Pediatric Infectious Disease Department, Instituto de Puericultura e Pediatria Martagão Gesteira, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil 21941-912.
J Trop Pediatr. 2021 Jan 29;67(1). doi: 10.1093/tropej/fmaa069.
Identify missed opportunities for the prevention and early diagnosis of congenital toxoplasmosis (CT) in infants followed up in a reference center for pediatric infectious diseases (PID) in Rio de Janeiro between January 2007 and December 2016.
Descriptive study including infants with CT, diagnosis established based on Brazil's Ministry of Health's criteria. All data regarding the infants and their mother's prenatal care were collected from the medical records of the Instituto de Puericultura e Pediatria Martagão Gesteira (IPPMG)-a tertiary public pediatric university hospital. The study enrolled infants aged between 0 and 12 months followed up in the PID department of IPPMG and with confirmed infection by Toxoplasma gondii in the period between January 2007 and December 2016. All patients with diagnosis of CT registered in the PID database of the IPPMG and admitted in the above-mentioned period were included in the study. Patients whose records were not available, or who went to just one clinic appointment were excluded.
The obstetric history of all 44 women, whose infants (45) were diagnosed with CT, was analyzed. Their median age was 22 years. None had undergone preconception serological testing for toxoplasmosis. Only 20 (45%) of them started antenatal care during the first trimester of gestation, a total of 24 (55%) had more than six antenatal care visits, and 16% of those did not undergo serological testing for toxoplasmosis. None were adequately informed of preventive measures. The diagnosis of acute toxoplasmosis was made in 50% of these pregnancies but 32% of the women were not treated. Only 10 children of these mothers were adequately screened and treated at birth.
Despite the existence of national recommendations, several opportunities were missed to prevent CT during the antenatal period and to diagnose and treat this condition in the neonatal period.
确定 2007 年 1 月至 2016 年 12 月在里约热内卢儿科传染病参考中心接受随访的婴儿中先天性弓形虫病（CT）预防和早期诊断的漏诊机会。
描述性研究，纳入符合巴西卫生部标准确诊为 CT 的婴儿。所有婴儿及其母亲产前保健的数据均从里约热内卢大学附属医院儿科传染病研究所（IPPMG）的病历中收集。该研究纳入了 2007 年 1 月至 2016 年 12 月期间在 IPPMG 儿科传染病科就诊且确认为弓形体感染的 0-12 月龄婴儿。所有在 IPPMG PID 数据库中登记且在此期间诊断为 CT 的患者均纳入本研究。排除记录不可用或仅就诊一次的患者。
分析了 44 名妇女的产科病史，她们的婴儿（45 名）被诊断为 CT。她们的中位年龄为 22 岁。无一例进行过弓形虫病的孕前血清学检测。只有 20 名（45%）在妊娠早期开始产前保健，共 24 名（55%）进行了 6 次以上产前保健，其中 16%的人没有进行弓形虫病血清学检测。没有人得到充分的预防措施信息。这些妊娠中 50%诊断为急性弓形虫病，但 32%的妇女未接受治疗。这些母亲中只有 10 名儿童在出生时得到了充分的筛查和治疗。
尽管存在国家建议，但仍有多个机会错过了在围产期预防 CT 以及在新生儿期诊断和治疗该病的机会。
