10 research outputs found
Profile of pregnant women and children treated at a reference center for congenital toxoplasmosis in the northern state of Minas Gerais, Brazil
Methods and challenges for the health impact assessment of vaccination programs in Latin America
Molecular characterisation of the NSP4 gene of group A human rotavirus G2P[4] strains circulating in SĂŁo Paulo, Brazil, from 1994 and 2006 to 2010
Mortalidade por doença meningocĂłcica no MunicĂpio de SĂŁo Paulo, Brasil: caracterĂsticas e preditores
A Multi-Component Meningococcal Serogroup B Vaccine (4CMenB): The Clinical Development Program
Suspected acute toxoplasmosis in pregnant women Suspeita de toxoplasmose aguda em gestantes
OBJECTIVE: To determine the prevalence of reagent serology for suspected acute toxoplasmosis in pregnant women and to describe clinical, laboratory and therapeutic profiles of mothers and their children. METHODS: A retrospective study was conducted with IgM-anti-Toxoplasma gondii-reagent pregnant women and their children who attended the public health system in the state of Paraná, Southern Brazil, from January 2001 to December 2003. Information were obtained from clinical, laboratory (ELISA IgM/IgG) and ultrasonographic data and from interviews with the mothers. To test the homogeneity of the IgM indices in relation to the treatment used, the Pearson's Chi-square test was applied. Comparisons were considered significant at a 5% level. RESULTS: Two hundred and ninety (1.0%) cases of suspected IgM-reagent infection were documented, with a prevalence of 10.7 IgM-reagent women per 1,000 births. Prenatal care started within the first 12 weeks for 214/290; 146/204 were asymptomatic. Frequent complaints included headaches, visual disturbance and myalgia. Ultrasonography revealed abnormalities in 13 of 204 pregnancies. Chemoprophylaxis was administered to 112/227; a single ELISA test supported most decisions to begin treatment. Pregnant women with IgM indices =2.000 tended to be treated more often. Among exposed children, 44/208 were serologically followed up and all were IgG-reagent, and three IgM-reagent cases showed clinical symptoms. CONCLUSIONS: The existence of pregnant women with laboratorially suspected acute toxoplasmosis who were not properly followed up, and of fetuses that were not adequately monitored, shows that basic aspects of the prenatal care are not being systematically observed. There is need of implementing a surveillance system of pregnant women and their children exposed to T. gondii.<br>OBJETIVO: Determinar a prevalĂŞncia de gestantes com sorologia reagente suspeita de toxoplasmose aguda e descrever as variáveis maternas e do concepto relacionadas ao perfil clĂnico, laboratorial e terapĂŞutico. MÉTODOS: Estudo retrospectivo com gestantes IgM anti-Toxoplasma gondii reagentes e conceptos atendidos em serviço pĂşblico de saĂşde do Paraná, de janeiro/2001-dezembro/2003. Foram obtidas informações a partir de dados dos registros clĂnicos, laboratoriais (ELISA IgM/IgG), ultrassonográficos e de entrevista materna. Para testar a homogeneidade dos indices de IgM em relação ao tratamento usado, aplicou-se o qui-quadrado de Pearson. O nĂvel de significância adotado foi de 5%. RESULTADOS: Ocorreram 290 casos (1,0%) IgM reagentes, evidenciando prevalĂŞncia de 10,7 gestantes com sorologia reagente a cada 1.000 nascimentos. Duzentos e quatorze de 290 gestantes iniciaram o prĂ©-natal atĂ© a 12ÂŞ semana de gestação; 146/204 foram assintomáticas; cefalĂ©ia, distĂşrbios visuais e mialgia foram queixas freqĂĽentes; 13/204 gestantes apresentaram anormalidades ao ultrassom; 112/227 gestantes receberam quimioprofilaxia; um Ăşnico teste ELISA apoiou a maioria das tomadas de decisĂŁo para a quimioprofilaxia. Houve tendĂŞncia em tratar gestantes com Ăndices de IgM=2.000. Dentre as crianças expostas, 44/208 tiveram algum acompanhamento sorolĂłgico, das quais todas foram IgG reagentes e trĂŞs casos IgM reagentes apresentaram manifestações clĂnicas. CONCLUSĂ•ES: A existĂŞncia de gestantes com suspeita laboratorial de toxoplasmose aguda nĂŁo devidamente investigada e de conceptos sem monitoração adequada evidenciam que aspectos fundamentais da assistĂŞncia prĂ©-natal nĂŁo estĂŁo sendo sistematicamente observados. Aponta-se a necessidade de implementar o sistema de vigilância para gestantes e crianças expostas ao T. gondii