Academic journal article Bulletin of the World Health Organization

Use of the Polymerase Chain Reaction in Diagnosing Congenital Toxoplasmosis

Academic journal article Bulletin of the World Health Organization

Use of the Polymerase Chain Reaction in Diagnosing Congenital Toxoplasmosis

Article excerpt

Congenital transmission of Toxoplasma gondii, a protozoan parasite that is distributed worldwide, can produce severe sequelae in liveborn infants, including a potentially fatal syndrome in which hydrocephalus, hepatosplenomegaly with jaundice, mental retardation, and chorioretinitis may occur. In addition, cases of toxoplasmosis among pregnant women, particularly those who are immunodeficient, can result in spontaneous abortion. An increase in the incidence of congenitally transmitted toxoplasmosis is to be expected in view of the spread of acquired immunodeficiency syndrome (AIDS).

Greater use is being made of the polymerase chain reaction (PCR) in the diagnosis of toxoplasmosis. If it is correctly performed, PCR is an extremely powerful diagnostic technique; however, its results require to be interpreted by specialists. Particularly in developed countries, there has been a tendency to promote PCR as means of resolving the many problems associated with the diagnosis of antenatal toxoplasmosis, including whether or not to voluntarily interrupt pregnancy. Allowing this trend to continue unchecked could have serious consequences. First, the value of PCR as a technique for diagnosing toxoplasmosis could be brought into question Second, and more importantly, there could be an increase in the number of pregnancies that are interrupted on nonmedical grounds, based solely on the diagnosis of toxoplasmosis by PCR, irrespective of whether the test was performed correctly. …

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