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Abstract

In Austria, mandatory screening for the prevention of congenital toxoplasmosis stipulates a serological test for antibodies against as early as possible in pregnancy. In the case of a seronegative result, subsequent tests at intervals of 8 weeks are requested. We analysed serological data from Styria, an Austrian federal state, to determine the seroprevalence and incidence of infections. The study included 353,599 tests from 103,316 women during 158,571 pregnancies from 1995 to 2012. The age-adjusted seroprevalence decreased from 43.3% in 1995 to 31.5% in 2012, with a yearly decline of 0.84% (95% confidence interval (CI): 0. 79 -0.88). The intergravid incidence showed an annual decrease of 4.2%. The average yearly incidence of intragravid and intergravid seroconversions was 0.52% (95% CI 0.45–0.61) and 0.72% (95% CI 0.67–0.77), respectively. If the difference between these rates (p < 0.001) can be explained by the effect of primary prevention such as avoiding raw meat and taking hygiene precautions when encountering cats or preparing vegetables, only ca two of seven (28%) infections were avoided by hygiene measures taken by pregnant women. Primary prevention may therefore have its limits.

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/content/10.2807/1560-7917.ES.2016.21.33.30317
2016-08-18
2024-12-21
/content/10.2807/1560-7917.ES.2016.21.33.30317
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References

