvie Abraham
- Laboratory of Parasitologie, Bichat-Claude Bernard
Hopital, Paris, France
| | | | - Vera Tesic
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
| | - Kathleen Beavis
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
| | - Ana Abeleda
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
| | - Mari Sautter
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
| | | | | | - Fatima Amarir
- Faculty of Sciences Aïn Chok, University Hassan
II, Casablanca, Morocco
| | - Kamal El Bissati
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
- INH, Rabat, Morocco
| | | | - Gabrielle Britton
- Instituto de Investigaciones Científicas Y Servicios
de Alta Tecnología AIP (INDICASAT-AIP), Ciudad de Panamá, Panama
- Sistema Nacional de Investigadores de Panamá
(SNI), Clayton, Panama
| | - Jorge Motta
- Tecnología E Innovación (SENACYT),
Secretaría Nacional de Ciencia, Ciudad de Panamá, Panama
| | - Eduardo Ortega-Barria
- Tecnología E Innovación (SENACYT),
Secretaría Nacional de Ciencia, Ciudad de Panamá, Panama
- GSK Vaccines, Panamá, Panama
| | - Isabel Luz Romero
- Tecnología E Innovación (SENACYT),
Secretaría Nacional de Ciencia, Ciudad de Panamá, Panama
| | - Paul Meier
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
| | - Michael Grigg
- Molecular Parasitology Section Laboratory of Parasitic
Diseases, National Institutes of Health, NIAID, Bethesda, MD, USA
| | | | - Jagannatha Rao Kosagisharaf
- Instituto de Investigaciones Científicas Y Servicios
de Alta Tecnología AIP (INDICASAT-AIP), Ciudad de Panamá, Panama
| | - Xavier Sáez Llorens
- Department of Pediatrics Infectious Diseases/Department of
Neonatology, Hospital del Niño Doctor José Renán Esquivel,
Ciudad de Panamá, Panama
- Sistema Nacional de Investigadores de Panamá
(SNI), Clayton, Panama
| | - Osvaldo Reyes
- Academia Interamericana de Panamá, Ciudad de
Panamá, Panama
- Hospital Santo Tomás, Ciudad de Panamá,
Panama
- Sistema Nacional de Investigadores de Panamá
(SNI), Clayton, Panama
| | - Rima McLeod
- Toxoplasmosis Programs and Initiatives in Panamá,
Ciudad de Panamá, Panama
- Institute for Genomics and Systems Biology, The University
of Chicago, Chicago, IL, USA
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
- The College, The University of Chicago, Chicago, IL,
USA
- The Global Health Center, The University of Chicago,
Chicago, IL, USA
- Toxoplasmosis Center, The University of Chicago, and
Toxoplasmosis Research Institute, Chicago, IL, USA
- Department of Pediatrics (Infectious Diseases), The
University of Chicago, Chicago, IL, USA
| |
Collapse
|
2
|
Felín MS, Wang K, Moreira A, Grose A, Leahy K, Zhou Y, Clouser FA, Siddiqui M, Leong N, Goodall P, Michalowski M, Ismail M, Christmas M, Schrantz S, Caballero Z, Norero X, Estripeaut D, Ellis D, Raggi C, Castro C, Rengifo-Herrera C, Moossazadeh D, Ramirez M, Pandey A, Ashi K, Dovgin S, Dixon A, Li X, Begeman I, Heichman S, Lykins J, Villalobos-Cerrud D, Fabrega L, Montalvo JLS, Mendivil C, Quijada MR, Fernández-Pirla S, de La Guardia V, Wong D, de Guevara ML, Flores C, Borace J, García A, Caballero N, de Saez MTM, Politis M, Ross S, Dogra M, Dhamsania V, Graves N, Kirchberg M, Mathur K, Aue A, Restrepo CM, Llanes A, Guzman G, Rebellon A, Boyer K, Heydemann P, Noble AG, Swisher C, Rabiah P, Withers S, Hull T, Frim D, McLone D, Su C, Blair M, Latkany P, Mui E, Vasconcelos-Santos DV, Villareal A, Perez A, Galvis CAN, Montes MV, Perez NIC, Ramirez M, Chittenden C, Wang E, Garcia-López LL, Muñoz-Ortiz J, Rivera-Valdivia N, Bohorquez-Granados MC, de-la-Torre GC, Padrieu G, Hernandez JDV, Celis-Giraldo D, Dávila JAA, Torres E, Oquendo MM, Arteaga-Rivera JY, Nicolae DL, Rzhetsky A, Roizen N, Stillwaggon E, Sawers L, Peyron F, Wallon M, Chapey E, Levigne P, Charter C, De Frias M, Montoya J, Press C, Ramirez R, Contopoulos-Ioannidis D, Maldonado Y, Liesenfeld O, Gomez C, Wheeler K, Zehar S, McAuley J, Limonne D, Houze S, Abraham S, Piarroux R, Tesic V, Beavis K, Abeleda A, Sautter M, El Mansouri B, El Bachir A, Amarir F, El Bissati K, Holfels E, Penn R, Cohen W, de-la-Torre A, Britton G, Motta J, Ortega-Barria E, Romero IL, Meier P, Grigg M, Gómez-Marín J, Kosagisharaf JR, Llorens XS, Reyes O, McLeod R. Building Programs to Eradicate Toxoplasmosis Part II: Education. Curr Pediatr Rep 2022; 10:93-108. [PMID: 36969368 PMCID: PMC10035399 DOI: 10.1007/s40124-022-00267-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Abstract
Purpose of Review
Review work to create and evaluate educational materials that could serve as a primary prevention strategy to help both providers and patients in Panama, Colombia, and the USA reduce disease burden of Toxoplasma infections.
