Positive benefit of postnatal treatment in congenital toxoplasmosis.

摘要

We read the editorial of Gilbert and Desateux.1 In their analysis, they take into account some newborn screening programmes for congenital toxoplasmosis in developing countries such as Brazil and Mexico, with reported rates of up to a maximum of 20 cases/10 000 live births; however, they did not mention our recent report that found a prevalence of 0.5% in a reference hospital in Colombia.2 This study found one child who died I week after birth. As we had information only on the frequency of deaths in a reference hospital, we carried out a study in a representative sample of all newborns from Quindio and found nearly the same prevalence: 0.6% (see letter in Archives of Disease in Children in response to the paper by Schmidt et al). Clearly, prevalence is higher in South America than in Europe, but in addition our cases are more symptomatic. In an analysis in 17 children congenitally infected and detected in prenatal and newborn screening programmes, 41% were symptomatic. Two children (11.7%) died before6 months of age; in four of 13 (30%), there were retinochoroidal lesions with ophthalmological examination and in four of 11 (36%) there was neurological involvement with ultrasound examination. Although only eight children were followed until the first year of life (two died before 6 months of age, thus 7 were lost to follow-up),, it is obvious that we did not need this period to conclude that our children are more affected than those reported by the group in Lyon (France), where 12% of children had ocular lesion during their first year of follow-up.