  1. Moncada PA, Montoya JG. Toxoplasmosis in the fetus and newborn: an update on prevalence, diagnosis and treatment. Expert Rev Anti Infect Ther. 2012;10(7):815-28.  https://doi.org/10.1586/eri.12.58  PMID: 22943404 
  2. Prusa A. on behalf of the Austrian working group on toxoplasmosis. Österreichische Richtlinie für das Toxoplasmose-Screening in der Schwangerschaft und frühen Kindheit. Screening, Therapie und kindliches Follow-up [Austrian guideline for toxoplasmosis screening in pregnancy and early childhood. Screening, treatment and follow-up of children]. Vienna: Austrian Society for Paediatrics; 2013. German. [Accessed 27 Jul 2015]. Available from: http://www.docs4you.at/Content.Node/Spezialbereiche/Infektiologie/TS/oesterreichische-Richtlinie-fuer-das-Toxoplasmose-Screening.php
  3. Aspöck H, Husslein P, Janisch H, Möse JR, Pollak A, Vander-Möse A, et al. [Toxoplasmosis. Recommendations for treatment of primary toxoplasma infection in pregnancy and congenital toxoplasmosis]. Gynakol Geburtshilfliche Rundsch. 1994;34(1):50-1. PMID: 8019174 
  4. Prusa AR, Kasper DC, Pollak A, Gleiss A, Waldhoer T, Hayde M. The Austrian Toxoplasmosis Register, 1992-2008. Clin Infect Dis. 2015;60(2):e4-10.  https://doi.org/10.1093/cid/ciu724  PMID: 25216688 
  5. Hotop A, Hlobil H, Gross U. Efficacy of rapid treatment initiation following primary Toxoplasma gondii infection during pregnancy. Clin Infect Dis. 2012;54(11):1545-52.  https://doi.org/10.1093/cid/cis234  PMID: 22460980 
  6. SYROCOT (Systematic Review on Congenital Toxoplasmosis) study group,Thiébaut R, Leproust S, Chêne G, Gilbert R. Effectiveness of prenatal treatment for congenital toxoplasmosis: a meta-analysis of individual patients’ data. Lancet. 2007;369(9556):115-22.  https://doi.org/10.1016/S0140-6736(07)60072-5  PMID: 17223474 
  7. Robert-Gangneux F, Dardé ML. Epidemiology of and diagnostic strategies for toxoplasmosis. Clin Microbiol Rev. 2012;25(2):264-96.  https://doi.org/10.1128/CMR.05013-11  PMID: 22491772 
  8. Hofhuis A, van Pelt W, van Duynhoven YTHP, Nijhuis CDM, Mollema L, van der Klis FR, et al. Decreased prevalence and age-specific risk factors for Toxoplasma gondii IgG antibodies in The Netherlands between 1995/1996 and 2006/2007. Epidemiol Infect. 2011;139(4):530-8.  https://doi.org/10.1017/S0950268810001044  PMID: 20492743 
  9. Jones JL, Kruszon-Moran D, Rivera HN, Price C, Wilkins PP. Toxoplasma gondii seroprevalence in the United States 2009-2010 and comparison with the past two decades. Am J Trop Med Hyg. 2014;90(6):1135-9.  https://doi.org/10.4269/ajtmh.14-0013  PMID: 24710615 
  10. Sagel U, Krämer A, Mikolajczyk RT. Incidence of maternal Toxoplasma infections in pregnancy in Upper Austria, 2000-2007. BMC Infect Dis. 2011;11(1):348.  https://doi.org/10.1186/1471-2334-11-348  PMID: 22168604 
  11. Villena I, Ancelle T, Delmas C, Garcia P, Brezin AP, Thulliez P, et al. Toxosurv network and National Reference Centre for Toxoplasmosis. Congenital toxoplasmosis in France in 2007: first results from a national surveillance system. Euro Surveill. 2010;15(25):19600. PMID: 20587361 
  12. Torgerson PR, Mastroiacovo P. The global burden of congenital toxoplasmosis: a systematic review. Bull World Health Organ. 2013;91(7):501-8.  https://doi.org/10.2471/BLT.12.111732  PMID: 23825877 
  13. Fricker-Hidalgo H, Cimon B, Chemla C, Dardé ML, Delhaes L, L’ollivier C, et al. Toxoplasma seroconversion with negative or transient immunoglobulin M in pregnant women: myth or reality? A French multicenter retrospective study. J Clin Microbiol. 2013;51(7):2103-11.  https://doi.org/10.1128/JCM.00169-13  PMID: 23616461 
  14. R: A Language and Environment for Statistical Computing. Vienna: R Foundation for Statistical Computing; 2015. Available from: http://www.R-project.org
  15. Thalhammer O. [The diagnosis and therapy of a toxoplasmosis infection in pregnancy. Birth of a healthy child in sulfonamide-pyrimethamine-treated lymph node toxoplasmosis in the 4th and 5th month of pregnancy]. Dtsch Med Wochenschr. 1960;85:177-9. German.  https://doi.org/10.1055/s-0028-1112415  PMID: 13837649 
  16. Larsen SO, Lebech M. Models for prediction of the frequency of toxoplasmosis in pregnancy in situations of changing infection rates. Int J Epidemiol. 1994;23(6):1309-14.  https://doi.org/10.1093/ije/23.6.1309  PMID: 7721535 
  17. Cook AJ, Gilbert RE, Buffolano W, Zufferey J, Petersen E, Jenum PA, et al. Sources of toxoplasma infection in pregnant women: European multicentre case-control study. European Research Network on Congenital Toxoplasmosis. BMJ. 2000;321(7254):142-7.  https://doi.org/10.1136/bmj.321.7254.142  PMID: 10894691 
  18. van der Giessen J, Fonville M, Bouwknegt M, Langelaar M, Vollema A. Seroprevalence of Trichinella spiralis and Toxoplasma gondii in pigs from different housing systems in The Netherlands. Vet Parasitol. 2007;148(3-4):371-4.  https://doi.org/10.1016/j.vetpar.2007.06.009  PMID: 17646053 
  19. National Institute for Health and Clinical Excellence (NICE). Antenatal Care: Routine Care for the Healthy Pregnant Woman. London: RCOG Press; 2008. [Accessed 30 Jul 2015] Available from: https://www.nice.org.uk/guidance/CG62
  20. Gollub EL, Leroy V, Gilbert R, Chêne G, Wallon MEuropean Toxoprevention Study Group (EUROTOXO). Effectiveness of health education on Toxoplasma-related knowledge, behaviour, and risk of seroconversion in pregnancy. Eur J Obstet Gynecol Reprod Biol. 2008;136(2):137-45.  https://doi.org/10.1016/j.ejogrb.2007.09.010  PMID: 17977641 
  21. Krueger WS, Hilborn ED, Converse RR, Wade TJ. Drinking water source and human Toxoplasma gondii infection in the United States: a cross-sectional analysis of NHANES data. BMC Public Health. 2014;14(1):711.  https://doi.org/10.1186/1471-2458-14-711  PMID: 25012250 
  22. Jones JL, Dubey JP. Waterborne toxoplasmosis--recent developments. Exp Parasitol. 2010;124(1):10-25.  https://doi.org/10.1016/j.exppara.2009.03.013  PMID: 19324041 
  23. Prusa AR, Kasper DC, Olischar M, Husslein P, Pollak A, Hayde M. Evaluation of serological prenatal screening to detect Toxoplasma gondii infections in Austria. Neonatology. 2013;103(1):27-34.  https://doi.org/10.1159/000342625  PMID: 23018152 
  24. Murat JB, Dard C, Fricker Hidalgo H, Dardé ML, Brenier-Pinchart MP, Pelloux H. Comparison of the Vidas system and two recent fully automated assays for diagnosis and follow-up of toxoplasmosis in pregnant women and newborns. Clin Vaccine Immunol. 2013;20(8):1203-12.  https://doi.org/10.1128/CVI.00089-13  PMID: 23740928 
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