Long-Term Outcomes in Children with Congenital Toxoplasmosis—A Systematic Review
Even in the absence of manifestations at birth, children with congenital toxoplasmosis (CT) may develop serious long-term sequelae later in life. This systematic review aims to present the current state of knowledge to base an informed decision on how to optimally manage these pregnancies and childr...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-10-01
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| Series: | Pathogens |
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| Online Access: | https://www.mdpi.com/2076-0817/11/10/1187 |
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| author | Justus G. Garweg François Kieffer Laurent Mandelbrot François Peyron Martine Wallon |
| author_facet | Justus G. Garweg François Kieffer Laurent Mandelbrot François Peyron Martine Wallon |
| author_sort | Justus G. Garweg |
| collection | DOAJ |
| description | Even in the absence of manifestations at birth, children with congenital toxoplasmosis (CT) may develop serious long-term sequelae later in life. This systematic review aims to present the current state of knowledge to base an informed decision on how to optimally manage these pregnancies and children. For this, a systematic literature search was performed on 28 July 2022 in PubMed, CENTRAL, ClinicalTrials.gov, Google Scholar and Scopus to identify all prospective and retrospective studies on congenital toxoplasmosis and its long-term outcomes that were evaluated by the authors. We included 31 research papers from several countries. Virulent parasite strains, low socioeconomic status and any delay of treatment seem to contribute to a worse outcome, whereas an early diagnosis of CT as a consequence of prenatal screening may be beneficial. The rate of ocular lesions in treated children increases over time to 30% in European and over 70% in South American children and can be considerably reduced by early treatment in the first year of life. After treatment, new neurological manifestations are not reported, while ocular recurrences are observed in more than 50% of patients, with a mild to moderate impact on quality of life in European cohorts when compared to a significantly reduced quality of life in the more severely affected South American children. Though CT is rare and less severe in Europe when compared with South America, antenatal screening is the only effective way to diagnose and treat affected individuals at the earliest possible time in order to reduce the burden of disease and achieve satisfying outcomes. |
| first_indexed | 2024-03-09T19:38:03Z |
| format | Article |
| id | doaj.art-f7d4c55c12eb478a97136c71dfbc6cc9 |
| institution | Directory Open Access Journal |
| issn | 2076-0817 |
| language | English |
| last_indexed | 2024-03-09T19:38:03Z |
| publishDate | 2022-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Pathogens |
| spelling | doaj.art-f7d4c55c12eb478a97136c71dfbc6cc92023-11-24T01:49:30ZengMDPI AGPathogens2076-08172022-10-011110118710.3390/pathogens11101187Long-Term Outcomes in Children with Congenital Toxoplasmosis—A Systematic ReviewJustus G. Garweg0François Kieffer1Laurent Mandelbrot2François Peyron3Martine Wallon4Swiss Eye Institute, Rotkreuz, and Uveitis Clinic, Berner Augenklinik, Zieglerstrasse 29, 3007 Bern, SwitzerlandAssistance Publique-Hôpitaux de Paris, Hôpital Armand Trousseau, Service de Néonatologie, 75012 Paris, FranceAssistance Publique-Hôpitaux de Paris, Hôpital Louis-Mourier Service de Gynécologie-Obstétrique, 178 rue des Renouillers, 92700 Colombes, FranceHospices Civils de Lyon, Hôpital de la Croix Rousse, Department of Parasitology and Medical Mycology, 69004 Lyon, FranceHospices Civils de Lyon, Hôpital de la Croix Rousse, Department of Parasitology and Medical Mycology, 69004 Lyon, FranceEven in the absence of manifestations at birth, children with congenital toxoplasmosis (CT) may develop serious long-term sequelae later in life. This systematic review aims to present the current state of knowledge to base an informed decision on how to optimally manage these pregnancies and children. For this, a systematic literature search was performed on 28 July 2022 in PubMed, CENTRAL, ClinicalTrials.gov, Google Scholar and Scopus to identify all prospective and retrospective studies on congenital toxoplasmosis and its long-term outcomes that were evaluated by the authors. We included 31 research papers from several countries. Virulent parasite strains, low socioeconomic status and any delay of treatment seem to contribute to a worse outcome, whereas an early diagnosis of CT as a consequence of prenatal screening may be beneficial. The rate of ocular lesions in treated children increases over time to 30% in European and over 70% in South American children and can be considerably reduced by early treatment in the first year of life. After treatment, new neurological manifestations are not reported, while ocular recurrences are observed in more than 50% of patients, with a mild to moderate impact on quality of life in European cohorts when compared to a significantly reduced quality of life in the more severely affected South American children. Though CT is rare and less severe in Europe when compared with South America, antenatal screening is the only effective way to diagnose and treat affected individuals at the earliest possible time in order to reduce the burden of disease and achieve satisfying outcomes.https://www.mdpi.com/2076-0817/11/10/1187congenital toxoplasmosislong-term outcomesfollow-uptreatment outcomeretinochoroiditis |
| spellingShingle | Justus G. Garweg François Kieffer Laurent Mandelbrot François Peyron Martine Wallon Long-Term Outcomes in Children with Congenital Toxoplasmosis—A Systematic Review Pathogens congenital toxoplasmosis long-term outcomes follow-up treatment outcome retinochoroiditis |
| title | Long-Term Outcomes in Children with Congenital Toxoplasmosis—A Systematic Review |
| title_full | Long-Term Outcomes in Children with Congenital Toxoplasmosis—A Systematic Review |
| title_fullStr | Long-Term Outcomes in Children with Congenital Toxoplasmosis—A Systematic Review |
| title_full_unstemmed | Long-Term Outcomes in Children with Congenital Toxoplasmosis—A Systematic Review |
| title_short | Long-Term Outcomes in Children with Congenital Toxoplasmosis—A Systematic Review |
| title_sort | long term outcomes in children with congenital toxoplasmosis a systematic review |
| topic | congenital toxoplasmosis long-term outcomes follow-up treatment outcome retinochoroiditis |
| url | https://www.mdpi.com/2076-0817/11/10/1187 |
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