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Three children with congenital toxoplasmosis: early report from a Swedish prospective screening study
G Malm1, K Teär Fahnehjelm, S Wiklund
1Department of Paediatrics, Huddinge University Hospital, Sweden.
Insights
Congenital toxoplasmosis screening in Swedish newborns using filter paper blood tests revealed an incidence below 1:10,000. Early detection and treatment are crucial for affected infants, even those asymptomatic at birth.
Area of Science:
- Medical Research
- Infectious Diseases
- Neonatal Screening
Background:
- Congenital toxoplasmosis poses a significant risk to newborns, potentially causing severe long-term health issues.
- Defining the incidence of congenital toxoplasmosis is essential for public health strategies and resource allocation.
- Newborn screening programs are vital for early identification and intervention.
Observation:
- A prospective study analyzed blood eluates from 40,978 Swedish newborns for antitoxoplasma antibodies (IgM and IgG).
- Three cases of congenital toxoplasmosis were identified through specific IgM antitoxoplasma antibodies.
- Two infants were asymptomatic at birth, while one presented with neonatal infection symptoms.
Findings:
- The incidence of congenital toxoplasmosis in Sweden, detected by IgM antibodies on filter paper, is less than 1:10,000.
- One affected child developed hydrocephalus and required neurosurgery, despite timely treatment.
- Despite severe initial symptoms in one case, all identified children showed normal development at follow-up.
Implications:
- Newborn screening for congenital toxoplasmosis using filter paper blood samples is feasible and effective.
- Early diagnosis and treatment can significantly improve outcomes for affected infants.
- This study provides crucial data on the incidence of congenital toxoplasmosis in Sweden, informing future public health policies.
Abstract:
The aim of this prospective study was to define the incidence of congenital toxoplasmosis in Sweden. Blood eluates collected on filter papers, Guthrie cards, from 40978 newborn babies were analysed for specific immunoglobulin M (IgM) and IgG antitoxoplasma antibodies. This is a preliminary report of three children with congenital toxoplasmosis, defined by the occurrence of antitoxoplasma-specific IgM antibodies. Two children were asymptomatic at birth. They were both normally developed at the age of 12 and 15 months, respectively. The third child had unidentified but uncomplicated symptoms of infection in the neonatal period. As a result of the screening congenital toxoplasmosis was confirmed and treatment instituted. Microphthalmus and peripheral chorioretinitis were detected in one eye. In spite of the chemotherapeutic treatment he developed hydrocephalus needing neurosurgical intervention at the age of 3 months. His development at 14 months was normal. The incidence in Sweden of congenital toxoplasmosis detected by specific IgM antitoxoplasma antibodies in blood from filter papers is less than 1:10000.