Evaluation of Toxoplasma, Rubella, and Cytomegalovirus serological results in women of childbearing age

SUMMARY OBJECTIVE This study aimed to determine the rates of IgG and IgM antibodies against cytomegalovirus, rubella, and Toxoplasma gondii (all of which may cause congenital infections) in women of childbearing age who were admitted to Bolu Abant İzzet Baysal University Training and Research Hospital. METHODS Between January 2015 and December 2017, Toxoplasma gondii, rubella, and cytomegalovirus IgM and IgG antibody levels were studied using the ELISA method (Architect i2000SR, Abbott, Germany) in patients aged 15 to 45 who attended the obstetrics and gynecology outpatient clinics. Toxoplasma gondii and cytomegalovirus IgG avidity levels were analyzed retrospectively. RESULTS A total of 13.470 tests were conducted in the laboratory. Seropositivity percentages of IgM antibodies were found to be 1.3%, 0.5%, and 1.6% for Toxoplasma (n = 3607), rubella (n = 3931), and cytomegalovirus (n = 3795), respectively. The seropositivity percentages of IgG antibodies were 22%, 94.2%, and 98.2% for Toxoplasma (n = 702), rubella (n = 693), and cytomegalovirus (n = 679), respectively. Primary infection (acute, recently acquired) was found in 7 (35%) patients with low Toxoplasma IgG avidity. One (3%) patient with low cytomegalovirus IgG avidity had a primary infection. CONCLUSION Toxoplasma gondii seronegativity was found to be high in the region. Therefore, screening women of childbearing age may be important for the prevention of congenital infections caused by Toxoplasma gondii.

RESUMO OBJETIVO O objetivo deste estudo foi determinar as taxas de anticorpos IgG e IgM contra citomegalovírus, rubéola e Toxoplasma gondii (todos os quais podem causar infecções congênitas) em mulheres em idade fértil que foram admitidas no Hospital de Pesquisa e Treinamento da Universidade Bolu Abant İzzet Baysal. MÉTODOS Entre janeiro de 2015 e dezembro de 2017, os níveis de anticorpos IgG e IgM para Toxoplasma gondii, rubéola e citomegalovírus foram estudados usando o método Elisa (Architect i2000SR, Abbott, Alemanha) em pacientes de 15 a 45 anos que compareceram a ambulatórios de obstetrícia e ginecologia. Os níveis de avidez de IgG para Toxoplasma gondii e citomegalovírus foram analisados retrospectivamente. RESULTADOS Um total de 13.470 testes foram realizados em laboratório. As porcentagens de soropositividade dos anticorpos IgM foram de 1,3%, 0,5% e 1,6% para Toxoplasma (n=3.607), rubéola (n=3.931) e citomegalovírus (n=3.795), respectivamente. As porcentagens de soropositividade dos anticorpos IgG foram 22%, 94,2% e 98,2% para Toxoplasma (n=702), rubéola (n=693) e citomegalovírus (n=679), respectivamente. Infecção primária (aguda, adquirida recentemente) foi encontrada em sete (35%) pacientes com baixa avidez para Toxoplasma IgG. Um (3%) paciente com baixa avidez para citomegalovírus IgG teve uma infecção primária. CONCLUSÃO A soronegatividade do Toxoplasma gondii foi alta na região. Portanto, testar mulheres em idade fértil pode ser importante para a prevenção de infecções congênitas causadas pelo Toxoplasma gondii.

Prevalencia de anticuerpos anti-Toxoplasma gondii en embarazadas en siete hospitales de Buenos Aires: Comparación entre 2006 y 2017 / Prevalence of anti-Toxoplasma gondii antibodies in pregnant women in seven hospitals in Buenos Aires area. Comparison 2006 vs. 2017

Se analizó; de forma retrospectiva la presencia de anticuerpos só;©ricos IgG e IgM anti-Toxoplasma gondii en las embarazadas que concurrieron a siete hospitales del ó;rea Metropolitana de Buenos Aires durante 2006 y 2017. La prevalencia de infecció;n, medida como presencia de anticuerpos, en 2006 vs. 2017, fue: Hospital Alemán: 22 y 17% (p = 0.004), Hospital Fiorito: 44 y 33% (p < 0.001), Hospital Gandulfo: 30 y 34% (p 0.025), Hospital Grierson: 60 y 44% (p < 0.001), Hospital Rivadavia: 59 y 51% (p=0.003), Maternidad Sardá 47 y 39% (p < 0.001) y Hospital Thompson: 61 y 51% (p < 0.001). La comparació;n demostró; una disminució;n estadísticamente significativa de la seroprevalencia en seis hos pitales. Tambín disminuyeron significativamente la reactividad para IgM en 2017 respecto de 2006 y la seroprevalencia para T. gondii en el total de la població;n de embarazadas estudiadas, lo que significa un mayor nó;ºmero de mujeres susceptible de desarrollar infecció;n aguda durante el embarazo.

