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

Year 2024, Volume: 6 Issue: 2, 74 - 79
https://doi.org/10.38175/phnx.1454937

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.

References

  • Dunn D, Wallon M, Peyron F, Petersen E, Peckham C, Gilbert R. Mother-to-child transmission of toxoplasmosis: risk estimates for clinical counselling. The Lancet. 1999;353(9167):1829-33.
  • Rostami A, Riahi S, Gamble H, Fakhri Y, Shiadeh MN, Danesh M, et al. Global prevalence of latent toxoplasmosis in pregnant women: a systematic review and meta-analysis. Clinical Microbiology and Infection. 2020;26(6):673-83.
  • Prevention CfDCa. Parasites - Toxoplasmosis (Toxoplasma infection): https://www.cdc.gov/; 2023 [updated June 9, 2023].
  • Varlı C, Türköz İ, Aydemir S, Emre S, Şimşek F, Yıldırmak MT. Toksoplazmoz. 2016.
  • Türkiye Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Uzmanlık Derneği Toksoplazmoz Tanı ve Tedavi Uzlaşı Raporu. Ankara: Bilimsel Tıp Yayınevi:2022.
  • Chaudhry SA, Gad N, Koren G. Toxoplasmosis and pregnancy. Canadian Family Physician. 2014;60(4):334-6.
  • Ahmed M, Sood A, Gupta J. Toxoplasmosis in pregnancy. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2020;255:44-50.
  • Teimouri A, Mohtasebi S, Kazemirad E, Keshavarz H. Role of Toxoplasma gondii IgG avidity testing in discriminating between acute and chronic toxoplasmosis in pregnancy. Journal of clinical microbiology. 2020;58(9):10.1128/jcm. 00505-20.
  • Jalca JC, Holguín AC, Zamora YV. Seroprevalence of Toxoplasmosis in Blood Donors: An Investigation from the Endemicity. Non-systematic Review. ESPOCH Congresses: The Ecuadorian Journal of STEAM. 2023:207–26.
  • Karakullukcu S, Beyhun N, Kaklikkaya N, Koksal I, Topbaş M, Buruk C, et al. Seroprevalence of Toxoplasmosis among 20 Years and Older Individuals in Trabzon, Turkey. Mikrobiyoloji bulteni. 2021;55(2).
  • Sert UY, Ozgu-Erdinc AS, Gokay S, Engin-Ustun Y. Toxoplasma screening results of 84587 pregnant women in a tertiary referral center in Turkey. Fetal and Pediatric Pathology. 2019;38(4):307-16.
  • Kul G, Tosun S, Aksaray S, Ustun Y, Ertem GT, Tosun ŞA, et al. Gebelerde Toxoplasma gondii, Rubella ve Sitomegalovirüs Seroprevalansı: Ülke Geneli Çok Merkezli Çalışma. Phoenix Medical Journal. 2023;5(3):171-6.
  • Yazısız H, Öngüt G, Öztürk Eryiğit F, Özhak B, Öğünç M, Sağlık İ, et al. Retrospective Evaluation of Anti-Toxoplasma gondii IgG, IgM and IgG Avidity Results in Akdeniz University Hospital Laboratory. Türk Mikrobiyoloji Cemiyeti Dergisi. 2019;49(2).
  • El-Bahaie ES, Ahmed FA-SMS, Ibrahim AIM, Abdel-Rahman EM. Toxoplasmosis and Iron Chelation in Toxoplasma Infection; Overview. Journal of Pharmaceutical Negative Results. 2023:727-32.
  • Gilbert R, Peckham C. Congenital toxoplasmosis in the United Kingdom: to screen or not to screen? Journal of Medical Screening. 2002;9(3):135-41.
  • Paquet C, Yudin MH, Allen VM, Bouchard C, Boucher M, Caddy S, et al. Toxoplasmosis in pregnancy: prevention, screening, and treatment. Journal of obstetrics and gynaecology Canada. 2013;35(1):78-9.
  • Picone O, Fuchs F, Benoist G, Binquet C, Kieffer F, Wallon M, et al. Toxoplasmosis screening during pregnancy in France: Opinion of an expert panel for the CNGOF. Journal of gynecology obstetrics and human reproduction. 2020;49(7):101814.
  • Goldstein EJ, Montoya JG, Remington JS. Management of Toxoplasma gondii infection during pregnancy. Clinical infectious diseases. 2008;47(4):554-66.
  • Güreser AS, Yapar D, Taşçi L, Boyacioğlu Zİ, Turgal E, Baykam N, et al. Hitit Üniversitesi Corum Eğitim ve Araştırma Hastanesi nde Lenfadenopati Ön Tanılı Olguların Toksoplazmoz Açısından İrdelenmesi. Türk Hijyen ve Deneysel Biyoloji Dergisi. 2017;74(3):237-42.
  • Haidar G, Singh N. Fever of unknown origin. New England Journal of Medicine. 2022;386(5):463-77.
  • Pazoki H, Ziaee M, Anvari D, Rezaei F, Ahmadpour E, Haghparast-Kenari B, et al. Toxoplasma gondii infection as a potential risk for chronic liver diseases: A systematic review and meta-analysis. Microbial pathogenesis. 2020;149:104578.
  • Babekir A, Mostafa S, Minor RC, Williams LL, Harrison SH, Obeng-Gyasi E. The association of Toxoplasma gondii IgG and liver injury in US adults. International Journal of Environmental Research and Public Health. 2022;19(12):7515.
  • Abhilash K, Roshine M, Vandana K, Varghese G. A probable case of acquired toxoplasmosis presenting as pyrexia of unknown origin in an immunocompetent individual. International Journal of Infectious Diseases. 2013;17(11):e1067-e8.
  • Arnous AM, Elgammal NE, Mostafa NE, Fawzy EM, Salama MA. Can human toxoplasmosis be within the differential diagnosis of fever of unknown origin: A cross-sectional study. Journal of the Egyptian Society of Parasitology. 2020;50(2):300-6.

