Global initiative for congenital toxoplasmosis: an observational and international comparative clinical analysis

Existing Reviews

Please note, new claims can take a short while to show up.

No claims yet.

Annotation Summary

Term Occurence Count Dictionary
toxoplasmosis 69 infectiousdiseases
congenital toxoplasmosis 47 infectiousdiseases
hepatitis B 1 infectiousdiseases
infectious disease 6 infectiousdiseases
pyrimethamine 6 infectiousdiseasesdrugs
sulfadiazine 5 infectiousdiseasesdrugs
sulfadoxine 2 infectiousdiseasesdrugs
syphilis 1 infectiousdiseases

Graph of close proximity drug and disease terms (within 200 characters).

Note: If this graph is empty, then there are no terms that meet the proximity constraint.

Review

Having read the paper, please pick a pair of statements from the paper to indicate that a drug and disease are related.

Select Drug Character Offset Drug Term Instance
pyrimethamine 4762 in the coming years[14],[15]. Current treatment of confirmed fetal infection requires treatment with pyrimethamine , sulfadiazine, and folinic acid[8]. There was an unprecedented 5000-fold increase in the price of pyrimethamine
pyrimethamine 4874 pyrimethamine, sulfadiazine, and folinic acid[8]. There was an unprecedented 5000-fold increase in the price of pyrimethamine in the US market recently, presenting a new challenge to the management of infected patients. New medicines
pyrimethamine 30188 continuous treatment in the first year of life in reducing symptoms and sequalae. Continuous treatment with pyrimethamine , sulfadiazine, and folinic acid was then adopted in Paris for pregnant women and infants. NCCCTS patients
pyrimethamine 34886 amniocentesis and fetal ultrasound. If amniotic fluid PCR is positive for Toxoplasma infection, treatment with pyrimethamine , folinic acid, and sulfadiazine or sulfadoxine should be initiated[73]. Infection is biologically confirmed
pyrimethamine 35075 Infection is biologically confirmed after birth, and infected newborns are treated. The combination of pyrimethamine –sulfadoxine and folinic acid is used after the infant is 3 months old in southern France. In Paris,
pyrimethamine 35215 acid is used after the infant is 3 months old in southern France. In Paris, treatment is continuous pyrimethamine with folinic acid and sulfadiazine.In France, more than 80% of human congenital toxoplasmosis is attributable
sulfadiazine 4356 delays transmission to the fetus, resulting in fewer infections or a milder infection. Pyrimethamine and sulfadiazine , with folinic acid, are the mainstays of treatment but do not treat the latent bradyzoite life-stage;
sulfadiazine 4777 years[14],[15]. Current treatment of confirmed fetal infection requires treatment with pyrimethamine, sulfadiazine , and folinic acid[8]. There was an unprecedented 5000-fold increase in the price of pyrimethamine in
sulfadiazine 30203 the first year of life in reducing symptoms and sequalae. Continuous treatment with pyrimethamine, sulfadiazine , and folinic acid was then adopted in Paris for pregnant women and infants. NCCCTS patients have been
sulfadiazine 34919 amniotic fluid PCR is positive for Toxoplasma infection, treatment with pyrimethamine, folinic acid, and sulfadiazine or sulfadoxine should be initiated[73]. Infection is biologically confirmed after birth, and infected
sulfadiazine 35251 months old in southern France. In Paris, treatment is continuous pyrimethamine with folinic acid and sulfadiazine .In France, more than 80% of human congenital toxoplasmosis is attributable to type-II T. gondii strains,
sulfadoxine 34935 positive for Toxoplasma infection, treatment with pyrimethamine, folinic acid, and sulfadiazine or sulfadoxine should be initiated[73]. Infection is biologically confirmed after birth, and infected newborns are
sulfadoxine 35091 biologically confirmed after birth, and infected newborns are treated. The combination of pyrimethamine– sulfadoxine and folinic acid is used after the infant is 3 months old in southern France. In Paris, treatment is
Select Disease Character Offset Disease Term Instance
congenital toxoplasmosis 59 Title: Emerging Microbes & InfectionsGlobal initiative for congenital toxoplasmosis : an observational and international comparative clinical analysisKamal El BissatiPauline LevigneJoseph