We analyzed the presence of IgG and IgM anti- Toxoplasma gondii, as a measure of infection, in pregnant women attending seven hospitals in the Metropolitan Area of Buenos Aires during 2006 and 2017. T. gondii seroprevalence in 2006 vs. 2017, was: Hospital Alemán: 22 and 17% (p = 0.004), Hospital Fiorito: 44 and 33% (p < 0.001), Hospital Gandulfo: 30 and 34% (p 0.025), Hospital Grierson 60 and 44% (p < 0.001), Hospital Rivadavia: 59 and 51% (p = 0.003), Hospital Sardá: 47 and 39% (p < 0. 001), and Hospital Thompson: 61 and 51% (p < 0.001). The comparison showed a significant decrease in seroprevalence in six hospitals. We also observed a significant decrease in the reactivity for IgM in 2017 compared to 2006 and in the seroprevalence for T. gondii in the overall population of pregnant women in the study. This means that a greater number of women are susceptible to develop acute infection during pregnancy.

Evaluation of a recombinant rhoptry protein 2 enzyme-linked immunoassay for the diagnosis of toxoplasmosis acquired during pregnancy

The aim of this study was to evaluate an enzyme-linked immunoassay with recombinant rhoptry protein 2 (ELISA-rROP2) for its ability to detectToxoplasma gondii ROP2-specific IgG in samples from pregnant women. The study included 236 samples that were divided into groups according to serological screening profiles for toxoplasmosis: unexposed (n = 65), probable acute infection (n = 48), possible acute infection (n = 58) and exposed to the parasite (n = 65). When an indirect immunofluorescence assay forT. gondii-specific IgG was considered as a reference test, the ELISA-rROP2 had a sensitivity of 61.8%, specificity of 62.8%, predictive positive value of 76.6% and predictive negative value of 45.4% (p = 0.0002). The ELISA-rROP2 reacted with 62.5% of the samples from pregnant women with probable acute infection and 40% of the samples from pregnant women with previous exposure (p = 0.0180). Seropositivity was observed in 50/57 (87.7%) pregnant women with possible infection. The results underscored that T. gondii rROP2 is recognised by specific IgG antibodies in both the acute and chronic phases of toxoplasmosis acquired during pregnancy. However, the sensitivity of the ELISA-rROP2 was higher in the pregnant women with probable and possible acute infections and IgM reactivity.

Prevalência de toxoplasmose em gestantes atendidas em dois centros de referência em uma cidade do Nordeste, Brasil / Prevalence of toxoplasmosis in pregnant women in two reference centers in a city in Northeast Brazil

OBJETIVO: Determinar a prevalência de toxoplasmose e identificar os principais fatores associados à sororeatividade em gestantes atendidas em dois centros de referência em uma cidade do Nordeste do Brasil. MÉTODOS: Foi realizado um estudo transversal com 561 gestantes atendidas em dois centros de referência para pré-natal de alto risco em uma cidade do Nordeste do Brasil. Todas foram entrevistadas por meio de um questionário epidemiológico e foram coletadas amostras de sangue em que foram realizadas sorologia anti-Toxoplasma gondii para IgG e IgM (ELISA), teste de avidez da IgG e reação em cadeia da polimerase (PCR). A análise estatística foi realizada com o programa SPSS version 18.0 Windows, usando odds ratio e intervalo de confiança de 95%, considerando-se o nível de significância de 5%. RESULTADOS: Constatou-se sororeatividade para toxoplasmose em 437 (77,0%), susceptibilidade em 124 (22,1%) e 5 (0,9%) gestantes com infecção ativa. Não encontramos associação significativa entre sororeatividade para toxoplasmose e idade, procedência, renda, escolaridade, situação da rede de esgotos, número de gestações e idade gestacional. As variáveis com associação significativa (p≤0,05) para sororeatividade foram: multigestas (p=0,03) e convívio com cães soltos na rua (p=0,001). CONCLUSÕES: O estudo permitiu identificar uma alta sororeatividade para toxoplasmose entre as pacientes atendidas no pré-natal, assim como os fatores associados à sororeatividade, devendo ser reforçadas orientações apropriadas sobre medidas de prevenção primária e monitoramento sorológico trimestral das gestantes nesse município e outras regiões do Nordeste do Brasil. .