Toksoplazmoz: Doğurganlık Çağındaki Kadınlarda Seroprevalans ve Gebelikteki Yaklaşım

Year 2024, Volume: 6 Issue: 2, 74 - 79
https://doi.org/10.38175/phnx.1454937

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.

References

  • Dunn D, Wallon M, Peyron F, Petersen E, Peckham C, Gilbert R. Mother-to-child transmission of toxoplasmosis: risk estimates for clinical counselling. The Lancet. 1999;353(9167):1829-33.
  • Rostami A, Riahi S, Gamble H, Fakhri Y, Shiadeh MN, Danesh M, et al. Global prevalence of latent toxoplasmosis in pregnant women: a systematic review and meta-analysis. Clinical Microbiology and Infection. 2020;26(6):673-83.
  • Prevention CfDCa. Parasites - Toxoplasmosis (Toxoplasma infection): https://www.cdc.gov/; 2023 [updated June 9, 2023].
  • Varlı C, Türköz İ, Aydemir S, Emre S, Şimşek F, Yıldırmak MT. Toksoplazmoz. 2016.
  • Türkiye Enfeksiyon Hastalıkları ve Klinik Mikrobiyoloji Uzmanlık Derneği Toksoplazmoz Tanı ve Tedavi Uzlaşı Raporu. Ankara: Bilimsel Tıp Yayınevi:2022.
  • Chaudhry SA, Gad N, Koren G. Toxoplasmosis and pregnancy. Canadian Family Physician. 2014;60(4):334-6.
  • Ahmed M, Sood A, Gupta J. Toxoplasmosis in pregnancy. European Journal of Obstetrics & Gynecology and Reproductive Biology. 2020;255:44-50.
  • Teimouri A, Mohtasebi S, Kazemirad E, Keshavarz H. Role of Toxoplasma gondii IgG avidity testing in discriminating between acute and chronic toxoplasmosis in pregnancy. Journal of clinical microbiology. 2020;58(9):10.1128/jcm. 00505-20.
  • Jalca JC, Holguín AC, Zamora YV. Seroprevalence of Toxoplasmosis in Blood Donors: An Investigation from the Endemicity. Non-systematic Review. ESPOCH Congresses: The Ecuadorian Journal of STEAM. 2023:207–26.
  • Karakullukcu S, Beyhun N, Kaklikkaya N, Koksal I, Topbaş M, Buruk C, et al. Seroprevalence of Toxoplasmosis among 20 Years and Older Individuals in Trabzon, Turkey. Mikrobiyoloji bulteni. 2021;55(2).
  • Sert UY, Ozgu-Erdinc AS, Gokay S, Engin-Ustun Y. Toxoplasma screening results of 84587 pregnant women in a tertiary referral center in Turkey. Fetal and Pediatric Pathology. 2019;38(4):307-16.
  • Kul G, Tosun S, Aksaray S, Ustun Y, Ertem GT, Tosun ŞA, et al. Gebelerde Toxoplasma gondii, Rubella ve Sitomegalovirüs Seroprevalansı: Ülke Geneli Çok Merkezli Çalışma. Phoenix Medical Journal. 2023;5(3):171-6.
  • Yazısız H, Öngüt G, Öztürk Eryiğit F, Özhak B, Öğünç M, Sağlık İ, et al. Retrospective Evaluation of Anti-Toxoplasma gondii IgG, IgM and IgG Avidity Results in Akdeniz University Hospital Laboratory. Türk Mikrobiyoloji Cemiyeti Dergisi. 2019;49(2).
  • El-Bahaie ES, Ahmed FA-SMS, Ibrahim AIM, Abdel-Rahman EM. Toxoplasmosis and Iron Chelation in Toxoplasma Infection; Overview. Journal of Pharmaceutical Negative Results. 2023:727-32.
