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Assessment of laboratory methods used in the diagnosis of congenital toxoplasmosis after maternal treatment with spiramycin in pregnancy.
[congenital toxoplasmosis]
The
different
laboratory
methods
used
in
the
diagnosis
of
congenital
toxoplasmosis
have
variable
sensitivity
and
specificity
.
There
is
no
evidence
to
prove
that
maternal
treatment
reduces
the
risk
of
fetal
infection
.
The
purpose
of
this
study
was
to
assess
methods
for
the
confirmation
of
congenital
toxoplasmosis
after
maternal
treatment
with
spiramycin
during
pregnancy
,
and
to
evaluate
the
effect
of
this
treatment
on
clinical
manifestations
of
the
disease
in
newborns
(
NB
)
.
This
was
a
community-based
,
cross-sectional
study
of
acute
toxoplasmosis
in
newborns
at
risk
of
acquiring
congenital
infection
.
Participating
newborns
were
born
in
the
Clinical
Hospital
Maternity
Ward
of
the
Federal
University
of
Goiás
.
Eligible
participants
were
divided
into
2
groups
:
group
1
consisted
of
44
newborns
born
to
mothers
treated
with
spiramycin
during
pregnancy
and
group
2
consisted
of
24
newborns
born
to
mothers
not
treated
with
spiramycin
during
pregnancy
because
the
diagnosis
of
toxoplasmosis
was
not
performed
.
The
sensitivity
and
specifity
of
PCR
for
T
.
gondii
DNA
in
peripheral
blood
and
serological
testing
for
specific
anti-
T
.
gondii
IgM
and
IgA
,
and
the
effects
of
maternal
spiramycin
treatment
on
these
parameters
,
were
determined
by
associating
test
results
with
clinical
manifestations
of
disease
.
The
sensitivity
of
the
markers
(
T
.
gondii
DNA
detected
by
PCR
,
and
the
presence
of
specific
anti-
T
.
gondii
IgM
and
IgA
)
for
congenital
toxoplasmosis
was
higher
in
group
2
than
in
group
1
(
31
.
6
,
68
.
4
,
36
.
8
%
and
3
.
7
,
25
.
9
,
11
.
1
%
respectively
)
.
Even
with
a
low
PCR
sensitivity
,
the
group
2
results
indicate
the
importance
of
developing
new
techniques
for
the
diagnosis
of
congenital
toxoplasmosis
in
newborns
.
Within
group
1
,
70
.
4
%
of
the
infected
newborns
were
asymptomatic
and
,
in
group
2
,
68
.
4
%
showed
clinical
manifestations
of
congenital
toxoplasmosis
.
The
higher
proportion
of
infants
without
clinical
symptoms
in
group
1
(
70
.
4
%
)
suggests
the
maternal
treatment
with
spiramycin
delays
fetal
infection
,
reducing
the
clinical
sequelae
of
the
disease
in
newborns
.
Given
the
low
sensitivity
of
the
tests
used
,
when
there
is
suspicion
of
congenital
transmission
several
serological
and
parasitological
tests
are
required
in
order
to
confirm
or
exclude
congenital
toxoplasmosis
in
newborns
.
Diseases
Validation
Diseases presenting
"acute toxoplasmosis in newborns"
symptom
congenital toxoplasmosis
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