Recent Findings
Educational programs had not been evaluated for efficacy in Panama, USA, or Colombia.
Summary
Educational programs for high school students, pregnant women, medical students and professionals, scientists, and lay personnel were created. In most settings, short-term effects were evaluated. In Panama, Colombia, and USA, all materials showed short-term utility in transmitting information to learners. These educational materials can serve as a component of larger public health programs to lower disease burden from congenital toxoplasmosis. Future priorities include conducting robust longitudinal studies of whether education correlates with reduced adverse disease outcomes, modifying educational materials as new information regarding region-specific risk factors is discovered, and ensuring materials are widely accessible.
Collapse
Affiliation(s)
| | - Kanix Wang
- Institute for Genomics and Systems Biology, The University
of Chicago, Chicago, IL, USA
| | - Aliya Moreira
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
- Instituto de Investigaciones Científicas y Servicios
de Alta Tecnología AIP (INDICASAT-AIP), Panama City, Panama
- Department of Pediatrics Infectious Diseases/Department of
Neonatology, Hospital del Niño Doctor José Renán Esquivel,
Panama City, Panama
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
- The College, The University of Chicago, Chicago, IL,
USA
- The Global Health Center, The University of Chicago,
Chicago, IL, USA
| | - Andrew Grose
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
- The Global Health Center, The University of Chicago,
Chicago, IL, USA
| | - Karen Leahy
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
| | - Ying Zhou
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
| | | | - Maryam Siddiqui
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
| | - Nicole Leong
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
| | - Perpetua Goodall
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
| | - Morgan Michalowski
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
| | - Mahmoud Ismail
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
| | - Monica Christmas
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
| | - Stephen Schrantz
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
| | - Zuleima Caballero
- Instituto de Investigaciones Científicas y Servicios
de Alta Tecnología AIP (INDICASAT-AIP), Panama City, Panama
| | - Ximena Norero
- Department of Pediatrics Infectious Diseases/Department of
Neonatology, Hospital del Niño Doctor José Renán Esquivel,
Panama City, Panama
| | - Dora Estripeaut
- Department of Pediatrics Infectious Diseases/Department of
Neonatology, Hospital del Niño Doctor José Renán Esquivel,
Panama City, Panama
| | - David Ellis
- Department of Pediatrics Infectious Diseases/Department of
Neonatology, Hospital del Niño Doctor José Renán Esquivel,
Panama City, Panama
| | - Catalina Raggi
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
- The College, The University of Chicago, Chicago, IL,
USA
- The Global Health Center, The University of Chicago,
Chicago, IL, USA
| | - Catherine Castro
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
- The Global Health Center, The University of Chicago,
Chicago, IL, USA
| | - Claudia Rengifo-Herrera
- Instituto de Investigaciones Científicas y Servicios
de Alta Tecnología AIP (INDICASAT-AIP), Panama City, Panama
- Universidad de Panamá, Panama City, Panama
| | - Davina Moossazadeh
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
- The College, The University of Chicago, Chicago, IL,
USA
- The Global Health Center, The University of Chicago,
Chicago, IL, USA
- Department of Statistics, The University of Chicago,
Chicago, IL, USA
| | - Margarita Ramirez
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
- The College, The University of Chicago, Chicago, IL,
USA
- The Global Health Center, The University of Chicago,
Chicago, IL, USA
| | - Abhinav Pandey
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
- The College, The University of Chicago, Chicago, IL,
USA
- The Global Health Center, The University of Chicago,
Chicago, IL, USA
| | - Kevin Ashi
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
- The Global Health Center, The University of Chicago,
Chicago, IL, USA
| | - Samantha Dovgin
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
- The College, The University of Chicago, Chicago, IL,
USA
| | - Ashtyn Dixon
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
| | - Xuan Li
- Rush University Medical School/Rush University Medical
Center, Chicago, IL, USA
| | - Ian Begeman
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
| | - Sharon Heichman
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
| | - Joseph Lykins
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
| | - Delba Villalobos-Cerrud
- Instituto de Investigaciones Científicas y Servicios
de Alta Tecnología AIP (INDICASAT-AIP), Panama City, Panama
| | - Lorena Fabrega
- Instituto de Investigaciones Científicas y Servicios
de Alta Tecnología AIP (INDICASAT-AIP), Panama City, Panama
| | - José Luis Sanchez Montalvo
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
- The Global Health Center, The University of Chicago,
Chicago, IL, USA
| | - Connie Mendivil
- Instituto de Investigaciones Científicas y Servicios
de Alta Tecnología AIP (INDICASAT-AIP), Panama City, Panama
| | - Mario R. Quijada