  • Gilbert R, Peckham C. Congenital toxoplasmosis in the United Kingdom: to screen or not to screen? Journal of Medical Screening. 2002;9(3):135-41.
  • Paquet C, Yudin MH, Allen VM, Bouchard C, Boucher M, Caddy S, et al. Toxoplasmosis in pregnancy: prevention, screening, and treatment. Journal of obstetrics and gynaecology Canada. 2013;35(1):78-9.
  • Picone O, Fuchs F, Benoist G, Binquet C, Kieffer F, Wallon M, et al. Toxoplasmosis screening during pregnancy in France: Opinion of an expert panel for the CNGOF. Journal of gynecology obstetrics and human reproduction. 2020;49(7):101814.
  • Goldstein EJ, Montoya JG, Remington JS. Management of Toxoplasma gondii infection during pregnancy. Clinical infectious diseases. 2008;47(4):554-66.
  • Güreser AS, Yapar D, Taşçi L, Boyacioğlu Zİ, Turgal E, Baykam N, et al. Hitit Üniversitesi Corum Eğitim ve Araştırma Hastanesi nde Lenfadenopati Ön Tanılı Olguların Toksoplazmoz Açısından İrdelenmesi. Türk Hijyen ve Deneysel Biyoloji Dergisi. 2017;74(3):237-42.
  • Haidar G, Singh N. Fever of unknown origin. New England Journal of Medicine. 2022;386(5):463-77.
  • Pazoki H, Ziaee M, Anvari D, Rezaei F, Ahmadpour E, Haghparast-Kenari B, et al. Toxoplasma gondii infection as a potential risk for chronic liver diseases: A systematic review and meta-analysis. Microbial pathogenesis. 2020;149:104578.
  • Babekir A, Mostafa S, Minor RC, Williams LL, Harrison SH, Obeng-Gyasi E. The association of Toxoplasma gondii IgG and liver injury in US adults. International Journal of Environmental Research and Public Health. 2022;19(12):7515.
  • Abhilash K, Roshine M, Vandana K, Varghese G. A probable case of acquired toxoplasmosis presenting as pyrexia of unknown origin in an immunocompetent individual. International Journal of Infectious Diseases. 2013;17(11):e1067-e8.
  • Arnous AM, Elgammal NE, Mostafa NE, Fawzy EM, Salama MA. Can human toxoplasmosis be within the differential diagnosis of fever of unknown origin: A cross-sectional study. Journal of the Egyptian Society of Parasitology. 2020;50(2):300-6.
There are 24 citations in total.

Details

Primary Language English
Subjects Infectious Diseases, Obstetrics and Gynaecology
Journal Section Research Articles
Authors

Aybegüm Özşahin 0000-0003-4500-8594

Sudem Mahmutoğlu Çolak 0000-0001-7214-2305

Tuba Ilgar 0000-0003-2476-8295

İlknur Esen Yıldız 0000-0003-2987-0483

Uğur Kostakoğlu 0000-0002-4589-0962

Ayşe Ertürk 0000-0001-6413-9165

Early Pub Date May 13, 2024
Publication Date
Submission Date March 19, 2024
Acceptance Date May 7, 2024
Published in Issue Year 2024 Volume: 6 Issue: 2

Cite

Vancouver Özşahin A, Mahmutoğlu Çolak S, Ilgar T, Yıldız İE, Kostakoğlu U, Ertürk A. Toxoplasmosis: Seroprevalence in Women of Reproductive Age and Approach in Pregnancy. Phnx Med J. 2024;6(2):74-9.

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