Journal of Tropical Medicine

Review Article

Systematic Review and Meta-Analysis of Congenital Toxoplasmosis Diagnosis: Advances and Challenges

Table 3

Diagnosis methods in blood samples.


Time of sample^† collection				Target		Assay employed for diagnosis^‡
Gestational weeks			At or after birth	Antibodies against T. gondii	Parasite and/or DNA	Immunoassay	PCR	Bioassay	Others	Ref.
1 to 13	14 to 26	27 to 41						Mouse inoculation

M-PB			M-PB, N-CB, N-PB (follow-up during the first year of life)	IgM, IgG	—	ISAGA for IgM; SFDT for IgG	—	—	—	[46]
	—		N-CB	—	Yes	—	529-bp and B1 genes (qPCR)	—	—	[68]
M-PB	M-PB, P-CB		M-PB, N-CB, N-PB (follow-up during the 1st year of life)	IgM, IgG, IgA	Yes	[dnr] (M-PB); ISAGA and IMX toxo for IgM (P-CB, N-CB, N-PB); IFAT AND FEIA for IgG (N-CB, N-PB); ICT for IgA (P-CB, N-CB, N-PB); laser immunonephelometry for total IgG, IgM, and IgA (N-PB)	—	Swiss Webster female mice (P-CB and N-CB)	Laser immunonephelometry for C4 complement and orosomucoid (N-PB)	[64]
M-PB			M-PB, N-CB, N-PB (follow-up during the first year of life)	IgM, IgG, IgA, IgG avidity	Yes	IFAT, MEIA, and ISAGA for IgM (M-PB, N-PB); DA, MEIA, and IFAT for IgG (M-PB, N-PB); (dnr) for IgA (N-PB)	B1 gene (N-CB)	(dnr) (N-CB)	—	[67]
	—		N-CB, N-PB	IgM, IgA	—	ISAGA for IgM and ELISA for IgA	—	—	—	[66]
	—		M-PB, N-CB, N-PB (follow-up during the first year of life)	IgM, IgG	—	ISAGA, ELISA, and IFAT for IgM; WB for IgG and IgM	—	—	—	[62]
	—		M-PB	IgM, IgG, IgA, IgG avidity	—	ELISA for IgM, IgG, and IgA; WB for IgM, IgG, IgA, and IgG avidity	—	—	—	[69]
	—		M-PB, N-CB, N-PB (follow-up during the first year of life)	IgM, IgG	—	WB for IgM and IgG (M-PB, N-CB, N-PB); ISAGA for IgM and IgA (N-PB); immunoenzymatic method (VIDAS toxo IgGII, VIDAS toxo IgG, IgG enzygnost toxoplasmosis) for IgG (N-PB)	—	—	—	[42]
M-PB				IgM, IgG, IgA, IgG avidity	—	Architect for IgM; architect and VIDAS for IgG; platelia for IgA; architect and VIDAS for IgG avidity	—	—	—	[54]
M-PB			N-PB	IgG1, IgG2, IgG3, IgG4	—	ELISA	—	—	—	[32]
	—		N-CB, N-PB (follow-up during the first year of life)		Yes	—	529-bp and B1 genes (qPCR)	—	—	[18]
	P-CB		—	IgM, IgG, IgA	—	ISAGA for IgM; ELISA for IgG and IgA	—	—		[14]
M-PB			N-CB	IgM, IgG avidity	Yes	Plateria for IgM (N-CB); enzygnost for IgG avidity (M-PB)	B1, cdk, BSR4, and SAG5E genes (nested-PCR)	—	—	[15]
M-PB			—	IgM, IgG, IgG avidity	—	ELISA for IgM and IgG; platelia for IgG avidity	—	—	—	[57]
M-PB			N-CB	IgM, IgG	—	Enzygnost for IgG avidity (M-PB); plateria for IgM (N-CB)	—	—	—	[19]
M-PB			—	IgM, IgG	—	ECLIA (elecsys), WB, IFAT, and platelia for IgG; ECLIA (elecsys), platelia and ISAGA for IgM	—	—	—	[40]
M-PB			N-PB	IgM, IgG, IgG avidity	—	MEIA for IgG; ELFA, VIDAS for IgM; VIDAS and ELFA for IgG avidity	—	—	—	[29]
M-PB			N-PB	IgM, IgG, IgG avidity	—	FEIA for IgM (M-PB); ELISA for IgG and IgG avidity (M-PB, N-PB)	—	—	—	[34]
M-PB			—	IgM, IgG, IgA, IgE, IgG avidity	—	ELISA for IgM; SFDT, AC/HS for IgG; ELISA for IgA; ELISA and ISAGA for IgE; VIDAS for IgG avidity	—	—	—	[25]
M-PB			N-PB (follow-up during the first year of life)	IgM, IgG, IgG avidity	—	VIDAS, ELISA, WB for IgM (M-PB); VIDAS, enzygnost, and WB for IgG (M-PB); VIDAS for IgG avidity (M-PB); ISAGA and WB for IgM (N-PB); enzygnost and WB for IgG (N-PB)	—	—	—	[63]
M-PB			—	IgM, IgG, IgA, IgG avidity	—	VIDAS for IgM, IgG, and IgG avidity; platelia for IgA; recombinant protein enzyme immunoassay (GRA3, GRA7, MIC3, and SAG1) for IgG avidity	—	—	—	[26]
M-PB			M-PB, N-PB (follow-up during two year of life)	IgM, IgG, IgG avidity	—	Access, VIDAS and IFA for IgG; access, IFA and ISAGA for IgM; VIDAS for IgG avidity	—	—	—	[27]
M-PB			—	IgM, IgG, IgG avidity	—	MEIA, EIA, ISAGA, and architect for IgM; MEIA, EIA, IFI, SFDT, and architect for IgG; VIDAS and architect for IgG avidity	—	—	—	[35]
M-PB			—	IgM, IgG	—	ISAGA and vitros for IgM; SFDT and vitros for IgG	—	—	—	[36]
M-PB			—	IgM, IgG, IgA, IgG avidity	—	IF, platelia, and ISAGA for IgM; IF and platelia for IgG; platelia for IgA; platelia for IgG avidity	—	—	—	[30]
M-PB			—	IgG	—	ELISA and IFA for IgG; WB with sera against tachyzoites proteins	—	—	—	[43]
M-PB			—	IgM, IgG	Yes	ELISA for IgG and IgM	TGR1E gene, RFLP at SAG2 locus	—	—	[16]
M-PB			—	IgG	—	ELISA, SAG2-LFIA, ROP2-LFIA, and SAG2 + ROP2-LFIA	—	—	—	[44]
