Ocular sequelae of congenital toxoplasmosis in Brazil compared with Europe
Toxoplasmic retinochoroiditis appears to be more severe in Brazil, where it is a leading cause of blindness, than in Europe, but direct comparisons are lacking. Evidence is accumulating that more virulent genotypes of Toxoplasma gondii predominate in South America. We compared prospective cohorts of...
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| creator | Gilbert, Ruth E Freeman, Katherine Lago, Eleonor G Bahia-Oliveira, Lilian M G Tan, Hooi Kuan Wallon, Martine Buffolano, Wilma Stanford, Miles R Petersen, Eskild |
| description | Toxoplasmic retinochoroiditis appears to be more severe in Brazil, where it is a leading cause of blindness, than in Europe, but direct comparisons are lacking. Evidence is accumulating that more virulent genotypes of Toxoplasma gondii predominate in South America.
We compared prospective cohorts of children with congenital toxoplasmosis identified by universal neonatal screening in Brazil and neonatal or prenatal screening in Europe between 1992 and 2003, using the same protocol in both continents.
Three hundred and eleven (311) children had congenital toxoplasmosis: 30 in Brazil and 281 in Europe, where 71 were identified by neonatal screening. Median follow up was 4.1 years in Europe and 3.7 years in Brazil. Relatively more children had retinochoroiditis during the first year in Brazil than in Europe (15/30; 50% versus 29/281; 10%) and the risk of lesions by 4 years of age was much higher: the hazard ratio for Brazil versus Europe was 5.36 (95%CI: 3.17, 9.08). Children in Brazil had larger lesions, which were more likely to be multiple and to affect the posterior pole (p |
| doi_str_mv | 10.1371/journal.pntd.0000277 |
| format | Article |
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We compared prospective cohorts of children with congenital toxoplasmosis identified by universal neonatal screening in Brazil and neonatal or prenatal screening in Europe between 1992 and 2003, using the same protocol in both continents.
Three hundred and eleven (311) children had congenital toxoplasmosis: 30 in Brazil and 281 in Europe, where 71 were identified by neonatal screening. Median follow up was 4.1 years in Europe and 3.7 years in Brazil. Relatively more children had retinochoroiditis during the first year in Brazil than in Europe (15/30; 50% versus 29/281; 10%) and the risk of lesions by 4 years of age was much higher: the hazard ratio for Brazil versus Europe was 5.36 (95%CI: 3.17, 9.08). Children in Brazil had larger lesions, which were more likely to be multiple and to affect the posterior pole (p<0.0001). In Brazil, visual impairment (<6/12 Snellen) was predicted for most affected eyes (87%, 27/31), but not in Europe (29%; 20/69, p<0.0001). The size of newly detected lesions decreased with age (p = 0.0007).
T. gondii causes more severe ocular disease in congenitally infected children in Brazil compared with Europe. The marked differences in the frequency, size and multiplicity of retinochoroidal lesions may be due to infection with more virulent genotypes of the parasite that predominate in Brazil but are rarely found in Europe.</description><identifier>ISSN: 1935-2735</identifier><identifier>ISSN: 1935-2727</identifier><identifier>EISSN: 1935-2735</identifier><identifier>DOI: 10.1371/journal.pntd.0000277</identifier><identifier>PMID: 18698419</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Age ; Biomedical research ; Brazil - epidemiology ; Child, Preschool ; Children & youth ; Clinical trials ; Epidemiology ; Europe - epidemiology ; Female ; Genotype ; Genotypes ; Hospitals ; Humans ; Infant ; Infant, Newborn ; Infectious Diseases ; Lesions ; Male ; Neonatal Screening ; Parasites ; Pediatrics and Child Health ; Pregnancy ; Pregnancy Complications, Parasitic - diagnosis ; Pregnancy Complications, Parasitic - epidemiology ; Pregnancy Complications, Parasitic - parasitology ; Public Health and Epidemiology/Infectious Diseases ; Studies ; Toxoplasma - genetics ; Toxoplasma - pathogenicity ; Toxoplasma gondii ; Toxoplasmosis ; Toxoplasmosis, Congenital - diagnosis ; Toxoplasmosis, Congenital - epidemiology ; Toxoplasmosis, Congenital - parasitology ; Toxoplasmosis, Ocular - diagnosis ; Toxoplasmosis, Ocular - epidemiology ; Toxoplasmosis, Ocular - parasitology ; Tropical diseases</subject><ispartof>PLoS neglected tropical diseases, 2008-08, Vol.2 (8), p.e277-e277</ispartof><rights>2008 Gilbert et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited: Gilbert RE, Freeman K, Lago EG, Bahia-Oliveira LMG, Tan HK, et al. (2008) Ocular