congenital toxoplasmosis 524 (epub): 9/2018Publication date (pmc-release): 9/2018Publication date (collection): /2018AbstractGlobally, congenital toxoplasmosis remains a significant cause of morbidity and mortality, and outbreaks of infection with T. gondii represent
congenital toxoplasmosis 877 health. Disease often is not recognized and is inadequately managed. Herein, we analyze the status of congenital toxoplasmosis in Morocco, Colombia, the United States, and France. We identify the unique challenges faced by each
congenital toxoplasmosis 1057 identify the unique challenges faced by each nation in the implementation of optimal approaches to congenital toxoplasmosis as a public health problem. We suggest that developed and developing countries use a multipronged approach,
congenital toxoplasmosis 3989 unrecognized[6]. Thus, serologic screening is the mainstay of identifying patients for treatment.Diagnosis of congenital toxoplasmosis is made using clinical findings and laboratory testing for the pregnant woman, fetus, and infant, often
congenital toxoplasmosis 5609 about priming the perfect protective immune response[15],[20]. A real estimation of the incidence of congenital toxoplasmosis is difficult because, in the majority of countries, it is not a disease for which reporting of the diagnosis
congenital toxoplasmosis 6721 improved hygiene practices in meat production. In the United States, it is estimated that the incidence of congenital toxoplasmosis ranges from 500 to 5000 cases annually[11],[26]. In Colombia (South America), a multicentric national
congenital toxoplasmosis 7057 variations related to mean annual rainfall[23]. The most important estimation about the global incidence of congenital toxoplasmosis was a meta-analysis published in 2013 in the Bulletin of the World Health Organization that described
congenital toxoplasmosis 7213 in 2013 in the Bulletin of the World Health Organization that described a global annual incidence of congenital toxoplasmosis of 190,100 cases (95% confidence interval, CI: 179,300–206,300). This was equivalent to a burden of
congenital toxoplasmosis 8352 well, with some reports indicating rates upto 40%[36]. In many of these countries, the prevalence of congenital toxoplasmosis is simply not reported nor recognized. Our literature search could not find any current data regarding
congenital toxoplasmosis 8843 containing Russia, as well as surrounding Eastern European states, was shown to have an incidence of congenital toxoplasmosis of 1.6 per 1000 live births, a high incidence. Kyrgyzstan, for example, had an estimated 173 seroconversion
congenital toxoplasmosis 9186 whereas the seroprevalence in urban areas was higher, at 16.4%[37]. The only recent study regarding congenital toxoplasmosis in Australia estimated a prevalence of 0.23 infected children per 1000 live births[38]. Melbourne had
congenital toxoplasmosis 10131 declining in some parts of the world[40],[41]. However, it is very likely that our current understanding of congenital toxoplasmosis incidence and prevalence is a substantial underestimate, and enhanced recognition of the implications
congenital toxoplasmosis 10414 her family, and health systems—means that we are likely only seeing the tip of an iceberg that is congenital toxoplasmosis . Most patients with congenital toxoplasmosis in countries where systematic screening is not routine
congenital toxoplasmosis 10459 we are likely only seeing the tip of an iceberg that is congenital toxoplasmosis. Most patients with congenital toxoplasmosis in countries where systematic screening is not routine are diagnosed with severe disease at birth[42].
congenital toxoplasmosis 10622 screening is not routine are diagnosed with severe disease at birth[42]. It has also been demonstrated that congenital toxoplasmosis can present without symptoms at birth but that this does not guarantee the absence of symptoms in the
congenital toxoplasmosis 11946 change and global transportation in the movement of parasite strains across international borders, congenital toxoplasmosis represents an important emerging infectious disease.Seroprevalence varies globally and within countries.