- Instituto de Investigaciones Científicas y Servicios
de Alta Tecnología AIP (INDICASAT-AIP), Panama City, Panama
| | - Silvia Fernández-Pirla
- Toxoplasmosis Programs and Initiatives in Panamá,
Panama City, Panama
- Instituto de Investigaciones Científicas y Servicios
de Alta Tecnología AIP (INDICASAT-AIP), Panama City, Panama
- Academia Interamericana de Panamá, Panama City,
Panama
- Hospital Santo Tomás, Panama City, Panama
| | - Valli de La Guardia
- Toxoplasmosis Programs and Initiatives in Panamá,
Panama City, Panama
- Instituto de Investigaciones Científicas y Servicios
de Alta Tecnología AIP (INDICASAT-AIP), Panama City, Panama
- Hospital Santo Tomás, Panama City, Panama
- Hospital San Miguel de Arcangel, Ciudad de Panama,
Panama
| | - Digna Wong
- Instituto de Investigaciones Científicas y Servicios
de Alta Tecnología AIP (INDICASAT-AIP), Panama City, Panama
| | - Mayrene Ladrón de Guevara
- Instituto de Investigaciones Científicas y Servicios
de Alta Tecnología AIP (INDICASAT-AIP), Panama City, Panama
- Hospital Santo Tomás, Panama City, Panama
| | | | | | - Anabel García
- Instituto de Investigaciones Científicas y Servicios
de Alta Tecnología AIP (INDICASAT-AIP), Panama City, Panama
| | | | - Maria Theresa Moreno de Saez
- Department of Pediatrics Infectious Diseases/Department of
Neonatology, Hospital del Niño Doctor José Renán Esquivel,
Panama City, Panama
| | - Michael Politis
- Toxoplasmosis Programs and Initiatives in Panamá,
Panama City, Panama
| | - Stephanie Ross
- Rush University Medical School/Rush University Medical
Center, Chicago, IL, USA
| | - Mimansa Dogra
- The Global Health Center, The University of Chicago,
Chicago, IL, USA
| | - Vishan Dhamsania
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
- The Global Health Center, The University of Chicago,
Chicago, IL, USA
- Capstone Program, Global Health Center, The University of
Chicago, Chicago, IL, USA
| | - Nicholas Graves
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
- The Global Health Center, The University of Chicago,
Chicago, IL, USA
- Capstone Program, Global Health Center, The University of
Chicago, Chicago, IL, USA
| | - Marci Kirchberg
- Capstone Program, Global Health Center, The University of
Chicago, Chicago, IL, USA
- Harris School of Public Policy, The University of
Chicago, Chicago, IL, USA
| | - Kopal Mathur
- Capstone Program, Global Health Center, The University of
Chicago, Chicago, IL, USA
- Harris School of Public Policy, The University of
Chicago, Chicago, IL, USA
| | - Ashley Aue
- The Global Health Center, The University of Chicago,
Chicago, IL, USA
- Harris School of Public Policy, The University of
Chicago, Chicago, IL, USA
| | - Carlos M. Restrepo
- Instituto de Investigaciones Científicas y Servicios
de Alta Tecnología AIP (INDICASAT-AIP), Panama City, Panama
| | - Alejandro Llanes
- Instituto de Investigaciones Científicas y Servicios
de Alta Tecnología AIP (INDICASAT-AIP), Panama City, Panama
| | - German Guzman
- Instituto de Investigaciones Científicas y Servicios
de Alta Tecnología AIP (INDICASAT-AIP), Panama City, Panama
| | - Arturo Rebellon
- Sanofi Aventis de Panamá S.A., University of South
Florida, Panama City, Panama
| | - Kenneth Boyer
- Rush University Medical School/Rush University Medical
Center, Chicago, IL, USA
| | - Peter Heydemann
- Rush University Medical School/Rush University Medical
Center, Chicago, IL, USA
| | - A. Gwendolyn Noble
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
- Northwestern University Feinberg School of Medicine,
Chicago, IL, USA
| | - Charles Swisher
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
- Northwestern University Feinberg School of Medicine,
Chicago, IL, USA
| | - Peter Rabiah
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
- NorthShore Evanston Hospital, Evanston, IL, USA
| | - Shawn Withers
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
| | - Teri Hull
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
| | - David Frim
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
| | - David McLone
- Northwestern University Feinberg School of Medicine,
Chicago, IL, USA
| | - Chunlei Su
- Department of Microbiology, The University of Tennessee,
Knoxville, TN, USA
| | - Michael Blair
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
| | - Paul Latkany
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
| | - Ernest Mui
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
| | | | - Alcibiades Villareal
- Instituto de Investigaciones Científicas y Servicios
de Alta Tecnología AIP (INDICASAT-AIP), Panama City, Panama
| | - Ambar Perez
- Instituto de Investigaciones Científicas y Servicios
de Alta Tecnología AIP (INDICASAT-AIP), Panama City, Panama
| | | | | | | | - Morgan Ramirez
- The College, The University of Chicago, Chicago, IL,
USA
| | - Cy Chittenden
- The College, The University of Chicago, Chicago, IL,
USA
| | - Edward Wang
- The College, The University of Chicago, Chicago, IL,
USA
| | | | - Juliana Muñoz-Ortiz
- Grupo de Investigación en Neurociencias,
Universidad del Rosario, Bogotá, Colombia
| | | | | | | | - Guillermo Padrieu
- Toxoplasmosis Programs and Initiatives in Panamá,
Panama City, Panama
- Instituto de Investigaciones Científicas y Servicios
de Alta Tecnología AIP (INDICASAT-AIP), Panama City, Panama
- Grupo de Investigación en Neurociencias,
Universidad del Rosario, Bogotá, Colombia
| | | | | | | | | | | | | | - Dan L. Nicolae
