Valor do teste de avidez da IgG como marcador de doença aguda ou crônica e de transmissão vertical na toxoplasmose
Ano de defesa: | 2009 |
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Autor(a) principal: | |
Orientador(a): | |
Banca de defesa: | |
Tipo de documento: | Dissertação |
Tipo de acesso: | Acesso aberto |
Idioma: | por |
Instituição de defesa: |
Universidade Federal de Goiás
|
Programa de Pós-Graduação: |
Programa de Pós-graduação em Medicina Tropical e Saúde Pública (IPTSP)
|
Departamento: |
Instituto de Patologia Tropical e Saúde Pública - IPTSP (RG)
|
País: |
Brasil
|
Palavras-chave em Português: | |
Palavras-chave em Inglês: | |
Área do conhecimento CNPq: | |
Link de acesso: | http://repositorio.bc.ufg.br/tede/handle/tede/3517 |
Resumo: | Toxoplasmosis is a parasitic disease widespread around the world caused by Toxoplasma gondii. Infection acquired during pregnancy may cause intrauterine damage and sequelae in the newborn. Serological testing for IgG/IgM anti-Toxoplasma antibodies may fail to differentiate between recent and past infection. Despite that, rapid diagnosis of acute infection during pregnancy allows rapid treatment and prevents or attenuates congenital toxoplasmosis. PURPOSE: to establish the frequency of acute toxoplasmosis in pregnant women, the vertical transmission rate and the value of specific IgG-avidity test to date infection in pregnancy; to evaluate the relationship between IgG-avidity and congenital toxoplasmosis. MATERIAL AND METHODS: this report summarizes a retrospective study performed on 235,993 pregnant women attended by “The Pregnancy Protection Program” – public health system (SUS) of the State of Goiás – Brazil, from January 2004 to December 2007. ELISA (IgG / IgM) and IgG-avidity test were performed for maternal screening of toxoplasmosis. Fetal and newborn investigation of the infection was performed by “The Toxoplasmosis Vertical Transmission Control Program” protocols. The association between data was statistically analyzed by the x2 test (p < 0,05 was considered statistically significant). RESULTS: the frequency of IgM-positive among pregnant women studied population was 0,7%. Among IgM-positive women, only 207 (12,5%) performed the screening test in first 3-month period of pregnancy and 91% of pregnant women presented high avidity ( > 40%). The vertical transmission rate was 62%. There was no statistically significant relationship between higher (> 40%) or lower (≤ 25%) IgG-avidity test and presence of congenital infection (p= 0,08 e p= 0,57, respectively). There was no statistically significant association between maternal diagnosis in first trimester, low avidity and vertical transmission rate. CONCLUSIONS: the frequency of IgM-positive in pregnant women was lower than Brazilian rates founded in other studies. The study showed high persistent vertical transmission rate besides prenatal management and treatment. The IgG-avidity was not useful to predict vertical transmission. These results indicate that the IgG-avidity test must be not carried out in all IgM-positive pregnant women in the State of Goiás-Brazil, as a confirmatory test for the diagnosis of maternal toxoplasmosis. |
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Avelino, Mariza Martinshttp://lattes.cnpq.br/7890944202988947http://lattes.cnpq.br/8535337313655113Alvarenga, Fernanda Rassi2014-11-03T20:18:53Z2009-06-26ALVARENGA, Fernanda Rassi. Valor do teste de avidez da IgG como marcador de doença aguda ou crônica e de transmissão vertical na toxoplasmose. 2009. 131 f. Dissertação (Mestrado em Medicina Tropical e Saúde Pública) - Universidade Federal de Goiás, Goiânia, 2009.http://repositorio.bc.ufg.br/tede/handle/tede/3517Toxoplasmosis is a parasitic disease widespread around the world caused by Toxoplasma gondii. Infection acquired during pregnancy may cause intrauterine damage and sequelae in the newborn. Serological testing for IgG/IgM anti-Toxoplasma antibodies may fail to differentiate between recent and past infection. Despite that, rapid diagnosis of acute infection during pregnancy allows rapid treatment and prevents or attenuates congenital toxoplasmosis. PURPOSE: to establish the frequency of acute toxoplasmosis in pregnant women, the vertical transmission rate and the value of specific IgG-avidity test to date infection in pregnancy; to evaluate the relationship between IgG-avidity and congenital