Abstract
Background: Early detection of Congenital Toxoplasmosis (CT) may improve neurological outcome and reduce chorioretinitis.
Aim: To assess feasibility of newborn CT screening & determine CT incidence.
Methods: Beginning 7/05, a 2 year pilot screening programme of consented testing was added to the national newborn screening programme using dried heel blood spots obtained 72 -120 hours after birth. A quantitative toxoplasma IgM assay was 1st performed, if > predetermined value, an ISAGA IgM was performed. Screen positive cases were confirmed with paired mother/infant serology. Confirmed CT infants underwent detailed evaluation and received 1 year anti-protozoals. Screening failure rate will be determined by cases referred to the paediatric infectious diseases service. Results: From 7/05-7/07, 144 564 infants were screened, 363 (0.25%) opted out. 34 required confirmatory serology. CT was confirmed in 15/34 infants; 13 asymptomatic, 2 symptomatic (1unilateral absence of central vision and fixation, & 1 congenital hydrocephalus). 4/13 asymptomatic cases had CT related abnormalities: 2 unilateral retinitis (1 with subsequent ocular reactivation), 2 bilateral retinitis & intracranial calcification. 14/15 confirmed cases commenced treatment. 1 infant with equivocal early serology, negative by Western Blot at 3 months, had CT confirmed at 1 year with persistent IgA and increasing dye test. 15/19 false positive results were attributed to prior maternal infection and confounding maternal antibody. 4/19 had no serologic evidence of maternal infection.
Conclusion: 15 infants had CT; 1 in 10 000, 2 (13%) were symptomatic. CT screening can be successfully added to existing newborn screening programmes. No screen failure case was identified.
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Ferguson, W., Mayne, P., Butler, K. et al. 303 Newborn Screening for Congenital Toxoplasmosis (CT) in the Republic of Ireland. Pediatr Res 68 (Suppl 1), 156 (2010). https://doi.org/10.1203/00006450-201011001-00303
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DOI: https://doi.org/10.1203/00006450-201011001-00303