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Why Prevent, Diagnose and Treat Congenital Toxoplasmosis?
McLeod, Rima; Kieffer, Francois; Sautter, Mari; Hosten, Tiffany & Pelloux, Herve
Abstract
Evidence that prevention, diagnosis and treatment of toxoplasmosis is beneficial developed as follows: antiparasitic
agents abrogate Toxoplasma gondii tachyzoite growth, preventing destruction of infected, cultured, mammalian
cells and cure active infections in experimental animals, including primates. They treat active infections in
persons who are immune-compromised, limit destruction of retina by replicating parasites and thereby treat ocular
toxoplasmosis and treat active infection in the fetus and infant. Outcomes of untreated congenital toxoplasmosis
include adverse ocular and neurologic sequelae described in different countries and decades. Better outcomes are
associated with treatment of infected infants throughout their first year of life. Shorter intervals between diagnosis
and treatment in utero improve outcomes. A French approach for diagnosis and treatment of congenital toxoplasmosis
in the fetus and infant can prevent toxoplasmosis and limit adverse sequelae. In addition, new data demonstrate
that this French approach results in favorable outcomes with some early gestation infections. A standardized approach
to diagnosis and treatment during gestation has not yet been applied generally in the USA. Nonetheless, a
small, similar experience confirms that this French approach is feasible, safe, and results in favorable outcomes in
the National Collaborative Chicago-based Congenital Toxoplasmosis Study cohort. Prompt diagnosis, prevention
and treatment reduce adverse sequelae of congenital toxoplasmosis.
Keywords
congenital toxoplasmosis - prevention - treatment
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