Department of Parasitology, Hôpital de la Croix-Rousse, Lyon, France.
Pediatr Infect Dis J. 2011 Jul;30(7):597-600. doi: 10.1097/INF.0b013e31820bb5f3.
Long-term evolution of congenital toxoplasmosis is not documented. We assessed the outcome of treated congenital toxoplasmosis in a cohort of adult individuals who had undergone ante- and postnatal treatment to provide information for pediatricians and parents on the evolution of the disease.
We conducted a questionnaire study on 126 adults with congenital toxoplasmosis (mean age: 22.2 years; age range: 18-31 years) monitored regularly until the time of inclusion. The main outcome measures were quality of life (Psychological General Well-Being Index) and visual function (VF14 questionnaire), and the outcomes were correlated with disease-specific factors.
Of the 102 patients (80.9%) who were finally included in the study, 12 (11.8%) presented neurologic effects and 60 (58.8%) manifested ocular lesions; in the latter category, 13 individuals (12.7%) had reduced visual function. The overall global quality-of-life score (74.7 ± 14.2) was close to the expected normal range for the general population (73.7 ± 15.3). Overall, visual function was only slightly impaired (M = 97.3; 95% confidence interval, 95.8-98.8). Although disease-independent critical life circumstances were associated with a reduced Psychological General Well-Being Index, this index was not influenced by any of the clinical characteristics of congenital toxoplasmosis. Neurologic pathologies, reduced visual acuity, foveal location of the retinal lesion, and squinting contributed to decreased visual function at follow-up.
Our data reveal that treated congenital toxoplasmosis has little effect on the quality of life and visual function of the affected individuals. These encouraging findings may help to alleviate the anxiety of affected individuals and their parents.
先天性弓形虫病的长期演变情况尚未记录。我们评估了接受过产前和产后治疗的一组成年个体的先天性弓形虫病的结果,为儿科医生和家长提供有关疾病演变的信息。
我们对 126 名先天性弓形虫病成人(平均年龄:22.2 岁;年龄范围:18-31 岁)进行了问卷调查研究,这些患者在纳入研究前均接受定期监测。主要观察指标为生活质量(一般心理幸福感指数)和视力功能(VF14 问卷),并将结果与疾病特异性因素相关联。
在最终纳入研究的 102 名患者中(80.9%),有 12 名(11.8%)出现神经系统影响,60 名(58.8%)出现眼部病变;在后一类中,有 13 名(12.7%)视力减退。总体全球生活质量评分(74.7±14.2)接近一般人群的预期正常范围(73.7±15.3)。总体而言,视力仅略有受损(M=97.3;95%置信区间,95.8-98.8)。尽管与疾病无关的关键生活情况与一般心理健康指数降低有关,但该指数不受先天性弓形虫病的任何临床特征影响。神经系统病变、视力下降、视网膜病变位于黄斑区和斜视均会导致随访时视力下降。
我们的数据显示,经治疗的先天性弓形虫病对受影响个体的生活质量和视力功能影响较小。这些令人鼓舞的发现可能有助于减轻受影响个体及其父母的焦虑。