- Department of Statistics, The University of Chicago,
Chicago, IL, USA
| | - Andrey Rzhetsky
- Institute for Genomics and Systems Biology, The University
of Chicago, Chicago, IL, USA
| | - Nancy Roizen
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
| | | | - Larry Sawers
- Department of Economics, American University, D,
Washington .C, USA
| | - Francois Peyron
- Institut des agents infectieux, Hôpital de la
Croix-Rousse, Lyon, France
| | - Martine Wallon
- Institut des agents infectieux, Hôpital de la
Croix-Rousse, Lyon, France
| | - Emanuelle Chapey
- Institut des agents infectieux, Hôpital de la
Croix-Rousse, Lyon, France
| | - Pauline Levigne
- Institut des agents infectieux, Hôpital de la
Croix-Rousse, Lyon, France
| | | | | | - Jose Montoya
- Remington Specialty Laboratory, Palo Alto, CA, USA
| | - Cindy Press
- Remington Specialty Laboratory, Palo Alto, CA, USA
| | | | - Despina Contopoulos-Ioannidis
- Department of Pediatrics, Division of Infectious
Diseases, Stanford University College of Medicine, Stanford, CA, USA
| | - Yvonne Maldonado
- Department of Pediatrics, Division of Infectious
Diseases, Stanford University College of Medicine, Stanford, CA, USA
| | | | - Carlos Gomez
- Department of Pediatrics, Division of Infectious
Diseases, Stanford University College of Medicine, Stanford, CA, USA
| | - Kelsey Wheeler
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
- The College, The University of Chicago, Chicago, IL,
USA
| | - Samantha Zehar
- Northwestern University Feinberg School of Medicine,
Chicago, IL, USA
| | - James McAuley
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
| | | | - Sandrine Houze
- Laboratory of Parasitologie, Bichat-Claude Bernard
Hopital, Paris, France
| | - Sylvie Abraham
- Laboratory of Parasitologie, Bichat-Claude Bernard
Hopital, Paris, France
| | | | - Vera Tesic
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
| | - Kathleen Beavis
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
| | - Ana Abeleda
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
| | - Mari Sautter
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
| | | | | | - Fatima Amarir
- Faculty of Sciences Ain Chock, University Hassan II,
Casablanca, Morocco
| | - Kamal El Bissati
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
- INH, Rabat, Morocco
| | - Ellen Holfels
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
| | - Richard Penn
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
| | - William Cohen
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
- The College, The University of Chicago, Chicago, IL,
USA
| | | | - Gabrielle Britton
- Instituto de Investigaciones Científicas y Servicios
de Alta Tecnología AIP (INDICASAT-AIP), Panama City, Panama
- Sistema Nacional de investigadores de Panamá
(SNI), Panama City, Panama
| | - Jorge Motta
- Sistema Nacional de investigadores de Panamá
(SNI), Panama City, Panama
- Secretaría Nacional de Ciencia, Tecnología
e Innovación (SENACYT), Panama City, Panama
| | - Eduardo Ortega-Barria
- Sistema Nacional de investigadores de Panamá
(SNI), Panama City, Panama
- Secretaría Nacional de Ciencia, Tecnología
e Innovación (SENACYT), Panama City, Panama
- GSK Vaccines, Panama City, Panama
| | - Isabel Luz Romero
- Secretaría Nacional de Ciencia, Tecnología
e Innovación (SENACYT), Panama City, Panama
| | - Paul Meier
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
| | - Michael Grigg
- Molecular Parasitology Section, Laboratory of Parasitic
Diseases, National Institutes of Health, NIAID, Bethesda, MD, USA
| | - Jorge Gómez-Marín
- Universidad del Quindío, Armenia, Colombia
- Jorge Gómez-Marín,
, Jagannatha Rao Kosagisharaf,
, Xavier Sáez Llorens,
, Osvaldo Reyes,
, Rima McLeod,
| | - Jagannatha Rao Kosagisharaf
- Instituto de Investigaciones Científicas y Servicios
de Alta Tecnología AIP (INDICASAT-AIP), Panama City, Panama
- Sistema Nacional de investigadores de Panamá
(SNI), Panama City, Panama
- Jorge Gómez-Marín,
, Jagannatha Rao Kosagisharaf,
, Xavier Sáez Llorens,
, Osvaldo Reyes,
, Rima McLeod,
| | - Xavier Sáez Llorens
- Department of Pediatrics Infectious Diseases/Department of
Neonatology, Hospital del Niño Doctor José Renán Esquivel,
Panama City, Panama
- Sistema Nacional de investigadores de Panamá
(SNI), Panama City, Panama
- Jorge Gómez-Marín,
, Jagannatha Rao Kosagisharaf,
, Xavier Sáez Llorens,
, Osvaldo Reyes,
, Rima McLeod,
| | - Osvaldo Reyes
- Universidad de Panamá, Panama City, Panama
- Hospital Santo Tomás, Panama City, Panama
- Sistema Nacional de investigadores de Panamá
(SNI), Panama City, Panama
- Jorge Gómez-Marín,
, Jagannatha Rao Kosagisharaf,
, Xavier Sáez Llorens,
, Osvaldo Reyes,
, Rima McLeod,
| | - Rima McLeod
- Toxoplasmosis Programs and Initiatives in Panamá,
Panama City, Panama
- Institute for Genomics and Systems Biology, The University
of Chicago, Chicago, IL, USA
- Pritzker School of Medicine, The University of Chicago,
Chicago, IL, USA
- Department of Ophthalmology and Visual Sciences, The
University of Chicago, Chicago, IL, USA
- The College, The University of Chicago, Chicago, IL,
USA
- The Global Health Center, The University of Chicago,
Chicago, IL, USA
- Toxoplasmosis Center, The University of Chicago, and
Toxoplasmosis Research Institute, Chicago, IL, USA
- Department of Pediatrics (Infectious Diseases), The
University of Chicago, Chicago, IL, USA
- Jorge Gómez-Marín,
, Jagannatha Rao Kosagisharaf,
, Xavier Sáez Llorens,