congenital toxoplasmosis 14308 toxoplasmosis.References were identified via use of PubMed from 1990 to 2016 with use of the terms “ congenital toxoplasmosis ”, “Morocco”, “Colombia”, “United States”, and “France”. Particularly relevant articles,
congenital toxoplasmosis 14855 North African country with a nominal GDP ranking of 60, Morocco represents a new frontier in studying congenital toxoplasmosis [46]. Previously, there was a paucity of data regarding disease epidemiology and prevalence, but new
congenital toxoplasmosis 19368 diversity of parasite strains in Morocco, in contrast to other studied countries. Clinical cases of congenital toxoplasmosis in Morocco are uncommon in the literature, highlighting the emerging nature of T. gondii infection in
congenital toxoplasmosis 19739 recently.Fig. 2Congenital toxoplasmosis in developing countries.Manifestations of ocular disease are common in congenital toxoplasmosis . However, the disease can be quite severe, and patients from Morocco, shown here, demonstrate significant
congenital toxoplasmosis 20224 unfortunately did not survive due to the severity of his illness. b Ocular involvement is also common in congenital toxoplasmosis . Substantial scarring of the retina is also possible, and disruption of the retina can lead to loss
congenital toxoplasmosis 20806 centersNumber of births with Toxoplasma infectionNumber of births in centers annuallyPrevalence of severe congenital toxoplasmosis per 10,000 live birthsOceanDakhla121794.6Rabat hospitals1538,0003.9MountainKhénifra123004.3Midelt120554.9Tinghir118565.4SaharaErrachidia225008Babies
congenital toxoplasmosis 21007 hospitals1538,0003.9MountainKhénifra123004.3Midelt120554.9Tinghir118565.4SaharaErrachidia225008Babies confirmed to be born with congenital toxoplasmosis and exhibiting clinical signs of infection (chorioretinitis, hydrocephalus, and cerebral calcifications)
congenital toxoplasmosis 21297 physicians across MoroccoFig. 3Congenital toxoplasmosis in Morocco.The geographic distribution of cases of congenital toxoplasmosis in a cohort of patients identified by Pr. Barkat are presented here and occurred across three distinct
congenital toxoplasmosis 21741 includes Errachidia (indicated in green). Although the sample size is small, with only 21 cases of severe congenital toxoplasmosis , it is suggestive of the possibility that there is a geographic variation in the rates of this parasitic
congenital toxoplasmosis 22797 disease.ColombiaColombia, situated in northern South America, is a nation with extensive experience with congenital toxoplasmosis and a nominal GDP ranking of 39[46],[55]. It is a tropical country with five different geographical
congenital toxoplasmosis 23132 seroprevalence of T. gondii antibodies is heterogenous between regions. Dry regions have lower frequencies of congenital toxoplasmosis (0–1 per 1000 newborns), and humid regions have a higher prevalence (2.5–3.8 per 1000 newborns)[23].
