A cross sectional study of leptospirosis and fetal death in Yucatan, Mexico / Estudio transversal de leptospirosis y muerte fetal en Yucatán, México

Introduction: Leptospirosis is a zoonotic disease affecting mainly to low income human population. Acute leptospiral infection during pregnancy has been associated with spontaneous abortion and fetal death during the first trimester and the abortion may occur as consequence of systemic failure. Objective: To estimate the frequency of Leptospira interrogans infection in women with spontaneous abortion in the state of Yucatan, Mexico. Methods: A cross sectional study on women with spontaneous abortion was conducted. Serum samples were tested for Leptospirosis by the microaglutination test, to estimate the frequency of the infecting serovar. The indirect ELISA IgM was used to detect recent infection by L. interrogans. DNA was extracted from paraffin-embedded tissue of placenta for PCR detection of L. interrogans. Results: Overall frequency of infection with L. interrogans in the 81 women with abortion was 13.6%. Five of the 12 serovars evaluated were found and included. Two of the 11 women with abortion and positive to microaglutination test were also positive to the ELISA IgM test. None samples were positive for PCR Leptospira diagnosis. Conclusion: two women could be associated with spontaneous abortion due to leptospirosis, because they showed antibodies against L. interrogans in the microaglutination test and ELISA IgM assays. Differences between regions were found with respect to the prevalences of lesptospirosis.

Introducción: Leptospirosis es una enfermedad zoonótica que afecta principalmente la población humana de bajos recursos. Infección aguda por leptospirosis durante el embarazo se ha asociado con aborto espontáneo y muerte fetal durante el primer trimestre del embarazo. Objetivo: Estimar la frecuencia de infección por Leptospira interrogans en mujeres con aborto espontáneo en el estado de Yucatán, México. Métodos: Se efectuó un estudio trasversal en 81 mujeres con aborto espontáneo. La prueba de referencia para Leptospirosis, prueba de microaglutinación, se utilizó para estimar la frecuencia de la serovar infectante. El ELISA IgM indirecto se utilizó para detectar infección reciente por L. interrogans. Se extrajo ADN a partir de tejido embebido en parafina de placenta para la detección de L. interrogans por PCR. Resultados: La frecuencia global de la infección con L. interrogans en 81 mujeres con aborto, fue del 13.6%. Se encontró cinco de 12 serovares de Leptospira. Dos de las 11 mujeres con aborto espontáneo y positivo a microaglutinación también fueron positivas a la prueba ELISA IgM. Ninguna muestra fue positiva hacia el diagnóstico PCR de Leptospira. Conclusion: Dos mujeres podrían estar asociados con el aborto espontáneo debido a la leptospirosis, porque mostraron anticuerpos contra L. interrogans en la microaglutinación y ensayos de ELISA IgM. Diferencias entre regiones fueron encontradas con respecto a las prevalencias de leptospirosis.

Infeccoes de transmissao vertical em material abortivo e sangue com enfase em Toxoplasmose gondii / Vertical transmission from abortive material and blood with emphasis on Toxoplasma gondii

OBJETIVO: Analisar os resultados sorológicos, anatomopatológicos e parasitológicos de material abortivo para infecções com risco de transmissão vertical, com ênfase na toxoplasmose. MÉTODOS: Foi realizado um estudo coorte-transversal tratando da prevalência das doenças infectoparasitárias. Participaram da pesquisa 105 mulheres que sofreram aborto espontâneo completo e/ou incompleto; elas foram entrevistadas por meio de um questionário, e foram coletadas amostras de sangue e material abortivo. Foram realizados testes imunológicos para toxoplasmose, doença de Chagas, rubéola, citomegalovírus e sífilis e análise anatomopatológica nos restos ovulares. RESULTADOS: 55% das mulheres tinham entre 20 e 30 anos de idade. A maioria (68%) apresentou idade gestacional entre a 7ª e a 14ª semanas. 54,3% das mulheres tinham o ensino médio completo ou incompleto. Pela análise da sorologia, a infecção com risco de transmissão vertical mais frequente foi o citomegalovírus (CMV) com 97,1% de positividade, e em seguida a rubéola, com 95,2%. A toxoplasmose teve um percentual de 54,3%, a doença de Chagas, de 1,9% e a sífilis, de 0,95%. A análise dos laudos de biópsia demonstrou que 63,1% apresentaram inflamação e 34%, ausência de inflamação. Das análises sorológica, anatomopatológica e parasitológica das 105 mulheres, 57 foram soropositivas para T. gondii, e nenhuma teve resultado positivo para a Reação em Cadeia da Polimerase (PCR) e para inoculação em camundongos. CONCLUSÕES: A prevalência de doenças com risco de transmissão congênita nas mulheres com abortamento espontâneo é importante, sendo necessárias pesquisas visando esclarecer a etiologia do aborto. .

