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[Childhood toxoplasmosis today]

S Goţia1, A Murgu, C Ailioaic

  • 1Facultatea de Medicină Clinica a II a Pediatrie, Universitatea de Medicină şi Farmacie Gr. T. Popa Iaşi.

Revista Medico-Chirurgicala a Societatii De Medici Si Naturalisti Din Iasi
|July 2, 2002
PubMed

Insights

This study highlights the rise in congenital toxoplasmosis and the prevalence of subclinical acquired toxoplasmosis. Individualized treatment is crucial, with Rovamicine showing comparable efficacy to Pirimetamine-Trimetoprim.

Area of Science:

  • Medical Parasitology
  • Pediatric Infectious Diseases
  • Public Health

Background:

  • Toxoplasmosis, caused by *Toxoplasma gondii*, presents challenges in diagnosis and treatment, particularly in congenital and acquired forms.
  • The study examines trends in toxoplasmosis over two decades, noting changes in disease manifestation and co-morbidities.
  • Increasing rates of immunodeficiency-generating diseases necessitate a re-evaluation of *Toxoplasma gondii* screening protocols.

Purpose of the Study:

  • To compare acquired and congenital toxoplasmosis in children across two distinct time periods.
  • To assess the efficacy of different treatment regimens for toxoplasmosis.
  • To emphasize the need for systematic *Toxoplasma gondii* screening and individualized therapeutic approaches.

Main Methods:

  • A comparative analysis of two pediatric patient cohorts hospitalized for toxoplasmosis between 1979-1985 (n=39) and 1991-1997 (n=117).
  • Evaluation of clinical manifestations, focusing on atypical and subclinical presentations of acquired toxoplasmosis.
  • Assessment of treatment outcomes comparing Rovamicine with Pirimetamine-Trimetoprim, considering co-existing conditions.

Main Results:

  • A significant proportion (54%) of acquired toxoplasmosis cases exhibited atypical or subclinical symptoms, underscoring the need for proactive screening.
  • Congenital toxoplasmosis incidence increased from 5% to 8% between the two study periods, highlighting potential gaps in maternal screening.
  • Rovamicine demonstrated comparable therapeutic effectiveness to Pirimetamine-Trimetoprim, suggesting treatment options despite limited therapeutic choices and drug resistance.
  • Co-morbidities such as chronic hepatitis B, tuberculosis, and HIV infection were prevalent, complicating treatment decisions.

Conclusions:

  • Systematic *Toxoplasma gondii* screening is essential, especially in at-risk populations and pregnant women, due to the rising incidence of congenital toxoplasmosis and subclinical acquired infections.
  • Treatment for toxoplasmosis requires a personalized approach, considering the patient's overall health status and the presence of other diseases.
  • Rovamicine offers a viable alternative treatment option, with efficacy similar to established regimens like Pirimetamine-Trimetoprim.

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