congenital toxoplasmosis 25902 the publication and implementation of evidence-based guidelines; impacts have been observed at the congenital toxoplasmosis consultation service at the Universidad del Quindio, with marked increases in early diagnosis during
congenital toxoplasmosis 26160 reduction in severe cases (Fig. 4b).Fig. 4Evolution of criteria diagnosis and clinical presentation for congenital toxoplasmosis in the University of Quindio Toxoplasma consultation service before and after implementation of evidence-based
congenital toxoplasmosis 26365 implementation of evidence-based guidelines in 2013.a Before 2013, when evidence-based guidelines for congenital toxoplasmosis were implemented, no cases based on seroconversion criteria presented for clinical consultation for
congenital toxoplasmosis 26490 were implemented, no cases based on seroconversion criteria presented for clinical consultation for congenital toxoplasmosis at the University of Quindio; after that date, three new cases were discovered by the monthly follow-up
congenital toxoplasmosis 27087 disease, as is often the case in countries without systematic screening. b Before 2013, 2–6 cases of congenital toxoplasmosis with severe neurological damage (hydrocephalus or hydranencephaly) were identified annually at the Universidad
congenital toxoplasmosis 27871 Nonetheless, it also experiences challenges to proper identification and management of patients with congenital toxoplasmosis [62]. Estimates of seropositivity in the country as a whole are lower than those found in Morocco or
congenital toxoplasmosis 28813 subpopulations have rates of seroprevalence in excess of 50%[6]. Estimation of the incidence and prevalence of congenital toxoplasmosis has been reported in the literature and corresponds, in large part, to areas where seroprevalence is
congenital toxoplasmosis 30505 characterized[45],[65],[66]. Longitudinal data are a particular strength of the US experience with congenital toxoplasmosis . Disease severity in the United States is variable, though the NCCCTS cohort includes many severely
congenital toxoplasmosis 31093 testing in the United States. Another cohort that has contributed substantively to the US approach to congenital toxoplasmosis is the New England Regional Newborn Screening Program in Massachusetts and New Hampshire[68].Some high-end
congenital toxoplasmosis 32414 therapy.FranceFrance is a developed country with a GDP ranking of 6[46]. In many ways, the French experience with congenital toxoplasmosis represents an ideal to which others might aspire. Mandatory gestational screening for toxoplasmosis
congenital toxoplasmosis 33886 disease severity in congenitally infected infants over this period has also been notedEarly diagnosis of congenital toxoplasmosis and treatment during pregnancy have proven to decrease transmission rates and improve clinical outcomes
congenital toxoplasmosis 34379 French food habits[53]. In addition to prevention and early detection of the disease, the management of congenital toxoplasmosis in France focuses on antenatal treatment. The French experience demonstrated the effectiveness of treatment
congenital toxoplasmosis 35298 treatment is continuous pyrimethamine with folinic acid and sulfadiazine.In France, more than 80% of human congenital toxoplasmosis is attributable to type-II T. gondii strains, characterized by slower growth and decreased virulence
congenital toxoplasmosis 37187 North African country. Colombia, with virulent organisms and inadequate resources, is a nation where congenital toxoplasmosis continues to represent a significant risk to population health. Waterborne infection remains a substantial
congenital toxoplasmosis 37842 with insufficient insurance coverage and access results in a poor understanding of the true scope of congenital toxoplasmosis there, and financial concerns limit access to screening. France, on the other hand, with mandatory gestational
congenital toxoplasmosis 38267 gold standard for any country seeking to establish a program to address the public health challenge of congenital toxoplasmosis . The ideal approach to gestational screening, beginning at 11 weeks gestation, is in Fig. 6.Fig. 6Initial
congenital toxoplasmosis 39469 more nuanced. Refer to work from the Palo Alto Reference Laboratory or papers on the management of congenital toxoplasmosis for further details regarding the screening protocol[8],[13]The natural question, then, is what drives
congenital toxoplasmosis 39663 natural question, then, is what drives differences between France and other analyzed nations in terms of congenital toxoplasmosis management and public health approaches? The answer is multifactorial but likely includes low prioritization
congenital toxoplasmosis 46845 risks to these interventions, it would be sensible that they are a component of any program addressing congenital toxoplasmosis . Educational programs and public health interventions to improve hygiene and reduce risk behaviors have
hepatitis B 43696 with multiplexed testing for other congenital infections that are also treatable, including syphilis, hepatitis B , and HIV, currently in development, will further facilitate screening programs[70],[82],[83]. These
infectious disease 9600 unable to reliably identify past exposure to T. gondii[39]. Congenital toxoplasmosis is not an emerging infectious disease in the traditional sense of the term of being a disease that is increasing in frequency. However, it
infectious disease 12004 parasite strains across international borders, congenital toxoplasmosis represents an important emerging infectious disease .Seroprevalence varies globally and within countries. For a presentation of this variation, see Fig. 1,
infectious disease 12255 experiences of nations in Europe, Africa, and North and South America with respect to this emerging infectious disease . In addition to providing a summary of present-day national approaches, we suggest several steps to
infectious disease 22681 detecting seroconversion and preventing morbidity and mortality in the unborn child caused by this emerging infectious disease .ColombiaColombia, situated in northern South America, is a nation with extensive experience with congenital
infectious disease 36381 gondii and in the public health approaches to and circumstances surrounding management of this emerging infectious disease . With T. gondii causing disease outbreaks that lead to loss of sight, significant morbidity, and even
infectious disease 47702 mothers as well as robust public health interventions to address the ongoing threat of this emerging infectious disease . These interventions have been demonstrated to prevent morbidity and mortality, to reduce human suffering,
syphilis 43686 costs, along with multiplexed testing for other congenital infections that are also treatable, including syphilis , hepatitis B, and HIV, currently in development, will further facilitate screening programs[70],[82],[83].