PURPOSE: To analyze the serological, anatomopathological and parasitological results obtained from abortive material in order to detect infections with the risk of vertical transmission, with emphasis on toxoplasmosis. METHODS: A cross-sectional cohort study was conducted in order to determine the prevalence of infectoparasitic diseases. A total of 105 women who suffered spontaneous complete or incomplete abortion participated in the study. The women were interviewed, answered a questionnaire and had their blood and abortive material collected. Immunological tests were carried out in order to detect toxoplasmosis, Chagas disease, rubeola, cytomegalovirus and syphilis, and anatomopathological analysis of the ovular remains was performed. RESULTS: 55% of the women studied were 20 to 30 years old. Most of them (68%) presented a gestational age between the 7th and 14th week. 54.3% of the women had complete or incomplete high school education. Serological analysis showed cytomegalovirus (CMV) as the most common vertically transmitted infection with 97.1% positivity, followed by rubeola with 95.2%. Toxoplasmosis showed 54.3% positivity, Chagas disease 1.9% and syphilis 0.95%. Anatomopathological analysis showed inflammation in 63.1% of the cases and absence of inflammation in 34%. The results of the serological, anatomopathological and parasitological analysis of the 105 participants showed that 57 women were T. gondii positive. However, none showed positivity in the polymerase chain reaction (PCR) or in mouse inoculation. CONCLUSIONS: The prevalence of diseases with the risk of vertical transmission is important in women with spontaneous abortion, indicating the need for more research in order to investigate the etiology of abortion. .

Seroprevalencia contra agentes ToRCH en mujeres indígenas en edad fértil, estado Zulia, Venezuela / Prevalence of infectious agents in indigenous women of childbearing age in Venezuela

Introducción. El termino ToRCH comprende a los patógenos Toxoplasma gondii, virus de la rubéola, citomegalovirus y virus herpes simple 1 y 2. En mujeres embarazadas expuestas pueden ser causa de abortos y malformaciones congénitas en el neonato. Objetivo. Determinar la seroprevalencia de infección por los agentes causantes del síndrome ToRCH en mujeres en edad fértil de algunas comunidades indígenas yukpa de Venezuela. Materiales y métodos. En el año 2007 fueron seleccionadas 109 muestras de 151 mujeres, en edades comprendidas entre 14 y 40 años. La detección de anticuerpos se hizo por el método de inmunoensayo enzimático indirecto o ELISA de Smartest Diagnostics™. Resultados. El 85,5 % presentó anticuerpos contra T. gondii, el 95,4 % para rubéola, el 75,2 % para citomegalovirus y el 97,2 % para el virus herpes simple 1 y 2. Se observa que el 21,1 % y el 30,2 % presentaron relación entre la variable aborto y las infecciones por citomegalovirus y virus herpes simple 1 y 2, respectivamente. Conclusiones. Existe alta seroprevalencia de infecciones por los agentes causantes del síndrome ToRCH en mujeres en edad fértil de la etnia indígena yukpa. Las condiciones sanitarias precarias y el consumo de agua contaminada con ooquistes, favorecen la adquisición de la infección por T. gondii. El hacinamiento, el inicio a temprana de edad de la actividad sexual y el número de parejas, pueden incidir en la presencia de citomegalovirus y virus herpes simple 1 y 2.