toxoplasmosis. MATERIAL AND METHODS: this report summarizes a retrospective study performed on 235,993 pregnant women attended by “The Pregnancy Protection Program” – public health system (SUS) of the State of Goiás – Brazil, from January 2004 to December 2007. ELISA (IgG / IgM) and IgG-avidity test were performed for maternal screening of toxoplasmosis. Fetal and newborn investigation of the infection was performed by “The Toxoplasmosis Vertical Transmission Control Program” protocols. The association between data was statistically analyzed by the x2 test (p < 0,05 was considered statistically significant). RESULTS: the frequency of IgM-positive among pregnant women studied population was 0,7%. Among IgM-positive women, only 207 (12,5%) performed the screening test in first 3-month period of pregnancy and 91% of pregnant women presented high avidity ( > 40%). The vertical transmission rate was 62%. There was no statistically significant relationship between higher (> 40%) or lower (≤ 25%) IgG-avidity test and presence of congenital infection (p= 0,08 e p= 0,57, respectively). There was no statistically significant association between maternal diagnosis in first trimester, low avidity and vertical transmission rate. CONCLUSIONS: the frequency of IgM-positive in pregnant women was lower than Brazilian rates founded in other studies. The study showed high persistent vertical transmission rate besides prenatal management and treatment. The IgG-avidity was not useful to predict vertical transmission. These results indicate that the IgG-avidity test must be not carried out in all IgM-positive pregnant women in the State of Goiás-Brazil, as a confirmatory test for the diagnosis of maternal toxoplasmosis.A toxoplasmose, parasitose prevalente em todo o mundo, quando adquirida na gestação pode ser transmitida para o feto e ocasionar agravos que limitarão o desenvolvimento da criança para o resto da vida. O diagnóstico laboratorial da toxoplasmose com os testes imunoenzimáticos disponíveis ainda tem limitada capacidade para determinar se a mulher grávida adquiriu infecção aguda durante a gestação, ou anteriormente. Por outro lado, o diagnóstico precoce de infecção aguda na gestante, associado à medicação específica adequada, pode mudar o prognóstico da infecção congênita, diminuindo as sequelas nas crianças. OBJETIVO: estabelecer a frequência de toxoplasmose aguda gestacional, a taxa de transmissão vertical e o valor do teste de avidez da IgG como marcador de doença aguda ou crônica, bem como sua associação com comprometimento do concepto. MATERIAL E MÉTODOS: estudo retrospectivo de análise dos casos de toxoplasmose aguda identificados em gestantes atendidas pelo serviço público de saúde (SUS), no Programa de Proteção à Gestante do Estado de Goiás (APAE/SES/SMS), no período de janeiro de 2004 a dezembro de 2007. O rastreamento de infecção aguda na gravidez foi realizado através da pesquisa de anticorpos IgM específicos em gota de sangue digital coletada em papel filtro, e em soro, bem como determinação da avidez da IgG nesta mesma amostra, todos pela técnica ELISA. O diagnóstico de infecção fetal e/ou neonatal foi realizado segundo protocolo utilizado no centro de referência do Programa de Controle Vertical da Toxoplasmose (HC/FM/IPTSP/UFG). A correlação entre as variáveis foi avaliada pelo teste do x2. Foi considerado estatisticamente significante valores de p < 0,05. RESULTADOS: foram realizados 235.993 exames no período de janeiro de 2004 a dezembro de 2007, no Estado de Goiás. A frequência de soropositividade para IgM no rastreamento foi de 0,7%. Somente 207 mulheres (12,5%) realizaram o teste no primeiro trimestre, sendo que 91% das gestantes apresentaram alta avidez (> 40%). A taxa de transmissão vertical foi de 62% no grupo de gestantes acompanhadas no HC/FM/UFG. Não houve relação estatisticamente significante entre baixa (≤ 25%) ou alta (> 40%) avidez com xii comprometimento do concepto (p=0,08 e p=0,57, respectivamente). Não houve associação significativa entre diagnóstico gestacional no primeiro trimestre com baixa avidez e transmissão vertical. CONCLUSÕES: a frequência de soropositividade na triagem pré-natal (provável toxoplasmose aguda) ficou abaixo da média nacional, mas a taxa de transmissão vertical permaneceu alta apesar do acompanhamento e do tratamento pré-natal. O teste de avidez da IgG teve pouco valor, em nosso meio, para