PMID- 17362565
OWN - NLM
STAT- MEDLINE
DCOM- 20070522
LR  - 20220129
IS  - 0969-1413 (Print)
IS  - 0969-1413 (Linking)
VI  - 14
IP  - 1
DP  - 2007
TI  - Screening for congenital toxoplasmosis: accuracy of immunoglobulin M and 
      immunoglobulin A tests after birth.
PG  - 8-13
AB  - OBJECTIVES: To determine the accuracy of postnatal screening for 
      toxoplasma-specific immunoglobulin (Ig) M and IgA. SETTING: Ten centres in three 
      European countries. METHODS: We compared results of the first postnatal IgM or 
      IgA test in infants with infected mothers identified by prenatal screening with 
      the reference standard for congenital infection status of specific IgG status at 
      one year of age. RESULTS: In all, 170 infected and 822 uninfected infants were 
      analysed. Overall, IgM or IgA testing detected only 52-55% of infected infants. 
      Sensitivity was highest between one and two weeks after birth and declined 
      thereafter. Specificity was highest from four weeks after birth. For IgM, but not 
      IgA, sensitivity was statistically significantly lower if the mother 
      seroconverted in the first and second trimesters of pregnancy (29% and 34%, 
      respectively) than the third (71%). Prenatal treatment with 
      pyrimethamine-sulphonamide did not significantly reduce IgM or IgA sensitivity. 
      Sensitivity was lowest for the immunofluorescence (IF) IgM test (10%) and the 
      enzyme-linked immunosorbent assay (ELISA) IgM test (29%), but similar for the 
      immunosorbent agglutination assay (ISAGA) IgM (54%), ISAGA IgA (58%) and ELISA 
      IgA (52%) tests. Specificity was significantly lower for the ISAGA IgA test (91%) 
      than for the ISAGA IgM (96%), IF IgM (100%), and ELISA IgA tests (98%). 
      CONCLUSIONS: Poor performance of IgM and IgA tests in the newborn, particularly 
      if the mother seroconverted in early pregnancy, casts doubt on the value of 
      neonatal screening in industrialized countries where the risk of clinical 
      manifestations during childhood is low. More accurate diagnostic tests are needed 
      for newborns identified by prenatal screening.
FAU - Gilbert, Ruth E
AU  - Gilbert RE
AD  - Centre for Paediatric Epidemiology and Biostatistics, Institute of Child Health, 
      London, UK. r.gilbert@ich.ucl.ac.uk
FAU - Thalib, Lukman
AU  - Thalib L
FAU - Tan, Hooi Kuan
AU  - Tan HK
FAU - Paul, Margaret
AU  - Paul M
FAU - Wallon, Martine
AU  - Wallon M
FAU - Petersen, Eskild
AU  - Petersen E
CN  - European Multicentre Study on Congenital Toxoplasmosis
LA  - eng
GR  - G0400546/MRC_/Medical Research Council/United Kingdom
GR  - R03 EY015287-01/EY/NEI NIH HHS/United States
PT  - Evaluation Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PL  - England
TA  - J Med Screen
JT  - Journal of medical screening
JID - 9433359
RN  - 0 (Immunoglobulin A)
RN  - 0 (Immunoglobulin M)
SB  - IM
MH  - Algorithms
MH  - Female
MH  - Humans
MH  - Immunoglobulin A/*analysis
MH  - Immunoglobulin M/*analysis
MH  - Infant, Newborn
MH  - Neonatal Screening/*standards
MH  - Pregnancy
MH  - Pregnancy Complications, Parasitic/diagnosis
MH  - Prenatal Diagnosis/standards
MH  - Sensitivity and Specificity
MH  - Serologic Tests/standards
MH  - Time Factors
MH  - Toxoplasmosis, Congenital/*diagnosis/immunology
EDAT- 2007/03/17 09:00
MHDA- 2007/05/23 09:00
CRDT- 2007/03/17 09:00
PHST- 2007/03/17 09:00 [pubmed]
PHST- 2007/05/23 09:00 [medline]
PHST- 2007/03/17 09:00 [entrez]
AID - 10.1258/096914107780154440 [doi]
PST - ppublish
SO  - J Med Screen. 2007;14(1):8-13. doi: 10.1258/096914107780154440.