PURPOSE: To determine the prevalence of toxoplasmosis and to identify the main factors associated with seroreactivity in pregnant women cared for at two reference centers in a city in Northeast Brazil. METHODS: A cross-sectional study was conducted on 561 pregnant women at two high-risk prenatal reference centers in a city in Northeast Brazil. All women were interviewed using an epidemiological questionnaire and had their blood samples collected for the following serological tests: anti-Toxoplasma gondii IgG and IgM (ELISA), IgG avidity test, and polymerase chain reaction (PCR). Statistical analysis was carried out using SPSS version 18.0 for Windows, calculating odds ratio, confidence interval of 95% and with the level of significance set at 5%. RESULTS: Seroreactivity for toxoplasmosis was detected in 437 women (77.0%), susceptibility in 124 (22.1%) and active infection in 5 (0.9%). There was no significant association between seroreactivity for toxoplasmosis and age, location, income, education, availability of sewage, number of pregnancies or gestational age. The variables significantly associated (p≤0.05) with seroreactivity were multiparity (p=0.03) and living with stray dogs (p=0.01). CONCLUSIONS: This study identified high seroreactivity for toxoplasmosis among patients seen during prenatal care, as well as factors associated with seroreactivity. Appropriate guidelines about primary preventive measures should be emphasized and quarterly serological monitoring is recommended for pregnant women in this city and elsewhere in the Northeast of Brazil. .

Seroprevalence of Toxoplasma gondii Among Primary School Children in Shandong Province, China

Although Toxoplasma gondii infection in primary school children has been investigated in many countries, limited surveys have been available in primary school children in China. In the present study, we report the seroprevalence of T. gondii infection in primary school children in Shandong province, China. Sera from 6,000 primary school children were evaluated for T. gondii antibodies with ELISA. The overall seroprevalence of T. gondii infection was 16.0% (961/6,000), of which 14.5% (870/6,000) were positive for anti-T. gondii IgG antibodies, 3.4% (206/6,000) positive for IgM, and 1.9% (115/6,000) were positive for both IgG and IgM. The results of the present investigation indicated a high seroprevalence of T. gondii infection in primary school children in Shandong province, China. Therefore, effective measures should be taken to prevent and control T. gondii infection in primary school children in this province. To the best of our knowledge, this is the first report of T. gondii seroprevalence in primary school children in Shandong province, China.

Direct genotyping of toxoplasma gondii in blood samples from pregnant women in Jazan, Saudi Arabia

Toxoplasma gondii [T. gondii] is divided three main clonal lineages designated as type I, II, and III and atypical genotypes were also detected. The distribution of T. gondii genotypes varied from one geographic area to another. This study characterized of T. gondii isolates from pregnant women in Jazan. Genetic analysis of the GRA6-coding fragment was performed for T. gondii genotyping using PCR-RFLP method. The seropositive for Toxoplasma-specific antibodies were determined using ELISA and were 27.9% in pregnant women in Saudi Arabia. Women seropositive for Toxoplasma IgG andIgM [GI=30] and for specific IgG [GII=30] were included. Among pregnant women, 83.3% of GI [women seropositive for IgG and IgM] and 90% of GII [women seropositive for IgG] were asymptomatic and observed clinical symptoms were fever [n=4] and cachexia [n=2] and lymphadenopathy [n=1]. GRA6-nested PCR was positive in 8 blood samples [13.3%], 5 of GI and 3 of GII seropositive women. RFLP analysis showed the detection of genotype I in 8 samples with no cases coinciding to pattern of type II or type III

Análise espacial da prevalência de toxoplasmose em gestantes de Aracaju, Sergipe, Brasil / Spatial distribution of anti-toxoplasma antibodies in pregnant women from Aracaju, Sergipe, Brazil

OBJETIVO: Analisar a distribuição espacial da prevalência de anticorpos antitoxoplasma em gestantes residentes em uma cidade do Nordeste do Brasil, e correlacionar a prevalência de anticorpos antitoxoplasma com a faixa etária materna e o local de residência. MÉTODOS: Estudo ecológico, descritivo e analítico, desenvolvido no período de 01 janeiro a 31 de dezembro de 2012. As informações foram obtidas retrospectivamente de um banco de dados, e processadas com o pacote estatístico Epi info (Epi 7, Centers for Disease Control and Prevention, Atlanta, EUA) e também em planilha do pacote Microsoft Office Excel, versão 2010. Para avaliar a associação entre a prevalência de anticorpos para a toxoplasmose e a faixa etária, foi aplicado o teste do X2. A análise espacial da prevalência dessa infecção foi realizada com o programa TerraView, versão 4.2.2, utilizando o estimador de intensidade Kernel, que permite estimar a quantidade de eventos em mapa para identificar áreas de maior concentração de casos no município. RESULTADOS: A soroprevalência encontrada para IgG foi de 68,5% (IC95% 67,2-69,8) e IgM de 0,36% (IC95% 0,23-0,6). Foi encontrado incremento da prevalência de IgG associado ao aumento da idade nos bairros mais antigos da capital. Entre as mulheres mais jovens, a maior prevalência foi nos bairros de periferia. Quanto ao anticorpo IgM, a concentração espacial foi mais elevada em bairros da periferia e não ocorreu associação significativa entre a soroprevalência e a idade. CONCLUSÃO: O geoprocessamento permitiu identificar as áreas de maior prevalência, assim como a faixa etária com maior suscetibilidade, servindo como instrumento de avaliação e implementação de medidas preventivas apropriadas para esse município ...

