Gestational toxoplasmosis: evolution of treatment protocols and impact on the reduction of fetal sequelae.

Abstract

Gestational toxoplasmosis is a preventable public health concern due to vertical transmission and severe fetal sequelae, even with treatment. It was expected that a systematic literature review from 2021 to 2026 would be conducted to address the impact of treatment protocols on neonatal damage. According to our findings, spiramycin is the most important strategy to prevent transmission, but triple therapy (pyrimethamine, sulfadiazine, and folinic acid) should be followed in cases of confirmed fetal infection. We also found that effective detection and early initiation of treatment are not always associated with adverse impacts on clinical care, and even with good progress, it is not favorable for infants due to deficiencies in prenatal care at the pregnancy level. In Brazil, the late referral of 85.6% of pregnant women and the presence of atypical Toxoplasma gondii strains were considered barriers to treatment. However, while pharmacological control is rapidly improving, effective prevention of congenital toxoplasmosis depends not only on the stability and reliability of serological screening in Primary Care and health education systems, but also on timely notification.