datar a infecção adquirida, pois a maioria das gestantes iniciou o pré-natal após o primeiro trimestre; também não mostrou associação com transmissão vertical, não sendo oportuna sua realização sistemática ou utilização como segundo teste na triagem pré-natal em Goiás.Submitted by Erika Demachki (erikademachki@gmail.com) on 2014-11-03T20:17:54Z No. of bitstreams: 2 Dissertação - Fernanda Rassi Alvarenga - 2009.pdf: 1178426 bytes, checksum: 23c15006d0ef89ee6336d71ed66e974e (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5)Approved for entry into archive by Erika Demachki (erikademachki@gmail.com) on 2014-11-03T20:18:53Z (GMT) No. of bitstreams: 2 Dissertação - Fernanda Rassi Alvarenga - 2009.pdf: 1178426 bytes, checksum: 23c15006d0ef89ee6336d71ed66e974e (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5)Made available in DSpace on 2014-11-03T20:18:53Z (GMT). No. of bitstreams: 2 Dissertação - Fernanda Rassi Alvarenga - 2009.pdf: 1178426 bytes, checksum: 23c15006d0ef89ee6336d71ed66e974e (MD5) license_rdf: 23148 bytes, checksum: 9da0b6dfac957114c6a7714714b86306 (MD5) Previous issue date: 2009-06-26application/pdfhttp://repositorio.bc.ufg.br/tede/retrieve/11467/Disserta%c3%a7%c3%a3o%20-%20Fernanda%20Rassi%20Alvarenga%20-%202009.pdf.jpgporUniversidade Federal de GoiásPrograma de Pós-graduação em Medicina Tropical e Saúde Pública (IPTSP)UFGBrasilInstituto de Patologia Tropical e Saúde Pública - IPTSP (RG)http://creativecommons.org/licenses/by-nc-nd/4.0/info:eu-repo/semantics/openAccessToxoplasmoseTeste de avidez da IgGToxoplasmose congênitaToxoplasmosisIgG-avidity testCongenital toxoplasmosisCLINICA MEDICA::DOENCAS INFECCIOSAS E PARASITARIASValor do teste de avidez da IgG como marcador de doença aguda ou crônica e de transmissão vertical na toxoplasmoseThe value of specific IgG – avidity test to date infeccion and its relationship with vertical transmission in toxoplasmosisinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesis8197219506590464977600600600-77690114445645562881767748423488408711reponame:Biblioteca Digital de Teses e Dissertações da UFGinstname:Universidade Federal de Goiás (UFG)instacron:UFGLICENSElicense.txtlicense.txttext/plain; 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dc.title.por.fl_str_mv |
Valor do teste de avidez da IgG como marcador de doença aguda ou crônica e de transmissão vertical na toxoplasmose |
dc.title.alternative.eng.fl_str_mv |
The value of specific IgG – avidity test to date infeccion and its relationship with vertical transmission in toxoplasmosis |
title |
Valor do teste de avidez da IgG como marcador de doença aguda ou crônica e de transmissão vertical na toxoplasmose |
spellingShingle |
Valor do teste de avidez da IgG como marcador de doença aguda ou crônica e de transmissão vertical na toxoplasmose Alvarenga, Fernanda Rassi Toxoplasmose Teste de avidez da IgG Toxoplasmose congênita Toxoplasmosis IgG-avidity test Congenital toxoplasmosis CLINICA MEDICA::DOENCAS INFECCIOSAS E PARASITARIAS |
title_short |
Valor do teste de avidez da IgG como marcador de doença aguda ou crônica e de transmissão vertical na toxoplasmose |
title_full |
Valor do teste de avidez da IgG como marcador de doença aguda ou crônica e de transmissão vertical na toxoplasmose |
title_fullStr |
Valor do teste de avidez da IgG como marcador de doença aguda ou crônica e de transmissão vertical na toxoplasmose |
title_full_unstemmed |
Valor do teste de avidez da IgG como marcador de doença aguda ou crônica e de transmissão vertical na toxoplasmose |
title_sort |
Valor do teste de avidez da IgG como marcador de doença aguda ou crônica e de transmissão vertical na toxoplasmose |
author |
Alvarenga, Fernanda Rassi |
author_facet |
Alvarenga, Fernanda Rassi |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Avelino, Mariza Martins |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/7890944202988947 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/8535337313655113 |
dc.contributor.author.fl_str_mv |
Alvarenga, Fernanda Rassi |
contributor_str_mv |
Avelino, Mariza Martins |
dc.subject.por.fl_str_mv |
Toxoplasmose Teste de avidez da IgG Toxoplasmose congênita |
topic |
Toxoplasmose Teste de avidez da IgG Toxoplasmose congênita Toxoplasmosis IgG-avidity test Congenital toxoplasmosis CLINICA MEDICA::DOENCAS INFECCIOSAS E PARASITARIAS |
dc.subject.eng.fl_str_mv |
Toxoplasmosis IgG-avidity test Congenital toxoplasmosis |
