The problem of toxoplasmosis in outpatient practice. Part III. Toxoplasmosis in pregnants and congenital toxoplasmosis

Abstract

Congenital toxoplasmosis is a consequence of acute toxoplasmosis in a pregnant woman. When assessing the risk of сongenital toxoplasmosis during pregnancy, methods for determining specific antibodies, the genetic material of the pathogen (polymerase chain reaction method), immunoglobulins G avidity are used. Molecular genetic methods have the greatest diagnostic value in the diagnosis of сongenital toxoplasmosis in children of the first year of life. Drug prevention of сongenital toxoplasmosis in Russia can be implemented with the use of spiramycin, antenatal therapy is impossible, and postnatal therapy is limited by the list of available antiprotozoal drugs. For the prevention of сongenital toxoplasmosis, the awareness of the population about the ways and factors of transmission of the pathogen is of primary importance.

Keywords

congenital toxoplasmosis / pregnancy / diagnosis / therapy / prevention

References

[1] Dubey JP, Murata FHA, Cerqueira-Cézar CK, et al. Congenital toxoplasmosis in humans: an update of worldwide rate of congenital infections. Parasitology. 2021;148(12):1406–1416. DOI: 10.1017/S0031182021001013

[2] Dubey J.P., Murata F.H.A., Cerqueira-Cézar C.K. et al. Congenital toxoplasmosis in humans: an update of worldwide rate of congenital infections // Parasitology. 2021. Vol. 148, No. 12. P. 1406–1416. DOI: 10.1017/S0031182021001013

[3] Milne GC, Webster JP, Walker M. Is the incidence of congenital toxoplasmosis declining? Trends Parasitol. 2023;39(1):26–37. DOI: 10.1016/j.pt.2022.10.003.3

[4] Milne G.C., Webster J.P., Walker M. Is the incidence of congenital toxoplasmosis declining? // Trends Parasitol. 2023. Vol. 39, No. 1. P. 26–37. DOI: 10.1016/j.pt.2022.10.003.3

[5] Garweg JG, Kieffer F, Mandelbrot L, et al. Long-term outcomes in children with congenital toxoplasmosis — a systematic review. Pathogens. 2022;11(10):1187. DOI: 10.3390/pathogens11101187

[6] Garweg J.G., Kieffer F., Mandelbrot L. et al. Long-term outcomes in children with congenital toxoplasmosis — a systematic review // Pathogens. 2022. Vol. 11, No. 10. P. 1187. DOI: 10.3390/pathogens11101187

[7] Melo MS, Cabrera LAA, Lima SVMA, et al. Temporal trend, spatial analysis and spatiotemporal clusters of infant mortality associated with congenital toxoplasmosis in Brazil: Time series from 2000 to 2020. Trop Med Int Health. 2023;28(6):476–485. DOI: 10.1111/tmi.13877

[8] Melo M.S., Cabrera L.A.A., Lima S.V.M.A. et al. Temporal trend, spatial analysis and spatiotemporal clusters of infant mortality associated with congenital toxoplasmosis in Brazil: Time series from 2000 to 2020 // Trop. Med. Int. Health. 2023. Vol. 28, No. 6. P. 476–485. DOI: 10.1111/tmi.13877

[9] Vasiliev VV, Romanova ES. The problem of toxoplasmosis in outpatient practice. Part I. Toxoplasmosis in immunocompromised patients. Russian Family Doctor. 2023;27(1):15–20. (In Russ.) DOI: 10.17816/RFD296574

[10] Васильев В.В., Романова Е.С. Проблема токсоплазмоза в амбулаторной практике. Часть I. Токсоплазмоз у иммунокомпрометированных пациентов // Российский семейный врач. 2023. Т. 27, № 1. С. 15–20. DOI: 10.17816/RFD296574

[11] Deganich M, Boudreaux C, Benmerzouga I. Toxoplasmosis infection during pregnancy. Trop Med Infect Dis. 2022;8(1):3. DOI: 10.3390/tropicalmed801000

[12] Deganich M., Boudreaux C., Benmerzouga I. Toxoplasmosis infection during pregnancy // Trop. Med. Infect. Dis. 2022. Vol. 8, No. 1. P. 3. DOI: 10.3390/tropicalmed801000

[13] de Barros RAM, Torrecilhas AC, Marciano MAM, et al. Toxoplasmosis in human and animals around the world. Diagnosis and perspectives in the one health approach. Acta Trop. 2022;231:e106432. DOI: 10.1016/j.actatropica.2022.106432

