Seroprevalence of toxoplasmosis among females in rural areas, Qalubeya governorate, Egypt

Toxoplasma gondii is an obligate intracellular protozoan parasite of significant public health importance, being a major cause of congenital infection and abortion as well as a significant and often fatal infection in the immuno-compromised hosts. Infection by T gondii is usually asymptomatic, but it can be life threatening in fetuses whose mothers are acutely infected during pregnancy. 10 determine the seroprevalence of Toxoplasma antibodies and the frequency of assumed associated complications among females in childbearing period in the rural community surrounding Benha Faculty of Medicine, Benha University, Qalubeya Governorate, Egypt. A total of 338 females were randomly selected from two villages scheduled in the routine Community Service Campaign Program [CSCP] of Benha Faculty of Medicine and from those attending Gynecology and Obstetrics Department, Benha University Hospital. Sera were screened for Toxoplasma IgG and IgM using enzyme immunoassay. One hundred and fifty females in the child bearing period aged from 15 to 49 years who fulfilled detailed history data, were chosen for assessment of the assumed associated risk of Toxoplasma complications, regarding unfavorable outcome of pregnancy. Of 338 sampled females, 165 [46.2%] and 17[5%] were seropositive for anti-Toxoplasma IgG and IgM, respectively, while out of 150 females in the childbearing period, corresponding results were 87 [58%] and 7 [4.7%], respectively. In the latter group, there was an observable difference in the age prevalence with peaks among 25-29 and 40-49 age groups for IgG positive females and among 25-29 and 45-49 years for IgM positive females, but this difference was statistically insignificant. There was a significant positive correlation between IgG positivity amid number of labors and also between IgM positivity amid history of congenital anomalies. The risk of abortion, congenital anomalies and stillbirth were insignificantly higher among IgG positive females. In IgM positive group, only an insignificant increased risk of congenital anomalies was observed. The IgG seroprevalence of T gondii among females in the childbearing age is relatively high [58%] indicating persistent favoring ecological circunistances. IgM seroprevalence [4.7%] suggested a potential considerable risk of primary infection during pregnancy with the subsequent risk of Toxoplasma congenital infection. Hence, it is worth considering routine antenatal screening of females as a mandatory measure, with follow up of seronegative case for possible seroconversion due to infection during pregnancy amid prompt treatment for sero-converted cases

Pathological changes in mice vaccinated with swap, challenged and treated with praziquantel

Not only SWAP vaccinated mice and challenged with Schistosoma mansoni cercaria [100 +/- 20 / mouse] showed a significantly decrease in worm burden of perfused vaccinated mice compared with control non vaccinated infected mice, but also minimized the size and number of granuloma in different tissues [intestine, spleen and liver] compared with infected control. Praziquantel therapy showed a significant decrease in egg granuloma size and number in the intestine but the liver showed less significant decrease in egg granuloma size and number. This observation may aggravate hepatic fibrosis, especially if some worms are still viable and shift to the liver due to partial drug resistance and/or incomplete therapy. These data may guide and recommend follow up and repeat therapeutic dose to surely kill and prevent worms from shift to the liver. There is a synergism between drug therapy and vaccination, which showed marked decrease in egg granuloma size and number in the liver, while the intestine was nearly cured. Finally SWAP vaccinated mice showed a partial protection due to acquired immunity but the mice are still susceptible to infection with Schistosoma

Resistance to reinfection with schistosomes in children specific IgE and IgA titres before and 3 months after praziquantel treatment

The characterized feature of humoral immune response to schistosomal infection is the production of specific antibodies. This study was performed in rural areas of Qualupia governorate, on large number of students [10-14 years]. They were subjected to complete history, clinical examination, urine and stool analysis for detection of schistosmal cases. Venous blood samples were collected from 72 schistosomal cases [32 males and 40 females] and from 20 non-schistosomal cases [control group]. Specific IgE, specific IgA, IgG assays by ELISA technique and eosinophilic count, were performed before and 3 months after praziquantel treatment for schistosomal cases of low and high resistance to reinfection. Reinfection susceptibility is invariable among males and females. Sera of the resistant cases showed a significant higher titers of anti-soluble egg antigen [anti-SEA] and anti-soluble worm antigen preparation [anti-SWAP] of both IgE and IgA than that among reinfected [low resistant] cases before and 3 months after praziquantel treatment IgE titers are not correlated with IgG titers among both groups. Anti-SEA IgA and IgE and anti-SWAP IgA and IgE were correlated positively with each other among schistosmal cases either resistant or reinfected, while anti-SEA and anti-SWAP IgA antibody levels of schistosomal cases with eosinophilia were significantly higher than that with normal eosinophilic counts. No correlation between intensity of infection [egg count] and IgE titers but, Anti-SEA IgA antibody titers of schistosomal cases were correlated negatively, before treatment, with intensity of infection but anti-SWAP IgA titers were not, which might indicate that anti-SEA Ag antibodies inhibit schistosomes for egg laying and subsequently pathological complications due to granuloma formation. In conclusion high levels of specific IgE and IgA against different Schistosomal antigens [SEA and SWAP] among high resistant cases and their positive correlation with each other and the negative correlation of IgA with intensity of infection demonstrate the role of IgE and IgA for host protection against schistosomal reinfection