Revista Brasileira de Saúde Materno Infantil
versión On-line ISSN 1806-9304
MARGONATO, Fabiana Burdini et al. Toxoplasmosis in pregnancy: diagnosis, treatment and the importance of clinical protocol. Rev. Bras. Saude Mater. Infant. [online]. 2007, vol.7, n.4, pp. 381-386. ISSN 1806-9304. http://dx.doi.org/10.1590/S1519-38292007000400005.
OBJECTIVES: to compare therapeutic and laboratory aspects of toxoplasmosis in pregnant women as well as its cost in a real situation and in a hypothetical situation employing a clinical protocol.METHODS: a time-series cohort study was carried out with pregnant women taking part between January and November 2004 in the prenatal program at the Primary Health Units in Londrina, Paraná, Brazil, whose prenatal routine laboratory tests included serology for acute toxoplasmosis. Data were obtained at the city's Department of Health and the University Hospital. Additional tests, treatment and corresponding expenses were compared with data from a hypothetical situation employing a clinical protocol. RESULTS: in the real situation, there was no definitive diagnosis for 75% of the pregnant women with reactive IgM for toxoplasmosis, and among those who underwent an additional test, the median time period between the two tests was 23 weeks; 28.5% of the women were treated without confirmation and a single confirmed case was not treated. Compared with the hypothetical situation, if an additional test had been carried out with the same blood sample it would have been possible to arrive at a definitive diagnosis of all cases. Lower expenditure on medicines would compensate for extra expenses related to additional tests. CONCLUSIONS: the results show the importance of an appropriate clinical protocol both for health protection and cost reduction.
Palabras clave : Toxoplasmosis; Treatment protocols; Prenatal diagnosis.