The effectiveness of congenital toxoplasmosis treatment in minimizing hearing loss: A systematic review

Abstract

Objective: Congenital toxoplasmosis is a condition caused by Toxoplasma gondii infection during pregnancy that can lead to serious consequences, including sensorineural hearing loss. This systematic review aimed to evaluate the efficacy of pharmacological treatment of congenital toxoplasmosis in mitigating hearing loss sequelae in children. Methods: The review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and was registered in Prospero under the number CRD42024581716. Defined according to the PICO strategy (P: population/patients; I: intervention/exposure; C: comparison/control; O: outcome), a search was conducted on 29 August 2024, in the following databases: Embase, Lilacs, PubMed, SciELO, Scopus, and Web of Science. Results: Of the 396 studies initially identified, 10 met the inclusion criteria, and 2 additional studies were included through manual search, totaling 12 articles for the review. The selected articles lacked standardization regarding therapeutic protocols, with most studies being from Brazil, where the regimen of sulfadiazine, pyrimethamine, and folinic acid for 1 year is recommended. Moreover, despite region-specific therapeutic schemes, a considerable portion of cases still exhibited auditory sequelae, suggesting a potential inefficacy of the implemented protocols. Conclusions: There are a small number of studies on the treatment of toxoplasmosis, and its effects on avoiding hearing outcomes are understudied. Locally, there is a need to establish good outcomes and targets to intervene. Strategies to improve adherence to long-term treatment, adjusts to the therapeutic protocol, alongside the promotion of research on the efficacy of treatments for specific outcomes of toxoplasmosis are necessary, especially in places where more virulent strains can be responsible for more aggressive infections and worse prognosis.