dc.subject.cnpq.fl_str_mv |
CLINICA MEDICA::DOENCAS INFECCIOSAS E PARASITARIAS |
description |
Toxoplasmosis is a parasitic disease widespread around the world caused by Toxoplasma gondii. Infection acquired during pregnancy may cause intrauterine damage and sequelae in the newborn. Serological testing for IgG/IgM anti-Toxoplasma antibodies may fail to differentiate between recent and past infection. Despite that, rapid diagnosis of acute infection during pregnancy allows rapid treatment and prevents or attenuates congenital toxoplasmosis. PURPOSE: to establish the frequency of acute toxoplasmosis in pregnant women, the vertical transmission rate and the value of specific IgG-avidity test to date infection in pregnancy; to evaluate the relationship between IgG-avidity and congenital toxoplasmosis. MATERIAL AND METHODS: this report summarizes a retrospective study performed on 235,993 pregnant women attended by “The Pregnancy Protection Program” – public health system (SUS) of the State of Goiás – Brazil, from January 2004 to December 2007. ELISA (IgG / IgM) and IgG-avidity test were performed for maternal screening of toxoplasmosis. Fetal and newborn investigation of the infection was performed by “The Toxoplasmosis Vertical Transmission Control Program” protocols. The association between data was statistically analyzed by the x2 test (p < 0,05 was considered statistically significant). RESULTS: the frequency of IgM-positive among pregnant women studied population was 0,7%. Among IgM-positive women, only 207 (12,5%) performed the screening test in first 3-month period of pregnancy and 91% of pregnant women presented high avidity ( > 40%). The vertical transmission rate was 62%. There was no statistically significant relationship between higher (> 40%) or lower (≤ 25%) IgG-avidity test and presence of congenital infection (p= 0,08 e p= 0,57, respectively). There was no statistically significant association between maternal diagnosis in first trimester, low avidity and vertical transmission rate. CONCLUSIONS: the frequency of IgM-positive in pregnant women was lower than Brazilian rates founded in other studies. The study showed high persistent vertical transmission rate besides prenatal management and treatment. The IgG-avidity was not useful to predict vertical transmission. These results indicate that the IgG-avidity test must be not carried out in all IgM-positive pregnant women in the State of Goiás-Brazil, as a confirmatory test for the diagnosis of maternal toxoplasmosis. |
publishDate |
2009 |
dc.date.issued.fl_str_mv |
2009-06-26 |
dc.date.accessioned.fl_str_mv |
2014-11-03T20:18:53Z |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/masterThesis |
format |
masterThesis |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
ALVARENGA, Fernanda Rassi. Valor do teste de avidez da IgG como marcador de doença aguda ou crônica e de transmissão vertical na toxoplasmose. 2009. 131 f. Dissertação (Mestrado em Medicina Tropical e Saúde Pública) - Universidade Federal de Goiás, Goiânia, 2009. |
dc.identifier.uri.fl_str_mv |
http://repositorio.bc.ufg.br/tede/handle/tede/3517 |
identifier_str_mv |
ALVARENGA, Fernanda Rassi. Valor do teste de avidez da IgG como marcador de doença aguda ou crônica e de transmissão vertical na toxoplasmose. 2009. 131 f. Dissertação (Mestrado em Medicina Tropical e Saúde Pública) - Universidade Federal de Goiás, Goiânia, 2009. |
url |
http://repositorio.bc.ufg.br/tede/handle/tede/3517 |
dc.language.iso.fl_str_mv |
por |
language |
por |
dc.relation.program.fl_str_mv |
8197219506590464977 |
dc.relation.confidence.fl_str_mv |
600 600 600 |
dc.relation.department.fl_str_mv |
-7769011444564556288 |
dc.relation.cnpq.fl_str_mv |
1767748423488408711 |
dc.rights.driver.fl_str_mv |
http://creativecommons.org/licenses/by-nc-nd/4.0/ info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
http://creativecommons.org/licenses/by-nc-nd/4.0/ |
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UFG |
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Brasil |
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Universidade Federal de Goiás |
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Biblioteca Digital de Teses e Dissertações da UFG |
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Biblioteca Digital de Teses e Dissertações da UFG |
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