, Osvaldo Reyes,
, Rima McLeod,
| |
Collapse
|
3
|
Boyer K, Hill D, Mui E, Wroblewski K, Karrison T, Dubey JP, Sautter M, Noble AG, Withers S, Swisher C, Heydemann P, Hosten T, Babiarz J, Lee D, Meier P, McLeod R. Unrecognized ingestion of Toxoplasma gondii oocysts leads to congenital toxoplasmosis and causes epidemics in North America. Clin Infect Dis 2011; 53:1081-9. [PMID: 22021924 DOI: 10.1093/cid/cir667] [Citation(s) in RCA: 106] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Congenital toxoplasmosis presents as severe, life-altering disease in North America. If mothers of infants with congenital toxoplasmosis could be identified by risks, it would provide strong support for educating pregnant women about risks, to eliminate this disease. Conversely, if not all risks are identifiable, undetectable risks are suggested. A new test detecting antibodies to sporozoites demonstrated that oocysts were the predominant source of Toxoplasma gondii infection in 4 North American epidemics and in mothers of children in the National Collaborative Chicago-based Congenital Toxoplasmosis Study (NCCCTS). This novel test offered the opportunity to determine whether risk factors or demographic characteristics could identify mothers infected with oocysts. METHODS Acutely infected mothers and their congenitally infected infants were evaluated, including in-person interviews concerning risks and evaluation of perinatal maternal serum samples. RESULTS Fifty-nine (78%) of 76 mothers of congenitally infected infants in NCCCTS had primary infection with oocysts. Only 49% of these mothers identified significant risk factors for sporozoite acquisition. Socioeconomic status, hometown size, maternal clinical presentations, and ethnicity were not reliable predictors. CONCLUSIONS Undetected contamination of food and water by oocysts frequently causes human infections in North America. Risks are often unrecognized by those infected. Demographic characteristics did not identify oocyst infections. Thus, although education programs describing hygienic measures may be beneficial, they will not suffice to prevent the suffering and economic consequences associated with congenital toxoplasmosis. Only a vaccine or implementation of systematic serologic testing of pregnant women and newborns, followed by treatment, will prevent most congenital toxoplasmosis in North America.
Collapse
Affiliation(s)
- Kenneth Boyer
- Department of Pediatrics, Rush University Medical Center, Chicago, Illinois, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
4
|
Benevento JD, Jager RD, Noble AG, Latkany P, Mieler WF, Sautter M, Meyers S, Mets M, Grassi MA, Rabiah P, Boyer K, Swisher C, McLeod R. Toxoplasmosis-associated neovascular lesions treated successfully with ranibizumab and antiparasitic therapy. ACTA ACUST UNITED AC 2008; 126:1152-6. [PMID: 18695115 DOI: 10.1001/archopht.126.8.1152] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Joseph D Benevento
- University of Chicago, AMBH S206, 5841 S Maryland Ave, Chicago, IL 60637, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Phan L, Kasza K, Jalbrzikowski J, Noble AG, Latkany P, Kuo A, Mieler W, Meyers S, Rabiah P, Boyer K, Swisher C, Mets M, Roizen N, Cezar S, Remington J, Meier P, McLeod R. Longitudinal study of new eye lesions in treated congenital toxoplasmosis. Ophthalmology 2007; 115:553-559.e8. [PMID: 17825418 DOI: 10.1016/j.ophtha.2007.06.022] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2006] [Revised: 06/06/2007] [Accepted: 06/09/2007] [Indexed: 10/22/2022] Open
Abstract
OBJECTIVE To determine the incidence of new chorioretinal lesions in patients with congenital toxoplasmosis who were treated throughout their first year of life. DESIGN Prospective longitudinal observation of a cohort. PARTICIPANTS One hundred thirty-two children were studied as part of the longitudinal observation. METHODS One hundred thirty-two children were treated during their first year of life with pyrimethamine, sulfadiazine, and leucovorin. They had eye examinations at prespecified intervals. MAIN OUTCOME MEASURES New chorioretinal lesions on fundus examination and fundus photographs. RESULTS The mean age (+/- standard deviation) is 10.8+/-5.1 years (range, 0.2-23). One hundred eight children have been evaluated for new chorioretinal lesions. Thirty-four (31%; 95% confidence interval, 23%-41%) of 108 children developed at least one chorioretinal lesion that was previously undetected. These occurred at varying times during their follow-up course. Fifteen children (14%) developed new central lesions, and 27 (25%) had newly detected lesions peripherally. Ten (9%) had more than one occurrence of new lesions developing, and 13 (12%) had new lesions in both eyes. Of those who developed new lesions, 14 children (41%) did so at age 10 or later. CONCLUSION New central chorioretinal lesions are uncommon in children with congenital toxoplasmosis who are treated during their first year of life. This finding contrasts markedly with earlier reports in the literature for untreated children or those treated for only 1 month near birth, in whom new lesions were much more prevalent (>/=82%). Our observation that 14 (41%) of the 34 children with new chorioretinal lesions had occurrences when they were 10 years or older indicates that long-term follow-up into the second decade of life is important in assessing the efficacy of treating toxoplasmosis during infancy.
