Table 2.
Congenital T. gondii infection in humans based on prenatal or postnatal screeninga
| Country | No. screened (years) | Infected children | Incidence rate | Symptomatic childrenb | Reference |
|---|---|---|---|---|---|
| Australia | 18 908 (1986–1989) | 3 | 1:6300 | 0 | Walpole et al. (1991) |
| Austria | 63 416 pregnant women (2000–2007) | 66 pregnant with primoinfection | Seroconversion rate in mothers 0.17%; no data on congenital infection | No data | Sagel et al. (2011) |
| Austria | 5545 | 4c | 1:1386 | No data | Prusa et al. (2013) |
| Austria | 1 387 680 (1992–2008) | 141 | 1: 10 000 | 7 died/terminated (4 spontaneous abortion, 2 hydrocephalus terminations, 1 porencephaly). Of the 17 live infants all had ICC, including microphthalmos in 2; 12 had neurological deficits within the first year of life | Prusa et al. (2015b) |
| Brazil | >364 130 (1995–2009) | >195 (newborn screening) | 5–23/10 000 | Data summarized in Dubey et al. (2012) | Neto et al. (2004); The SYROCOT (2007); Gilbert et al. (2008) |
| Brazil (Minas Gerais) | 146 307 (2006–2007) | 190 (newborn screening) | 13: 10 000 | >142 (142 RC, 39 ICC, 12 hydrocephalus, 10 microcephaly, 46 hearing loss, 4 died) | Vasconcelos-Santos et al. (2009); de Resende et al. (2010) |
| Brazil (Sergipe) | 15 204 (1999) newborns | 6 (newborn screening) | 4: 10 000 | 4 (3 RC, 1 ICC) | Inagaki et al. (2012) |
| Brazil (Goiás) | 246-newborns (2003–2011) | 162 (prenatal screening) | No data | 128 (50 RC, 51 ICC, 19 brain ventriculomegaly or hydrocephalus, 66 severe generalized disease, 13 blinds, 7 died) | Avelino et al. (2014) |
| Brazil (Paraná) | 31 (2000–2010) | 29 (prenatal or postnatal screening) | No data | 26 symptomatic at 1 month (16 RC, 13 ICC, 6 hydrocephalus, 2 microphthalmia, 1 microcephaly, 3 hearing loss) | Capobiango et al. (2014) |
| Brazil (Rio Grande do Sul) | 41 305 (2004–2014) | 24 (prenatal screening) | 6: 10 000 | 19 (13 RC, 9 ICC, 1 hydrocephalus, 5 microcephaly, 5 hearing loss, 1 cataract, 1 spastic). Of 5 children born asymptomatic, 3 remained IgG at 12 months, 1 became IgG negative at 15 months, and 1 lost to follow-up | Bischoff et al. (2016) |
| Brazil (Rondônia) | 102 963 (4 years) | 126 (newborn screening) | 12: 10 000 | 126 newborns with symptoms suggestive of congenital toxoplasmosis | Paraguassú-Chaves et al. (2019) |
| Brazil (Paraná) | 65 375 (2002–2016) | 39 (29 prenatal screening) | 6: 10 000 (15-year average) | 15 without clinical data, 12 of 24 symptomatic (12 RC, 3 ICC, 2 hydrocephalus) | Takahashi et al. (2019) |
| Brazil (Rio Grande do Sul) | 77 follow-up neonates, infants or children (1996–2017) | 77 infected children followed up to a median of 10 years (2–25) (65 prenatal or postnatal screening) | No data | 62 (55 RC, 44 ICC, 18 brain ventriculomegaly, 4 hydrocephalus, 9 microcephaly, 3 hearing loss) new RC lesions after the first year in 29 patients, with peaks at 4–5 and 9–14 years | Lago et al. (2021) |
| Colombia | 937 | 1 | No data | RC | Gomez-Marin et al. (1997) |
| Colombia | 2786 women + 522 newborns | 17d | 14:2786 | 4 RC, 4 ICC, 3 RC | Gómez (2005); Gallego-Marín et al. (2006); Gomez-Marin et al. (2007); The SYROCOT (2007) |
| Colombia | 15 333 (2003–2008) | 15 | No data | 7 symptomatic, 3 died in first month after birth. Hydrocephalus in 1, ICC in 3, RC in 3 | Gómez-Marin et al. (2011) |
| Denmark | 89 873 | 27 | 1:3328 | 5 (hydrocephalus and RC in 1, ICC and RC 1, ICC and retarded in 1, blind and retarded in 1) | Lebech et al. (1999); Gilbert and Peckham (2001) |
| Finland | 16 733 (1988–1989) | 4 | 1:4481 | 2 (ICC and RC in 1), no additional cases in 5-years follow-up | Lappalainen et al. (1995) |
| France | 30 768 | 36 | 1:854 | 7 (RC 7, CNS 1) | Philippe et al. (1988) |
