1
|
Briciu V, Ionică AM, Flonta M, Almaș A, Muntean M, Topan A, Horvat M, Ungureanu L, Lupșe M. Toxoplasmosis Screening during Pregnancy in a Romanian Infectious Diseases Tertiary Center: Results of a 15 Years Follow-Up Program. Microorganisms 2023; 11:2189. [PMID: 37764033 PMCID: PMC10537741 DOI: 10.3390/microorganisms11092189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 08/13/2023] [Accepted: 08/29/2023] [Indexed: 09/29/2023] Open
Abstract
Maternal infection with Toxoplasma gondii during pregnancy may have serious consequences for the fetus. In Romania, screening for toxoplasmosis is included in the first antenatal visit. A retrospective study was performed on all toxoplasmosis antenatal screening patients between May 2008 and February 2023. Twenty-seven thousand one hundred sixty-nine (27,169) pregnant women presented for prenatal screening once (22,858) or several times: during the same pregnancy (209) or during multiple pregnancies (4102). Thirty-one thousand six hundred fifty-eight (31,658) tests for IgM and IgG antibodies were performed. Nine thousand eighty-three (9083) tests (28.69%), corresponding to 7911 women (29.12%), were positive for IgG antibodies. The seroprevalence increased with patients' age, decreased in time intervals, and was more frequently associated with rural residence. At risk for acquiring the infection during the pregnancy were women with negative anti-Toxoplasma IgG antibodies (70.88%), but only 0.9% of them presented for rescreening during the same pregnancy. Acute Toxoplasma infection (ATI) was suspected in 44 patients (0.16%) due to IgG seroconversion and/or low or borderline IgG avidity. A questionnaire follow-up interview was performed, and no congenital toxoplasmosis was identified in children born from mothers with probable ATI. Our study demonstrates poor compliance with the screening program in the Romanian population.
Collapse
Affiliation(s)
- Violeta Briciu
- Department of Infectious Diseases, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400348 Cluj-Napoca, Romania
- Clinical Hospital of Infectious Diseases of Cluj-Napoca, 400348 Cluj-Napoca, Romania
| | - Angela Monica Ionică
- Clinical Hospital of Infectious Diseases of Cluj-Napoca, 400348 Cluj-Napoca, Romania
| | - Mirela Flonta
- Clinical Hospital of Infectious Diseases of Cluj-Napoca, 400348 Cluj-Napoca, Romania
| | - Ariana Almaș
- Clinical Hospital of Infectious Diseases of Cluj-Napoca, 400348 Cluj-Napoca, Romania
| | - Monica Muntean
- Department of Infectious Diseases, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400348 Cluj-Napoca, Romania
- Clinical Hospital of Infectious Diseases of Cluj-Napoca, 400348 Cluj-Napoca, Romania
| | - Adriana Topan
- Department of Infectious Diseases, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400348 Cluj-Napoca, Romania
- Clinical Hospital of Infectious Diseases of Cluj-Napoca, 400348 Cluj-Napoca, Romania
| | - Melinda Horvat
- Department of Infectious Diseases, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400348 Cluj-Napoca, Romania
- Clinical Hospital of Infectious Diseases of Cluj-Napoca, 400348 Cluj-Napoca, Romania
| | - Liviu Ungureanu
- Clinical Hospital of Infectious Diseases of Cluj-Napoca, 400348 Cluj-Napoca, Romania
| | - Mihaela Lupșe
- Department of Infectious Diseases, “Iuliu Hațieganu” University of Medicine and Pharmacy, 400348 Cluj-Napoca, Romania
- Clinical Hospital of Infectious Diseases of Cluj-Napoca, 400348 Cluj-Napoca, Romania
| |
Collapse
|
2
|
Radoi CL, Zlatian OM, Balasoiu M, Giubelan L, Stoian AC, Dragonu L, Neacsu A, Iliescu DG. Toxoplasma gondii Seroprevalence and Trends in Women Presenting for Toxoplasma Screening in South-West Romania. Microorganisms 2023; 11:2057. [PMID: 37630617 PMCID: PMC10458910 DOI: 10.3390/microorganisms11082057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 08/07/2023] [Accepted: 08/09/2023] [Indexed: 08/27/2023] Open
Abstract
Toxoplasmosis, caused by the obligate intracellular protozoan parasite Toxoplasma gondii (T. gondii), is a globally prevalent zoonotic disease with potentially severe implications for immunocompromised individuals, pregnant women, and their fetuses/children. This study examined the prevalence of anti-T. gondii IgM and IgG antibodies in two groups of childbearing age women, including 653 participants in Group 1 (2013-2016) and 3221 participants in Group 2 (2019-2022). Our results revealed a decrease in the overall positivity rate of anti-T. gondii IgM antibodies from 2.32% to 1.06%, suggesting improved public health interventions over time. However, there were variations among different age groups and between rural and urban environments, with a significant decrease in urban areas across all age groups from Group 1 to Group 2. Regarding anti-T. gondii IgG antibodies, we did not observe a significant change in the seropositivity rate between the two groups. In the rural population with an age group over 35 years, we observed the highest positivity rate in Group 2. This study provided information on the risk factors and burden of toxoplasmosis in women of childbearing age with data that can be valuable to public health policies and the planning of healthcare measures for effective toxoplasmosis management.