Collapse
Affiliation(s)
- Laura Phan
- University of Chicago School of Medicine, Chicago, Illinois 60637, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
6
|
Roizen N, Kasza K, Karrison T, Mets M, Noble AG, Boyer K, Swisher C, Meier P, Remington J, Jalbrzikowski J, McLeod R, Kipp M, Rabiah P, Chamot D, Estes R, Cezar S, Mack D, Pfiffner L, Stein M, Danis B, Patel D, Hopkins J, Holfels E, Stein L, Withers S, Cameron A, Perkins J, Heydemann P. Impact of visual impairment on measures of cognitive function for children with congenital toxoplasmosis: implications for compensatory intervention strategies. Pediatrics 2006; 118:e379-90. [PMID: 16864640 DOI: 10.1542/peds.2005-1530] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES The purpose of this work was to determine whether visual impairment caused by toxoplasmic chorioretinitis is associated with impaired performance of specific tasks on standardized tests of cognitive function. If so, then we worked to determine whether there are patterns in these difficulties that provide a logical basis for development of measures of cognitive function independent of visual impairment and compensatory intervention strategies to facilitate learning for such children. METHODS Sixty-four children with congenital toxoplasmosis with intelligence quotient scores > or = 50 and visual acuity sufficient to cooperate with all of the intelligence quotient subscales had assessments of their vision, appearance of their retinas, and cognitive testing performed between 3.5 and 5 years of age. These evaluations took place between 1981 and 1998 as part of a longitudinal study to determine outcome of congenital toxoplasmosis. Children were evaluated at 3.5 or 5 (37 children) or both 3.5 and 5 (27 children) years of age. Cognitive function was measured using the Wechsler Preschool and Primary Scale of Intelligence-Revised. Wechsler Preschool and Primary Scale of Intelligence-Revised scale scores were compared for children grouped as those children who had normal visual acuity in their best eye (group 1), and those who had impaired vision in their best eye (acuity < 20/40) because of macular disease (group 2). Demographic characteristics were compared for children in the 2 groups. Test scores were compared between groups using all of the 3.5-year-old visits, all of the 5-year-old visits, and using each child's "last" visit (ie, using the 5-year-old test results when a child was tested at both 3.5 and 5 years of age or only at 5 years, otherwise using the 3.5-year-old test results). The results were similar and, therefore, only the results from the last analysis are reported here. RESULTS There were 48 children with normal visual acuity in their best eye (group 1) and 16 children with impaired vision because of macular involvement in their best eye (group 2). Ethnicity and socioeconomic scores were similar. There was a significantly greater proportion of males in group 2 compared with group 1 (81% vs 46%). There was no significant diminution in Wechsler Preschool and Primary Scale of Intelligence-Revised test scores between 3.5 and 5 years of age for the 27 children tested at both of these ages. Verbal intelligence quotient, performance intelligence quotient, full-scale intelligence quotient scores, and all of the scaled scores except arithmetic and block design were significantly lower for children in group 2 compared with group 1. The majority of the differences remained statistically significant or borderline significant after adjusting for gender. However, the difference in overall verbal scores does not remain statistically significant. Mean +/- SD verbal (98 +/- 20) and performance (95 +/- 17) intelligence quotients were not significantly different for children in group 1. However, verbal (88 +/- 13) and performance intelligence quotients (78 +/- 17) were significantly different for children in group 2. For children in group 2, their lowest scale scores were in object assembly, geometric design, mazes, and picture completion, all timed tests that involved visual discrimination of linear forms with small intersecting lines. In the 2 scales scored that did not differ between groups 1 and 2, arithmetic and block design, timing and vision but not linear forms were components of the tasks. Children with monocular and binocular normal visual acuity did not differ in verbal, performance, or full-scale intelligence quotients or any of the subscale tests. Difficulty with sight or concomitant neurologic involvement also seemed to impact the ability to acquire information, comprehension skills, and vocabulary and performance in similarities testing. After controlling for gender, however, these differences were diminished, and there were no longer differences in overall verbal scores. As noted above, results were generally similar when all of the tests for 3.5-year-olds or 5-year-olds were analyzed separately. At the 3.5-year visit there were fewer significant differences between the 2 groups for the verbal components than at the 5-year visit. CONCLUSIONS In children with congenital toxoplasmosis and bilateral macular disease (group 2) because of toxoplasmic chorioretinitis, scaled scores were lowest on timed tests that require discrimination of fine intersecting lines. Although the severity of ocular and neurologic involvement is often congruent in children with congenital toxoplasmosis, ophthalmologic involvement seems to account for certain specific limitations on tests of cognitive function. Children with such visual impairment compensate with higher verbal skills, but their verbal scores are still less than those of children with normal vision, and in some cases significantly so, indicating that vision impairment might affect other aspects of cognitive testing. Patterns of difficulties noted in the subscales indicate that certain compensatory intervention strategies to facilitate learning and performance may be particularly helpful for children with these impairments. These patterns also provide a basis for the development of measures of cognitive function independent of visual impairment.
