Evaluación del tratamiento de la toxoplasmosis gestacional en una cohorte colombiana

Objectives. To determine the efficacy of the in utero treatment for toxoplasmosis on clinical symptoms of children at first year of life. Design. Prospective cohort analysis of clinical and laboratory data in newborn children until the first year of life. Setting. Toxoplasmosis clinic, third level of reference at the health centre at the Universidad de Quindio. Patients. 38 children detected during prenatal screening programs or newborn screening program and children referred for symptoms. Measurements. Anti-Toxoplasma IgG ELISA, IgM and IgA assays by ISAGA and Western blot. Fundoscopic examination by ophthalmologists and transfontanellar ecography. Results. 26 infected children were found amongst 38 studied. Trans-mission in treated mothers occurred in 9 of 18 cases (50%), whereas in nontreated mothers it was found in 17 out of 20 (85%); however, this was linked to the gestational age when infection was acquired (adjusted OR = 0.3, 95%CI 0.01-5.5, p = 0.07). There were less frequency of symptoms in utero treated newborns but this was not significant statistically (OR for symptoms in utero treated children = 0.25, 95% CI 0.03 - 2; p(Fisher) = 0.13). Conclusions. This Colombian cohort confirms previous reports in French series that show a lack of a significant effect of prenatal treatment; however, this number of children will be used in SYROCOT to determine an effect, if any, which would be small. This justifies the search for new treatments.