Congenital Toxoplasmosis: A Neglected Disease? – Current Brazilian public health policy

Abstract

Toxoplasmosis is a cosmopolite disease caused by the protozoan parasite, Toxoplasma gondii. The infection may be contracted through the ingestion of raw or undercooked meat or unpasteurised milk, organ transplants, blood transfusion, through the placenta in vertical transmission or by direct contact with the faeces of infected felids or even through the ingestion of sporulated oocysts in water or food. In immunocompetent individuals, it is generally asymptomatic. However, in patients with various degrees of immunodeficiency and in pregnant women, it may cause severe sequelae and can be fatal. In pregnant women, the prenatal diagnosis should be made as early as possible, so that therapy may be applied to reduce parasitemia and avoid transplacental infection. Despite the high prevalence of infected individuals around the world (20 - 90%), in some European Union countries, such as France and Austria, the average incidence of foetal toxoplasmosis was reduced from 40% to 7% by means of specific programs. In Brazil, seroprevalence may vary between 40% and > 80% (South/Southeast - North/Centre-West/Northeast), reflecting a significant disparity between the public health policies and resources applied in the different regions of the country and the human development index (HDI) of each of them. The lack of consistent and periodical data on seroprevalence per region makes it difficult to understand the significance of this infection and to plan specific public health policies and strategies. Also important is the fact that Hemotherapy Units are not required to screen blood components for toxoplasmosis, not even for immunocompromised patients and pregnant women, or organ transplants. Regarding basic and clinical research, toxoplasmosis is not a priority if compared to the allocation of government funds and incentives to other tropical illnesses, such as: Chagas disease, Leishmaniasis, Dengue fever. There are also few study groups in Brazil that focus in this basic area, for genomics and proteomics studies of T. gondii strains – for the design of new methods of diagnosis, antiparasitic drugs and a vaccine model for humans and animals. This article reviews the historical, taxonomic and epidemiologic aspects, diagnosis methods, treatment and technical-scientific aspects of Toxoplasma gondii and toxoplasmosis in the Brazilian context

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oai:doaj.org/article:b88e2667d3284ec6b568b11664fcb518Last time updated on 6/4/2019

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