[14] de Barros R.A.M., Torrecilhas A.C., Marciano M.A.M. et al. Toxoplasmosis in human and animals around the world. Diagnosis and perspectives in the one health approach // Acta Trop. 2022. Vol. 231. P. e106432. DOI: 10.1016/j.actatropica.2022.106432

[15] Almeria S, Dubey JP. Foodborne transmission of Toxoplasma gondii infection in the last decade. An overview. Res Vet Sci. 2021;135:371–385. DOI: 10.1016/j.rvsc.2020.10.019

[16] Almeria S., Dubey J.P. Foodborne transmission of Toxoplasma gondii infection in the last decade. An overview // Res. Vet. Sci. 2021. Vol. 135. P. 371–385. DOI: 10.1016/j.rvsc.2020.10.019

[17] de Oliveira Azevedo CT, do Brasil PE, Guida L, Lopes Moreira ME. Performance of polymerase chain reaction analysis of the amniotic fluid of pregnant women for diagnosis of congenital toxoplasmosis: a systematic review and meta-analysis. PLoS One. 2016;11(4):e0149938. DOI: 10.1371/journal.pone.0149938

[18] de Oliveira Azevedo C.T., do Brasil P.E., Guida L., Lopes Moreira M.E. Performance of polymerase chain reaction analysis of the amniotic fluid of pregnant women for diagnosis of congenital toxoplasmosis: a systematic review and meta-analysis // PLoS One. 2016. Vol. 11, No. 4. P. e0149938. DOI: 10.1371/journal.pone.0149938

[19] Zhou Y, Leahy K, Grose A, et al. Novel paradigm enables accurate monthly gestational screening to prevent congenital toxoplasmosis and more. medRxiv. 2023;2023:04.26.23289132. DOI: 10.1101/2023.04.26.23289132

[20] Zhou Y., Leahy K., Grose A. et al. Novel paradigm enables accurate monthly gestational screening to prevent congenital toxoplasmosis and more // medRxiv. 2023. Vol. 2023. P. 04.26.23289132. DOI: 10.1101/2023.04.26.23289132

[21] Holec-Gąsior L, Sołowińska K. IgG avidity test as a tool for discrimination between recent and distant toxoplasma gondii infection-current status of studies. Antibodies (Basel). 2022;11(3):52. DOI: 10.3390/antib11030052

[22] Holec-Gąsior L., Sołowińska K. IgG avidity test as a tool for discrimination between recent and distant toxoplasma gondii infection-current status of studies // Antibodies (Basel). 2022. Vol. 11, No. 3. P. 52. DOI: 10.3390/antib11030052

[23] Wilson RD. Acute perinatal infection and the evidenced-based risk of intrauterine diagnostic testing: a structured review. Fetal Diagn Ther. 2020;47(9):653–664. DOI: 10.1159/000508042

[24] Wilson R.D. Acute perinatal infection and the evidenced-based risk of intrauterine diagnostic testing: a structured review // Fetal Diagn. Ther. 2020. Vol. 47, No. 9. P. 653–664. DOI: 10.1159/000508042

[25] Findal G, Helbig A, Haugen G, et al. Management of suspected primary Toxoplasma gondii infection in pregnant women in Norway: twenty years of experience of amniocentesis in a low-prevalence population. BMC Pregnancy Childbirth. 2017;17(1):127. DOI: 10.1186/s12884-017-1300-1

[26] Findal G., Helbig A., Haugen G. et al. Management of suspected primary Toxoplasma gondii infection in pregnant women in Norway: twenty years of experience of amniocentesis in a low-prevalence population // BMC Pregnancy Childbirth. 2017. Vol. 17, No. 1. P. 127. DOI: 10.1186/s12884-017-1300-1

[27] Skvarc M. Diagnostic accuracy of adjusted low IgG avidity index to predict acute Toxoplasma gondii infection in the first trimester of pregnancy. Folia Parasitol (Praha). 2022;69:2022.023. DOI: 10.14411/fp.2022.023

[28] Skvarc M. Diagnostic accuracy of adjusted low IgG avidity index to predict acute Toxoplasma gondii infection in the first trimester of pregnancy // Folia Parasitol. (Praha). 2022. Vol. 69. P. 2022.023. DOI: 10.14411/fp.2022.023

[29] Mandelbrot L, Kieffer F, Sitta R, et al. Prenatal therapy with pyrimethamine + sulfadiazine vs spiramycin to reduce placental transmission of toxoplasmosis: a multicenter, randomized trial. Am J Obstet Gynecol. 2018;219(4):386.e1–386.e9. DOI: 10.1016/j.ajog.2018.05.031

