Incidence of acute symptomatic toxoplasma retinochoroiditis in south London according to country of birth

BMJ 1995;310:1037-1040 (22 April)

Papers

Incidence of acute symptomatic toxoplasma retinochoroiditis in south London according to country of birth

R E Gilbert, Wellcome Trust fellow in clinical epidemiology,^a M R Stanford, senior clinical research fellow,^b H Jackson, registrar in ophthalmology,^c R E Holliman, Director,^d M D Sanders, consultant ophthalmologist ^b

^a Department of Epidemiology and Biostatistics, Institute of Child Health, London WC1N 1EH, ^b Medical Eye Unit, St Thomas's Hospital, London SE1 7EH, ^c Department of Ophthalmology, St George's Hospital, London SW17 0QT, ^d Public Health Laboratory Service Toxoplasma Reference Unit, St George's Hospital, London SW17 0QT

Correspondence to: Dr Gilbert.

Abstract

Objective: To determine the incidence of acute symptomatic toxoplasmaretinochoroiditis presenting to ophthalmologists for patientsborn in Britain and elsewhere.
Design: Population based, cross sectional study.
Setting: 11 districts in south Greater London.
Subjects: All patients presenting to NHS ophthalmologists withsymptoms due to acute toxoplasma retinochoroiditis in 1992-3.
Main outcome measure: Intraocular inflammation in associationwith a retinochoroidal scar, active adjoining retinitis, andIgG serum antibodies to toxoplasma.
Results: The estimated incidence of acute symptomatic retinochoroiditisfor all people born in Britain was 0.4/100 000/year and forblack people born in west Africa 57/100 000/year. If a meanof two symptomatic episodes per lifetime is assumed, 100 peopleborn in Britain may be affected each year, about a fifth ofthe estimated 500-600 congenitally infected people born eachyear.
Conclusions: A substantial proportion of people with acute symptomatictoxoplasma retinochoroiditis were born outside the country,and the number born in Britain was smaller than the number previouslyestimated to develop retinochoroidal lesions due to congenitaltoxoplasmosis. These findings suggest that prenatal screeningfor toxoplasmosis in Britain may be of limited benefit.

Key messages

Key messages
Prevention of toxoplasma retinochoroiditis is considered to be a major benefit of prenatal screening as previous studies have suggested that 80% of congenitally infected children would eventually develop retinochoroiditis
This report shows that the incidence of symptomatic toxoplasma retinochoroiditis is nearly 100 times higher in black people born in west Africa than in subjects born in Britain
In subjects born in Britain acute symptomatic toxoplasma retinochoroiditis is much less common than expected, affecting about one fifth of the estimated number of congenitally infected people
These findings suggest that the potential benefits of prenatal screening for toxoplasma infection in Britain are limited

Add to CiteULike CiteULike Add to Complore Complore Add to Connotea Connotea Add to Del.icio.us Del.icio.us Add to Digg Digg Add to Reddit Reddit Add to StumbleUpon StumbleUpon Add to Technorati Technorati What's this?

Relevant Article

Incidence of toxoplasma retinochoroiditis: D O Ho-Yen, A W L Joss, and L Dargie
BMJ 1995 311: 691-692. [Extract] [Full Text]

This article has been cited by other articles:

de-la-Torre, A, Rios-Cadavid, A C, Cardozo-Garcia, C M, Gomez-Marin, J E (2009). Frequency and factors associated with recurrences of ocular toxoplasmosis in a referral centre in Colombia. Br J Ophthalmol 93: 1001-1004 [Abstract] [Full text]
Wallon, M., Kodjikian, L., Binquet, C., Garweg, J., Fleury, J., Quantin, C., Peyron, F. (2004). Long-Term Ocular Prognosis in 327 Children With Congenital Toxoplasmosis. Pediatrics 113: 1567-1572 [Abstract] [Full text]
Jones, J. L., Kruszon-Moran, D., Wilson, M., McQuillan, G., Navin, T., McAuley, J. B. (2001). Toxoplasma gondii Infection in the United States: Seroprevalence and Risk Factors. Am J Epidemiol 154: 357-365 [Abstract] [Full text]
Whittle, R M, Wallace, G R, Whiston, R A, Dumonde, D C, Stanford, M R (1998). Human antiretinal antibodies in toxoplasma retinochoroiditis. Br J Ophthalmol 82: 1017-1021 [Abstract] [Full text]
Ho-Yen, D O, Joss, A W L, Dargie, L (1995). Incidence of toxoplasma retinochoroiditis. BMJ 311: 691c-692 [Full text]
Hay, J, Dutton, G N (1995). Toxoplasma and the eye. BMJ 310: 1021-1022 [Full text]