Collapse
Affiliation(s)
- Cristiana Luiza Radoi
- Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (C.L.R.); (A.N.)
| | - Ovidiu Mircea Zlatian
- Medical Laboratory, County Clinical Emergency Hospital of Craiova, 200349 Craiova, Romania;
- Microbiology Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Maria Balasoiu
- Medical Laboratory, County Clinical Emergency Hospital of Craiova, 200349 Craiova, Romania;
- Microbiology Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| | - Lucian Giubelan
- Infectious Diseases Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (L.G.); (A.C.S.); (L.D.)
- “Victor Babes” Infectious Diseases and Pneumophtisiology Clinical Hospital, 200349 Craiova, Romania
| | - Andreea Cristina Stoian
- Infectious Diseases Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (L.G.); (A.C.S.); (L.D.)
| | - Livia Dragonu
- Infectious Diseases Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (L.G.); (A.C.S.); (L.D.)
- “Victor Babes” Infectious Diseases and Pneumophtisiology Clinical Hospital, 200349 Craiova, Romania
| | - Alexandru Neacsu
- Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania; (C.L.R.); (A.N.)
| | - Dominic Gabriel Iliescu
- Obstetric and Gynecology Department, County Clinical Emergency Hospital of Craiova, 200349 Craiova, Romania;
- Obstetric and Gynecology Department, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania
| |
Collapse
|
3
|
Ferreira AP, Santana DS, Figueiredo ERL, Simões MC, de Morais DF, Tavares VB, de Sousa JG, Silva MJA, de Campos Gomes F, de Melo Neto JS. Sociodemographic and Clinical Factors for Microcephaly Secondary to Teratogenic Infections in Brazil: An Ecological Study. Viruses 2023; 15:1675. [PMID: 37632018 PMCID: PMC10457789 DOI: 10.3390/v15081675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2023] [Revised: 07/17/2023] [Accepted: 07/27/2023] [Indexed: 08/27/2023] Open
Abstract
Microcephaly is a neurological condition characterized by anomalies in the growth of the cranial circumference. This study aims to examine the association between sociodemographic and clinical variables and the occurrence of secondary microcephaly in newborns in Brazil. It also aims to investigate the association between this congenital anomaly and teratogenic infections. This research adopts an observational approach with an ecological, descriptive, and analytical design. The sample includes infants aged ≤28 days and registered in the country's Live Births Information System from January 2015 to December 2021. Newborns were categorized into G1, consisting of newborns with one of the three infections (Zika, toxoplasmosis, or syphilis), and G2, consisting of newborns with two of the three infections. A total of 1513 samples were analyzed and divided into two groups: one infection (syphilis n = 423; toxoplasmosis n = 295; or Zika n = 739) and two infections (n = 56). The northeastern region of Brazil has the highest prevalence of microcephaly. Regarding the population profile, the Zika virus infection is more common among white mothers, while the syphilis infection is more common among black mothers. Among newborns with microcephaly, boys have a lower prevalence of toxoplasmosis infection, while girls have a lower prevalence of Zika virus infection. This study provides pertinent information on each infection and contributes to the epidemiologic understanding of the association between teratogenic infections and microcephaly.