PURPOSE: To analyze the spatial distribution of the prevalence of anti-toxoplasma gondii antibodies in pregnant women from a Brazilian Northeast city, and to correlate such prevalence with average maternal age and place of residence. METHODS: A descriptive, analytical and ecological study was conducted from January 1st to December 31st 2012. Data were obtained retrospectively from the Medical Specialties Center database and processed with the Epi info statistical package (Epi 7, Centers for Disease Control and Prevention, Atlanta, USA) and with Microsoft Excel 2010. The X2 test was applied to assess the association between the prevalence of antibodies to toxoplasma gondii and the average age. Spatial analysis of infection prevalence was performed using the TerraView software, version 4.2.2, with Kernel density estimation, which estimates the quantity of events through maps in order to identify areas with the highest concentration of cases in the city. RESULTS: The seroprevalence of IgG was 68.5% (95%CI 67.2-69.8) and the prevalence of IgM was 0.36% (95%CI 0.23-0.6). A higher IgG prevalence was associated with increased age in the oldest neighborhoods of the state capital, whereas a higher IgG prevalence among younger women was detected in suburban neighborhoods. The spatial concentration of IgM antibodies was higher in suburban neighborhoods, with no significant correlation between seroprevalence and age. CONCLUSION: Geoprocessing allowed the identification of areas with the highest prevalence, as well as the most susceptible average age and it was also useful as an instrument for the evaluation and implementation of appropriate preventive measures for this municipality and for other regions of Brazil. .

Soroepidemiologia de Toxoplasma gondii em idosos atendidos pela Estratégia Saúde da Família, Porto Alegre, Rio Grande do Sul, Brasil / Seroepidemiology of Toxoplasma gondii in elderly individuals treated under the Family Health Strategy, Porto Alegre, Rio Grande do Sul, Brazil

O objetivo desse estudo foi avaliar a soroprevalência para Toxoplasma gondii e a relacionar com as condições socioeconômicas, higiênicas, sanitárias e de saúde nos idosos da Estratégia Saúde da Família - ESF, do município de Porto Alegre, Rio Grande do Sul, Brasil. A pesquisa realizada foi um estudo transversal, no qual foi aplicado um questionário de inquérito epidemiológico e realizada coleta de sangue. A avaliação de IgG e IgM anti-T. gondii foi realizada pela técnica de ELISA. Foram avaliados 599 idosos com soroprevalência para IgG anti-T. gondii de 88,0% e de 0,8% para IgM. Na análise multivariada, as variáveis que se associaram de forma independente para IgG positivo foram: faixa etária, renda pessoal e uso de óculos; e para IgM positivo: faixa etária, autopercepção de saúde e uso de óculos. Os resultados obtidos chamam a atenção pela alta prevalência de IgG anti-T. gondii nos idosos da ESF de Porto Alegre, gerando uma preocupação no caso de ocorrência de reativação da toxoplasmose e desenvolvimento dos sintomas mais graves dessa infecção.

The aim of this study was to evaluate the seroprevalence of Toxoplasma gondii and relate it to the socioeconomic, hygienic, sanitary and health conditions of the elderly of the Family Health Strategy (FHS) in the city of Porto Alegre, Rio Grande do Sul, Brazil. The research involved a cross-sectional study in which a questionnaire with epidemiologic questions was applied and blood samples were taken. The assessment of IgG and IgM anti-T. gondii was performed using the ELISA technique. Seroprevalence was evaluated among 599 elderly individuals with 88% for IgG anti-T. gondii and with 0.8% for IgM. In the multivariate analysis, the variables that associated themselves independently with positive IgG were age range, personal income and wearing spectacles. Those associated with positive IgM were age, self-rated health and wearing spectacles. The results call attention to the high prevalence of IgG anti-T. gondii in elderly individuals in the FHS in Porto Alegre, generating concern in the event that the reactivation of toxoplasmosis and the development of more severe symptoms of this infection occur.

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. .

