title: Incidence of congenital toxoplasmosis estimated by neonatal screening: relevance of diagnostic confirmation in asymptomatic newborn infants.
abstract: Congenital toxoplasmosis is rarely identified by routine clinical examination. The aim of this study was to estimate the incidence of the disease in the region of Ribeirão Preto, south-eastern Brazil. A definitive diagnosis was made on the basis of the persistence of anti-Toxoplasma IgG antibodies beyond 1 year of age. Blood samples obtained from 15,162 neonates and adsorbed onto filter paper were tested for anti-Toxoplasma IgM antibodies. Fifteen samples gave positive results. A definitive diagnosis was confirmed in five of the 13 infants (38.5%) who completed follow-up. These five infants presented with serum IgM and/or IgA antibodies, and clinical abnormalities. Disease incidence was estimated to be 3.3/10,000 (95% CI 1.0-7.7), indicating the need for preventive measures. Neonatal screening is feasible, but screening tests with a better performance are required; positive screening results must be carefully confirmed.
authors.affiliation: Department of Pediatrics, Faculty of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brasil.
authors.forename: C G
authors.initials: CG
authors.lastname: Carvalheiro
authors.forename: M M
authors.initials: MM
authors.lastname: Mussi-Pinhata
authors.forename: A Y
authors.initials: AY
authors.lastname: Yamamoto
authors.forename: C B S
authors.initials: CB
authors.lastname: De Souza
authors.forename: L M Z
authors.initials: LM
authors.lastname: Maciel
mesh_terms: D000818:Animals; D000913:Antibodies, Protozoan / Q000097:blood; D001938:Brazil / Q000453:epidemiology; D005260:Female; D006801:Humans; D007075:Immunoglobulin M / Q000097:blood; D015994:Incidence; D007231:Infant, Newborn; D008297:Male; D015997:Neonatal Screening / Q000379:methods*; D011237:Predictive Value of Tests; D014122:Toxoplasma / Q000276:immunology / Q000302:isolation & purification; D014125:Toxoplasmosis, Congenital / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology*
chemical_list: D000913:Antibodies, Protozoan; D007075:Immunoglobulin M