PREVENTION OF CONGENITAL TOXOPLASMOSIS IN EUROPE

To sound out prevalent opinions among health authorities in Europe con cerning the control and prevention of congenital toxoplasmosis (CT), a questionnaire was sent to the 28 WHO member countries in Europe. The questionnaire was returned by 23 countries. Only 7 countries recommend systematic screening of pregnant women. The reasons given by the 14 c ountries which do not recommend systematic screening are diverse: reco mmendations are in preparation, unfavourable cost-benefit return, abse nce of satisfactory treatment, programme not possible, incidence level too low, etc. 11 countries have a surveillance system for CT, of whic h only 3 are among the countries which recommend systematic screening. However, the absence of a multidisciplinary approach does not permit proper surveillance of cases. It appears from this survey that control of CT is undertaken in a very heterogeneous manner in Europe and no c ountry has a programme whose impact on CT can be measured. So far, the European experience does not permit conclusions either in favour of o r against a programme for the systematic screening of CT. However, cos t-benefit analysis plays a very important role in determining whether such a programme should be implemented. Parameters such as the securit y of diagnosis (standardization of methods, quality and experience of the laboratories) and the monitoring of cases (definition, multidiscip linary approach to the surveillance and long-term treatment of patient s, national collection of case reports, evaluation of the programme) a re indispensable for the implementation of an effective surveillance s ystem.