toxoplasmosis 70 Title: Emerging Microbes & InfectionsGlobal initiative for congenital toxoplasmosis : an observational and international comparative clinical analysisKamal El BissatiPauline LevigneJoseph
toxoplasmosis 535 9/2018Publication date (pmc-release): 9/2018Publication date (collection): /2018AbstractGlobally, congenital toxoplasmosis remains a significant cause of morbidity and mortality, and outbreaks of infection with T. gondii represent
toxoplasmosis 888 Disease often is not recognized and is inadequately managed. Herein, we analyze the status of congenital toxoplasmosis in Morocco, Colombia, the United States, and France. We identify the unique challenges faced by each
toxoplasmosis 1068 the unique challenges faced by each nation in the implementation of optimal approaches to congenital toxoplasmosis as a public health problem. We suggest that developed and developing countries use a multipronged approach,
toxoplasmosis 4000 Thus, serologic screening is the mainstay of identifying patients for treatment.Diagnosis of congenital toxoplasmosis is made using clinical findings and laboratory testing for the pregnant woman, fetus, and infant, often
toxoplasmosis 5620 priming the perfect protective immune response[15],[20]. A real estimation of the incidence of congenital toxoplasmosis is difficult because, in the majority of countries, it is not a disease for which reporting of the diagnosis
toxoplasmosis 6732 practices in meat production. In the United States, it is estimated that the incidence of congenital toxoplasmosis ranges from 500 to 5000 cases annually[11],[26]. In Colombia (South America), a multicentric national
toxoplasmosis 7068 to mean annual rainfall[23]. The most important estimation about the global incidence of congenital toxoplasmosis was a meta-analysis published in 2013 in the Bulletin of the World Health Organization that described
toxoplasmosis 7224 the Bulletin of the World Health Organization that described a global annual incidence of congenital toxoplasmosis of 190,100 cases (95% confidence interval, CI: 179,300–206,300). This was equivalent to a burden of
toxoplasmosis 8363 some reports indicating rates upto 40%[36]. In many of these countries, the prevalence of congenital toxoplasmosis is simply not reported nor recognized. Our literature search could not find any current data regarding
toxoplasmosis 8570 regarding the prevalence of seropositivity for T. gondii in Russia. A review of the global state of toxoplasmosis by Torgerson and Mastroiacovo described an increase in seroprevalence in Russia, although the magnitude
toxoplasmosis 8854 Russia, as well as surrounding Eastern European states, was shown to have an incidence of congenital toxoplasmosis of 1.6 per 1000 live births, a high incidence. Kyrgyzstan, for example, had an estimated 173 seroconversion
toxoplasmosis 9197 seroprevalence in urban areas was higher, at 16.4%[37]. The only recent study regarding congenital toxoplasmosis in Australia estimated a prevalence of 0.23 infected children per 1000 live births[38]. Melbourne had
toxoplasmosis 9567 susceptible population that is unable to reliably identify past exposure to T. gondii[39]. Congenital toxoplasmosis is not an emerging infectious disease in the traditional sense of the term of being a disease that is
toxoplasmosis 10142 parts of the world[40],[41]. However, it is very likely that our current understanding of congenital toxoplasmosis incidence and prevalence is a substantial underestimate, and enhanced recognition of the implications
toxoplasmosis 10425 and health systems—means that we are likely only seeing the tip of an iceberg that is congenital toxoplasmosis . Most patients with congenital toxoplasmosis in countries where systematic screening is not routine
toxoplasmosis 10470 likely only seeing the tip of an iceberg that is congenital toxoplasmosis. Most patients with congenital toxoplasmosis in countries where systematic screening is not routine are diagnosed with severe disease at birth[42].
