Congenital Toxoplasmosis despite a well established program for screening?

A. Trojovsky^a,b, Christa Fast^b, Astrid Lercher^c, Barbara Pertl^c, Regina Gratzl^d, Angelika Vander-Möse^e, H. Rosegger^b

Summary

The prevention of Congenital Toxoplasmosis is based on:

• counselling seronegative women to avoid infection during pregnancy by informing them about the transmission mechanism (primary prevention);
• detection of seroconversion to start treatment of the women before the fetus gets infected (secondary prevention);
• treatment of infected fetuses and newborn children to reduce severity of tissue destruction and to prevent long-term morbidity (tertiary prevention).

Pregnant women are routinely screened for Congenital Toxoplasmosis in Austria. Every infected woman is treated with spiramycine, pyrimethamine and sulfadiazine until delivery. Infected newborns are treated during their first year of life.

We analyzed the data of 78 pregnant women with an acute infection of Toxoplasmosis found by the regular screening program and followed up their offsprings. 2 newborn children showed overt Congenital Toxoplasmosis with severe clinical symptoms, 12 children more were subclinical infected; none of them showed chorioretinitis in a follow up at the end of the first year of life.

We analyzed the data of the serological tests during pregnancy of the mothers. The interval between the tests of the infected children were long in most cases.

In a second study we questioned 46 pregnant women about their information of the prevention of Congenital Toxoplasmosis. 35 of them had no or a very poor knowledge.

For the further reduction of Congenital Toxoplasmosis we discuss 2 aspects: Information about methods for primary prevention should be more available; and the interval between the serological tests should be reduced.

Author's Institutiones:

• (a) Humangenetisches Labor (Ärztliche Leiterin: Ass. Prof. Dr. Hannelore Zierler) am Institut für Medizinische Biologie und Humangenetik (Vorstand: Univ. Prof. Dr. K. Wagner) der Universität Graz
• (b) Frühgeburtenstation (Leiter: Univ. Prof. Dr. H. Rosegger)
• (c) der Geburtshilflich-gynäkologischen Universitätsklinik Graz (Vorstand: Univ. Prof. Dr. R. Winter)
• (d) Toxoplasmoselabor, Universitätsklinik für Kinderheilkunde Wien, Abt. für Neonatologie, Intensivmedizin und angeborene Störungen (Leiter: o. Univ. Prof. Dr. A. Pollak)
• (e) Mutter-Kind-Paß-Stelle der Stmk. Gebietskrankenkasse (Leiterin: Dr. Angelika Vander-Möse)
  

  Address: Dr. Alex Trojovsky Früh- und Neugeborenenstation Univ.-Frauenklinik Graz aktuell: Rettenbacherstrasse 5 A-8044 Graz or step over to ALEX TROJOVSKY's home-page

  member of the Karl-Franzens-University Graz/Austria

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