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Should We Screen for Toxoplasma in Pregnancy? A Five Year Observation within a Literature Review

Yıl 2024, Cilt: 14 Sayı: 2, 193 - 197, 22.05.2024
https://doi.org/10.33631/sabd.1370022

Öz

Aim: Toxoplasmosis is a disease caused by Toxoplasma gondii that continues to be a problem all over the world. It can be asymptomatic in a healthy adult. İnfection during pregnancy; causes stillbirth, fetal miscarriage or growth retardation. The disease can cause blindness, deafness or severe neurological sequelae in the baby. In this study, it was aimed to retrospectively investigate the seroprevalence of T. gondii in pregnant women who applied to the obstetrics clinics of our hospital and to review the literature.
Material and methods: In this study, anti-Toxoplasma IgG and IgM test results of 112 pregnant women who applied to the obstetrics and gynecology outpatient clinics of our hospital between January 2015 and December 2019 were evaluated retrospectively
Results: Samples were sent to our laboratory from 32 (29%) patients in 2015, 32 (29%) in 2016, 23 (20%) in 2017, 18 (16%) in 2018, and 7 (6%) patients in 2019. Anti-Toxoplasma IgM positivity was found in only two (2%) patients, and anti-Toxoplasma IgG positivity was positive in 22 (20%) patients. Two patients with IgM positivity also had IgG positivity.
Conclusion We think that it is necessary for the Ministry of Health to support the studies to be done on the screening of toxoplasmosis in large pregnant populations and to lead the formation of a national program by evaluating the obtained data together with other studies, and it is a rational approach to carry out a correct screening by the relevant institutions and physicians until this program is established.

