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First Colombian multicentric newborn screening for congenital toxoplasmosis.

Gómez-Marin JE, de-la-Torre A, Angel-Muller E, Rubio J, Arenas J, Osorio E, Nuñez L, Pinzon L, Mendez-Cordoba LC, Bustos A, de-la-Hoz I, Silva P, Beltran M, Chacon L, Marrugo M, Manjarres C, Baquero H, Lora F, Torres E, Zuluaga OE, Estrada M, Moscote L, Silva MT, Rivera R, Molina A, Najera S, Sanabria A, Ramirez ML, Alarcon C, Restrepo N, Falla A, Rodriguez T, Castaño G - PLoS Negl Trop Dis (2011)

Bottom Line: All children with positive samples by IgM, IgA, clinical diagnosis or treatment during pregnancy were recalled for confirmatory tests after day 10 of life. 61 positive samples for specific IgM (0.39%) and 9 positives for IgA (0.5%) were found. 143 questionnaires were positive for a clinical diagnosis or treatment for toxoplasmosis during pregnancy. 109 out of the 218 children that had some of the criteria for postnatal confirmatory tests were followed.A significant correlation was found between a high incidence of markers for congenital toxoplasmosis and higher mean annual rainfall for the city.Incidence for congenital toxoplasmosis is significantly different between hospitals or maternal child health services from different cities in Colombia.

View Article: PubMed Central - PubMed

Affiliation: Grupo GEPAMOL, Centro de Investigaciones Biomédicas, Universidad del Quindio, Armenia, Colombia. gepamol2@uniquindio.edu.co

ABSTRACT

Aims: To determine the incidence of congenital toxoplasmosis in Colombian newborns from 19 hospital or maternal child health services from seven different cities of five natural geographic regions (Caribbean, Central, Andean, Amazonia and Eastern).

Materials and methods: We collected 15,333 samples from umbilical cord blood between the period of March 2009 to May 2010 in 19 different hospitals and maternal-child health services from seven different cities. We applied an IgM ELISA assay (Vircell, Spain) to determine the frequency of IgM anti Toxoplasma. The results in blood cord samples were confirmed either by western blot and repeated ELISA IgM assay. In a sub-sample of 1,613 children that were negative by the anti-Toxoplasma IgM assay, the frequency of specific anti-Toxoplasma IgA by the ISAGA assay was determined. All children with positive samples by IgM, IgA, clinical diagnosis or treatment during pregnancy were recalled for confirmatory tests after day 10 of life.

Results: 61 positive samples for specific IgM (0.39%) and 9 positives for IgA (0.5%) were found. 143 questionnaires were positive for a clinical diagnosis or treatment for toxoplasmosis during pregnancy. 109 out of the 218 children that had some of the criteria for postnatal confirmatory tests were followed. Congenital toxoplasmosis infection was confirmed in 15 children: 7 were symptomatic, and three of them died before the first month of life (20% of lethality). A significant correlation was found between a high incidence of markers for congenital toxoplasmosis and higher mean annual rainfall for the city.

Conclusions: Incidence for congenital toxoplasmosis is significantly different between hospitals or maternal child health services from different cities in Colombia. Mean annual rainfall was correlated with incidence of congenital toxoplasmosis.

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Related in: MedlinePlus

Flowchart and results of the postnatal confirmatory tests at the follow up.
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pntd-0001195-g002: Flowchart and results of the postnatal confirmatory tests at the follow up.

Mentions: We found and followed 109 of the 218 children that had some of the criteria for postnatal confirmatory tests (Figure 2). We confirmed a congenital toxoplasmosis infection in 15 children: 7 were symptomatic, and three of them died before the first month of life. Eight infected children were identified by a positive specific IgM test in umbilical cord blood sample, one by a positive specific IgA test in umbilical cord blood, five by the past history of treatment during pregnancy and one by compatible symptoms. A summary of the clinical characteristics, criteria for recruitment and for diagnosis is showed in Table 3.


