title: Incidence of symptomatic toxoplasma eye disease: aetiology and public health implications.
abstract: Ocular disease is the commonest disabling consequence of toxoplasma infection. Incidence and lifetime risk of ocular symptoms were determined by ascertaining affected patients in a population-based, active reporting study involving ophthalmologists serving a population of 7.4 million. Eighty-seven symptomatic episodes were attributed to toxoplasma infection. Bilateral visual acuity of 6/12 or less was found in seven episodes (8%) and was likely to have been transient in most cases. Black people born in West Africa had a 100-fold higher incidence of symptoms than white people born in Britain. Only two patients reported symptoms before 10 years of age. The estimated lifetime risk of symptoms in British born individuals (52% of all episodes) was 18/100000 (95% confidence interval: 10.8-25.2). The low risk and mild symptoms in an unscreened British population indicate limited potential benefits of prenatal or postnatal screening. The late age at presentation suggests a mixed aetiology of postnatally acquired and congenital infection for which primary prevention may be appropriate, particularly among West Africans.
authors.affiliation: Department of Epidemiology and Public Health, Institute of Child Health, University College London Medical School, UK.
authors.forename: R E
authors.initials: RE
authors.lastname: Gilbert
authors.forename: D T
authors.initials: DT
authors.lastname: Dunn
authors.forename: S
authors.initials: S
authors.lastname: Lightman
authors.forename: P I
authors.initials: PI
authors.lastname: Murray
authors.forename: C E
authors.initials: CE
authors.lastname: Pavesio
authors.forename: P D
authors.initials: PD
authors.lastname: Gormley
authors.forename: J
authors.initials: J
authors.lastname: Masters
authors.forename: S P
authors.initials: SP
authors.lastname: Parker
authors.forename: M R
authors.initials: MR
authors.lastname: Stanford
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D017668:Age of Onset; D044383:Black People; D002648:Child; D002675:Child, Preschool; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008875:Middle Aged; D011634:Public Health; D012306:Risk; D014126:Toxoplasmosis, Ocular / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology*; D044465:White People / Q000706:statistics & numerical data