Kaynakça

  • Hegab SM, Al-Mutawa SA. Immunopathogenesis oftoxoplasmosis. Clin Exp Med. 2003; 3(2): 84-105.
  • Paniker CKJ. Paniker’s Textbook of Medical Parasitology. Eight edition. 2013; 87-99
  • Liu Q, Wang ZD, Huang SY, Zhu XQ. Diagnosis of toxoplasmosis and typing of Toxoplasma gondii. Parasites and Vectors. 2015; 8(1): 1-14.
  • Hill D, Dubey JP. Toxoplasma gondii: Transmission, diagnosis, and prevention. Clin Microbiol Infect. 2002; 8(10): 634-40.
  • Tamer GS, Dundar D, Caliskan E. Seroprevalence of Toxoplasma gondii, rubella and cytomegalovirus among pregnant women in western region of Turkey. Clin Investig Med. 2009; 32(1): 43-7.
  • Ville Y, Leruez-Ville M. Managing infections in pregnancy. Curr Opin Infect Dis. 2014; 27(3): 251-7.
  • Yıldız Ç, Akkar ÖB, Krakuş S, Cetin A. Review / Derleme Congenital toxoplasmosis Konjenital toksoplazmozis. Basic Clin Sci 2015; 4 62-69. 2015; 4: 62-9.
  • Derleme D, Paper I. Toksoplazmoz Tanısı. 2008;61(3).
  • Filiz A. Aile Hekimliği ve gebelikte enfeksiyonlar. Turkiye Klin J FamMed-Special Top. 2014; 5: 81-94.
  • Maldonado YA, Read JS, Byington CL, Barnett ED, Davies HD, Edwards KM, et al. Diagnosis, treatment, and prevention of congenital toxoplasmosis in the United States. Pediatrics. 2017; 139(2).
  • Ceylan AN, Benli A. Muş ı̇li̇ndeki̇ gebelerde Toxoplasma gondii seroprevalansini beli̇rlenmesi̇. Ankem Derg. 2022; 36(1): 31-5.
  • Duran A. The prevalence of toxoplasmosıs provınces of Izmır and Manısa. 2015; 19(3): 146-9.
  • Aydemir Ö, Karakeçe E, Köroğlu M, Altındiş M. Evaluation of seroprevalence of Toxoplasma gondii in women who were referred to obstetric outpatient clinics. Türk Mikrobiyoloji Cemiy Derg. 2018; 48(2): 125-9.
  • Bakacak M. Seroprevalance of Toxoplasma gondii, rubella and cytomegalovirus among pregnant women. Dicle Med J. 2014; 41(2): 326-31.
  • Durukan H, Çevikoğlu Kıllı M. Retrospective evaluation of the seropositivity rate of toxoplasmosis and clinical results in pregnant women that were admitted to a tertiary health ınstitution between 2012 and 2017 in Turkey. Turkiye parazitolojii Derg. 2019; 43(3): 106-10.
  • Pappas G, Roussos N, Falagas ME. Toxoplasmosis snapshots: Global status of Toxoplasma gondii seroprevalence and implications for pregnancy and congenital toxoplasmosis. Int J Parasitol. 2009; 39(12): 1385-94.
  • Al-Adhroey AH, Mehrass AAKO, Al-Shammakh AA, Ali AD, Akabat MYM, Al-Mekhlafi HM. Prevalence and predictors of Toxoplasma gondii infection in pregnant women from Dhamar, Yemen. BMC Infect Dis. 2019; 19(1): 1-9.
  • Mandelbrot L, Kieffer F, Sitta R, Laurichesse-Delmas H, Winer N, Mesnard L, et al. Prenatal therapy with pyrimethamine + sulfadiazine vs spiramycin to reduce placental transmission of toxoplasmosis: a multicenter, randomized trial. Am J Obstet Gynecol. 2018; 219(4): 386.e1-386.e9.
  • Syrocot T, Review S, Toxoplasmosis C. Effectiveness of prenatal treatment for congenital toxoplasmosis: a meta-analysis of individual patients’ data. Lancet. 2007; 369(9556): 115-22.
  • Cornu C, Bissery A, Malbos C, Garwig R, Cocherel C, Ecochard R, et al. Factors affecting the adherence to an antenatal screening programme: an experience with toxoplasmosis screening in France. Euro Surveill. 2009; 14(9): 21-5.
  • Gilbert RE, Peckham CS. Congenital toxoplasmosis in the United Kingdom: To screen or not to screen? J Med Screen. 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. J Obstet Gynaecol Canada. 2013; 35(1): 78-9.
  • Olliaro P. Congenital toxoplasmosis. Clin Evid (Online). 2003; (9): 763-6.
  • Avelino MM, Amaral WN, Rodrigues IMX, Rassi AR, Gomes MBF, Costa TL, et al. Congenital toxoplasmosis and prenatal care state programs. BMC Infect Dis. 2014; 14(1).
  • Luz LA da, Aquino R, Medina MG. Avaliação da qualidade da Atenção Pré-Natal no Brasil. Saúde em Debate. 2018; 42: 111-26.
  • Bamba S, Cissé M, Sangaré I, Zida A, Ouattara S, Guiguemdé RT. Seroprevalence and risk factors of Toxoplasma gondii infection in pregnant women from Bobo Dioulasso, Burkina Faso. BMC Infect Dis. 2017; 17(1): 1-6.
  • Sa H. “Doğum Öncesi Bakım Yönetim Rehberi” T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü, 925, Ankara, 2018.
  • Training AN. Özgün Çalışma / Original Article. 2022; 48(2): 1-7.
  • Montoya JG. Systematic screening and treatment of toxoplasmosis during pregnancy: is the glass half full or half empty? Am J Obstet Gynecol. 2018 Oct 1; 219(4): 315-9.
  • Strang AGGF, Ferrari RG, do Rosario DK, Nishi L, Evangelista FF, Santana PL, et al. The congenital toxoplasmosis burden in Brazil: Systematic review and meta-analysis. Acta Trop. 2020 Nov 1; 211: 105608.
  • Takmaz T. Seroprevalence of Toxoplasma gondii infection in pregnant population re-visited; changing trends and call for action. Erciyes Med J. 2020; 43(3): 278-81.

Gebelerde Toxoplazma Tarayalım mı? Literatür Değerlendirmesi Eşliğinde Beş Yıllık Gözlem

Yıl 2024, Cilt: 14 Sayı: 2, 193 - 197, 22.05.2024
https://doi.org/10.33631/sabd.1370022