Introduction. The ToRCH syndrome includes the following infectious pathogens: Toxoplasma gondii, rubella, cytomegalovirus and herpes simplex virus 1 and 2. In susceptible pregnant women, these pathogens can cause abortions and congenital malformation in the newborn babies. Objective. The seroprevalence of infection by ToRCH agents was determined in women of childbearing age in several Venezuelan Yukpa indigenous communities. Material and methods. In 2007, 109 samples were selected from 151 women with an age range of 14 to 40 years old. The determination of antibodies against ToRCH agents was carried out through the indirect enzyme immunoassay technique by ELISA´s technique of Smartest Diagnostics. Results. Of the 109 samples, 85.5% presented antibodies against T. gondii, 95.4% for rubella, 75.2% for cytomegalovirus and 97.2% for and herpes simplex virus 1 and 2. A relationship between abortion and infection by cytomegalovirus and herpes simplex virus 1and 2 was noted in 21.1% and 30.2% of women presented, respectively. Conclusions. The findings show a high prevalence of ToRCH agents in women in childbearing age in Yukpa indigenous communities in Venezuela. Poor sanitary conditions and consumption of water contaminated with oocysts may be an important way of transmission of T. gondii. Overcrowding in the communities, sexual activity at an early age and number of partners and may be related to the presence of cytomegalovirus and herpes simplex virus HSV-1 and 2.

Sheep abortion associated with Neospora caninum in Mato Grosso do Sul, Brazil / Abortos por Neospora caninum em ovinos em Mato Grosso do Sul

Canids are the main hosts of Neospora caninum, but cattle, (sheep, goats and horses may serve as intermediary hosts. N. caninum infection of pregnant intermediary hosts may provoke abortion and neonatal infections. This study is the first to report lamb abortion associated with N. caninum in Mato Grosso do Sul. Epidemiological data were obtained from interviews with sheep producers. For microscopic examination, fragments of different organs removed from 4 sheep fetuses, aborted and necropsied, were fixed in 10% formaldehyde, embedded in paraffin and subjected to the hematoxylin-eosin staining protocol and immunohistochemistry (IHC) to test for N. caninum and Toxoplasma gondii. The abortion outbreak studied was reported from a herd of 268 Santa Inês sheep (including 186 pregnant ewes), with 10 abortion cases in the last third of gestation. Four fetuses were examined, 3 from a same ewe. At necropsy, one fetus exhibited crackling in the lung and all its organs were reddish. Histological findings detected mononuclear cell infiltrates among myocardium fibers and around blood vessels, in addition to circular structures with basophilic points resembling protozoans. IHC tests revealed strongly positive staining for N. caninum and weakly positive for T. gondii, characterizing N. caninum infection.

Neospora caninum é um protozoário que tem o cão como hospedeiro defiinitivo e, bovinos, ovinos, caprinos e equinos como hospedeiros intermediários. Nestas últimas espécies pode provocar abortos e infecções neonatais. Este trabalho é o primeiro relato de aborto em ovinos associado com N. caninum no Mato Grosso do Sul. Os dados epidemiológicos foram obtidos através de entrevistas com o proprietário dos animais. Quatro fetos foram necropsiados, dos quais foram colhidos fragmentos de diversos órgãos fiixados em formol a 10%, incluídos em parafiina, processados pela técnica usual de hematoxilina e eosina e também foi realizada imuno-histoquímica para N. caninum e Toxoplasma gondii. O surto ocorreu em um rebanho constituído por 268 ovinos da raça Santa Inês, destes 186 eram fêmeas prenhes, no terço fiinal de gestação e 10 abortaram. Dos quatro fetos analisados, três eram da mesma fêmea, sendo um de menor tamanho. À necropsia o pulmão de um dos fetos estava crepitante e todos os órgãos estavam avermelhados. Os achados histológicos foi infiiltrado mononuclear entre as fiibras do miocárdio e ao redor dos vasos, além de estruturas circulares compostas por pontilhados basofiílicos semelhantes a protozoários. A IHQ revelou marcação fortemente positiva para N. caninum e fracamente positiva para T. gondii, caracterizando infecção por N. caninum.

