Programs for control of congenital toxoplasmosis.

Area of Science:

• Medical Parasitology
• Public Health
• Obstetrics

Background:

• Congenital toxoplasmosis poses risks including miscarriage and fetal neurological/ocular damage.
• Prenatal screening and educational programs have shown success in reducing toxoplasmosis prevalence globally.
• Brazil has implemented regional screening, with a specific program in Londrina, Parana.

Purpose of the Study:

• To evaluate the effectiveness of the "Health Surveillance Program for Toxoplasmosis Acquired during Pregnancy and Congenital Toxoplasmosis" in Londrina, Parana.
• To assess the program's impact on referral rates, medication consumption, and standardization of care.
• To highlight the benefits of a structured, consensual approach to managing toxoplasmosis in pregnancy.

Main Methods:

• Implementation of a comprehensive program including serological screening, prevention advice, and quarterly monitoring for seronegative pregnant women.
• Monitoring of pregnant women and infants with acute infections and mandatory case notification.
• Program evaluation over the first four years of implementation.

Main Results:

• A 63% reduction in pregnant women and 42% in children referred to reference services.
• Significant decrease in the consumption of folic acid (62%) and sulfadiazine (67%).
• Standardization of care and improved physician decision-making through defined protocols.

Conclusions:

• The Londrina program demonstrates substantial success in reducing congenital toxoplasmosis and associated healthcare burdens.
• Standardized protocols and technical support are crucial for effective management and resource optimization.
• Establishing an ideal, consensual conduct for toxoplasmosis management can lead to significant public resource savings and reduced disease incidence.