Perinatal Toxoplasmosis, Northern Taiwan

摘要

To the Editor: Toxoplasmosis iscaused by a protozoan parasite knownas Toxoplasma gondii, which is foundin animals worldwide and is readilytransmitted to humans. The preva-lence of T. gondii–specific immuno-globulin (IgG) antibodies in womenranges from ≈15% in the UnitedStates (1) to ≈55% in Europe (2). Rateof transmission to a fetus in the first,second, and third trimesters is 8%,25%, and 60%, respectively (3). Therate of congenital toxoplasmosis inthe United States is 1–10 per 10,000live births (4). Most infants infectedin utero are born without obvioussigns of toxoplasmosis, and learningor visual disabilities do not develop inup to 80% until their second or thirddecade of life (5,6).In 1985 in Taiwan, the prevalencerates of T. gondii–specific IgG, asdetermined by ELISA, for pregnantwomen and their neonates were10.2% and 11.6%, respectively. Nosamples from mothers or neonateswere screened for IgM titers (7).During the past 20 years, however, thelifestyle, socioeconomic environment,and healthcare system have changedsubstantially in Taiwan. Overseastraveling has become more conven-ient, and Taiwan residents often travelto toxoplasmosis-endemic areas. Thenumber of babies born to immigrantmothers has also recently increased inTaiwan. Our objective was to estimatethe seroprevalence of perinatallytransmitted T. gondii in northernTaiwan.We tested sera collected from con-secutive samples of women and theirneonates (live births only) at 1 med-ical center, 1 local hospital, and 2obstetric clinics in northern Taiwanfrom April 2004 through January2005, which was 1 investigation ofthe Taiwan Birth Panel Study.Informed consent was obtained fromeither parent before enrollment in thestudy. Serum samples from cordblood of 483 neonates and pairedsamples from their mothers were ana-lyzed for T. gondii–specific IgG andIgM titers by ELISA (DiagnosticProducts Corporation, Los Angeles,CA, USA) (IgG sensitivity 94%,specificity 100%; IgM sensitivity96.9%, specificity 91%) (8). Samplesfrom the mothers were tested within 2days of delivery. Additional dataabout health measures and conditionswere collected by trained interviewersusing structured questionnaires