Background: Treatment of Toxoplasma gondii infection acquired during pregnancy differs in many countries. In Germany, spiramycin is given until the 16th week of pregnancy, followed by at least 4 weeks of combination therapy with pyrimethamine, sulfadiazine, and folinic acid independent of the infection stage of the fetus. If infection of the fetus is confirmed by polymerase chain reaction or if fetal ultrasound indicates severe symptoms (hydrocephalus, ventricular dilation), treatment is continued until delivery with regular monitoring of pyrimethamine and sulfadiazine concentration in maternal blood and observation of possible adverse effects. In other European countries, such as France, only spiramycin is given unless infection of the fetus is proven.
Methods: To evaluate the effectiveness of the German treatment scheme, a retrospective analysis of 685 women who showed a serological constellation consistent with primary infection in pregnancy and their children was performed.
Results: We found an increased transmission rate to the fetus with increased time in gestation and a decreased risk of clinical manifestations. In comparison with studies performed in other countries, the overall transmission rate (4.8%) and the rate of clinical manifestations in newborns (1.6%) were lower.
Conclusions: Use of spiramycin from time of diagnosis of acute acquisition of infection by the pregnant woman until week 16, followed by pyrimethamine, sulfadiazine, and folinic acid for at least 4 weeks in combination with a standardized follow-up program is efficient in reducing transplacental transmission of the parasite and the burden of disease in the newborn.
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http://dx.doi.org/10.1093/cid/cis234 | DOI Listing |
Sci Rep
January 2025
Department of Zoonotic Diseases, National Research Centre, Dokki, Giza, 12622, Egypt.
Toxoplasmosis induced by Toxoplasma gondii is a well-known health threat, that prompts fatal encephalitis increased with immunocompromised patients, in addition, it can cause chorioretinitis, microcephaly, stillbirth in the fetus and even led to death. Standard therapy uses sulfadiazine and pyrimethamine drugs revealed beneficial results during the acute stage, however, it has severe side effects. UPLC-ESI-MS/MS used to explore C.
View Article and Find Full Text PDFParasit Vectors
December 2024
Laboratory of Parasitic Diseases, College of Veterinary Medicine, Shanxi Agricultural University, Taigu, Shanxi Province, 030801, People's Republic of China.
PLoS Negl Trop Dis
October 2024
Pediatric Infectious Diseases and Immunodeficiencies Unit, Hospital Infantil Vall d'Hebron, Barcelona, Catalonia, Spain.
Background: Some regions of Spain are withdrawing their pregnancy screening program for congenital toxoplasmosis (CT). The Spanish Research Network of Congenital Toxoplasmosis (REIV-TOXO) was created to describe the current status of CT in Spain. The aims of this study were to describe the epidemiological and clinical characteristics of CT and to evaluate the effect of prenatal treatment on clinical outcomes to inform decision-making policies.
View Article and Find Full Text PDFRev Inst Med Trop Sao Paulo
October 2024
Universidade Federal de Jataí, Instituto de Ciências da Saúde, Programa de Pós-Graduação em Ciências Aplicadas à Saúde, Jataí, Goiás, Brazil.
Iran J Parasitol
January 2024
Department of Parasitology and Mycology, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran.
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