Incidence of toxoplasmosis in 5532 pregnant women in Crete, Greece: management of 185 cases at risk.
OBJECTIVE
To study the incidence of toxoplasmosis in pregnant women in Crete and to test a designed protocol for handling those at risk of delivering congenitally infected infants.


METHODS
Pregnant women were screened serologically over a period of 5 years. Cases with suspected acute toxoplasmosis were treated, peripheral blood (PB), and amniotic fluid (AF) tested by polymerase chain reaction (PCR) and culture, and fetuses monitored by ultrasonography. The absence of congenital infection in infants was confirmed by serology and clinical evaluation.


RESULTS
Of the 5532 pregnant women followed, 70.57% remained seronegative, 29.45% were seropositive, and there was direct evidence of seroconversion in six cases. Acute toxoplasmosis was suspected in 185 cases, maternal parasitemia was detected in five cases and positive amniotic fluid in one case. Congenital infection was excluded in all infants followed, based on the absence of ultrasound findings in utero, lack of clinical symptoms at birth, negative Western blotting (WB) at birth and 3 months later, and descending serology for a year.


CONCLUSIONS
Overall, 29.45% of the pregnant women followed were seropositive, 3.3% with suspected acute toxoplasmosis, and in 0.02% cases there was evidence of maternofetal transmission. The protocol tested allowed differentiation between acute and latent toxoplasmosis, safe management of the cases at risk and assisted in avoidance of unwarranted pregnancy terminations.
Antoniou
Maria
M
Laboratory of Clinical Bacteriology, Parasitology, Zoonoses and Geographical Medicine, Faculty of Medicine, University of Crete, P.O. Box 2208, 71003 Heraklion, Crete, Greece. antoniou@med.uoc.gr
Tzouvali
Haris
H
Sifakis
Stavros
S
Galanakis
Emmanouil
E
Georgopoulou
Effie
E
Liakou
Vassiliki
V
Giannakopoulou
Christina
C
Koumantakis
Evgenios
E
Tselentis
Yiannis
Y
D002985:Clinical Protocols; D005260:Female; D006115:Greece / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D018445:Infectious Disease Transmission, Vertical / Q000706:statistics & numerical data*; D008403:Mass Screening; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy; D011256:Pregnancy Outcome; D018566:Pregnancy, High-Risk; D014123:Toxoplasmosis / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy