Programs for control of congenital toxoplasmosis.
Congenital toxoplasmosis can cause miscarriage and neurological and/or eye damage to the fetus. Since Austria and France established the prenatal screening, the prevalence of toxoplasmosis has declined from 50% to 35% and 84% to 44%, respectively. Other countries, such as the United Kingdom, have educational practices to reduce the risk of infection in seronegative pregnant women. In Brazil, prenatal screening is carried out in the states of Mato Grosso do Sul and Minas Gerais and the cities of Curitiba and Porto Alegre. In Londrina, state of Parana, the "Health Surveillance Program for Toxoplasmosis Acquired during Pregnancy and Congenital Toxoplasmosis" was established, which is based on serological screening, advising on prevention measures and quarterly serological monitoring in pregnant women that are initially seronegative, in addition to the monitoring of pregnant women and children with acute infection and case notification. In the first four years of implementation, the program evaluation showed a 63% reduction in the number of pregnant women and 42% in the number of children referred to reference services, resulting in the opening of vacancies for the care of patients with other diseases. As for medications, there was a 62% reduction in consumption of folic acid and 67% of sulfadiazine. Moreover, the definition of the protocols resulted in the standardization of care and safety for the decision-making by physicians. Therefore, as there are several protocols individualized in various departments and regions, the establishment of an ideal, consensual conduct with technical support, will result in implementing measures that will certainly save public resources, with the decrease in congenital toxoplasmosis.
Departamento de Ciências Patológica, Centro de Ciências Biológicas, Universidade Estadual de Londrina, Londrina, PR, Brazil. fabiuel@yahoo.com.br
Fabiana Maria Ruiz
FM
Lopes-Mori
Regina
R
Mitsuka-Breganó
Jaqueline Dario
JD
Capobiango
Inácio Teruo
IT
Inoue
Edna Maria Vissoci
EM
Reiche
Helena Kaminami
HK
Morimoto
Antônio Marcelo Barbante
AM
Casella
Laura Helena França de Barros
LH
Bittencourt
Roberta Lemos
RL
Freire
Italmar Teodorico
IT
Navarro
D005260:Female; D006801:Humans; D009313:National Health Programs; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000517:prevention & control*; D015397:Program Evaluation; D012307:Risk Factors; D014123:Toxoplasmosis / Q000517:prevention & control*; D014125:Toxoplasmosis, Congenital / Q000453:epidemiology / Q000517:prevention & control*