M-PB			—	IgM, IgG, IgA, IgG avidity	—	ELISA, IF, ISAGA, and rMEP-ELISA for IgM; ELISA, IF, and rMEP-ELISA for IgG; ISAGA for IgA; VIDAS for IgG avidity	—	—	—	[47]
M-PB			—	IgM, IgG	—	EIA (platelia-toxo IgM®) for IgM; EIA (platelia-toxo IgG®), FAT (toxospot IF®), and WB (LDBIO-toxo II IgG®) for IgG	—	—	—	[48]
M-PB			N-PB	IgM, IgG, IgG avidity	—	VIDAS, architect, liaison, IFAT, ISAGA for IgM, VIDAS, architect, liaison, IFAT, and SFDT for IgG; VIDAS, architect, and liaison IgG avidity	—	—	—	[49]
M-PB			—	IgM, IgG, IgG avidity	—	CML for IgM; IFI, CML, and ELISA-rROP2 for IgG; CML for IgG avidity	—	—	—	[53]
M-PB			—	IgM, IgG, IgG avidity	—	ELFA, IFAT for IgM; ELFA, and IFAT for IgG; ELISA for IgG avidity	—	—	—	[55]
M-PB			—	IgM, IgG	—	Architect, platelia, and VIDAS for IgM; architect, platelia, VIDAS, liaison toxo IgG II®, elecsys toxo IgG® TGS TA toxo IgG®, and WB (LDBIO-toxo II IgG®) for IgG	—	—	—	[58]
M-PB			—	IgM, IgG, IgA, IgG avidity	Yes	ELISA for IgM, IgG, IgA, and IgG avidity	B1 gene (nested PCR); P30 gene (PCR-ELISA)	—	—	[21]
M-PB			—	IgM, IgG	—	EIA (platelia-toxo IgM®) for IgM; EIA (platelia-toxo IgG®), FAT (ToxoSpot IF®), WB (LDBIO-toxo II IgG western blot®), and homemade WB with soluble tachyzoite antigens for IgG	—	—	—	[50]
M-PB			—	IgM, IgG, IgA, IgE IgG avidity	—	ELISA for IgM; SFDT and AC/HS for IgG; ELISA for IgA; ELISA and ISAGA for IgE; EIA for IgG avidity	—	—	—	[24]
M-PB			N-PB	IgM, IgG, IgG avidity	—	ISAGA for IgM; SFDT for IgG	—	—	—	[13]
M-PB			—	IgM, IgG, IgG avidity	Yes	Latex agglutination test (latex-toxo kit ELISA) for IgM; ELISA for IgG; ELISA for IgG avidity	529-bp	—	—	[52]
M-PB			—	IgM, IgG, IgG avidity	—	ELISA for IgM; IFAT and ELISA with rP35a or rP22a proteins for IgG; ELISA (VIDAS) and ELISA with rP35a or rP22a proteins for IgG avidity	—	—	—	[56]
M-PB			—	IgM, IgG, IgG avidity	—	ELISA for IgM; IFAT and ELISA with P22Ag protein for IgG; ELISA (VIDAS) and IA with LPC-P22Ag protein for IgG avidity	—	—	—	[60]
M-PB			—	IgM, IgG, IgG avidity	—	IF and ELISA for IgM; IF and ELISA for IgG, EIA for IgG avidity	—	—	—	[59]
M-PB			—	IgM, IgG, IgG avidity	—	ELISA (platelia) for IgM; ELISA (platelia) for IgG; platelia for IgG avidity	—	—	—	[51]
M-PB			—	IgM, IgG	—	ISAGA and ECLIA for IgM; SFDT and ECLIA for IgG	—	—	—	[38]
M-PB			—	IgM, IgG, IgG avidity	—	VIDAS, IF, ISAGA, and euroimmun ELISA for IgM; VIDAS, IF, euroimmun ELISA and ELISA with GRA6 protein for IgG for IgG; euroimmun ELISA and ELISA with GRA6 protein for IgG avidity	—	—	—	[39]
M-PB			—	IgM, IgG, IgA, IgG avidity	—	ELISA for IgM; SFDT and AC/HS for IgG; ELISA for IgA; VIDAS for IgG avidity	—	—	—	[61]
M-PB			—	IgM, IgG	—	VIDAS, IF, ISAGA, euroimmun ELISA, and ELISA with rGRA6 for IgM; VIDAS, IF, euroimmun ELISA, and ELISA with rGRA6 for IgG	—	—	—	[33]
M-PB			—	IgM, IgG	Yes	ELISA for IgM and IgG	B1 gene	—	—	[45]
M-PB			—	IgM, IgG, IgG avidity	Yes	VIDAS for IgM, IgG, and IgG avidity	B1 gene (nested PCR)	—	—	[31]
M-PB			—	IgM, IgG	Yes	ELISA for IgM and IgG	B1 gene (nested PCR)	—	—	[28]
M-PB			—		Yes	—	B1 gene	—	—	[65]
M-PB			N-PB (follow-up during two years of life)	IgM, IgG, IgG avidity	—	IF for IgM and IgG (M-PB); VIDAS for IgG avidity (M-PB); [dnr] for IgM and IgG (N-PB)	—	—	Blood count and liver enzymes (N-PB)	[22]
M-PB			M-PB, N-PB	IgM, IgG, IgG avidity	—	ELISA and WB for IgM (M-PB, N-PB); ISAGA for IgM (N-PB); ELISA and WB for IgG (M-PB, N-PB); ELISA for IgG avidity (M-PB)	—	—	—	[23]
M-PB			N-CB, N-PB (follow-up during two years of life)	IgM, IgG, IgA, IgG avidity	—	ELISA for IgM (M-PB); ELISA for IgG avidity (M-PB); [dnr] for IgM and IgG (N-CB); MEIA, ELFA and IFAT for IgM (N-PB), MEIA for IgG (N-PB); ELISA for IgA (N-PB)	—	—	—	[37]
M-PB			—	IgM, IgG, IgG avidity	—	ELISA for IgM and IgG; ELISA euroimmun for IgG avidity	—	—	—	[41]
M-PB			N-PB (follow-up during two years of life)	IgM, IgG, IgA, IgG avidity	—	VIDAS, vidia, AxSYM, architect, cobas, enzygnost, advia centaur, platelia, liaison, ISAGA, ICT, and IFAT for IgM (M-PB); VIDAS, vidia, AxSYM, architect, cobas, enzygnost, advia centaur, platelia, liaison, IFAT, toxo-screen, WB (LDBio toxo II IgG), HSDA, IA, and SFDT for IgG (M-PB); ISAGA, ICT, and platelia for IgA (M-PB); VIDAS, platelia, and architect for IgG avidity (M-PB); EIA, ISAGA, ICT, WB, and ELIFA for IgM and IgA (N-PB); EIA, ISAGA, and ICT for IgA (N-PB)	—	—	—	[17]