Öz

Amaç: Toksoplazmoz, Toksoplazma gondii’ nin neden olduğu, dünyanın her yerinde sorun olmaya devam eden bir hastalıktır. Sağlıklı bir erişkinde asemptomatik seyredebilir. Gebelikte geçirilen enfeksiyon; ölü doğum, fetal abortus veya gelişme geriliğine yol açmaktadır. Hastalık bebekte körlük, sağırlık veya ağır nörolojik sekellere sebep olabilmektedir. Bu çalışmada hastanemizin kadın doğum polikliniklerine başvuran gebelerde T. gondii seroprevalansının retrospektif olarak araştırılması ve literatürün gözden geçirilmesi amaçlanmıştır.
Gereç ve Yöntemler: Çalışmamızda, hastanemizin kadın doğum polikliniklerine Ocak 2015-Aralık 2019 tarihleri arasında başvuran 112 adet gebe kadının anti-Toxoplazma IgG ve anti-Toxoplazma IgM sonuçları retrospektif olarak değerlendirildi.
Bulgular: Laboratuvarımıza 2015 yılında 32 (%29), 2016 yılında 32 (%29), 2017 yılında 23 (%20), 2018 yılında 18 (%16), 2019 yılında 7 (%6) hastadan örnek gönderildiği saptanmıştır. Anti Toksoplazma IgM pozitifliği sadece iki (%2) hastada, anti-Toksoplazma IgG pozitifliği ise 22 (%20) hastada belirlenmiştir. IgM pozitifliği saptanan iki hasta da aynı zamanda IgG pozitifliği de mevcuttu.
Sonuç: TC Sağlık Bakanlığının geniş gebe popülasyonlarında toksoplazmozun taranması ile ilgili yapılacak çalışmaları desteklemesi, çıkacak verilerin diğer çalışmalarla birlikte değerlendirilerek ulusal bir programın oluşmasına öncülük etmesinin gerekli olduğunu, bu program oluşana kadarki süreçte doğru bir taramanın yapılmasının ilgili kurum ve hekimler tarafından uygulanmasının akılcı bir yaklaşım olduğunu düşünmekteyiz.