Evaluation of Recombinant SAG1, SAG2, and SAG3 Antigens for Serodiagnosis of Toxoplasmosis

Serologic tests are widely accepted for diagnosing Toxoplasma gondii but purification and standardization of antigen needs to be improved. Recently, surface tachyzoite and bradyzoite antigens have become more attractive for this purpose. In this study, diagnostic usefulness of 3 recombinant antigens (SAG1, SAG2, and SAG3) were evaluated, and their efficacy was compared with the available commercial ELISA. The recombinant plasmids were transformed to JM109 strain of Escherichia coli, and the recombinants were expressed and purified. Recombinant SAG1, SAG2, and SAG3 antigens were evaluated using different groups of sera in an ELISA system, and the results were compared to those of a commercial IgG and IgM ELISA kit. The sensitivity and specificity of recombinant surface antigens for detection of anti-Toxoplasma IgG in comparison with commercially available ELISA were as follows: SAG1 (93.6% and 92.9%), SAG2 (100.0% and 89.4%), and SAG3 (95.4% and 91.2%), respectively. A high degree of agreement (96.9%) was observed between recombinant SAG2 and commercial ELISA in terms of detecting IgG anti-Toxoplasma antibodies. P22 had the best performance in detecting anti-Toxoplasma IgM in comparison with the other 2 recombinant antigens. Recombinant SAG1, SAG2, and SAG3 could all be used for diagnosis of IgG-specific antibodies against T. gondii.

Prevalence of mijl-toxoplasma gondii antibodies in aborted ewes in kuwait

Serum samples from 528 aborted ewes from different sheep flocks in Kuwait were tested for Toxoplasma gondii. The indirect hemagglutination test [MAT] was used with a titer of 1:80 considered positive. Antibodies to T. gondii were found in 94 [17.8%]. The highest number of positive ewes [23; 24.5%] had a titer of 1:640. Only one aborted ewe had a titer of 1:2560.This study is the first to report Toxoplasma infection in sheep which may pose risk to humans who consume under cooked mutton. The detection of Toxoplasma antibodies in aborted ewes refers to the implication of toxoplasmosis in abortion among sheep in Kuwait

Prevalência de sorologia positiva para HIV, hepatite B, toxoplasmose e rubéola em gestantes do noroeste paranaense / Prevalence of positive sorology for HIV, hepatitis B, toxoplasmosis and rubella in pregnant women from the northwestern region of the state of Paraná

OBJETIVO: Verificar a soroprevalência do vírus da imunodeficiência humana (HIV), hepatite B (VHB), toxoplasmose e rubéola em gestantes do noroeste paranaense. MÉTODOS: Foi realizado um estudo retrospectivo a partir dos resultados de exames sorológicos de triagem no pré-natal de 1.534 pacientes atendidas durante o primeiro semestre de 2010. Foram incluídos somente resultados do primeiro exame de pré-natal e aqueles com pesquisa simultânea de IgG e IgM para toxoplasmose e rubéola. A sorologia foi realizada por enzimaimunoensaio em micropartículas (MEIA). Para análise estatística foi empregado o teste do χ², com nível de significância de 5%. RESULTADOS: A positividade para o HIV foi de 0,3%, a sorologia para VHB pelo marcador HBsAg foi positiva em 0,5% das gestantes, enquanto a reatividade para anticorpos IgM anti-Toxoplasma gondii foi de 1,1% e para IgG de 59%. Em relação à rubéola nenhuma sorologia mostrou positividade para IgM, e para IgG a reatividade foi de 99,6%. A análise dos resultados mostrou que não há associação entre as soroprevalências estudadas e a idade das pacientes, exceto quanto à frequência de IgG anti-T. gondii, que foi mais elevada na faixa etária entre 30 e 44 anos. CONCLUSÃO: A soroprevalência dessas doenças infecciosas em gestantes do noroeste do Paraná é compatível com outras regiões do Brasil.

PURPOSE: To ascertain the seroprevalence of human immunodeficiency virus (HIV), hepatitis B (HBV), toxoplasmosis and rubella infections in pregnant women in northwestern Paraná. METHODS: We conducted a retrospective study based on the results of serological screening during prenatal care of 1,534 patients during the first half of 2010. We included only results from the first prenatal exam and with a simultaneous search for IgG and IgM antibodies to rubella and toxoplasmosis. Serology was performed by microparticle enzyme immunoassay (MEIA). Data were analyzed statistically by the χ² test, with the level of significance set at 5%. RESULTS: HIV positivity was 0.3%, positivity of HBV serology (HbsAg) was 0.5%, reactivity to IgM antibodies to Toxoplasma gondii was 1.1%, and reactivity to IgG antibodies was 59.0%. For rubella, no patient was positive for IgM, and IgG reactivity was 99.6%. Data analysis showed no statistical association between seroprevalence and patient age, except for the frequency of anti-T. gondii IgG, which was higher in the 30 to 44 year age group. CONCLUSION: The prevalence of these infectious diseases in pregnant women from northwestern Paraná is comparable to that observed in other regions of Brazil.