First Colombian multicentric newborn screening for congenital toxoplasmosis.

Gómez-Marin JE, de-la-Torre A, Angel-Muller E, Rubio J, Arenas J, Osorio E, Nuñez L, Pinzon L, Mendez-Cordoba LC, Bustos A, de-la-Hoz I, Silva P, Beltran M, Chacon L, Marrugo M, Manjarres C, Baquero H, Lora F, Torres E, Zuluaga OE, Estrada M, Moscote L, Silva MT, Rivera R, Molina A, Najera S, Sanabria A, Ramirez ML, Alarcon C, Restrepo N, Falla A, Rodriguez T, Castaño G - PLoS Negl Trop Dis (2011)

Flowchart and results of the postnatal confirmatory tests at the follow up.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3104965&req=5

pntd-0001195-g002: Flowchart and results of the postnatal confirmatory tests at the follow up.
Mentions: We found and followed 109 of the 218 children that had some of the criteria for postnatal confirmatory tests (Figure 2). We confirmed a congenital toxoplasmosis infection in 15 children: 7 were symptomatic, and three of them died before the first month of life. Eight infected children were identified by a positive specific IgM test in umbilical cord blood sample, one by a positive specific IgA test in umbilical cord blood, five by the past history of treatment during pregnancy and one by compatible symptoms. A summary of the clinical characteristics, criteria for recruitment and for diagnosis is showed in Table 3.

Bottom Line: All children with positive samples by IgM, IgA, clinical diagnosis or treatment during pregnancy were recalled for confirmatory tests after day 10 of life. 61 positive samples for specific IgM (0.39%) and 9 positives for IgA (0.5%) were found. 143 questionnaires were positive for a clinical diagnosis or treatment for toxoplasmosis during pregnancy. 109 out of the 218 children that had some of the criteria for postnatal confirmatory tests were followed.A significant correlation was found between a high incidence of markers for congenital toxoplasmosis and higher mean annual rainfall for the city.Incidence for congenital toxoplasmosis is significantly different between hospitals or maternal child health services from different cities in Colombia.

View Article: PubMed Central - PubMed

Affiliation: Grupo GEPAMOL, Centro de Investigaciones Biomédicas, Universidad del Quindio, Armenia, Colombia. gepamol2@uniquindio.edu.co

ABSTRACT

Aims: To determine the incidence of congenital toxoplasmosis in Colombian newborns from 19 hospital or maternal child health services from seven different cities of five natural geographic regions (Caribbean, Central, Andean, Amazonia and Eastern).

Materials and methods: We collected 15,333 samples from umbilical cord blood between the period of March 2009 to May 2010 in 19 different hospitals and maternal-child health services from seven different cities. We applied an IgM ELISA assay (Vircell, Spain) to determine the frequency of IgM anti Toxoplasma. The results in blood cord samples were confirmed either by western blot and repeated ELISA IgM assay. In a sub-sample of 1,613 children that were negative by the anti-Toxoplasma IgM assay, the frequency of specific anti-Toxoplasma IgA by the ISAGA assay was determined. All children with positive samples by IgM, IgA, clinical diagnosis or treatment during pregnancy were recalled for confirmatory tests after day 10 of life.

Results: 61 positive samples for specific IgM (0.39%) and 9 positives for IgA (0.5%) were found. 143 questionnaires were positive for a clinical diagnosis or treatment for toxoplasmosis during pregnancy. 109 out of the 218 children that had some of the criteria for postnatal confirmatory tests were followed. Congenital toxoplasmosis infection was confirmed in 15 children: 7 were symptomatic, and three of them died before the first month of life (20% of lethality). A significant correlation was found between a high incidence of markers for congenital toxoplasmosis and higher mean annual rainfall for the city.

Conclusions: Incidence for congenital toxoplasmosis is significantly different between hospitals or maternal child health services from different cities in Colombia. Mean annual rainfall was correlated with incidence of congenital toxoplasmosis.

Show MeSH
Related in: MedlinePlus