Genotyping of toxoplasma gondii strains in pregnant women with toxoplasmosis in Gezira state, central Sudan

To perform genotyping of Toxoplasma gondii among pregnant women with toxoplasmosis in Central Sudan. The study group was presented by 94 pregnant women who had abortion between the second and fourth months of gestation, whereas the control group consisted of 64 full term normally delivered women. The study was conducted at Wad Medani Teaching hospital, Gezira State, Central Sudan during the period of March 2002 to May 2004. PCR test on aborted and placental tissue revealed positivity rate of 19.1% and 22.3%, in study and control groups respectively, with no significant difference between them [P=0.55]. This compared to a seroprevalence rate of 35.1% and 39.4% in study and control groups respectively. Genotyping form clinical samples using PCR/RELP revealed Toxoplasma gondii type II in 89% and 95% of the study and control group respectively, whereas, 11% and 5% were infected with type III. The most prevalent strain of T. gondii among the pregnant women was Type II followed by type III but type I was completely absent

Immunostaining method to explore cellular immunity against toxoplasma gondii in Iraqi women with a history of abortion

To explore cellular immunity against Toxoplasma gondii in Iraqi women with a history of abortion using the immunostaining method. Sixty women who had abortion were selected for this study. The presence of anti-Toxoplasma antibodies in their sera was confirmed via ELISA testing. Heparinized blood and serum were collected. The women were divided into three groups according to the presence of specific anti-Toxoplasma antibodies in their serum. These groups included: women with IgG [18], women with IgM [14] and women with both IgG and IgM [12]. The other 16 women had no antibodies against Toxoplasma. Twenty-four healthy-looking women had been selected as controls. Those that revealed any antibody titer against Toxoplasma were excluded from the study. The isolated peripheral blood leukocytes [PBL] were tested for cell surface markers [CD3, CD4, CD8 and CD71] using monoclonal antibodies against T-cell subsets. All the surface makers revealed significantly higher percentages when compared to the healthy controls. The results indicate a strong cellular immune response during toxoplasmosis

Toxoplasmosis: the innocent suspect of pregnancy wastage in Duhok, Iraq

To identify the true contribution of toxoplasmosis to fetal loss and bad obstetric history, we tested 310 women, 77.4% of whom had had single or multiple fetal loss, for evidence of infection. The study was conducted in Duhok, northern Iraq, from July 2002 till September 2003. All the women were examined for the presence of toxoplasma-specific IgM antibodies by enzyme-linked immunofluorescent assay; only 3 [0.97%] tested positive. We also tested 187 of the women by latex agglutination test; 55 tested positive. Histopathological examination was done for 9 pregnant women who tested positive by the latex agglutination test but we found no evidence of toxoplasma infection. The results indicate that the contribution of toxoplasmosis to fetal loss in our region is greatly overestimated

Toxoplasmosis y aborto en evolución / Toxoplasmosis and abortion in evolution

Para conocer la prevalencia de toxoplasmosis en población abierta de Comitán Chiapas, se realizó estudio serológico por inmunofluorescncia indirecta en voluntarios sanos. Además se identifico la presencia de anticuerpos anti Toxoplasma gondii en 50 mujeres con aborto en evolución. Los resultados mostraron que alrededor de 5 por ciento de la población general tiene títulos positivos de anticuerpos anti Toxoplasma gondii, y el 18 por ciento en el caso de las mujeres con aborto en volución. Se concluyó que la seropositividad para esta parasitosis estadísticamente es signficativa en los casos de aborto que entre la población general (P<0.006) y también, es significativamente mayor a las mujeres con aborto, que con respecto a la mujeres de la población general de Comitán Chiapas (P<0.01)

Descripción de un caso de aborto bovino asociado a infección por Neospora sp en México / Description of a case of bovine abortion associated to Neospora sp infection in México

En el siguiente informe se describe un caso de aborto bovino asociado a neosporosis en México. El feto fue remitido para su estudio al Departamento de Patología de la Facultad de Medicina Veterinaria y Zootecnia de la Universidad Nacional Autónoma de México. El feto fue expulsado al quinto mes de gestación, siendo macho y de raza Holstein. En el estudio microscópico se encontró encefalitis no supurativa con múltiples focos de necrosis y gliosis, además de un quiste parasitario oval de pared gruesa de 21 x 22 mm. Varias secciones de tejido nervioso desparafinadas se examinaron para estudio inmunohistoquímico, utilizando anticuerpos anti Neospora caninum encontrándose grupos de taquizoitos extracelulares asociados a las áreas de gliosis. También se encontró miocarditis y hepatitis no supurativa discreta. Se cree que este es el primer caso descrito en México de aborto bovino asociado a lesiones características y a la presencia de estructuras parasitarias correspondientes a Neospora sp. Sin embargo, es necesario realizar más estudios anatomopatológicos e inmunológicos para poder determinar la prevalencia y la significancia de aborto bovino asociado a neosporosis en México