toxoplasmosis 10633 routine are diagnosed with severe disease at birth[42]. It has also been demonstrated that congenital toxoplasmosis can present without symptoms at birth but that this does not guarantee the absence of symptoms in the
toxoplasmosis 11957 global transportation in the movement of parasite strains across international borders, congenital toxoplasmosis represents an important emerging infectious disease.Seroprevalence varies globally and within countries.
toxoplasmosis 12424 national approaches, we suggest several steps to develop successful programs for the management of toxoplasmosis at a national level, drawing on collective experience and evidence obtained over the last several decades.Fig.
toxoplasmosis 14206 lend themselves to a more generalized discussion of how best to prevent congenital infections such as toxoplasmosis .References were identified via use of PubMed from 1990 to 2016 with use of the terms “congenital toxoplasmosis”,
toxoplasmosis 14319 toxoplasmosis.References were identified via use of PubMed from 1990 to 2016 with use of the terms “congenital toxoplasmosis ”, “Morocco”, “Colombia”, “United States”, and “France”. Particularly relevant articles,
toxoplasmosis 14866 country with a nominal GDP ranking of 60, Morocco represents a new frontier in studying congenital toxoplasmosis [46]. Previously, there was a paucity of data regarding disease epidemiology and prevalence, but new
toxoplasmosis 15149 Ministry of Health and collaborations with the University of Chicago is leading to the recognition that toxoplasmosis is a significant public health challenge in the country. Morocco presents unique challenges to the full
toxoplasmosis 16731 47.33%[50]. Early data indicate an impact of the oceanic climate, with an increasing prevalence of toxoplasmosis in this region. Despite regional variation in seroprevalence, rates found in this North African nation
toxoplasmosis 19379 of parasite strains in Morocco, in contrast to other studied countries. Clinical cases of congenital toxoplasmosis in Morocco are uncommon in the literature, highlighting the emerging nature of T. gondii infection in
toxoplasmosis 19654 common, it has gone unrecognized by the global health establishment until very recently.Fig. 2Congenital toxoplasmosis in developing countries.Manifestations of ocular disease are common in congenital toxoplasmosis. However,
toxoplasmosis 19750 2Congenital toxoplasmosis in developing countries.Manifestations of ocular disease are common in congenital toxoplasmosis . However, the disease can be quite severe, and patients from Morocco, shown here, demonstrate significant
toxoplasmosis 20235 did not survive due to the severity of his illness. b Ocular involvement is also common in congenital toxoplasmosis . Substantial scarring of the retina is also possible, and disruption of the retina can lead to loss
toxoplasmosis 20641 and choroidal neovascular membranes (observed using optical coherence tomography)Table 1Congenital toxoplasmosis in MoroccoGeographic regionRegional hospital centersNumber of births with Toxoplasma infectionNumber
toxoplasmosis 20817 births with Toxoplasma infectionNumber of births in centers annuallyPrevalence of severe congenital toxoplasmosis per 10,000 live birthsOceanDakhla121794.6Rabat hospitals1538,0003.9MountainKhénifra123004.3Midelt120554.9Tinghir118565.4SaharaErrachidia225008Babies
toxoplasmosis 21018 hospitals1538,0003.9MountainKhénifra123004.3Midelt120554.9Tinghir118565.4SaharaErrachidia225008Babies confirmed to be born with congenital toxoplasmosis and exhibiting clinical signs of infection (chorioretinitis, hydrocephalus, and cerebral calcifications)
toxoplasmosis 21232 calcifications) were diagnosed by physicians and reported in 2015 by physicians across MoroccoFig. 3Congenital toxoplasmosis in Morocco.The geographic distribution of cases of congenital toxoplasmosis in a cohort of patients
toxoplasmosis 21308 MoroccoFig. 3Congenital toxoplasmosis in Morocco.The geographic distribution of cases of congenital toxoplasmosis in a cohort of patients identified by Pr. Barkat are presented here and occurred across three distinct
toxoplasmosis 21752 Errachidia (indicated in green). Although the sample size is small, with only 21 cases of severe congenital toxoplasmosis , it is suggestive of the possibility that there is a geographic variation in the rates of this parasitic