Collapse
Affiliation(s)
- Arlison Pereira Ferreira
- Unidade de Pesquisa Clínica e Experimental do Sistema Urogenital (UPCEURG), Instituto de Ciências da Saúde, Universidade Federal do Pará (UFPA), Belém 66075-110, PA, Brazil; (A.P.F.); (D.S.S.); (E.R.L.F.); (V.B.T.); (J.G.d.S.)
| | - Davi Silva Santana
- Unidade de Pesquisa Clínica e Experimental do Sistema Urogenital (UPCEURG), Instituto de Ciências da Saúde, Universidade Federal do Pará (UFPA), Belém 66075-110, PA, Brazil; (A.P.F.); (D.S.S.); (E.R.L.F.); (V.B.T.); (J.G.d.S.)
| | - Eric Renato Lima Figueiredo
- Unidade de Pesquisa Clínica e Experimental do Sistema Urogenital (UPCEURG), Instituto de Ciências da Saúde, Universidade Federal do Pará (UFPA), Belém 66075-110, PA, Brazil; (A.P.F.); (D.S.S.); (E.R.L.F.); (V.B.T.); (J.G.d.S.)
| | - Marcelo Coelho Simões
- Programa de Pós-Graduação em Ciências Ambientais, Universidade do Estado do Pará (UEPA), Belém 66095-100, PA, Brazil;
| | - Dionei Freitas de Morais
- Faculdade de Medicina de São José do Rio Preto (FAMERP), São José do Rio Preto 15090-000, SP, Brazil;
| | - Victória Brioso Tavares
- Unidade de Pesquisa Clínica e Experimental do Sistema Urogenital (UPCEURG), Instituto de Ciências da Saúde, Universidade Federal do Pará (UFPA), Belém 66075-110, PA, Brazil; (A.P.F.); (D.S.S.); (E.R.L.F.); (V.B.T.); (J.G.d.S.)
| | - Juliana Gonçalves de Sousa
- Unidade de Pesquisa Clínica e Experimental do Sistema Urogenital (UPCEURG), Instituto de Ciências da Saúde, Universidade Federal do Pará (UFPA), Belém 66075-110, PA, Brazil; (A.P.F.); (D.S.S.); (E.R.L.F.); (V.B.T.); (J.G.d.S.)
| | | | | | - João Simão de Melo Neto
- Unidade de Pesquisa Clínica e Experimental do Sistema Urogenital (UPCEURG), Instituto de Ciências da Saúde, Universidade Federal do Pará (UFPA), Belém 66075-110, PA, Brazil; (A.P.F.); (D.S.S.); (E.R.L.F.); (V.B.T.); (J.G.d.S.)
| |
Collapse
|
4
|
Vargas-Villavicencio JA, Cañedo-Solares I, Correa D. Anti-Toxoplasma gondii IgM Long Persistence: What Are the Underlying Mechanisms? Microorganisms 2022; 10:microorganisms10081659. [PMID: 36014077 PMCID: PMC9415799 DOI: 10.3390/microorganisms10081659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Revised: 08/11/2022] [Accepted: 08/12/2022] [Indexed: 11/16/2022] Open
Abstract
Diagnosis of Toxoplasma gondii acute infection was first attempted by detection of specific IgM antibodies, as for other infectious diseases. However, it was noted that this immunoglobulin declines slowly and may last for months or even years. Apart from the diagnostic problem imposed on clinical management, this phenomenon called our attention due to the underlying phenomena that may be causing it. We performed a systematic comparison of reports studying IgM antibody kinetics, and the data from the papers were used to construct comparative plots and other graph types. It became clear that this phenomenon is quite generalized, and it may also occur in animals. Moreover, this is not a technical issue, although some tests make more evident the prolonged IgM decay than others. We further investigated biological reasons for its occurrence, i.e., infection dynamics (micro-reactivation–encystment, reinfection and reactivation), parasite strain relevance, as well as host innate, natural B cell responses and Ig class-switch problems inflicted by the parasite. The outcomes of these inquiries are presented and discussed herein.
Collapse
Affiliation(s)
| | - Irma Cañedo-Solares
- Laboratorio de Inmunología Experimental, Instituto Nacional de Pediatría, Mexico City 04530, Mexico
| | - Dolores Correa
- Dirección de Investigación/Centro de Investigación en Ciencias de la Salud, FCS, Universidad Anáhuac México Campus Norte, Av Universidad Anáhuc 46, Lomas Anáhuac, Huixquilucan 52786, Mexico
- Correspondence: ; Tel.: +52-(55)-5627-0210-7637
| |
Collapse
|