IgG Western Blot for Confirmatory Diagnosis of Equivocal Cases of Toxoplasmosis by EIA-IgG and Fluorescent Antibody Test

The performance values of available techniques used in serodiagnosis of toxoplasmosis are satisfactory but they raise problems of equivocal and discordant results for very low IgG titers. Recently marketed, LDBio-Toxo II IgG Western blot (IB) showed an excellent correlation with the dye test. We estimated the proportion of equivocal and discordant results between the enzyme immunoassay Platelia Toxo IgG (EIA-IgG) and fluorescent antibody test (FAT) and assessed the usefulness of the IB as a confirmatory test. Out of 2,136 sera collected from pregnant women, 1,644 (77.0%) tested unequivocally positive and 407 (19.0%) were negative in both EIA-IgG and FAT. The remaining 85 (4%) sera showed equivocal or discordant results. Among them, 73 (85.9%) were positive and 12 (14.1%) were negative in IB. Forty-one (89.1%) equivocal sera in EIA-IgG and 46 (86.8%) equivocal sera in FAT were positive in IB. Reducing the cut-off values of both screening techniques improved significantly their sensitivity in detecting very low IgG titers at the expense of their specificity. In conclusion, equivocal results in routine-used techniques and their discordance in determination of the immune status in pregnancy women were not uncommon. IB test appeard to be highly useful in these situations as a confirmatory technique.

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.

Soroepidemiologia da toxoplasmose em gestantes a partir da implantação do Programa de Vigilância da Toxoplasmose Adquirida e Congênita em municípios da região oeste do Paraná / Seroepidemiology of toxoplasmosis in pregnant women since the implementation of the Surveillance Program of Toxoplasmosis Acquired in Pregnancy and Congenital in the western region of Paraná, Brazil

OBJETIVO: Avaliar a suscetibilidade das gestantes à toxoplasmose em serviço público de saúde de dois municípios da região oeste do Paraná. MÉTODOS: Foram avaliadas 422 gestantes por meio da pesquisa sorológica de anticorpos IgG e IgM anti-Toxoplasma gondii (ELISA e MEIA). As soronegativas repetiram a sorologia no segundo e terceiro trimestre de gestação. Em um dos municípios, também foi realizada a triagem neonatal em 27 recém-nascidos para detecção de IgM anti-Toxoplasma gondii pelo teste de fluorometria. Todas as gestantes responderam a um questionário epidemiológico, para análise dos fatores associados ao risco da infecção pelo Toxoplasma gondii. Para análise estatística, foram consideradas a variável dependente da presença de IgG anti-Toxoplasma gondii e as variáveis independentes contidas no questionário epidemiológico. RESULTADOS: A prevalência de anticorpos IgG anti-Toxoplasma gondii nas gestantes foi de 59,8 e 60,6 por cento. Em um dos municípios, as variáveis associadas à presença de anticorpos IgG foram baixo nível de escolaridade e mais de uma gestação. Não houve associação com os outros fatores investigados, como a ingestão de carnes cruas ou mal cozidas, vegetais crus, salames coloniais, manipulação de terra ou areia, horta em casa e gatos em casa. No outro município, não foi observada associação estatística com nenhuma das variáveis estudadas. Não foi confirmado nenhum caso de infecção aguda nem de soroconversão em ambos os municípios. Nenhuns dos recém-nascidos avaliados apresentou positividade para toxoplasmose. CONCLUSÃO: A toxoplasmose é comum nas gestantes atendidas pelo serviço público de saúde da região estudada e há 40 por cento delas suscetíveis à infecção. Esse dado reforça a necessidade de manter o programa implantado nesses municípios.

PURPOSE: To evaluate the susceptibility to toxoplasmosis in pregnant women in the public health service from two cities in the western region of Paraná, Brazil. METHODS: Four thousand twenty-two pregnant women were evaluated for anti-Toxoplasma gondii IgG and IgM by ELISA and MEIA. Seronegative pregnant women repeated the serology in the second and third trimester of pregnancy. Neonatal screening of 27 newborns was also performed in one of the cities to detect IgM anti- Toxoplasma gondii by fluorometry. All pregnant women answered an epidemiological questionnaire to analyze the factors associated with the risk of infection by Toxoplasma gondii. For statistical analysis, the presence of IgG anti-Toxoplasma gondii was considered as the dependent variable and the variables contained in the epidemiological questionnaire as the independent ones. RESULTS: The prevalence of anti-Toxoplasma gondii IgG in pregnant women was 59.8 and 60.6 percent. In one of the cities, the variables associated with the presence of IgG antibodies were low educational level and more than one pregnancy. There was no association with other factors studied such as consumption of raw or undercooked meat, consumption of raw vegetables, consumption of colonial salami, handling soil or sand, the presence of a home vegetable garden and cats in the household. In the other city there was no statistical association with the variables studied. No case of acute infection and no seroconversion were confirmed in either city. None of the infants evaluated were positive for toxoplasmosis. CONCLUSION: Toxoplasmosis is common in pregnant women attended by the public health service in the region studied and 40 percent of them are susceptible to the infection. These data reinforce the need to keep the screening program in these cities.

