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Therapy for Common Parasitic Diseases in Pregnancy in the United States: A Review and a Survey of Obstetrician/Gynecologists Level of Knowledge About These Diseases

Jones, Jeffrey L. MD, MPH*; Schulkin, Jay PhD†; Maguire, James H. MD‡

Obstetrical & Gynecological Survey: June 2005 - Volume 60 - Issue 6 - pp 386-393
CME Program: CATEGORY 1 CME REVIEW ARTICLES 15, 16, AND 17: CME REVIEW ARTICLE 16

A number of food- and waterborne parasitic diseases that are common in the United States can adversely impact women during pregnancy. Therapeutic considerations during pregnancy for these diseases are reviewed. Also, the level of knowledge of obstetrician–gynecologists about diagnosis and treatment of these diseases (toxoplasmosis, cryptosporidiosis, giardiasis, amebiasis, cyclosporiasis, trichinellosis, ascariasis, and taeniasis) was estimated by means of a questionnaire developed by the Centers for Disease Control and Prevention (CDC) and the American College of Obstetricians and Gynecologists (ACOG). Of the 1200 obstetrician–gynecologists surveyed, 521 (43%) responded. In general, respondents gave correct answers to questions about toxoplasmosis, but for other illnesses responses, it varied. For example, most (61.4%) respondents gave incorrect answers about treatment of cryptosporidiosis in pregnancy, and many (41.2%) respondents incorrectly identified metronidazole as the safest treatment for giardiasis in the first trimester of pregnancy. Although knowledge among obstetrician–gynecologists about toxoplasmosis is good, there is a wide variation in knowledge about other common food- and waterborne parasitic diseases that are likely to be encountered in the United States. Therapeutic considerations for these diseases during pregnancy are discussed.

Target Audience: Obstetricians & Gynecologists, Family Physicians

Learning Objectives: After completion of this article, the reader should be able to list the various common protozoal diseases, to outline the clinical manifestations as well as route of spread for each of the protozoal diseases, and to outline potential therapies for each of the protozoal diseases.

*Chief, Diagnostics and Epidemiology Team, Parasitic Diseases Branch, Division of Parasitic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia; †Director of Research, American College of Obstetricians and Gynecologist, Washington, DC; and ‡Chief, Parasitic Diseases Branch, Division of Parasitic Diseases, National for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia

Chief Editor’s Note: This article is the 16th of 36 that will be published in 2005 for which a total of up to 36 Catgory 1 CME credits can be earned. Instructions for how credits can be earned appear on the last page of the Table of Contents. This CME activity is supported by an unrestricted educational grant from Procter & Gamble.

The authors have disclosed that they have no financial relationships with or interests in any commercial companies pertaining to this educational activity.

This article includes discussion of off-label usages of FDA-approved drugs or of drugs that have not been approved by the FDA. For approved drugs, please consult product labeling for the approved usage.

Wolters Kluwer Health has identified and resolved all faculty conflicts of interest regarding this educational activity.

Reprint requests to: Jeffrey L. Jones, MD, MPH, Division of Parasitic Diseases, NCID, Centers for Disease Control and Prevention, Mailstop F-22, 4770 Buford Highway NE, Atlanta, GA 30341-3724. E-mail: jlj1@cdc.gov.

© 2005 Lippincott Williams & Wilkins, Inc.