Pathogenesis of Infection and Preconception Management of T. gondii Infection.
[Pathogenesis of Infection and Preconception Management of T. gondii Infection.]Ameth Hawkins Villarreal1
1. Consultorios Centro Médico Nacional, Panamá, Rep. de Panamá.
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Abstract
La toxoplasmosis es una infección provocada por el parásito unicelular Toxoplasma gondii. Según las encuestas serológicas de la Tercera Encuesta Nacional de Salud y Nutrición en los Estados Unidos, alrededor del 23% de los adolescentes y adultos tienen signos serológicos de infección por T. gondii, de los cuales el 15% son mujeres en edad fértil. Estas infecciones suelen ser asintomáticas o causar síntomas leves en el adulto (como fiebre, malestar general y linfadenopatía), pero la infección en la mujer embarazada puede provocar graves problemas de salud en el feto si se transmite el parásito (toxoplasmosis congénita) y ocasionar secuelas graves en el bebé como coriorretinits, retraso mental, ceguera, sordera sensorineural y epilepsia. No hay evidencia concluyente de que la prueba y el cuidado preconcepcional reduzcan la infección por Toxoplasma gondii o mejoren el tratamiento de las mujeres infectadas. Por otro lado, si se realiza el asesoramiento preconcepcional, las mujeres que dieron positivo pueden estar tranquilas de que no corren riesgo de infección durante el embarazo y las que dieron negativo pueden recibir consejos sobre cómo prevenir la infección. Las mujeres que se infectan durante el embarazo deben recibir tratamiento. Se deben implementar programas educativos y de detección temprana para las embarazadas que sean rentables para reducir el impacto financiero y emocional de esta enfermedad.
Abstract
Toxoplasmosis is an infection caused by the single-celled parasite Toxoplasma gondii. According to serologic surveys from the Third National Health and Nutrition Survey in the United States, about 23% of adolescents and adults have serologic signs of T. gondii infection, of which 15% are women of childbearing age. These infections are usually asymptomatic or cause mild symptoms in the adult (such as fever, malaise, and lymphadenopathy), but infection in the pregnant woman can cause serious health problems in the fetus if the parasite is transmitted (congenital toxoplasmosis) and cause severe sequelae in the infant such as chorioretinits, mental retardation, blindness, sensorineural deafness, and epilepsy. There is no conclusive evidence that preconception testing and care reduces Toxoplasma gondii infection or improves treatment of infected women. On the other hand, if preconception counseling is performed, women who tested positive can be reassured that they are not at risk of infection during pregnancy and those who tested negative can receive advice on how to prevent infection. Women who become infected during pregnancy should be treated. Cost-effective educational and early detection programs for pregnant women should be implemented to reduce the financial and emotional impact of this disease.
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