Costa et al. BMC Public Health 2012, 12:73 http://www.biomedcentral.com/1471-2458/12/73 R E S E A R C H A R T I C L E Open Access Preventive behavior for toxoplasmosis in pregnant adolescents in the state of Ceara, Brazil Fabianne Ferreira Costa1*, Ana Paula Soares Gondim1, Mary Braga de Lima1, Jose Ueleres Braga2, Luiza Jane Eyre de Souza Vieira1 and Maria Alix Leite Araújo1 Abstract Background: When toxoplasmosis is acquired during pregnancy, it can be transmitted to the fetus causing severe lesions in the first two gestational trimesters. This study analyzed the main factors associated with the preventive behavior for toxoplasmosis among pregnant adolescents in the city of Fortaleza in northeast Brazil. Methods: It is a cross-sectional study conducted from March 2009 to November 2010, with a sample of 320 pregnant adolescents, ages ranging from 12 to 19 years old, receiving prenatal care in the Public Health Care System. Bivariate and multivariate logistic regression model analyses were used to identify the association between preventive behavior for toxoplasmosis, and the independent variables and 95% confidence interval. Results: We observed that 16.3% of the pregnant adolescents showed preventive behavior for toxoplasmosis. The factors positively associated to the preventive behavior for toxoplasmosis were: age group between 12 and 14 years old (OR = 2.75; 95%CI 1.23-6.12) and more than two prenatal consultations (OR = 2.19; 95%CI 1.17-4.09). Conclusions: Noteworthy is the importance of a serologic follow-up for pregnant adolescents with clearer and more precise information about risk factors and the importance of adopting preventive behaviors. Thus, it is necessary to establish educational measures for handling food and raising kittens during prenatal care. Background When toxoplasmosis is acquired during pregnancy, it can be transmitted to the fetus causing more severe lesions in the first two gestational trimesters [1,2]. Clini- cal diagnosis of toxoplasmosis is difficult, considering that circa 90 to 95% of the infected pregnant women do not show any symptoms [3]. Although it results in side effects, the disease has been little studied in terms of its magnitude and importance. In some countries such as Brazil, toxoplasmosis is not a notifiable disease. In Brazil, according to the technical Manual of the Qualified and Humanized Care for the Prenatal and Puerperal Periods [4], toxoplasmosis screening is recom- mended in the first prenatal consultation, whenever pos- sible, through the detection of antibodies classified as IgG and IgM. IgG higher than 1:2048 implies the pre- sence of active infection and it should be followed by IgM testing in paired serology. Stable and low IgG * Correspondence: fabianneicapui@bol.com.br 1Master of Collective Health, University of Fortaleza, Av. Washington Soares, 1321, Bairro Edson Queiroz, CEP 60.811-905 Fortaleza, Ceará, Brasil Full list of author information is available at the end of the article antibodies (1:2 to 1:500) can represent previous or per- sistent infection [5]. The treatment is instituted, for free, in the public health system [4,5]. However, it should be emphasized that even if the service does not provide the test, the health professional is not exempted from pro- viding information about what the disease is, its trans- mission and preventive care. The main objective of the prenatal and puerperal care is to counsel the woman from the beginning of pregnancy, ensuring, in the end the birth of a healthy child as well as guaranteeing neo- natal and maternal well-being [6]. The detection of specific IgM antibodies has been the most used marker for the serologic diagnosis of recent toxoplasmosis. However, the persistence of specific IgM antibodies in some patients and the use of tests with a low specificity have made the interpretation of the sero- logic results difficult when there is suspicion of toxo- plasmosis [7] and may lead to errors in the diagnosis interpretation. The IgM test is considered an unaccepta- ble false positive predictor to evaluate, during preg- nancy, the diagnosis of the acute infection of toxoplasmosis [8], while the IgG serologic test © 2012 Costa et all; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.