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Seroprevalence of toxoplasmosis and current thinking regarding screening in pregnancy: A review of the literature and case study discussion.

机译：弓形虫病的血清阳性率和目前关于妊娠筛查的想法：文献复习和案例研究讨论。

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摘要

The approach to the diagnosis and treatment of congenital toxoplasmosis has been one of flux and debate, fueled by lack of knowledge, lack of consensus, different methods of screening and different national policies for screening in different parts of the world. Countries with higher prevalence of disease such as in Europe and South America have a heightened awareness of the need to screen and treat for this parasitic infection during pregnancy. In contrast, in the United States, it is a condition scarcely discussed and has been largely ignored except in some large centers and by a few researchers. Policies and research strategies for any condition should start with obtaining good data. The aims of this thesis included a review of prevalence studies conducted in the United States, focused on the past 20 years, combined with a description of original research conducted by the author several years ago. The latter was a cross-sectional study performed in Houston, one of the largest American cities with a great ethnic mix. The study analyzed prevalence rates of Toxoplasma gondii IgG antibody in sera of women of reproductive age. Overall seroprevalence was 12.3%. In keeping with other studies, higher prevalence correlated with lower socioeconomic status, Black and Hispanic and Asian ethnicities, and increasing age. A literature search revealed only three prevalence studies performed in the United States over the past 20 years, with another four studies only referred to as personal communications or within a textbook, without further study detail available. The literature review also revealed a lack of consensus on whether or not to screen for toxoplasmosis in pregnancy, and even whether or not treatment in utero is worthwhile.;Proponents of screening and treatment in pregnancy site studies both in the United States and France, emphasize that treatment reduces disease manifestations in infants. Opponents cite other studies that show only marginal benefits, together with potential side effects of medication regimens and generation of anxiety in parents. What is agreed on so far is the value of educating pregnant women on how to avoid contracting toxoplasmosis, and educating physicians on making the best use of reference laboratories before major treatment decisions are made. Further research to reevaluate the literature critically, review new treatment regimens and examine costs and benefits of screening and treatment of toxoplasmosis in pregnancy, bringing together European and American researchers, is needed.
机译：由于缺乏知识，缺乏共识，不同的筛查方法以及世界不同地区的不同国家筛查政策，先天性弓形虫病的诊断和治疗方法一直是热门话题之一。在欧洲和南美等疾病高发的国家，人们越来越意识到在怀孕期间需要筛查和治疗这种寄生虫感染的意识。相比之下，在美国，这种情况很少被讨论，除了一些大型研究中心和一些研究人员以外，基本上已经被忽略了。任何情况下的政策和研究策略均应从获取良好数据开始。本文的目的包括回顾在美国进行的流行病学研究，重点是过去20年，并结合作者几年前进行的原始研究的描述。后者是在休斯敦进行的一项横断面研究，休斯敦是美国人口众多的最大城市之一。该研究分析了弓形虫弓形虫IgG抗体在育龄妇女血清中的流行率。总体血清阳性率为12.3％。与其他研究一致，较高的患病率与较低的社会经济地位，黑人和西班牙裔及亚洲种族以及年龄增长相关。文献搜索显示，过去20年来，在美国仅进行了三项流行病学研究，另外四项研究仅被称为个人交流或教科书，没有进一步的研究细节可用。文献综述还显示，对于是否在妊娠中筛查弓形虫病，甚至在子宫内进行治疗是否值得，尚无共识。;美国和法国的妊娠现场研究的支持者强调这种治疗可以减少婴儿的疾病表现。反对者援引了其他研究，这些研究仅显示出微不足道的益处，以及药物治疗的潜在副作用和父母焦虑的产生。迄今为止，已经达成共识的是，对孕妇进行避免弓形虫病的教育，以及对医生进行重大治疗决策之前最好地利用参考实验室的教育具有价值。需要进一步的研究来重新评估文献，审查新的治疗方案，并检查妊娠弓形虫病筛查和治疗的成本和收益，并将欧美研究人员召集在一起。

著录项

  • 作者

    Bakht, Fred R.;

  • 作者单位

    The University of Texas School of Public Health.;

  • 授予单位 The University of Texas School of Public Health.;
  • 学科 Epidemiology.;Obstetrics.;Parasitology.
  • 学位 M.P.H.
  • 年度 2009
  • 页码 44 p.
  • 总页数 44
  • 原文格式 PDF
  • 正文语种 eng
  • 中图分类
  • 关键词

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