Screening pregnant women to diagnose and promptly treat saves sight and cognition

Monthly screening with a novel point of care test that meets WHO criteria for a perfect test presents a new method to block transmission and illness in babies because it enables prompt effective treatment.

McLeod R, Cohen W, Dovgin S, Finkelstein L, Boyer K Human Toxoplasmosis, Chapter 4 In Weiss L and Kim K (Editors) Toxoplasma gondii:The Model Apicomplexan. Elsevier publisher. In Press.Link expected to be available June 2020

There are now data and consensus that the sooner a pregnant woman is treated to protect her baby from congenital toxoplasmosis, the better the outcome. This approach we defined together for a small number of U.S. children, found on a much larger scale in France and Austria, now has been adopted as the best approach for the diagnosis, treatment and prevention of congenital toxoplasmosis. This prompt treatment in pregnancy results in babies being born without any signs of disease and may prevent fetal infection. We have begun an initiative to implement this approach widely in many countries, including the United States. We developed educational materials to complement those we have made available in text books and the medical literature. We have proven these educational materials are effective learning tools. We are updating our website to make these new materials freely and readily available at toxoplasmosis.org for everyone in the new year.

We, with families who have a child with congenital toxoplasmosis and others, have now demonstrated that the use of an inexpensive ($4-6) point of care test to diagnose infection acquired by women during pregnancy enabling prompt treatment is feasible in many settings. We have been working with our French colleagues and the Food and Drug Administration to design and carry out the work needed for its approval for use in the United States, and colleagues have been working with this in other countries. It will be important for prevention of this infection. It will bring women to pre-natal care which they might not otherwise receive, thus providing “spillover” benefits. It will result in substantial savings for health care. We also have published an important analysis that shows that there can be good outcomes when hydrocephalus due to toxoplasmosis s treated promptly surgically along with medicines. We have discovered with our Seattle, French and Colombian colleagues that we can find serum biomarkers of active infection in children and very recently (in preparation) recent infections in pregnant women, which should lead to improvements in care.