^†M-PB: maternal peripherical blood; N-CB: neonatal cord blood; P-CB: prenatal cord blood; N-PB: neonatal peripherical blood. ^‡AC/HS: differential agglutination (of acetone [AC]-fixed versus that of formalin [HS]-fixed tachyzoites); CIP-ELIFA: comparative immunological profile (CIP) method with revelation by enzyme-linked immunofiltration assay (ELIFA); CML: chemiluminescence; DA: direct agglutination assay; DNA: deoxyribonucleic acid; dnr: details not reported; ECLIA: electrochemiluminescence immunoassay; EIA: enzyme immunoassay; ELFA: enzyme-linked fluorescent assay; ELIFA: enzyme-linked immunofiltration assay; ELISA: enzyme-linked immunosorbent assay; FAT: fluorescent antibody test; FEIA: fluorometric enzyme immunoassay; GGT: gamma glutamyl transpeptidase; HSDA: high-sensitivity direct agglutination; IA: immunoagglutination; ICT: immunocapture method using a suspension of tachyzoites prepared in the laboratory; IF: immunofluorescence test; IFAT: indirect-fluorescent antibody test; IMX: Abbott IMx automated benchtop immunochemistry analyzer system (MEIA + fluorescence polarization immunoassay (FPIA)); ISAGA: immunosorbent agglutination assay; LDH: lactate dehydrogenase; LFIA: lateral flow immunoassay; LPC: latex-protein complexes; MEIA: microparticle enzyme immunoassay; PCR: polymerase chain reaction; q-PCR: quantitative polymerase chain reaction; rMEP: recombinant multi-epitope fusion peptide; SFDT: Sabin–Feldman dye test; VIDAS: immunodiagnostic assay system; WB: western blot; y-GT: y glutamyltranspeptidase.