[30] Mandelbrot L., Kieffer F., Sitta R. et al. Prenatal therapy with pyrimethamine + sulfadiazine vs spiramycin to reduce placental transmission of toxoplasmosis: a multicenter, randomized trial // Am. J. Obstet. Gynecol. 2018. Vol. 219, No. 4. P. 386.e1–386.e9. DOI: 10.1016/j.ajog.2018.05.031

[31] Dunay IR, Gajurel K, Dhakal R, et al. Treatment of toxoplasmosis: historical perspective, animal models, and current clinical practice. Clin Microbiol Rev. 2018;31(4):e00057–17. DOI: 10.1128/CMR.00057-17

[32] Dunay I.R., Gajurel K., Dhakal R. et al. Treatment of toxoplasmosis: historical perspective, animal models, and current clinical practice // Clin. Microbiol. Rev. 2018. Vol. 31, No. 4. P. e00057–17. DOI: 10.1128/CMR.00057-17

[33] Prasil P, Sleha R, Kacerovsky M, Bostik P. Comparison of adverse reactions of spiramycin versus pyrimethamine/sulfadiazine treatment of toxoplasmosis in pregnancy: is spiramycin really the drug of choice for unproven infection of the fetus? J Matern Fetal Neonatal Med. 2023;36(1):2215377. DOI: 10.1080/14767058.2023.2215377

[34] Prasil P., Sleha R., Kacerovsky M., Bostik P. Comparison of adverse reactions of spiramycin versus pyrimethamine/sulfadiazine treatment of toxoplasmosis in pregnancy: is spiramycin really the drug of choice for unproven infection of the fetus? // J. Matern. Fetal Neonatal Med. 2023. Vol. 36, No. 1. P. 2215377. DOI: 10.1080/14767058.2023.2215377

[35] Paltseva AI, Zverko VL, Sinitsa LN, et al. Congenital toxoplasmosis. Clinical observation. Journal of the Grodno State Medical University. 2020;18(5):611–618. (In Russ.) DOI: 10.25298/2221-8785-2020-18-5-611-618

[36] Пальцева А.И., Зверко В.Л., Синица Л.Н. и др. Bрожденный токсоплазмоз. клиническое наблюдение // Журнал Гродненского государственного медицинского университета. 2020. Т. 18, № 5. С. 611–618. DOI: 10.25298/2221-8785-2020-18-5-611-618

[37] Sotnikov SA, Krjukov EYu, Iova AS, et al. Сlinical report of generalized congenital toxoplasmosis. Journal Infectology. 2014;6(4):87–92. (In Russ.) DOI: 10.22625/2072-6732-2014-6-4-87-92

[38] Сотников С.А., Крюков Е.Ю., Иова А.С. и др. Клинический случай генерализованного врожденного токсоплазмоза // Журнал инфектологии. 2014. Т. 6, № 4. С. 87–92. DOI: 10.22625/2072-6732-2014-6-4-87-92

[39] Loh FK, Nathan S, Chow SC, Fang CM. Vaccination challenges and strategies against long-lived Toxoplasma gondii. Vaccine. 2019;37(30):3989–4000. DOI: 10.1016/j.vaccine.2019.05.083

[40] Loh F.K., Nathan S., Chow S.C., Fang C.M. Vaccination challenges and strategies against long-lived Toxoplasma gondii // Vaccine. 2019. Vol. 37, No. 30. P. 3989–4000. DOI: 10.1016/j.vaccine.2019.05.083

[41] Barros M, Teixeira D, Vilanova M, et al. Vaccines in congenital toxoplasmosis: advances and perspectives. Front Immunol. 2021;11:621997. DOI: 10.3389/fimmu.2020.621997

[42] Barros M., Teixeira D., Vilanova M. et al. Vaccines in congenital toxoplasmosis: advances and perspectives // Front. Immunol. 2021. Vol. 11. P. 621997. DOI: 10.3389/fimmu.2020.621997

[43] El Bissati K, Levigne P, Lykins J, et al. Global initiative for congenital toxoplasmosis: an observational and international comparative clinical analysis. Emerg Microbes Infect. 2018;7(1):165. DOI: 10.1038/s41426-018-0164-4

[44] El Bissati K., Levigne P., Lykins J. et al. Global initiative for congenital toxoplasmosis: an observational and international comparative clinical analysis // Emerg. Microbes Infect. 2018. Vol. 7, No. 1. P. 165. DOI: 10.1038/s41426-018-0164-4

RIGHTS & PERMISSIONS

Eco-Vector