PREVENTION OF CONGENITAL TOXOPLASMOSIS IN SZEGED, HUNGARY

Background. Toxoplasma gondii infection of the fetus can only be disco vered or prevented by the appropriate serological screening and subseq uent treatment of the mother and her offspring. In Hungary, there is n o obligatory toxoplasma screening for pregnant women and both the repo rting and follow-up of congenital toxoplasmosis cases is limited. In 1 987 we started a systematic study in the Szeged region of Hungary, in which all pregnant women were screened and appropriate treatment given to all mothers and their offspring where congenital toxoplasmosis was suspected. Methods. All pregnant women were routinely screened within the first 16 weeks of gestation;or toxoplasma antibodies by complemen t fixation test (CFT). Seronegative cases were retested for possible s eroconversion every second month, Patients with CFT litres greater tha n or equal to 1:256 were retested for anti-P30 immunoglobulin A (IgA), IgM and IgG antibodies by ELISA and/or SDS-PAGE-Western immunoblot in order to distinguish the acute and chronic phases oi the infection. R esults. Up to the end of 1994, the sera of 17 735 gravidae were screen ed. Ten women were found to have seroconverted during pregnancy and 78 had high initial antibody levels accompanied by anti-P30 IgA antibodi es at the very first screening. These two groups together were conside red as definitely (10) or possibly (78) infected with Toxoplasma durin g pregnancy and were treated with Spiramycin. Ali of their offspring w ere also treated for one month and followed-up by systematic serologic al and clinical screening for 2 years. No congenital toxoplasmosis was found in any of the offspring. Conclusions. Antenatal, early diagnosi s and treatment of toxoplasmosis in mothers, together with treatment a nd followup of their offspring, may considerably reduce the incidence of the disease in the offspring.