Collapse
MESH Headings
- Child, Preschool
- Cognition Disorders/etiology
- Ethnicity/statistics & numerical data
- Female
- Humans
- Infant
- Infant, Newborn
- Intelligence Tests
- Language Tests
- Macula Lutea/pathology
- Male
- Pattern Recognition, Visual
- Prospective Studies
- Toxoplasmosis, Congenital/complications
- Toxoplasmosis, Congenital/psychology
- Toxoplasmosis, Ocular/complications
- Toxoplasmosis, Ocular/congenital
- Toxoplasmosis, Ocular/psychology
- Vision Disorders/etiology
- Vision Disorders/psychology
- Vision, Binocular
- Vision, Monocular
- Visual Acuity
- Wechsler Scales
Collapse
Affiliation(s)
- Nancy Roizen
- Department of Pediatrics, University of Chicago, Chicago, Illinois, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
7
|
McLeod R, Boyer K, Karrison T, Kasza K, Swisher C, Roizen N, Jalbrzikowski J, Remington J, Heydemann P, Noble AG, Mets M, Holfels E, Withers S, Latkany P, Meier P. Outcome of treatment for congenital toxoplasmosis, 1981-2004: the National Collaborative Chicago-Based, Congenital Toxoplasmosis Study. Clin Infect Dis 2006; 42:1383-94. [PMID: 16619149 DOI: 10.1086/501360] [Citation(s) in RCA: 188] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2005] [Accepted: 12/19/2005] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Without treatment, congenital toxoplasmosis has recurrent, recrudescent, adverse outcomes. Long-term follow-up of infants with congenital toxoplasmosis treated throughout their first year of life with pyrimethamine and sulfadiazine has not been reported. METHODS Between 1981 and 2004, one hundred twenty infants (current mean age +/- standard deviation, 10.5 +/- 4.8 years) with congenital toxoplasmosis were treated with 1 of 2 doses of pyrimethamine plus sulfadiazine; therapy was initiated shortly after birth and continued for 12 months. Children who received treatment were evaluated at birth and at predetermined intervals; the focus of the evaluations was on prespecified end points: motor abnormalities, cognitive outcome, vision impairment, formation of new eye lesions, and hearing loss. RESULTS Treatment of infants without substantial neurologic disease at birth with pyrimethamine and sulfadiazine for 1 year resulted in normal cognitive, neurologic, and auditory outcomes for all patients. Treatment of infants who had moderate or severe neurologic disease (as defined in this article in the Treatments subsection of Methods) at birth resulted in normal neurologic and/or cognitive outcomes for >72% of the patients, and none had sensorineural hearing loss. Ninety-one percent of children without substantial neurologic disease and 64% of those with moderate or severe neurologic disease at birth did not develop new eye lesions. Almost all of these outcomes are markedly better than outcomes reported for children who were untreated or treated for 1 month in earlier decades (P<.01 to P<.001). Sex and severity of disease were comparable in our 2 treatment groups, and no significant differences in efficacy or toxicity were noted between the 2 treatment groups (P > .05). CONCLUSIONS Although not all children did well with treatment, the favorable outcomes we noted indicate the importance of diagnosis and treatment of infants with congenital toxoplasmosis.
Collapse
Affiliation(s)
- Rima McLeod
- Department of Ophthalmology and Visual Sciences, University of Chicago, Chicago, Illinois 60637, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Boyer KM, Holfels E, Roizen N, Swisher C, Mack D, Remington J, Withers S, Meier P, McLeod R. Risk factors for Toxoplasma gondii infection in mothers of infants with congenital toxoplasmosis: Implications for prenatal management and screening. Am J Obstet Gynecol 2005; 192:564-71. [PMID: 15696004 DOI: 10.1016/j.ajog.2004.07.031] [Citation(s) in RCA: 137] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The purpose of this study was to determine whether demographic characteristics, history of exposure to recognized transmission vehicles, or illness that was compatible with acute toxoplasmosis during gestation identified most mothers of infants with congenital toxoplasmosis. STUDY DESIGN Mothers of 131 infants and children who were referred to a national study of treatment for congenital toxoplasmosis were characterized demographically and questioned concerning exposure to recognized risk factors or illness. RESULTS No broad demographic features identified populations that were at risk. Only 48% of mothers recognized epidemiologic risk factors (direct or indirect exposure to raw/undercooked meat or to cat excrement) or gestational illnesses that were compatible with acute acquired toxoplasmosis during pregnancy. CONCLUSION Maternal risk factors or compatible illnesses were recognized in retrospect by fewer than one half of North American mothers of infants with toxoplasmosis. Educational programs might have prevented acquisition of Toxoplasma gondii by those mothers who had clear exposure risks. However, only systematic serologic screening of all pregnant women at prenatal visits or of all newborn infants at birth would prevent or detect a higher proportion of these congenital infections.
Collapse
|
9
|
McLeod R, Boyer K, Roizen N, Stein L, Swisher C, Holfels E, Hopkins J, Mack D, Karrison T, Patel D, Pfiffner L, Remington J, Withers S, Meyers S, Aitchison V, Mets M, Rabiah P, Meier P. The child with congenital toxoplasmosis. Curr Clin Top Infect Dis 2001; 20:189-208. [PMID: 10943525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Affiliation(s)
- R McLeod
- Department of Ophthalmology, University of Chicago, Illinois, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
10
|
Abstract
Muscle biopsies at age 7 months in a set of dizygotic male twins born floppy showed typical features of congenital fiber-type disproportion (CFTD). One of the twins died at age 1 year due to respiratory complications. The second one subsequently developed facial diplegia and external ophthalmoplegia. He never walked, remained wheelchair bound, and required continuous ventilatory support. He underwent repeat biopsies at ages 2 and 4, which showed many atrophic type 1 muscle fibers containing central nuclei and severe type 2 fiber deficiency compatible with centronuclear myopathy (CNM). Two-dimensional gel electrophoresis of muscle showed decreases of type II myosin light chains 2 and 3, suggestive of histochemical type I fiber deficiency. The progressive nature of morphological changes in one of our patients cannot be explained by maturational arrest. Repeat biopsies in cases of CFTD with rapid clinical deterioration may very well show CNM.
