title: First Colombian multicentric newborn screening for congenital toxoplasmosis.
abstract: OBJECTIVE
  To determine the incidence of congenital toxoplasmosis in Colombian newborns from 19 hospital or maternal child health services from seven different cities of five natural geographic regions (Caribbean, Central, Andean, Amazonia and Eastern).
  
  
  METHODS
  We collected 15,333 samples from umbilical cord blood between the period of March 2009 to May 2010 in 19 different hospitals and maternal-child health services from seven different cities. We applied an IgM ELISA assay (Vircell, Spain) to determine the frequency of IgM anti Toxoplasma. The results in blood cord samples were confirmed either by western blot and repeated ELISA IgM assay. In a sub-sample of 1,613 children that were negative by the anti-Toxoplasma IgM assay, the frequency of specific anti-Toxoplasma IgA by the ISAGA assay was determined. All children with positive samples by IgM, IgA, clinical diagnosis or treatment during pregnancy were recalled for confirmatory tests after day 10 of life.
  
  
  RESULTS
  61 positive samples for specific IgM (0.39%) and 9 positives for IgA (0.5%) were found. 143 questionnaires were positive for a clinical diagnosis or treatment for toxoplasmosis during pregnancy. 109 out of the 218 children that had some of the criteria for postnatal confirmatory tests were followed. Congenital toxoplasmosis infection was confirmed in 15 children: 7 were symptomatic, and three of them died before the first month of life (20% of lethality). A significant correlation was found between a high incidence of markers for congenital toxoplasmosis and higher mean annual rainfall for the city.
  
  
  CONCLUSIONS
  Incidence for congenital toxoplasmosis is significantly different between hospitals or maternal child health services from different cities in Colombia. Mean annual rainfall was correlated with incidence of congenital toxoplasmosis.
authors.affiliation: Grupo GEPAMOL, Centro de Investigaciones Biomédicas, Universidad del Quindio, Armenia, Colombia. gepamol2@uniquindio.edu.co
authors.forename: Jorge Enrique
authors.initials: JE
authors.lastname: Gómez-Marin
authors.forename: Alejandra
authors.initials: A
authors.lastname: de-la-Torre
authors.forename: Edith
authors.initials: E
authors.lastname: Angel-Muller
authors.forename: Jorge
authors.initials: J
authors.lastname: Rubio
authors.forename: Jaime
authors.initials: J
authors.lastname: Arenas
authors.forename: Elkin
authors.initials: E
authors.lastname: Osorio
authors.forename: Lilian
authors.initials: L
authors.lastname: Nuñez
authors.forename: Lyda
authors.initials: L
authors.lastname: Pinzon
authors.forename: Luis Carlos
authors.initials: LC
authors.lastname: Mendez-Cordoba
authors.forename: Agustin
authors.initials: A
authors.lastname: Bustos
authors.forename: Isabel
authors.initials: I
authors.lastname: de-la-Hoz
authors.forename: Pedro
authors.initials: P
authors.lastname: Silva
authors.forename: Monica
authors.initials: M
authors.lastname: Beltran
authors.forename: Leonor
authors.initials: L
authors.lastname: Chacon
authors.forename: Martha
authors.initials: M
authors.lastname: Marrugo
authors.forename: Cristina
authors.initials: C
authors.lastname: Manjarres
authors.forename: Hernando
authors.initials: H
authors.lastname: Baquero
authors.forename: Fabiana
authors.initials: F
authors.lastname: Lora
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Torres
authors.forename: Oscar Elias
authors.initials: OE
authors.lastname: Zuluaga
authors.forename: Monica
authors.initials: M
authors.lastname: Estrada
authors.forename: Lacides
authors.initials: L
authors.lastname: Moscote
authors.forename: Myriam Teresa
authors.initials: MT
authors.lastname: Silva
authors.forename: Raul
authors.initials: R
authors.lastname: Rivera
authors.forename: Angie
authors.initials: A
authors.lastname: Molina
authors.forename: Shirley
authors.initials: S
authors.lastname: Najera
authors.forename: Antonio
authors.initials: A
authors.lastname: Sanabria
authors.forename: Maria Luisa
authors.initials: ML
authors.lastname: Ramirez
authors.forename: Claudia
authors.initials: C
authors.lastname: Alarcon
authors.forename: Natalia
authors.initials: N
authors.lastname: Restrepo
authors.forename: Alejandra
authors.initials: A
authors.lastname: Falla
authors.forename: Tailandia
authors.initials: T
authors.lastname: Rodriguez
authors.forename: Giovanny
authors.initials: G
authors.lastname: Castaño
mesh_terms: D000913:Antibodies, Protozoan / Q000097:blood*; D015153:Blotting, Western; D003105:Colombia / Q000453:epidemiology; D004797:Enzyme-Linked Immunosorbent Assay; D005312:Fetal Blood / Q000276:immunology; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D015994:Incidence; D007231:Infant, Newborn; D008403:Mass Screening / Q000379:methods; D010274:Parasitology / Q000379:methods; D016036:Seroepidemiologic Studies; D014122:Toxoplasma / Q000276:immunology / Q000302:isolation & purification*; D014125:Toxoplasmosis, Congenital / Q000175:diagnosis / Q000453:epidemiology*; D014887:Weather
chemical_list: D000913:Antibodies, Protozoan; D007070:Immunoglobulin A; D007075:Immunoglobulin M