Lopes-Mori Fabiana Maria Ruiz, Mitsuka-Breganó Regina, Capobiango Jaqueline Dario, Inoue Inácio Teruo, Reiche Edna Maria Vissoci, Morimoto Helena Kaminami, Casella Antônio Marcelo Barbante, Bittencourt Laura Helena França de Barros, Freire Roberta Lemos, Navarro Italmar Teodorico
Departamento de Ciências Patológica, Centro de Ciências Biológicas, Universidade Estadual de Londrina, Londrina, PR, Brazil.
Rev Assoc Med Bras (1992). 2011 Sep-Oct;57(5):594-9. doi: 10.1590/s0104-42302011000500021.
Congenital toxoplasmosis can cause miscarriage and neurological and/or eye damage to the fetus. Since Austria and France established the prenatal screening, the prevalence of toxoplasmosis has declined from 50% to 35% and 84% to 44%, respectively. Other countries, such as the United Kingdom, have educational practices to reduce the risk of infection in seronegative pregnant women. In Brazil, prenatal screening is carried out in the states of Mato Grosso do Sul and Minas Gerais and the cities of Curitiba and Porto Alegre. In Londrina, state of Parana, the "Health Surveillance Program for Toxoplasmosis Acquired during Pregnancy and Congenital Toxoplasmosis" was established, which is based on serological screening, advising on prevention measures and quarterly serological monitoring in pregnant women that are initially seronegative, in addition to the monitoring of pregnant women and children with acute infection and case notification. In the first four years of implementation, the program evaluation showed a 63% reduction in the number of pregnant women and 42% in the number of children referred to reference services, resulting in the opening of vacancies for the care of patients with other diseases. As for medications, there was a 62% reduction in consumption of folic acid and 67% of sulfadiazine. Moreover, the definition of the protocols resulted in the standardization of care and safety for the decision-making by physicians. Therefore, as there are several protocols individualized in various departments and regions, the establishment of an ideal, consensual conduct with technical support, will result in implementing measures that will certainly save public resources, with the decrease in congenital toxoplasmosis.
先天性弓形虫病可导致流产以及胎儿的神经和/或眼部损伤。自奥地利和法国开展产前筛查以来，弓形虫病的患病率分别从50%降至35%，从84%降至44%。其他国家，如英国，有教育措施来降低血清学阴性孕妇的感染风险。在巴西，南马托格罗索州和米纳斯吉拉斯州以及库里蒂巴市和阿雷格里港市开展了产前筛查。在巴拉那州的隆德里纳，设立了“孕期获得性弓形虫病和先天性弓形虫病健康监测项目”，该项目基于血清学筛查，为预防措施提供建议，并对最初血清学阴性的孕妇进行每季度的血清学监测，此外还对急性感染的孕妇和儿童进行监测及病例通报。在实施的头四年，项目评估显示转诊至参考服务机构的孕妇数量减少了63%，儿童数量减少了42%，从而为其他疾病患者的护理腾出了空位。至于药物方面，叶酸消耗量减少了62%，磺胺嘧啶减少了67%。此外，方案的确定使护理标准化，并为医生的决策提供了安全性。因此，由于各个部门和地区有多个个性化的方案，在技术支持下建立理想的、达成共识的行为方式，将导致实施肯定能节省公共资源的措施，同时降低先天性弓形虫病的发病率。