toxoplasmosis 22808 disease.ColombiaColombia, situated in northern South America, is a nation with extensive experience with congenital toxoplasmosis and a nominal GDP ranking of 39[46],[55]. It is a tropical country with five different geographical
toxoplasmosis 23143 gondii antibodies is heterogenous between regions. Dry regions have lower frequencies of congenital toxoplasmosis (0–1 per 1000 newborns), and humid regions have a higher prevalence (2.5–3.8 per 1000 newborns)[23].
toxoplasmosis 25190 countries[60].To face these public health challenges, in recent years, Colombia has invested in research on toxoplasmosis . The first formal guidelines (including GRADE recommendations, based on Cochrane Reviews, and economic
toxoplasmosis 25514 of Infectious Diseases and the Colombian Association of Gynecologists for diagnosis and treatment of toxoplasmosis during pregnancy[60]. Official guidelines were launched in 2013 and included economic evaluation of
toxoplasmosis 25913 publication and implementation of evidence-based guidelines; impacts have been observed at the congenital toxoplasmosis consultation service at the Universidad del Quindio, with marked increases in early diagnosis during
toxoplasmosis 26171 severe cases (Fig. 4b).Fig. 4Evolution of criteria diagnosis and clinical presentation for congenital toxoplasmosis in the University of Quindio Toxoplasma consultation service before and after implementation of evidence-based
toxoplasmosis 26376 implementation of evidence-based guidelines in 2013.a Before 2013, when evidence-based guidelines for congenital toxoplasmosis were implemented, no cases based on seroconversion criteria presented for clinical consultation for
toxoplasmosis 26501 implemented, no cases based on seroconversion criteria presented for clinical consultation for congenital toxoplasmosis at the University of Quindio; after that date, three new cases were discovered by the monthly follow-up
toxoplasmosis 27098 often the case in countries without systematic screening. b Before 2013, 2–6 cases of congenital toxoplasmosis with severe neurological damage (hydrocephalus or hydranencephaly) were identified annually at the Universidad
toxoplasmosis 27882 it also experiences challenges to proper identification and management of patients with congenital toxoplasmosis [62]. Estimates of seropositivity in the country as a whole are lower than those found in Morocco or
toxoplasmosis 28303 Additionally, one recent estimate of disease prevalence using insurance claims suggested that 2.4% of toxoplasmosis diagnosed in those with private insurance were congenital[62]. While this study suggested ~6900 cases
toxoplasmosis 28422 diagnosed in those with private insurance were congenital[62]. While this study suggested ~6900 cases of toxoplasmosis annually, it is likely an underestimate given the sampling bias. Privately insured patients may have
toxoplasmosis 28824 rates of seroprevalence in excess of 50%[6]. Estimation of the incidence and prevalence of congenital toxoplasmosis has been reported in the literature and corresponds, in large part, to areas where seroprevalence is
toxoplasmosis 29821 likely that this pattern occurs in other countries, although evidence for this is lacking.Congenital toxoplasmosis has been well studied, with a national center at the University of Chicago in the National Collaborative
toxoplasmosis 30516 characterized[45],[65],[66]. Longitudinal data are a particular strength of the US experience with congenital toxoplasmosis . Disease severity in the United States is variable, though the NCCCTS cohort includes many severely
toxoplasmosis 31104 the United States. Another cohort that has contributed substantively to the US approach to congenital toxoplasmosis is the New England Regional Newborn Screening Program in Massachusetts and New Hampshire[68].Some high-end
toxoplasmosis 32425 developed country with a GDP ranking of 6[46]. In many ways, the French experience with congenital toxoplasmosis represents an ideal to which others might aspire. Mandatory gestational screening for toxoplasmosis
toxoplasmosis 32525 toxoplasmosis represents an ideal to which others might aspire. Mandatory gestational screening for toxoplasmosis started in France in the late 1970s, became monthly in 1992 and is reimbursed by social security[71].
