Doğurganlık Çağındaki Kadınlarda Toksoplazma, Kızamıkçık ve Sitomegalovirus Seroprevalansı

Öz

Giriş Toxoplasma gondii (TOX), Rubella virüsü (RUV) ve Sitomegalovirus (CMV) enfeksiyonları, gebelik öncesi ve üreme çağındaki kadınlarda ciddi sorunlara yol açan başlıca patojenlerdir. Bu çalışmanın amacı, Muğla ilinde doğurganlık çağındaki kadınlarda T. gondii, rubella ve sitomegalovirus seroprevalanslarının değerlendirilmesi amaçlanmıştır. Gereç ve Yöntemler Ocak 2019 – Ocak 2025 tarihleri arasında Anti-CMV IgM, Anti-CMV IgG, Anti-CMV IgG Avidite, Anti-Rubella IgM, Anti-Rubella IgG, Anti-Toxo IgM, Anti-Toxo IgG ve Anti-Toxo IgG Avidite parametreleri çalışılan, 16-55 yaş aralığındaki olgular dahil edildi. Testler Roche Cobas e 601 (Roche, Germany) cihazında analiz edildi. Bulgular Seroprevalansları; Toxo IgM %1,6 ve Toxo IgG %19,8 idi. Toxo IgG aviditesi, %45,2’i düşük avidite ve %54,8’i yüksek avidite idi. Rubella IgM %0,7 ve Rubella IgG %92,9 idi. CMV IgM %1,4 ve CMV IgG %97 idi. CMV IgG aviditesi, %4,3’ü düşük avidite ve %95,7’si ise yüksek avidite idi. Toxo IgM için en yüksek %1,7(78) ile 31-40 yaş arasında, Toxo IgG için en yüksek %26,5(184) ile 40 yaş üzerinde; Rubella IgM için en yüksek %0,8(31) ile 31-40 yaş arasında, Rubella IgG için en yüksek %96,2(51) ile ≤ 20; CMV IgM için en yüksek %1,5(60) ile 31-40 yaş arasında, CMV IgG için en yüksek %98(49) ile 20 yaş ve altında görüldü. Toxo IgM 38 vaka, Rubella IgM 14 vaka ve CMV IgM 33 vaka ile en yüksek 2023 yılında idi. Sonuç Bölgemizdeki doğurganlık çağındaki kadınlarda T. gondii, Rubella ve CMV seropozitifliğinin sonuçları, Türkiye'nin diğer bölgelerinde bulunan sonuçlarla benzerdir. Gebelerde Toksoplazma, Rubella ve CMV enfeksiyonlarının taranması konusunda bir fikir birliği yoktur. Her hekim, kendi bölgesindeki seropozitiflik oranlarına bakarak tarama kararını vermelidir. Bu nedenle, her bölgenin etkili tarama için kendi verilerine sahip olması önemlidir.

Anahtar Kelimeler

• Toxoplasma gondii
• Rubella
• CMV
• Seroprevalans
• Avidite

Seroprevalence of Toxoplasma, Rubella, and Cytomegalovirus in Women of Childbearing Age

Öz

Objective: T. gondii, Rubella, and Cytomegalovirus infections can lead to significant complications in women of reproductive age. This study aimed to evaluate the seroprevalence of T. gondii, Rubella, and Cytomegalovirus among women of childbearing age in Muğla, Türkiye. Methods: The study included cases aged 16-55 years who were tested for Anti-CMV IgM, IgG, Avidity; Anti-Rubella IgM, IgG; Anti-Toxoplasma IgM, IgG and Avidity between January 2019 and January 2025. The analyses were performed using the Roche Cobas e 601 analyzer (Roche, Germany). Results: The seroprevalence rates were as follows: Toxoplasma IgM 1.6%, Toxoplasma IgG 19.8%, with 45.2% of IgG-positive cases exhibiting low avidity. Rubella IgM was detected in 0.7% and Rubella IgG in 92.9% of the cases. CMV IgM was positive in 1.4% and CMV IgG in 97%, with 4.3% of IgG-positive cases showing low avidity. Positivity for Toxoplasma IgM, Rubella IgM, and CMV IgM was highest in the 31–40 age group. Toxoplasma IgG positivity was most prevalent in women over 40 years of age, while Rubella IgG and CMV IgG seroprevalences were highest among women aged 20 years and under. The highest number of positive cases were observed in 2023 for Toxoplasma IgM (n=38), Rubella IgM (n=14), and CMV IgM (n=33). Conclusion: There is currently no consensus regarding the routine screening of pregnant women for T. gondii, Rubella, and CMV infections. Physicians should consider regional seroprevalences when making screening decisions. Therefore, it is essential that each region has access to its own epidemiological data to guide effective screening strategies. Keywords: Avidity, CMV, seroprevalence, Rubella, Toxoplasma gondii.