Non-association between anti-Toxoplasma gondii antibodies and ABO blood group system

Toxoplasma gondii infects humans through the gastrointestinal tract (GIT), which elicits humoral immune response with specific antibodies. The expression of the ABO blood group glycoconjugates also occurs in this same system and may influence the human susceptibility of infection by T. gondii. The aim of the present study was to investigate the association between ABO blood group phenotypes and the presence of anti-T. gondii antibodies. Data - including age, results of serology tests for T. gondii infection and ABO blood group phenotypes - were assembled from the medical records of 1,006 pregnant women attended in the Base Hospital of the Medical School of São José do Rio Preto, Brazil, between 2001 and 2004. The chi-square test was used to compare the results with the level of significance set at 5 percent. Of the studied cases, 64.1 percent (645/1006) and 35.9 percent (391/1006) presented respectively positive and negative serology tests for anti-T. gondii antibodies. The mean age of those who tested positive was higher than those with negative serology tests (p = 0.0004). The frequencies of ABO blood group phenotypes were similar in those with and without anti-T. gondii antibodies (p = 0.35). In conclusion, the ABO blood group system is not associated with the presence or absence of anti-T. gondii antibodies.

Seroprevalence of toxoplasmosis, leptospirosis and brucellosis in sugarcane fieldworkers in Trinidad and Tobago / Seroprevalencia de la toxoplasmosis, la leptospirosis y la brucelosis en los trabajadores de las plantaciones de caña de azúcar en Trinidad y Tobago

Sugarcane field-workers, like rice field-workers, livestock farmers and abattoir workers are known to be occupationally exposed to zoonotic agents. The study determined the seroprevalence of immunoglobulins to Toxoplasma gondii (IgM), Leptospira spp (IgM) and Brucella abortus (IgG) in sugarcane field-workers across weighing stations in the island of Trinidad. In addition, the association of risk factors to infections by the three zoonoses was investigated. Blood samples were collected from consenting apparently healthy sugarcane field-workers across the island of Trinidad. Current/acute infection in individuals was determined in the sera of individuals using the enzyme immunoassay (EIA) for T gondii IgM antibodies, enzyme-linked immunosorbent assay (ELISA) for Leptospira spp IgM immunoglobulins and both buffered plate agglutination test (BPAT) and competitive ELISA for B abortus IgG antibodies. The seroprevalence of IgM immunoglobulins to T gondii was 15.7% (64 of 407) and to Leptospira spp was 0.7% (5 of 704) and the difference was statistically significant (p 0 < 0.05; χ2). All 704 samples tested for B abortus IgG immunoglobulins were negative. All risk factors (age, gender, race and type of work done) were not statistically significantly (p > 0.05; χ2) associated with infections by T gondii and Leptospira spp. It was concluded that sugarcane field-workers in Trinidad were at high risk of acute toxoplasmosis and, to a lesser extent, to leptospirosis. The fact that the four risk factors studied were not significantly associated with T gondiiand Leptospira spp infections suggests that they may not be important in the epidemiology of both diseases in the population studied.

Se sabe que los trabajadores de las plantaciones de caña de azúcar - al igual que los trabajadores de los campos de arroz, la ganadería y los mataderos - se hallan expuestos a agentes zoonóticos debido a su ocupación. El estudio determinó la seroprevalencia de las inmunoglobulinas en relación con Toxoplasma gondii (IgM), Leptospira spp (IgM) y Brucella abortus (IgG) en los trabajadores cañeros a lo largo de las estaciones de pesaje en la isla de Trinidad. Además, se investigó la asociación de factores de riesgo de infecciones por las tres formas de zoonosis. Se obtuvieron muestras de sangre a lo largo de la isla de Trinidad, tomadas de trabajadores cañeros de apariencia saludable, que dieron su consentimiento. La infección aguda presente en los individuos, fue determinada en sus sueros mediante el inmunoensayo enzimático (IEE) para anticuerpos de T gondii IgM, el ensayo inmunosorbente vinculado a enzimas (ELISA) para inmunoglobulinas frente a Leptospira spp IgM, y la prueba de aglutinación tamponada en placa (BPAT) así como el ELISA competitivo para anticuerpos de B abortus IgG. Palabras claves: toxoplasmosis, leptospirosis, brucelosis, trabajadores cañeros, Trinidad. La seroprevalencia de inmunoglobulinas IgM para T gondii fue de 15,7% (64 de 407) en tanto que para la Leptospira spp fue 0,7% (5 de 704). La diferencia fue estadísticamente significativa (p 0 < 0.05; c²). Las 704 muestras sometidas a la prueba de inmunoglobulinas para B abortus IgG, fueron negativas. Los factores de riesgo (edad, género, raza y tipo de trabajo realizado) no estuvieron significativamente asociados (p > 0.05; c²) de manera estadística con las infecciones por T gondii y Leptospira spp Se llegó a la conclusión de que los trabajadores cañeros de Trinidad presentaban un alto riesgo de toxoplasmosis aguda y, en menor medida, de leptospirosis. El hecho de que los cuatro factores de riesgo estudiados no estaban significativamente asociadas con T gondiiy a infecciones de Leptospira spp, sugiere que puede que no sean importantes en la epidemiología de ambas enfermedades en la población estudiada.

