CONGENITAL TOXOPLASMOSIS: A NARRATIVE REVIEW

Abstract

THE AIM OF THIS STUDY WAS TO PROMOTE A LITERATURE REVIEW ON TOXOPLASMOSIS AND ITS
CONSEQUENCES IN PRIME INFECTION DURING PREGNANCY. A BIBLIOGRAPHIC REVIEW OF THE NARRATIVE
TYPE WAS PROMOTED WITH RESEARCH OF SCIENTIFIC ARTICLES IN THE DATABASES SCIELO, PUBMED AND
GOOGLE SCHOLAR, USING THE KEYWORDS: TOXOPLASMOSIS, TOXOPLASMA GONDII, CONGENITAL
TOXOPLASMOSIS AND PREGNANCY. PUBLICATIONS IN ENGLISH WERE INCLUDED IN THE STUDY AND
PORTUGUESE MADE AVAILABLE IN FULL WITHIN FIVE YEARS. FROM THIS LITERATURE REVIEW IT WAS VERIFIED
THAT TOXOPLASMOSIS IS A PROTOZOOSIS CAUSED BY THE PARASITE TOXOPLASMA GONDII. ITS
TRANSMISSION OCCURS AFTER THE INGESTION OF SPORULATED OOCYSTS OF T. GONDII, WHICH ARE RELEASED
INTO THE ENVIRONMENT AFTER PERFORMING SEXUAL CYCLE IN FELINES, BEING ELIMINATED IN THE FECES OF
CONTAMINATED CATS. THUS, THEY MAY BE PRESENT IN CONTAMINATED WATER DUE TO LACK OF BASIC
SANITATION, CONSUMPTION OF RAW OR UNDERCOOKED MEAT AND CONTACT WITH INFECTED SAND, AMONG
OTHERS. VERTICAL TRANSMISSION OCCURS BY TRANSPLACENTAL ROUTE AND IS CALLED CONGENITAL
TOXOPLASMOSIS. EACH REGION HAS A DEMOGRAPHIC CHARACTERISTIC THAT CAN INFLUENCE THE INCREASE
IN INFECTION. PREGNANT WOMEN WITH TOXOPLASMOSIS IN THE ACUTE PHASE MAY PRESENT WITH
SYMPTOMS SUGGESTIVE OF PRIMARY INFECTION, ESPECIALLY FEVER, HEADACHE, LYMPH NODE
ENLARGEMENT, ASTHENIA, MYALGIA, AND SORE THROAT. CONGENITAL TOXOPLASMOSIS CAN CAUSE A FEW
CONSEQUENCES FOR THE FETUS, SUCH AS PREMATURE BIRTH, INTELLECTUAL DISABILITY, SEVERE
DEVELOPMENTAL DELAYS, INTRAUTERINE GROWTH RESTRICTION, JAUNDICE, HEPATOSPLENOMEGALY,
INTRACRANIAL CALCIFICATIONS, HYDROCEPHALUS OR RETINOCHOROIDITIS. BECAUSE IT HAS A MAJOR IMPACT
ON HUMAN HEALTH, TOXOPLASMOSIS REQUIRES PROPER SCREENING, DIAGNOSIS, AND TREATMENT TO
PREVENT OR MINIMIZE ITS POTENTIAL DAMAGE. STUDIES HAVE REPORTED ON THE PREVALENCE OF
CONGENITAL INFECTION BY T. GONDII TO BE BETWEEN 0.6-1.3/1000 LIVE BIRTHS IN BRAZIL. IT WAS
SUGGESTED THAT THE CHANCE OF TRANSPLACENTAL TRANSMISSION, THAT IS, FROM MOTHER TO FETUS IS
VARIABLE BETWEEN 18.5 AND 23%. THE RISK OF FETAL INFECTION IN THE FIRST TRIMESTER IS LESS THAN
15%, BUT IN GENERAL, THE DISEASE IS SEVERE IN THE NEWBORN. THE RISK OF INFECTION INCREASES
BETWEEN 20 AND 50% IN THE SECOND TRIMESTER AND BETWEEN 55 AND 80% IN THE THIRD TRIMESTER
OF PREGNANCY, BUT THE NEWBORN IS ASYMPTOMATIC OR HAS LESS SEVERE DISEASE. PRIMARY HEALTH
CARE (PHC) IS CONSIDERED THE GATEWAY TO HEALTH SERVICES AND HAS GREAT RELEVANCE IN THE
INFORMATION TRANSMITTED FOR THE MONITORING OF CASES IN MULTIDISCIPLINARY TEAMS, BEING DETERMINANT FOR THE CHANGE OF BEHAVIORS AND FOR THE ADOPTION OF HEALTHY LIFESTYLE HABITS. IT WAS CONCLUDED THAT TOXOPLASMOSIS IS AN IMPORTANT PUBLIC HEALTH PROBLEM, ESPECIALLY WHEN IT CAUSES HARM TO THE FETUS THROUGH VERTICAL TRANSMISSION; SHOULD BE STUDIED AND ORIENTED TO THE
POPULATION AND ESPECIALLY PREGNANT WOMEN, BECAUSE IT IS A COMMON DISEASE AND PREVENTION
AND SYMPTOMS OFTEN UNKNOWN.