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Prevalence of Toxoplasma Infection in Mexican Newborns and Children: A Systematic Review from 1954 to 2009

DOI: 10.5402/2012/501216

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Abstract:

Introduction. Recent studies in Mexico have shown that from 20/10,000 to 58/10,000 newborns with Toxoplasma infection could be undetected. The aim of this study was to determine the weighed prevalence of T. gondii infection and describe the epidemiological transition of infection in newborns. Methods. Research literature reporting Toxoplasma infection prevalence in Mexican newborns and children were searched in five international databases. Weighted prevalence was calculated by inverse variance-weighted method in asymptomatic and symptomatic study groups, and the epidemiological transition was estimated by a lineal regression analysis. Results. The weighed prevalence in 4833 asymptomatic newborns was 0.616%, CI95% (0.396%–0.835%) ( ), whereas, among 895 symptomatic newborns, the weighed prevalence was 3.02%, CI 95% (1.91%–4.1%) ( ). A downward trend of 0.25%/year represented an accumulated decrease of ?13,75% in the prevalence in the symptomatic newborns throughout 55 years, whereas, in the asymptomatic children, the prevalence was similar over the course of the years. Conclusion. The high-weighted prevalence of congenital Toxoplasma infection in newborns justifies that Toxoplasma gondii testing be included in the screening programs for women during pregnancy and newborns in Mexico. A rapid diagnosis and treatment strategy could aid in limiting a potential damage to the newborns. 1. Introduction Toxoplasma gondii is a coccidian protozoa of the Apicomplexa family that was first described in 1908. It is the causal agent of congenital toxoplasmosis (CT) that occurs when mothers are infected with this protozoan for the first time during pregnancy and by transplacental transmission infecting the fetus [1]. Damage to the visual and central nervous system can be severe if the fetus is infected during the first trimester [2]; during the second and third trimesters, disorders are less severe and newborns can present an asymptomatic infection and later on develop chorioretinitis, mental retardation, and sensory damage [3]. It can also occur at final term, during placental detachment, or while in delivery. At least, 15 distinct T. gondii strain types have been found throughout the world by enzyme-linked immunoabsorbent assay (ELISA) [1]. Strain types II and not exclusively II (NE-II) have been detected by specific antibodies that recognize allelic peptide motifs of the distinct strain types. NE-II strain is associated with premature birth and infants infected with severe manifestations of disease than infants infected by strain type II parasites [4]. CT is a

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