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Incidence of symptomatic toxoplasma eye disease: aetiology and public health implications

Published online by Cambridge University Press:  01 October 1999

R. E. GILBERT
Affiliation:
Department of Epidemiology and Public Health, Institute of Child Health, University College London Medical School, 30 Guilford Street, London WC1N 1EH, UK
D. T. DUNN
Affiliation:
Department of Epidemiology and Public Health, Institute of Child Health, University College London Medical School, 30 Guilford Street, London WC1N 1EH, UK
S. LIGHTMAN
Affiliation:
Department of Clinical Ophthalmology, Institute of Ophthalmology, Moorfield's Eye Hospital, City Road, London EC1 2PD, UK
P. I. MURRAY
Affiliation:
Academic Unit of Ophthalmology, The University of Birmingham, Birmingham and Midland Eye Centre, City Road NHS Trust, Dudley Road, Birmingham B18 7QU, UK
C. E. PAVESIO
Affiliation:
Department of Clinical Ophthalmology, Institute of Ophthalmology, Moorfield's Eye Hospital, City Road, London EC1 2PD, UK
P. D. GORMLEY
Affiliation:
Department of Clinical Ophthalmology, Institute of Ophthalmology, Moorfield's Eye Hospital, City Road, London EC1 2PD, UK
J. MASTERS
Affiliation:
Department of Epidemiology and Public Health, Institute of Child Health, University College London Medical School, 30 Guilford Street, London WC1N 1EH, UK
S. P. PARKER
Affiliation:
Department of Epidemiology and Public Health, Institute of Child Health, University College London Medical School, 30 Guilford Street, London WC1N 1EH, UK
M. R. STANFORD
Affiliation:
Medical Eye Unit, St Thomas' Hospital, London SE1 7EH, UK
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Abstract

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Ocular disease is the commonest disabling consequence of toxoplasma infection. Incidence and lifetime risk of ocular symptoms were determined by ascertaining affected patients in a population-based, active reporting study involving ophthalmologists serving a population of 7·4 million. Eighty-seven symptomatic episodes were attributed to toxoplasma infection. Bilateral visual acuity of 6/12 or less was found in seven episodes (8%) and was likely to have been transient in most cases. Black people born in West Africa had a 100-fold higher incidence of symptoms than white people born in Britain. Only two patients reported symptoms before 10 years of age. The estimated lifetime risk of symptoms in British born individuals (52% of all episodes) was 18/100000 (95% confidence interval: 10·8–25·2). The low risk and mild symptoms in an unscreened British population indicate limited potential benefits of prenatal or postnatal screening. The late age at presentation suggests a mixed aetiology of postnatally acquired and congenital infection for which primary prevention may be appropriate, particularly among West Africans.

Type
Research Article
Copyright
© 1999 Cambridge University Press