Anahtar Kelimeler

• Toxoplasma gondii
• Rubella
• CMV
• Seroprevalence
• Avidity

Kaynakça

1. Nabizadeh E, Ghotaslou A, Salahi B, Ghotaslou R. The Screening of Rubella Virus, Cytomegalovirus, Hepatitis B Virus, and Toxoplasma gondii Antibodies in Prepregnancy and Reproductive-Age Women in Tabriz, Iran. Infectious diseases in obstetrics and gynecology. 2022;2022:4490728. doi:10.1155/2022/4490728
2. Deka S, Kalita D, Paul M, Badoni G, Mathuria YP. Seroprevalence and Determinants of ToRCH Pathogens in Pregnant Women in the Sub-Himalayan Region. Cureus. Feb 2022;14(2):e21946. doi:10.7759/cureus.21946
3. Dinkar A, Singh J. Seroprevalence of Toxoplasma, Rubella, CMV and HSV infection at a teaching hospital: A 7 year study from North India. Journal of family medicine and primary care. May 2020;9(5):2253-2257. doi:10.4103/jfmpc.jfmpc_176_20
4. Alaçam S, Bakır A, Karatas A, et al. Investigation of seroprevalence of Toxoplasma, Rubella and Cytomegalovirus in pregnant population in Istanbul. Journal of Anatolian Medical Research. 2020;5(3):19-24. https://dergipark.org.tr/ en/download/article-file/1359753
5. Gurlek B, Colak S. Antenatal toxoplasma gondii, rubella and cytomegalovirus infection screening among pregnant women attending tertiary university hospital. Gynecology Obstetrics & Reproductive Medicine. 2019;25(2):74-80.
6. Mocanu AG, Gorun F, Ciohat I, et al. Simultaneous Seroprevalence to Toxoplasma gondii, Cytomegalovirus and Rubella Virus in Childbearing Women from Western Romania. Medicina (Kaunas, Lithuania). Sep 2 2021;57(9). doi:10.3390/medicina57090927
7. Zhang L, Wang X, Liu M, et al. The epidemiology and disease burden of congenital TORCH infections among hospitalized children in China: A national cross-sectional study. PLoS neglected tropical diseases. Oct 2022;16(10):e0010861. doi:10.1371/journal.pntd.0010861
8. Uğur AR, Esenkaya Ü, Günenc O. Evaluation of Toxoplasma gondii, CMV, and Rubella Seropositivity and Avidity Tests in the First Trimester of Pregnancy: Why to Test? Journal of Biotechnology and Strategic Health Research. 2023;7(3):174-182. doi:10.34084/bshr.1361444

9. Gürses G, Doni NY, Şimşek Z, Aksoy M, Hilali NG, Özek B. Evaluation of T. gondii, rubella, and cytomegalovirus seroprevalences among female Syrian refugees in Sanliurfa, Turkiye. The Journal of Infection in Developing Countries. 2024;18(06):964-971. doi: https://doi.org/10.3855/jidc.18614
10. Kahraman H, Savcı Ü. Rubella, cytomegalovirus and toxoplasmosis seroprevalence in pregnants in Çorum province. Anatolian Current Medical Journal. 2022;4(2):202-205. doi: 10.38053/acmj.1062754
11. 1Avcioglu F, Behcet M, Kurtoglu MG. Evaluation of Toxoplasma, Rubella, and Cytomegalovirus serological results in women of childbearing age. Revista da Associação Médica Brasileira. 2020;66:789-793. doi: 10.1590/1806-9282.66.6.789
12. Numan O, Vural F, Aka N, Alpay M, Coskun ADE. TORCH seroprevalence among patients attending obstetric Care Clinic of Haydarpasa Training and Research Hospital affiliated to association of Istanbul northern Anatolia public hospitals. Northern clinics of Istanbul. 2015;2(3):203. doi: 10.14744/nci.2015.55376
13. Bahçeci İ, Karaca E, Duran ÖF, Aksoy D, İbik YE, Kırcı UB. Bölgemizde Doğurganlık Çağındaki Kadınlarda Toxoplasma, Rubella ve Sitomegalovirüs Seroprevalansı. Turkiye Parazitol Derg. 2023;47(1):11-15. doi: 10.4274/tpd.galenos.2022.07379
14. Sirin MC, Agus N, Yilmaz N, et al. Seroprevalence of Toxoplasma gondii, Rubella virus and Cytomegalovirus among pregnant women and the importance of avidity assays. Saudi medical journal. 2017;38(7):727. doi: 10.15537/smj.2017.7.18182
15. Al-Hakami AM, Paul E, Al-Abed F, et al. Prevalence of toxoplasmosis, rubella, cytomegalovirus, and herpes (TORCH) infections among women attending the antenatal care clinic, maternity hospital in Abha, Southwestern Saudi Arabia. Saudi Med J. Jul 2020;41(7):757-762. doi:10.15537/smj.2020.7.25121
16. Palazzotto E, Bonura F, Calà C, et al. Serological status for TORCH in women of childbearing age: a decade-long surveillance (2012-2022) in Italy. Journal of medical microbiology. Jul 2023;72(7)doi:10.1099/jmm.0.001733
17. Warnecke JM, Pollmann M, Borchardt-Lohölter V, et al. Seroprevalences of antibodies against ToRCH infectious pathogens in women of childbearing age residing in Brazil, Mexico, Germany, Poland, Turkey and China. Epidemiology and infection. Oct 30 2020;148:e271. doi:10.1017/s0950268820002629 Çiçek C, Akıneden A, Türkel S. Sitomegalovirus, Rubella ve Toksoplasma Gondii’nin Gebelerdeki Seropozitifliği ve IgG Avidite Testleri. Ahi Evran Medical Journal. 2023;7(1):26-31. doi: 10.46332/aemj.1013492
18. Altunal LN, Esen AB, Karagöz G, Yaşar KK. Seroprevalence of Toxoplasma Gondii, Rubella, and Cytomegalovirus Among Pregnant Refugees and Turkish Women: A Retrospective Comparative Study. Southern Clinics of Istanbul Eurasia. 2018;29(4). doi: 10.14744/scie.2018.66375
19. Ezer B, Kaya H, Kılıç F, Özdemir M, Kaba K. Seroprevalence of Toxoplasma gondii, Rubella, Cytomegalovirus Detected by Enzyme Linked Fluorescent Assay Method in Pregnant Women Who Applied to Meram Medical Faculty Hospital in Konya Province. Turk Mikrobiyol Cem Derg. 2023;53(1):28-34. doi:10.54453/tmcd.2023.44827