Resumen de Evaluación del tratamiento de la toxoplasmosis gestacional en una cohorte colombiana
- español
Objetivo. Determinar la utilidad del tratamiento de latoxoplasmosis in utero, en términos del desenlace clínico de los niños durante el primer año de vida. Diseño. Estudio de cohorte prospectivo con seguimiento y evaluación clínica y de laboratorio en niños hasta elprimer año de edad. Lugar. Consulta de toxoplasmosis,tercer nivel de referencia en el centro de salud de laUniversidad del Quindío. Población. Se estudiaron 38niños que fueron reclutados en los programas detamizaje prenatal, programas de tamizaje neonatal yniños que acudieron para diagnóstico neonatal. Mediciones. Medición de anticuerpos anti-ToxoplasmaIgG mediante ELISA, IgM e IgA por ISAGA y Westernblot. Oftalmoscopia directa por oftalmólogos y resultados de ecografía transfontanelar.
- English
Objectives. To determine the efficacy of the in utero treatment for toxoplasmosis on clinical symptoms of children at first year of life.Design. Prospective cohort analysis of clinical and laboratory data in newborn children until the first year of life.Setting. Toxoplasmosis clinic, third level of reference at the health centre at the Universidad de Quindío.Patients. 38 children detected during prenatal screening programs or newborn screening program and children referred for symptoms.Measurements. Anti-Toxoplasma IgG ELISA, IgM and IgA assays by ISAGA and Western blot. Fundoscopic examination by ophthalmologists and transfontanellar ecography.Results. 26 infected children were found amongst 38 studied. Trans-mission in treated mothers occurred in 9 of 18 cases (50%), whereas in nontreated mothers it was found in 17 out of 20 (85%); however, this was linked to the gestational age when infection was acquired (adjusted OR = 0.3, 95%CI 0.01-5.5, p = 0.07). There were less frequency of symptoms in utero treated newborns but this was not significant statistically (OR for symptoms in utero treated children = 0.25, 95% CI 0.03 - 2; p(Fisher) = 0.13).Conclusions. This Colombian cohort confirms previous reports in French series that show a lack of a significant effect of prenatal treatment;however, this number of children will be used in SYROCOT to determine an effect, if any, which would be small. This justifies the search for new treatments.
