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The congenital toxoplasmosis burden in Brazil: Systematic review and meta-analysis.
Acta Tropica ( IF 2.1 ) Pub Date : 2020-06-29 , DOI: 10.1016/j.actatropica.2020.105608
Ana G G F Strang 1 , Rafaela G Ferrari 2 , Denes K do Rosário 3 , Leticia Nishi 4 , Fernanda F Evangelista 5 , Priscilla L Santana 6 , Amanda H de Souza 7 , Francini M Mantelo 7 , Ana Lúcia F Guilherme 6
Affiliation  

Congenital toxoplasmosis is a zoonosis caused by the intracellular Apicomplexa protozoan Toxoplasma gondii. This infection causes subclinical or clinical lesions, such as retinochoroiditis and central nervous system lesions. The severity of fetal infection is related to the stage of pregnancy and the efficacy of the gestational treatment on fetal infection, whether it is achieved, or if it starts early. South America is the region with the highest burden of congenital toxoplasmosis and the most pathogenic genotypes. Here, we present the results of a comprehensive systematic review and meta-analysis of the congenital toxoplasmosis in Brazil. PubMed, Web of Science, and CAPES databases were used to search for relevant studies that were published between 1 January 2007 and 31 December 2018. The final searching process yielded 21 papers. The studies accounted for 469 children with congenital toxoplasmosis. Of these, 269 (57%) had a diagnosis in the postnatal period. Concerning mothers, 209 (44.6%) underwent prenatal care, but 47 (22.5%) did not receive any drug for toxoplasmosis treatment. There were 226 (48.2%) children with retinochoroiditis; 83 (17.7%) with brain calcifications; 9 (1.9%) with neurosensory auditory dysfunction; and 2 (0.42%) with human immunodeficiency virus coinfection. A total of 460 (98%) children had a medical and multidisciplinary follow-up for at least one year and the most frequent genotype was #11(BRII), found in seven children. There was a statistical correlation between the mother's treatment and asymptomatic children. The gestational treatment seems to protects the fetus since children of mothers who received anti-T. gondii medications have a better prognosis. The retinochoroiditis was the main finding among children, followed by brain calcifications.



中文翻译:

巴西先天性弓形虫病负担:系统评价和荟萃分析。

先天性弓形虫病是由细胞内的蜂原原生动物弓形虫引起的人畜共患病。这种感染会引起亚临床或临床病变,例如视网膜脉络膜炎和中枢神经系统病变。胎儿感染的严重程度与妊娠阶段以及妊娠治疗对胎儿感染的有效性有关,无论这种感染是否实现或是否开始得早。南美洲是先天性弓形虫病负担最大,病原体基因型最多的地区。在这里,我们介绍了对巴西先天性弓形虫病进行全面系统回顾和荟萃分析的结果。使用PubMed,Web of Science和CAPES数据库搜索2007年1月1日至2018年12月31日之间发布的相关研究。最终的搜索过程产生了21篇论文。该研究包括了469名先天性弓形虫病儿童。其中,有269名(57%)在产后诊断。关于母亲,有209名(44.6%)接受了产前检查,但47名(22.5%)没有接受任何弓形虫病治疗药物。226名(48.2%)儿童视网膜脉络膜炎;脑钙化的患者为83(17.7%);9名(1.9%)患有神经感觉性听觉功能障碍;2例(0.42%)人免疫缺陷病毒合并感染。共有460名(98%)儿童接受了医学和多学科随访至少一年,并且最常见的基因型是#11(BRII),发现于7名儿童中。母亲的治疗与无症状的儿童之间存在统计相关性。自从接受抗T抗体的母亲的孩子以来,妊娠治疗似乎可以保护胎儿。刚迪药的预后较好。视网膜脉络膜炎是儿童的主要发现,其次是脑钙化。

更新日期:2020-07-01
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