toxoplasmosis 32831 women during pregnancy and information about hygiene and dietary recommendations. The seroprevalence of toxoplasmosis was approximately 43.8% in 2003 and decreased over several years due to improved hygiene conditions
toxoplasmosis 33897 in congenitally infected infants over this period has also been notedEarly diagnosis of congenital toxoplasmosis and treatment during pregnancy have proven to decrease transmission rates and improve clinical outcomes
toxoplasmosis 34390 habits[53]. In addition to prevention and early detection of the disease, the management of congenital toxoplasmosis in France focuses on antenatal treatment. The French experience demonstrated the effectiveness of treatment
toxoplasmosis 35309 continuous pyrimethamine with folinic acid and sulfadiazine.In France, more than 80% of human congenital toxoplasmosis is attributable to type-II T. gondii strains, characterized by slower growth and decreased virulence
toxoplasmosis 36673 Colombia face unique challenges to the appropriate management of the public health implications of toxoplasmosis . Morocco has a nationally mandated gestational screening but has not invested adequately in screening
toxoplasmosis 37198 African country. Colombia, with virulent organisms and inadequate resources, is a nation where congenital toxoplasmosis continues to represent a significant risk to population health. Waterborne infection remains a substantial
toxoplasmosis 37465 untreated due to inadequate health infrastructure.Developed nations are not immune to risks posed by toxoplasmosis . The United States represents a combination of parasite and host diversity, with substantial resources
toxoplasmosis 37853 insufficient insurance coverage and access results in a poor understanding of the true scope of congenital toxoplasmosis there, and financial concerns limit access to screening. France, on the other hand, with mandatory gestational
toxoplasmosis 38278 for any country seeking to establish a program to address the public health challenge of congenital toxoplasmosis . The ideal approach to gestational screening, beginning at 11 weeks gestation, is in Fig. 6.Fig. 6Initial
toxoplasmosis 39480 nuanced. Refer to work from the Palo Alto Reference Laboratory or papers on the management of congenital toxoplasmosis for further details regarding the screening protocol[8],[13]The natural question, then, is what drives
toxoplasmosis 39674 question, then, is what drives differences between France and other analyzed nations in terms of congenital toxoplasmosis management and public health approaches? The answer is multifactorial but likely includes low prioritization
toxoplasmosis 41624 widely available in a more economical fashion, such that those pregnant women and infants diagnosed with toxoplasmosis can be adequately treated. Possible approaches include the encouragement of more widely and easily distributed
toxoplasmosis 42754 with treatment, and screening can be accomplished easily and without harm. Treatment for gestational toxoplasmosis is not different in that regard from that of other congenital infections. Prusa et al. proved the favorable
toxoplasmosis 43250 antenatal treatment, their policy makers have prioritized their investments and policies concerning toxoplasmosis differently from those in France, Germany, Austria, Brazil, Uruguay, Panama, and Slovenia, which all
toxoplasmosis 46856 interventions, it would be sensible that they are a component of any program addressing congenital toxoplasmosis . Educational programs and public health interventions to improve hygiene and reduce risk behaviors have
toxoplasmosis 47282 immunocompromised patients.Some countries have prioritized their investments and policies concerning toxoplasmosis differently than others, choosing not to implement systematic screening. However, while decisions on

You must be authorized to submit a review.