Журнал бактериологии и паразитологии

Абстрактный

Screening for maternal toxoplasmosis during pregnancy: laboratory diagnostics from a public health perspective

Sagel U and Kramer A.

Serologic screening for maternal Toxoplasma infections during pregnancy has recently been called into question. We review some of the diagnostic difficulties for routine laboratories, poor public health management of existing screening programs, and their mutually detrimental effects on program performance and on toxoplasmosis research. False-positive screening tests may be more likely than true maternal Toxoplasma infections, and diagnosis often depends on confirmatory testing in experienced reference laboratories. Apart from clear seroconversions, any marker for assigning the time of infection
to the current pregnancy (IgM, IgG avidity, etc.) suffers from important limitations. With poor compliance, many screening alerts come from early serum samples in pregnancy that are difficult to test, while seroconversions are rarely observed due to the lack of follow-up samples in late pregnancy. From a public health perspective, inadequate epidemiological assessment and research, insufficient quality control for compliance, and insufficient attention to diagnostic specificities in developing more effective prevention programs have resulted in low effectiveness. These shortcomings have contributed to concerns about preventive screening for toxoplasma during pregnancy. We
recommend that a group of public health decision makers, epidemiologists, and experts from toxoplasmosis reference laboratories re-evaluate existing interventions in this country to create a well-designed prevention program that avoids these shortcomings.