| France | Children from 1206 infected mothers (1987–2000) | 366 | No data | 65 (ICC 24, RC 46) | The SYROCOT (2007) |
| France | 818 700 (2007) | 272e | 3.4: 10 000 | 11 prenatal (6 abortions, 5 fetal deaths), 28 symptomatic (ICC 21, 3 hydrocephalus, 4 macular chorioretinitis) | Villena et al. (2010) |
| France | Children from 1,624 infected mothers (1992–2008) | 207f | No data | 32 (RC), 22 (ICC), 5 hydrocephalus, 2 hepatosplenomegaly | Wallon et al. (2013) |
| Germany | 262 912 (1999–2002) | 55 | 1:4762 | 12 (ICC 5, RC 2, ICC and RC 4, hydrocephalus, ICC and RC 1) | Schmidt et al. (2006) |
| Greece | 63 suspected (2006–2009) | 21 | 4.5–5.1 per 100 000 births | 14 confirmed and 7 probable cases. 10 symptomatic at birth (RC in 5) | Aptouramani et al. (2012) |
| Hungary | 17 735 (1987–1994) | 0 | No data | No data | Szénási et al. (1997) |
| Italy | 28 247 (1996–2000) | 2 | 1: 14 123 | 0 at birth, new RC in 3 in 1-year follow-up | Valcavi et al. (1995) |
| Italy | Children from 43 infected mothers (1996–2000) | 15 | No data | 3 (ICC 3, RC 3) | The SYROCOT (2007) |
| Morocco | 48 890 (2015) | 21 | 4–8/10 000 births | No data | El-Bissati et al. (2018) |
| The Netherlands | 28 049 (1987–1988) | 12 | No data | 3 (ICC 1, RC 3) | Gilbert and Peckham (2001), The SYROCOT (2007) |
| The Netherlands | 10 008 (2006) | 18 | No data | No follow-up | Kortbeek et al. (2009) |
| Norway | 35 940 (1992–1993) | 11 | 1 (RC with loss of vision) | Jenum et al. (1998) | |
| Norway | Children from 33 infected mothers (1992–1994) | 17 | No data | 6 (ICC 4, RC 3) | The SYROCOT (2007) |
| Panama | 2,326 pregnant women screening and newborn babies testing (2017–2018) | 9 | 3.8/1000 live births | No data | Flores et al. (2021) |
| Poland | >27 516 (1998–2000) | 20 | No data | 5 (ICC 5, RC 1) | Paul et al. (2000, 2001a, b); The SYROCOT (2007) |
| Spain | 16 362 women surveyed (1999) | 5g | No data | 4 born asymptomatic | Muñoz Batet et al. (2004) |
| Sweden | 35 000 (1992–1993; 1997–1998) | 3 | No data | 1 (ICC, RC) | Evengård et al. (1999, 2001) |
| USA | >635 000 (1986–1992) | 50 + 5 | 1: 10 000 | 19 (14 CNS, 9 RC), 1–6-year follow-up in 39 children, new eye lesions in 4 | Guerina et al. (1994); Guerina (1994) |
Modified from Dubey (2010).
CNS, central nervous system signs; ICC, intracerebral calcification; NS, not stated; RC, retinochoroiditis.
Of 3708 mothers, 7 seroconverted during pregnancy. One infected fetus with abnormal prenatal ultrasound identified by prenatal screening, and infections in 3 babies were found by cord blood screening.
Of 2786 screened, 19 mothers seroconverted during pregnancy and 14 children were born infected. Three children were found infected by screening of 532 newborns; 8 of these infected children were selected for The SYROCOT analysis because diagnosis of cerebral lesion was done with tomography; those studies based on ultrasound were discarded (personnel communication from Gomez-Marin to J.P.D-February 25, 2021).
In 2007, there were 818 700 live births in France through the national screening programme; 272 congenital T. gondii-infections were recognized; 160 infections were diagnosed postnatally (130 at the age of 2 months, 22 between 2 months and 1 year). Of 235 cases, infection was acquired in first trimester in 17 (7%), 83 (35%) in the second trimester and 135 (58%) in third trimester.
Of 1624 mothers who seroconverted during pregnancy. Lesions in utero in 5, 20 at birth, 21 after birth. RC lesions discovered at birth in 2, in the first year in 20 and third year in 5.
In a multicentre retrospective study of 16 362 women in Barcelona in 1999, seroprevalence was 28.6% with primary infection of 1.02 per 1000 susceptible women; 9 of 12 susceptible women seroconverted during pregnancy. Out of 5 infected children, 4 were asymptomatic at birth; outcome of fifth infant was not stated.