Prevalence of toxoplasmosis in pregnant women and vertical transmission of <i>Toxoplasma gondii</i> in patients from basic units of health from Gurupi, Tocantins, Brazil, from 2012 to 2014

Introduction Toxoplasmosis is a parasitary disease that presents high rates of gestational and congenital infection worldwide being therefore considered a public health problem and a neglected disease. Objective To determine the prevalence of toxoplasmosis amongst pregnant women and vertical transmission of Toxoplasma gondii in their newborns attended in the Basic Units of Health (BUH) from the city of Gurupi, state of Tocantins, Brazil. Methods A prevalence study was performed, including 487 pregnant women and their newborns attended in the BUH of the urban zone of the city of Gurupi, state of Tocantins, Brazil, during the period from February 2012 to February 2014. The selection of the pregnant women occurred by convenience. In the antenatal admission they were invited to participate in this study. Three samples of peripheral blood were collected for the detection of specific anti-T. gondii IgG, IgM and IgA through ELISA, for the polimerase chain reaction (PCR) and IgG avidity during pregnancy. When IgM antibodies were detected the fetal and newborn infection investigation took place. The newborn was investigated right after birth and after one year of age through serology and PCR to confirm/exclude the vertical transmission. The analyses were performed in the Studies of the Host-Parasite Relationship Laboratory (LAERPH, IPTSP-UFG), Goiania, state of Goias, Brazil. The results were inserted in a data bank in Epi-Info 3.3.2 statistic software in which the analysis was performed with p≤5%. Results The toxoplasmosis infection was detected in 68.37% (333/487, CI95%: 64.62–72.86). The toxoplasmosis chronic infection prevalence was of 63.03% (307/487, CI95%: 58.74–67.32). The prevalence of maternal acute infection was of 5.33% (26/487; CI95%: 3.3–7.3) suspected by IgM antibodies detection in the peripheral blood. The prevalence of confirmed vertical transmission was of 28% (7/25; CI95%: 10.4–45.6). Conclusions These results show an elevated prevalence of toxoplasmosis in pregnant women and vertical transmission of T. gondii in the city of Gurupi, state of Tocantins, Brazil.引言 弓形虫病是一种寄生性疾病，在全球范围内具有较高的妊娠感染与先天性感染发生率，因此被视为公共卫生问题及被忽视的疾病。 研究目的 明确巴西托坎廷斯州古鲁皮市基层卫生单元（Basic Units of Health, BUH）就诊孕妇的弓形虫病感染率，以及其新生儿的刚地弓形虫（Toxoplasma gondii）垂直传播情况。 研究方法 本研究为现况调查，于2012年2月至2014年2月期间，纳入巴西托坎廷斯州古鲁皮市城区基层卫生单元就诊的487名孕妇及其新生儿作为研究对象。孕妇招募采用方便抽样法，在产前入院时邀请其参与本研究。采集三份外周血样本，通过酶联免疫吸附试验（ELISA）检测特异性抗刚地弓形虫IgG、IgM及IgA抗体，同时开展聚合酶链反应（PCR）检测与IgG亲和力检测。若检测到IgM抗体，则启动胎儿及新生儿感染调查。分别于新生儿出生即刻及出生后1年，通过血清学检测与PCR验证或排除垂直传播。数据分析工作在巴西戈亚斯州戈亚尼亚市的宿主-寄生虫关系研究实验室（LAERPH, IPTSP-UFG）完成。研究数据录入Epi-Info 3.3.2统计软件，以p≤5%作为统计学显著性阈值开展分析。 研究结果 本研究共检出弓形虫病感染68.37%（333/487，95%置信区间：64.62~72.86）。其中慢性弓形虫病感染率为63.03%（307/487，95%置信区间：58.74~67.32）。经外周血IgM抗体检测疑似的孕妇急性感染率为5.33%（26/487；95%置信区间：3.3~7.3）。确诊的垂直传播率为28%（7/25，95%置信区间：10.4~45.6）。 研究结论 本研究结果显示，巴西托坎廷斯州古鲁皮市孕妇群体的弓形虫病感染率与新生儿刚地弓形虫垂直传播率均处于较高水平。