Sequelae of Congenital Toxoplasmosis in Brazil Compared with Europe. PLoS Negl Trop Dis 2(8): e277. doi:10.1371/journal.pntd.0000277</rights><rights>Gilbert et al. 2008</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c593t-270a19d3b5d0c3bc446ab926ccd56d2550f8a6e76ba1d62f1b9f68d993960b623</citedby><cites>FETCH-LOGICAL-c593t-270a19d3b5d0c3bc446ab926ccd56d2550f8a6e76ba1d62f1b9f68d993960b623</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2493041/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2493041/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79342,79343</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18698419$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-42647$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Gilbert, Ruth E</creatorcontrib><creatorcontrib>Freeman, Katherine</creatorcontrib><creatorcontrib>Lago, Eleonor G</creatorcontrib><creatorcontrib>Bahia-Oliveira, Lilian M G</creatorcontrib><creatorcontrib>Tan, Hooi Kuan</creatorcontrib><creatorcontrib>Wallon, Martine</creatorcontrib><creatorcontrib>Buffolano, Wilma</creatorcontrib><creatorcontrib>Stanford, Miles R</creatorcontrib><creatorcontrib>Petersen, Eskild</creatorcontrib><creatorcontrib>European Multicentre Study on Congenital Toxoplasmosis (EMSCOT)</creatorcontrib><creatorcontrib>for The European Multicentre Study on Congenital Toxoplasmosis (EMSCOT)</creatorcontrib><title>Ocular sequelae of congenital toxoplasmosis in Brazil compared with Europe</title><title>PLoS neglected tropical diseases</title><addtitle>PLoS Negl Trop Dis</addtitle><description>Toxoplasmic retinochoroiditis appears to be more severe in Brazil, where it is a leading cause of blindness, than in Europe, but direct comparisons are lacking. Evidence is accumulating that more virulent genotypes of Toxoplasma gondii predominate in South America.
We compared prospective cohorts of children with congenital toxoplasmosis identified by universal neonatal screening in Brazil and neonatal or prenatal screening in Europe between 1992 and 2003, using the same protocol in both continents.
Three hundred and eleven (311) children had congenital toxoplasmosis: 30 in Brazil and 281 in Europe, where 71 were identified by neonatal screening. Median follow up was 4.1 years in Europe and 3.7 years in Brazil. Relatively more children had retinochoroiditis during the first year in Brazil than in Europe (15/30; 50% versus 29/281; 10%) and the risk of lesions by 4 years of age was much higher: the hazard ratio for Brazil versus Europe was 5.36 (95%CI: 3.17, 9.08). Children in Brazil had larger lesions, which were more likely to be multiple and to affect the posterior pole (p<0.0001). In Brazil, visual impairment (<6/12 Snellen) was predicted for most affected eyes (87%, 27/31), but not in Europe (29%; 20/69, p<0.0001). The size of newly detected lesions decreased with age (p = 0.0007).
T. gondii causes more severe ocular disease in congenitally infected children in Brazil compared with Europe. The marked differences in the frequency, size and multiplicity of retinochoroidal lesions may be due to infection with more virulent genotypes of the parasite that predominate in Brazil but are rarely found in Europe.</description><subject>Age</subject><subject>Biomedical research</subject><subject>Brazil - epidemiology</subject><subject>Child, Preschool</subject><subject>Children & youth</subject><subject>Clinical trials</subject><subject>Epidemiology</subject><subject>Europe - epidemiology</subject><subject>Female</subject><subject>Genotype</subject><subject>Genotypes</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Infant</subject><subject>Infant, Newborn</subject><subject>Infectious Diseases</subject><subject>Lesions</subject><subject>Male</subject><subject>Neonatal Screening</subject><subject>Parasites</subject><subject>Pediatrics and Child Health</subject><subject>Pregnancy</subject><subject>Pregnancy Complications, Parasitic - diagnosis</subject><subject>Pregnancy Complications, Parasitic - epidemiology</subject><subject>Pregnancy Complications, Parasitic - parasitology</subject><subject>Public Health and Epidemiology/Infectious Diseases</subject><subject>Studies</subject><subject>Toxoplasma - genetics</subject><subject>Toxoplasma - pathogenicity</subject><subject>Toxoplasma gondii</subject><subject>Toxoplasmosis</subject><subject>Toxoplasmosis, Congenital - diagnosis</subject><subject>Toxoplasmosis, Congenital - epidemiology</subject><subject>Toxoplasmosis, Congenital - parasitology</subject><subject>Toxoplasmosis, Ocular - diagnosis</subject><subject>Toxoplasmosis, Ocular - epidemiology</subject><subject>Toxoplasmosis, Ocular - parasitology</subject><subject>Tropical diseases</subject><issn>1935-2735</issn><issn>1935-2727</issn><issn>1935-2735</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><sourceid>DOA</sourceid><recordid>eNp9kktv1DAUhSMEog_4BwgiIZUNM_gde4NUSoGiSt0AW8uvTD1y4tROKPDr8cwE6CCEN7bscz9fH5-qegLBEuIGvlrHKfUqLId-tEtQBmqae9UhFJguUIPp_Tvrg-oo5zUAVFAOH1YHkDPBCRSH1ccrMwWV6uxuJheUq2Nbm9ivXO9HFeoxfotDULmL2efa9_WbpH74UCTdoJKz9a0fr-vzKcXBPaoetCpk93iej6vP784_nX1YXF69vzg7vVwYKvBY-gEKCos1tcBgbQhhSgvEjLGUWUQpaLlirmFaQctQC7VoGbdCYMGAZggfV8923CHELGcbsoSIc7i1oSgudgob1VoOyXcqfZdRebndiGklVRq9CU4aRJgFtoCJJdpY3WpmnGssIkQL6grr5Y6Vb90w6T3aW__ldEubukkSxMjm6tdzc5PunDWuH5MKe1X7J72_lqv4VSIiMCCwAF7MgBTLl-RRdj4bF4LqXZyybDBmvOF448PJf5VQEN4gSorw-V_Cf5tGdiqTYs7Jtb-bhkBuEverSm4SJ-fElbKndx_8p2iOGP4J83PVpw</recordid><startdate>20080801</startdate><enddate>20080801</enddate><creator>Gilbert, Ruth E</creator><creator>Freeman, Katherine</creator><creator>Lago, Eleonor G</creator><creator>Bahia-Oliveira, Lilian M G</creator><creator>Tan, Hooi Kuan</creator><creator>Wallon, Martine</creator><creator>Buffolano, Wilma</creator><creator>Stanford, Miles R</creator><creator>Petersen, Eskild</creator><general>Public Library of Science</general><general>Public Library of Science (PLoS)</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7SS</scope><scope>7T2</scope><scope>7T7</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AEUYN</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>C1K</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>F1W</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>H95</scope><scope>H97</scope><scope>K9.</scope><scope>L.G</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>P64</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>D93</scope><scope>DOA</scope></search><sort><creationdate>20080801</creationdate><title>Ocular sequelae of congenital toxoplasmosis in Brazil compared with Europe</title><author>Gilbert, Ruth E ; Freeman, Katherine ; Lago, Eleonor G ; Bahia-Oliveira, Lilian M G ; Tan, Hooi Kuan ; Wallon, Martine ; Buffolano, Wilma ; Stanford, Miles R ; Petersen, Eskild</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c593t-270a19d3b5d0c3bc446ab926ccd56d2550f8a6e76ba1d62f1b9f68d993960b623</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Age</topic><topic>Biomedical research</topic><topic>Brazil - epidemiology</topic><topic>Child, Preschool</topic><topic>Children & youth</topic><topic>Clinical trials</topic><topic>Epidemiology</topic><topic>Europe - epidemiology</topic><topic>Female</topic><topic>Genotype</topic><topic>Genotypes</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Infant</topic><topic>Infant, Newborn</topic><topic>Infectious Diseases</topic><topic>Lesions</topic><topic>Male</topic><topic>Neonatal Screening</topic><topic>Parasites</topic><topic>Pediatrics and Child Health</topic><topic>Pregnancy</topic><topic>Pregnancy Complications, Parasitic - diagnosis</topic><topic>Pregnancy Complications, Parasitic - epidemiology</topic><topic>Pregnancy Complications, Parasitic - parasitology</topic><topic>Public Health and Epidemiology/Infectious Diseases</topic><topic>Studies</topic><topic>Toxoplasma - genetics</topic><topic>Toxoplasma - pathogenicity</topic><topic>Toxoplasma gondii</topic><topic>Toxoplasmosis</topic><topic>Toxoplasmosis, Congenital - diagnosis</topic><topic>Toxoplasmosis, Congenital - epidemiology</topic><topic>Toxoplasmosis, Congenital - parasitology</topic><topic>Toxoplasmosis, Ocular - diagnosis</topic><topic>Toxoplasmosis, Ocular - epidemiology</topic><topic>Toxoplasmosis, Ocular - parasitology</topic><topic>Tropical diseases</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gilbert, Ruth E</creatorcontrib><creatorcontrib>Freeman, Katherine</creatorcontrib><creatorcontrib>Lago, Eleonor G</creatorcontrib><creatorcontrib>Bahia-Oliveira, Lilian M G</creatorcontrib><creatorcontrib>Tan, Hooi Kuan</creatorcontrib><creatorcontrib>Wallon, Martine</creatorcontrib><creatorcontrib>Buffolano, Wilma</creatorcontrib><creatorcontrib>Stanford, Miles R</creatorcontrib><creatorcontrib>Petersen, Eskild</creatorcontrib><creatorcontrib>European Multicentre Study on Congenital Toxoplasmosis (EMSCOT)</creatorcontrib><creatorcontrib>for The European Multicentre Study on Congenital Toxoplasmosis (EMSCOT)</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Entomology Abstracts (Full archive)</collection><collection>Health and Safety Science Abstracts (Full archive)</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Public Health Database</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest One Sustainability</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>ASFA: Aquatic Sciences and Fisheries Abstracts</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Aquatic Science & Fisheries Abstracts (ASFA) 1: Biological Sciences & Living Resources</collection><collection>Aquatic Science & Fisheries Abstracts (ASFA) 3: Aquatic Pollution & Environmental Quality</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Aquatic Science & Fisheries Abstracts (ASFA) Professional</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Umeå universitet</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PLoS neglected tropical diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gilbert, Ruth E</au><au>Freeman, Katherine</au><au>Lago, Eleonor G</au><au>Bahia-Oliveira, Lilian M G</au><au>Tan, Hooi Kuan</au><au>Wallon, Martine</au><au>Buffolano, Wilma</au><au>Stanford, Miles R</au><au>Petersen, Eskild</au><aucorp>European Multicentre Study on Congenital Toxoplasmosis (EMSCOT)</aucorp><aucorp>for The European Multicentre Study on Congenital Toxoplasmosis (EMSCOT)</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Ocular sequelae of congenital toxoplasmosis in Brazil compared with Europe</atitle><jtitle>PLoS neglected tropical diseases</jtitle><addtitle>PLoS Negl Trop Dis</addtitle><date>2008-08-01</date><risdate>2008</risdate><volume>2</volume><issue>8</issue><spage>e277</spage><epage>e277</epage><pages>e277-e277</pages><issn>1935-2735</issn><issn>1935-2727</issn><eissn>1935-2735</eissn><abstract>Toxoplasmic retinochoroiditis appears to be more severe in Brazil, where it is a leading cause of blindness, than in Europe, but direct comparisons are lacking. Evidence is accumulating that more virulent genotypes of Toxoplasma gondii predominate in South America.
We compared prospective cohorts of children with congenital toxoplasmosis identified by universal neonatal screening in Brazil and neonatal or prenatal screening in Europe between 1992 and 2003, using the same protocol in both continents.
Three hundred and eleven (311) children had congenital toxoplasmosis: 30 in Brazil and 281 in Europe, where 71 were identified by neonatal screening. Median follow up was 4.1 years in Europe and 3.7 years in Brazil. Relatively more children had retinochoroiditis during the first year in Brazil than in Europe (15/30; 50% versus 29/281; 10%) and the risk of lesions by 4 years of age was much higher: the hazard ratio for Brazil versus Europe was 5.36 (95%CI: 3.17, 9.08). Children in Brazil had larger lesions, which were more likely to be multiple and to affect the posterior pole (p<0.0001). In Brazil, visual impairment (<6/12 Snellen) was predicted for most affected eyes (87%, 27/31), but not in Europe (29%; 20/69, p<0.0001). The size of newly detected lesions decreased with age (p = 0.0007).
T. gondii causes more severe ocular disease in congenitally infected children in Brazil compared with Europe. The marked differences in the frequency, size and multiplicity of retinochoroidal lesions may be due to infection with more virulent genotypes of the parasite that predominate in Brazil but are rarely found in Europe.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>18698419</pmid><doi>10.1371/journal.pntd.0000277</doi><oa>free_for_read</oa></addata></record> |
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| ispartof | PLoS neglected tropical diseases, 2008-08, Vol.2 (8), p.e277-e277 |
| issn | 1935-2735 1935-2727 1935-2735 |
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| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central; PubMed Central Open Access; Public Library of Science (PLoS) |
| subjects | Age Biomedical research Brazil - epidemiology Child, Preschool Children & youth Clinical trials Epidemiology Europe - epidemiology Female Genotype Genotypes Hospitals Humans Infant Infant, Newborn Infectious Diseases Lesions Male Neonatal Screening Parasites Pediatrics and Child Health Pregnancy Pregnancy Complications, Parasitic - diagnosis Pregnancy Complications, Parasitic - epidemiology Pregnancy Complications, Parasitic - parasitology Public Health and Epidemiology/Infectious Diseases Studies Toxoplasma - genetics Toxoplasma - pathogenicity Toxoplasma gondii Toxoplasmosis Toxoplasmosis, Congenital - diagnosis Toxoplasmosis, Congenital - epidemiology Toxoplasmosis, Congenital - parasitology Toxoplasmosis, Ocular - diagnosis Toxoplasmosis, Ocular - epidemiology Toxoplasmosis, Ocular - parasitology Tropical diseases |
| title | Ocular sequelae of congenital toxoplasmosis in Brazil compared with Europe |
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