Kaynakça

  • Hegab SM, Al-Mutawa SA. Immunopathogenesis oftoxoplasmosis. Clin Exp Med. 2003; 3(2): 84-105.
  • Paniker CKJ. Paniker’s Textbook of Medical Parasitology. Eight edition. 2013; 87-99
  • Liu Q, Wang ZD, Huang SY, Zhu XQ. Diagnosis of toxoplasmosis and typing of Toxoplasma gondii. Parasites and Vectors. 2015; 8(1): 1-14.
  • Hill D, Dubey JP. Toxoplasma gondii: Transmission, diagnosis, and prevention. Clin Microbiol Infect. 2002; 8(10): 634-40.
  • Tamer GS, Dundar D, Caliskan E. Seroprevalence of Toxoplasma gondii, rubella and cytomegalovirus among pregnant women in western region of Turkey. Clin Investig Med. 2009; 32(1): 43-7.
  • Ville Y, Leruez-Ville M. Managing infections in pregnancy. Curr Opin Infect Dis. 2014; 27(3): 251-7.
  • Yıldız Ç, Akkar ÖB, Krakuş S, Cetin A. Review / Derleme Congenital toxoplasmosis Konjenital toksoplazmozis. Basic Clin Sci 2015; 4 62-69. 2015; 4: 62-9.
  • Derleme D, Paper I. Toksoplazmoz Tanısı. 2008;61(3).
  • Filiz A. Aile Hekimliği ve gebelikte enfeksiyonlar. Turkiye Klin J FamMed-Special Top. 2014; 5: 81-94.
  • Maldonado YA, Read JS, Byington CL, Barnett ED, Davies HD, Edwards KM, et al. Diagnosis, treatment, and prevention of congenital toxoplasmosis in the United States. Pediatrics. 2017; 139(2).
  • Ceylan AN, Benli A. Muş ı̇li̇ndeki̇ gebelerde Toxoplasma gondii seroprevalansini beli̇rlenmesi̇. Ankem Derg. 2022; 36(1): 31-5.
  • Duran A. The prevalence of toxoplasmosıs provınces of Izmır and Manısa. 2015; 19(3): 146-9.
  • Aydemir Ö, Karakeçe E, Köroğlu M, Altındiş M. Evaluation of seroprevalence of Toxoplasma gondii in women who were referred to obstetric outpatient clinics. Türk Mikrobiyoloji Cemiy Derg. 2018; 48(2): 125-9.
  • Bakacak M. Seroprevalance of Toxoplasma gondii, rubella and cytomegalovirus among pregnant women. Dicle Med J. 2014; 41(2): 326-31.
  • Durukan H, Çevikoğlu Kıllı M. Retrospective evaluation of the seropositivity rate of toxoplasmosis and clinical results in pregnant women that were admitted to a tertiary health ınstitution between 2012 and 2017 in Turkey. Turkiye parazitolojii Derg. 2019; 43(3): 106-10.
  • Pappas G, Roussos N, Falagas ME. Toxoplasmosis snapshots: Global status of Toxoplasma gondii seroprevalence and implications for pregnancy and congenital toxoplasmosis. Int J Parasitol. 2009; 39(12): 1385-94.
  • Al-Adhroey AH, Mehrass AAKO, Al-Shammakh AA, Ali AD, Akabat MYM, Al-Mekhlafi HM. Prevalence and predictors of Toxoplasma gondii infection in pregnant women from Dhamar, Yemen. BMC Infect Dis. 2019; 19(1): 1-9.
  • Mandelbrot L, Kieffer F, Sitta R, Laurichesse-Delmas H, Winer N, Mesnard L, et al. Prenatal therapy with pyrimethamine + sulfadiazine vs spiramycin to reduce placental transmission of toxoplasmosis: a multicenter, randomized trial. Am J Obstet Gynecol. 2018; 219(4): 386.e1-386.e9.
  • Syrocot T, Review S, Toxoplasmosis C. Effectiveness of prenatal treatment for congenital toxoplasmosis: a meta-analysis of individual patients’ data. Lancet. 2007; 369(9556): 115-22.
  • Cornu C, Bissery A, Malbos C, Garwig R, Cocherel C, Ecochard R, et al. Factors affecting the adherence to an antenatal screening programme: an experience with toxoplasmosis screening in France. Euro Surveill. 2009; 14(9): 21-5.
  • Gilbert RE, Peckham CS. Congenital toxoplasmosis in the United Kingdom: To screen or not to screen? J Med Screen. 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. J Obstet Gynaecol Canada. 2013; 35(1): 78-9.
  • Olliaro P. Congenital toxoplasmosis. Clin Evid (Online). 2003; (9): 763-6.
  • Avelino MM, Amaral WN, Rodrigues IMX, Rassi AR, Gomes MBF, Costa TL, et al. Congenital toxoplasmosis and prenatal care state programs. BMC Infect Dis. 2014; 14(1).
  • Luz LA da, Aquino R, Medina MG. Avaliação da qualidade da Atenção Pré-Natal no Brasil. Saúde em Debate. 2018; 42: 111-26.
  • Bamba S, Cissé M, Sangaré I, Zida A, Ouattara S, Guiguemdé RT. Seroprevalence and risk factors of Toxoplasma gondii infection in pregnant women from Bobo Dioulasso, Burkina Faso. BMC Infect Dis. 2017; 17(1): 1-6.
  • Sa H. “Doğum Öncesi Bakım Yönetim Rehberi” T.C. Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü, 925, Ankara, 2018.
  • Training AN. Özgün Çalışma / Original Article. 2022; 48(2): 1-7.
  • Montoya JG. Systematic screening and treatment of toxoplasmosis during pregnancy: is the glass half full or half empty? Am J Obstet Gynecol. 2018 Oct 1; 219(4): 315-9.
  • Strang AGGF, Ferrari RG, do Rosario DK, Nishi L, Evangelista FF, Santana PL, et al. The congenital toxoplasmosis burden in Brazil: Systematic review and meta-analysis. Acta Trop. 2020 Nov 1; 211: 105608.
  • Takmaz T. Seroprevalence of Toxoplasma gondii infection in pregnant population re-visited; changing trends and call for action. Erciyes Med J. 2020; 43(3): 278-81.
Toplam 31 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Konular Tıbbi Mikrobiyoloji (Diğer)
Bölüm Araştırma Makaleleri
Yazarlar

Ceren Gültekin 0000-0002-2067-9431

Eda Kayabaşı 0000-0003-0461-335X

Esma Yıldırım 0000-0001-8021-7653

Şükrü Öksüz 0000-0002-4893-5564

Yayımlanma Tarihi 22 Mayıs 2024
Gönderilme Tarihi 10 Kasım 2023
Kabul Tarihi 15 Şubat 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 14 Sayı: 2

Kaynak Göster

Vancouver Gültekin C, Kayabaşı E, Yıldırım E, Öksüz Ş. Gebelerde Toxoplazma Tarayalım mı? Literatür Değerlendirmesi Eşliğinde Beş Yıllık Gözlem. SABD. 2024;14(2):193-7.