Neosporosis y toxoplasmosis en la liebre europea (Lepus europaeus) en la provincia de La Pampa (Argentina) / Infectious diseases and reproductive status in european hare (Lepus europaeus) in La Pampa province (Argentina)

El objetivo de este trabajo fue determinar la prevalencia a Neospora caninum (Nc) y Toxoplasma gondii (Tg) y conocer el periodo reproductivo de la liebre europea (Lepus europaeus) en la provincia de La Pampa (Argentina). Para ello se muestrearon 106 liebres procedentes de acopiadores de la provincia de La Pampa. Los sueros fueron analizados por un ensayo inmunoenzimático de competición para determinar anticuerpos a Nc y para Tg se realizó una prueba de hemaglutinación indirecta. Se encontraron 66 hembras, de las cuales 13 estaban preñadas, y 40 machos (p=0,01). Sobre un total de 44 sueros analizados para Nc, 5 (11,4%) dieron positivo. De los 106 sueros estudiados para Tg ninguno fue positivo.

The objective of this study was to determine the prevalence of these diseases and to know the reproductive season of the European hare (Lepus europaeus) in the Province of La Pampa (Argentina). To that aim, 106 hares coming from different places from La Pampa province were sampled. .Nc antibody diagnosis was performed by means of a competitive enzimoimmunoassay (ELISA-c), and an hemo-agglutination indirect assay (HAI) for Tg were carried out to know the disease status. From the total of hares sampled, 40 were male, 66 female (p=0.01) and 13 (19.7%) of them were detected as pregnant. Nc sero-prevalence was 11.4% over a total of 44. From 106 sera analyzed by HAI no one was positive for Tg.

Toxoplasma gondii infection induces lipid metabolism alterations in the murine host

Host lipids have been implicated in the pathogenesis of Toxoplasma gondiiinfection. To determine if Toxoplasmainfection influences the lipid status in the normal host, we assessed serum lipids of Swiss-Webster mice during infection with the BGD-1 strain (type-2) at a series of time points. Mice were bled at days zero and 42 post-infection, and subgroups were additionally bled on alternating weeks (model 1), or sacrificed at days zero, 14 and 42 (model 2) for the measurement of total cholesterol (Chl), high density lipoproteins (HDL), low density lipoproteins (LDL) and triglycerides and adiponectin. At day 42, brains were harvested for cyst enumeration. A significant decrease (p = 0.02) in HDL and total Chl was first noted in infected vs. control mice at day 14 and persisted to day 42 (p = 0.013). Conversely, LDL was unaltered until day 42, when it increased (p = 0.043). Serum LDL levels at day 42 correlated only with cyst counts of above 300 (found in 44 percent mice), while the change in HDL between days zero and 42 correlated with both the overall mean cyst count (p = 0.041) and cyst counts above 300 (p = 0.044). Calculated per cyst, this decrease in HDL in individual animals ranged from 0.1-17 µmol/L, with a mean of 2.43 ± 4.14 µmol/L. Serum adiponectin levels remained similar between infected and control mice throughout the experiment.

Seroprevalence and associated risk factors of toxoplasmosis in pregnant women in Hebron district, Palestine

To measure the prevalence of toxoplasmosis, we tested 204 pregnant women for IgG and IgM antibodies to Toxoplasma gondii using an enzyme-linked immunoassay. The study was conducted in Hebron district during the year 2005. The seroprevalence of IgG antibodies to T. gondii was 27.9% while IgM seroprevalence was 17.6%; the seroprevalence of T. gondii increased with age. More women from rural areas [36.8%] had IgG antibodies to T. gondii than urban women [21.4%]. Possible routes of infection were contaminated soil, drinking rainwater and eating raw vegetables rather than eating uncooked meat or contact with cats. The prevalence of previous abortion was 37.3%, with a slight [but not statistically significant] association with toxoplasmosis