Toksoplazmoz: Doğurganlık Çağındaki Kadınlarda Seroprevalans ve Gebelikteki Yaklaşım

Abstract

Amaç: Toksoplazmoz çoğunlukla asemptomatik seyreden paraziter enfeksiyon hastalığıdır. Bağışık yanıtı baskılanmış konaklarda ve fetal enfeksiyonlarda ağır klinik tablolara yol açabilmektedir. Özellikle konjenital toksoplazmozun uygun takip ve tedavi şekliyle engellenebilmesinin mümkün olması nedeniyle çalışmamızda bölgemizin duyarlı popülasyonunun ve seroprevelansının belirlenmesi ve bu grupta enfeksiyonların seyrinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Çalışmamıza son beş yılda üçüncü basamak hastanemize başvuran ve Anti Toxoplasma IgM ve IgG testi çalışılan hastalar dahil edildi. toxoplasmosis seroprevelansı, gebelerdeki primer enfeksiyonun seyri ve uygulanan tedaviler, ayrıca gebe olmayan hastalardaki akut toksoplazmoz enfeksiyonları incelendi. Bulgular: Çalışmaya dahil edilen 5545 kadında seropozitiflik oranı %30.7 (n=1703), 4503 gebede ise seropozitiflik oranı %31 (n=1399) olarak tespit edilmiştir. Primer enfeksiyonu olan 16 gebeden birine ailenin isteğiyle tıbbi abortus uygulanmış, gebelerin yalnızca dördü gebelik sonuna kadar önerilen tedaviyi kullanmış, izlem sırasında hiçbir yenidoğanda konjenital toksoplazmoz tespit edilmemiştir. Çalışmaya dahil edilen hastaların 26’sı (%0.4) ateş, 37’si (%0.6) lenfadenopati (LAP) ve 29’u (%0.5) karaciğer fonksiyon testlerindeki yüksekliğinin sebebinin araştırılması için tetkik edilmiş, LAP ile izlenen hastalardan 4’üne (%10.8) akut toksoplazmoz tanısı koyulmuştur. Sonuç: Toksoplazmoz seroprevelansının belirlenerek özellikle gebelerdeki olası primer enfeksiyonların tespiti ve bu grup hastaların izlem ve tedavilerinin aksamaması uğruna klinisyenlerin hastaları doğru yönlendirmesi konjenital toksoplazmozun engellenmesi adına oldukça önemlidir.

Keywords

• Konjenital Toksoplazmoz
• Seroloji
• Ateş
• Lenfadenopati

Toxoplasmosis: Seroprevalence in Women of Reproductive Age and Approach in Pregnancy

Abstract

Objective: Toxoplasmosis is a parasitosis that is mostly asymptomatic. It can lead to severe clinical conditions in immunosuppressed patients and fetal infections. Since it is possible to prevent congenital toxoplasmosis with appropriate follow-up and treatment, our study aimed to determine the susceptible population and seroprevalence of our region and to evaluate the course of infections in this group. Material and Method: Patients who applied to our tertiary hospital in the last five years and to whose Anti Toxoplasma IgM and IgG tests were performed were included in our study. Toxoplasmosis seroprevalence, the course of primary infection in pregnant women, the treatments applied, and also acute toxoplasmosis infections in non-pregnant patients were examined. Results: The seropositivity rate was found to be 30.7% (n=1703) in 5545 women included in the study, and the seropositivity rate was 31% (n=1399) in 4503 pregnant women. Sixteen pregnant women with primary infection were followed up in our hospital; one underwent medical abortion at the request of the family, and only four used the recommended treatment. Congenital toxoplasmosis was not detected in any newborn. Of the patients included, 26 (0.4%) were examined to investigate the etiology of fever, 37 (0.6%) for lymphadenopathy (LAP), and 29 (0.5%) for elevated liver enzymes. Among the patients with LAP, four (10.8%) were diagnosed with acute toxoplasmosis. Conclusion: As a result, it is important to determine the seroprevalence of toxoplasmosis, to detect possible primary infections, especially in pregnant women, and ensure close monitoring of these patients.

Keywords

• congenital toxoplasmosis
• serology
• fever
• lypmhadenopathy

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