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在哥伦比亚亚美尼亚(金迪奥省)一家医院进行的用于先天性弓形虫病和新生儿筛查的蛋白质印迹分析的临床验证。

Clinical validation of a western blot assay for congenital toxoplasmosis and newborn screening in a hospital in Armenia (Quindio) Colombia.

作者信息

Gallego-Marín Carolina, Henao Ana Carolina, Gómez-Marín Jorge Enrique

机构信息

Grupo de Estudio en Parasitología Molecular (GEPAMOL), Centro de Investigaciones Biomédicas, Universidad del Quindio, Armenia (Q), Colombia.

出版信息

J Trop Pediatr. 2006 Apr;52(2):107-12. doi: 10.1093/tropej/fmi072. Epub 2005 Jul 13.

Abstract

Congenital Toxoplasma infection can only be discovered or prevented by the appropriate serological screening and subsequent treatment of the mother and her offspring. In Colombia, there is no obligatory Toxoplasma screening for pregnant women and both the reporting and follow-up of congenital toxoplasmosis cases is limited, thereby is a public health problem that have no been addressed by health authorities. The aim of this study was to investigate the occurrence of congenital toxoplasmosis in a public hospital from Armenia, Colombia. A total of 200 serum samples of cord blood were collected. We applied a western blot assay (ID Blot DPC Diagnostics, US) for Toxoplasma IgG, IgM and IgA antibodies that was validated in a cohort of children with confirmed presence or absence of congenital infection. The sensitivity of western blot assay was 91 per cent and the specificity was 100 per cent. In the cord blood samples, we found one infected child that died at day 4 of life and his infection was confirmed by PCR of the B1 specific Toxoplasma gene on brain biopsy. This results show a high prevalence (0.5 per cent, IC95 per cent 0.2-0.8) of Toxoplasma infection in Colombian newborns. Thus, we recommend additional studies to determine the cost-effectiveness of a newborn screening program for congenital toxoplasmosis in other settings in Colombia.

摘要

先天性弓形虫感染只能通过对母亲及其后代进行适当的血清学筛查和后续治疗来发现或预防。在哥伦比亚,没有对孕妇进行强制性的弓形虫筛查,先天性弓形虫病病例的报告和随访都很有限,因此这是一个卫生当局尚未解决的公共卫生问题。本研究的目的是调查哥伦比亚亚美尼亚一家公立医院先天性弓形虫病的发生情况。共收集了200份脐带血血清样本。我们应用了一种针对弓形虫IgG、IgM和IgA抗体的蛋白质印迹分析方法(美国ID Blot DPC诊断公司),该方法在一组确诊有无先天性感染的儿童队列中得到了验证。蛋白质印迹分析的敏感性为91%,特异性为100%。在脐带血样本中,我们发现一名感染儿童在出生后第4天死亡,通过对其脑活检组织进行B1特异性弓形虫基因的PCR检测证实了他的感染。这些结果显示哥伦比亚新生儿中弓形虫感染的患病率很高(0.5%,95%置信区间0.2 - 0.8)。因此,我们建议开展更多研究,以确定在哥伦比亚其他地区开展先天性弓形虫病新生儿筛查项目的成本效益。

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