Collapse
Affiliation(s)
- M J Danon
- Department of Neurology, New York Medical College, Valhalla 10595, USA
| | | | | | | |
Collapse
|
11
|
McAuley J, Boyer KM, Patel D, Mets M, Swisher C, Roizen N, Wolters C, Stein L, Stein M, Schey W. Early and longitudinal evaluations of treated infants and children and untreated historical patients with congenital toxoplasmosis: the Chicago Collaborative Treatment Trial. Clin Infect Dis 1994; 18:38-72. [PMID: 8054436 DOI: 10.1093/clinids/18.1.38] [Citation(s) in RCA: 203] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Between December 1981 and May 1991, 44 infants and children with congenital toxoplasmosis were referred to our study group. A uniform approach to evaluation and therapy was developed and is described herein along with the clinical characteristics of these infants and children. In addition, case histories that illustrate especially important clinical features or previously undescribed findings are presented. Factors that contributed to the more severe disabilities included delayed diagnosis and initiation of therapy; prolonged, concomitant neonatal hypoxia and hypoglycemia; profound visual impairment; and prolonged, uncorrected increased intracranial pressure with hydrocephalus and compression of the brain. Years after therapy was discontinued, three children developed new retinal lesions (without loss of visual acuity when therapy for Toxoplasma gondii was initiated promptly), and three children experienced a new onset of afebrile seizures. Most remarkable were the normal developmental, neurological, and ophthalmologic findings at the early follow-up evaluations of many--but not all--of the treated children despite severe manifestations, such as substantial systemic disease, hydrocephalus, microcephalus, multiple intracranial calcifications, and extensive macular destruction detected at birth. These favorable outcomes contrast markedly with outcomes reported previously for children with congenital toxoplasmosis who were untreated or treated for only 1 month.
Collapse
MESH Headings
- Animals
- Calcinosis/diagnosis
- Calcinosis/drug therapy
- Chemistry, Pharmaceutical
- Child
- Child, Preschool
- Drug Administration Schedule
- Drug Therapy, Combination/adverse effects
- Drug Therapy, Combination/therapeutic use
- Feasibility Studies
- Humans
- Infant
- Leucovorin/therapeutic use
- Magnetic Resonance Imaging
- Neutropenia/chemically induced
- Physical Examination
- Pilot Projects
- Prenatal Care
- Pyrimethamine/therapeutic use
- Spiramycin/therapeutic use
- Sulfadiazine/therapeutic use
- Tomography, X-Ray Computed
- Toxoplasma
- Toxoplasmosis, Cerebral/complications
- Toxoplasmosis, Cerebral/diagnosis
- Toxoplasmosis, Cerebral/drug therapy
- Toxoplasmosis, Congenital/complications
- Toxoplasmosis, Congenital/diagnosis
- Toxoplasmosis, Congenital/drug therapy
- Toxoplasmosis, Ocular/complications
- Toxoplasmosis, Ocular/diagnosis
- Toxoplasmosis, Ocular/drug therapy
- Treatment Outcome
Collapse
Affiliation(s)
- J McAuley
- Department of Medicine, Michael Reese Hospital, Chicago, Illinois 60616
| | | | | | | | | | | | | | | | | | | |
Collapse
|
12
|
McLeod R, Mack DG, Boyer K, Mets M, Roizen N, Swisher C, Patel D, Beckmann E, Vitullo D, Johnson D. Phenotypes and functions of lymphocytes in congenital toxoplasmosis. J Lab Clin Med 1990; 116:623-35. [PMID: 2146348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Comparisons of lymphocyte surface phenotypes and functions were made among 25 pediatric patients with congenital toxoplasmosis (ages 1 month to 5 years) and 24 uninfected babies, a baby with postnatally acquired infection, and 6 uninfected, 7 recently infected, and 6 chronically infected adults. Percentages of lymphocytes with B1, T11, T3, T4, T8, T6, B4, Ia, NKH phenotypes and T4 to T8 ratios of infected and uninfected babies were the same (p greater than 0.05). Lymphocytes from congenitally infected babies had lower blastogenic responses (mean stimulation index [SI] = 5) to Toxoplasma lysate antigens (TLA) than lymphocytes from adult control groups with recent and chronic infection (Mean SIs = 32, 72; p less than 0.001). Compared to infected adults, congenitally infected children had similar or greater responses to concanavalin A (mean SIs = 94; 118, 76, p greater than 0.05) and in mixed leukocyte culture (mean SIs = 63; 22, 26, p greater than 0.05). For symptomatic babies, low blastogenic response to TLA correlated with more severe disease at presentation (p = 0.002). Lymphocyte blastogenic responses to TLA were increased for most children when they were older than 15 months, but responses remained less than adult levels for 9 of the 17 older children studied. There was no correlation between concomitant serum pyrimethamine levels and lymphocyte blastogenic responses to TLA. Pyrimethamine and sulfonamide treatment in vitro and in vivo did not alter lymphocyte response to TLA. Lymphocytes from congenitally infected babies failed to produce either gamma interferon or Interleukin 2 when cultured with TLA. In contrast, they produced these lymphokines when cultured with concanavalin A or phytohemagglutinin. Specific deficits in cell-mediated immune responses to TLA may account for the significant organ damage that occurs in infants and children with congenital toxoplasmosis.
Collapse
Affiliation(s)
- R McLeod
- Department of Medicine, Michael Reese Hospital, Chicago, IL
| | | | | | | | | | | | | | | | | | | |
Collapse
|
13
|
|
14
|
Williams A, Swisher C, Bremer HL. Critical care of seizures. Crit Care Update 1981; 8:22-5. [PMID: 6765673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
|
15
|
Swisher C, Williams A. Herpes encephalitis: a nursing challenge. J Neurosurg Nurs 1981; 13:34-7. [PMID: 6259302 DOI: 10.1097/01376517-198102000-00008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
|
16
|
Swisher C. Emergency visits help build practice. Dent Stud 1976; 54:61-3. [PMID: 1078245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
|