1
|
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
|
2
|
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
|
3
|
de Paula HL, Vendrame SA, Wess LC, Konopka CK, Gonçalves TDL, Beck ST. Toxoplasma gondii outbreak in southern Brazil: heterogeneity of the serological humoral response in pregnant women and outcomes in newborns. Diagn Microbiol Infect Dis 2022; 103:115724. [DOI: 10.1016/j.diagmicrobio.2022.115724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 05/02/2022] [Accepted: 05/07/2022] [Indexed: 11/03/2022]
|
4
|
Vivacqua DPF, Paz AB, Frota ACC, Penna CRR, Martins MG, Abreu TF, Hofer CB. Antenatal factors related to congenital toxoplasmosis in Rio De Janeiro, Brazil. J Matern Fetal Neonatal Med 2021; 35:7200-7206. [PMID: 34219602 DOI: 10.1080/14767058.2021.1946507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Toxoplasmosis is one of the main preventable congenital infections in Brazil. This manuscript aims to describe antenatal factors possibly associated with congenital toxoplasmosis (CT). METHODS This is a case-control study, with data collected from medical records, from infants admitted under one year of age at the Infectious Diseases Clinic of Instituto de Puericultura e Pediatria Martagão Gesteira, reference center from Rio de Janeiro, exposed to toxoplasmosis during their antenatal period. Patients diagnosed with CT were classified as cases and those exposed without infection as controls. RESULTS A total of 289 patients were followed up in 10 years. CT was confirmed in 43 (14.9%) of which six (14%) were asymptomatic, five (12%) had the classic triad (retinochoroiditis, hydrocephalus and intracranial calcifications), 27/42 (64.3%) had reactive IgM. Even after adjusted for prematurity, cases were born with lower weight (OR 0.49 - IC95% 0.33-0.73). There was a 13% increase in chance of CT per gestational week of the maternal diagnosis. Maternal fever, consumption of poorly washed vegetables during pregnancy, and diagnosis in the third trimester were associated with CT (OR: 6.43, 6.55, and 2.16, respectively). CONCLUSION Fever during pregnancy, consumption of poorly washed vegetables and diagnosis in the third trimester were associated with CT. Infants with diagnosis of CT were born with lower weight than the controls.
Collapse
Affiliation(s)
| | - Adriana Barbosa Paz
- Instituto de Puericultura e Pediatria Martagão Gesteira, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ana Cristina Cisne Frota
- Instituto de Puericultura e Pediatria Martagão Gesteira, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Claudia Renata Rezende Penna
- Instituto de Puericultura e Pediatria Martagão Gesteira, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Mariana Guerreiro Martins
- Instituto de Puericultura e Pediatria Martagão Gesteira, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Thalita Fernandes Abreu
- Instituto de Puericultura e Pediatria Martagão Gesteira, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Cristina Barroso Hofer
- Instituto de Puericultura e Pediatria Martagão Gesteira, Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil
| |
Collapse
|
5
|
Maternal Anti- Toxoplasma Treatment during Pregnancy Is Associated with Reduced Sensitivity of Diagnostic Tests for Congenital Infection in the Neonate. J Clin Microbiol 2021; 59:JCM.01368-20. [PMID: 33208476 DOI: 10.1128/jcm.01368-20] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 11/13/2020] [Indexed: 11/20/2022] Open
Abstract
Neonatal diagnosis of congenital toxoplasmosis is based on a combination of serological and molecular tests. Maternal screening and treatment differ according to national policies and may impact the sensitivity of diagnostic methods in infants at birth. In this multicenter study, 115 neonates born to 61 treated (53%) and 54 (47%) untreated women were retrospectively included in three centers (France, Serbia, and the United States) to assess the impact of maternal anti-Toxoplasma treatment on the performance of neonatal workup at birth (neosynthesized anti-Toxoplasma IgM, IgA, and IgG and quantitative PCR [qPCR]) using univariate and multivariate approaches. Independently of the time of maternal seroconversion, the serological techniques were impacted differently by maternal treatment. The detection of IgM by immunosorbent agglutination assay (ISAGA) and Western blotting (WB) dropped from 90.7% and 88.2% in untreated neonates to 53.3% and 51.9% in treated neonates (P < 0.05), whereas IgM enzyme-linked immunosorbent assay (ELISA) and IgA ISAGA were not significantly affected by maternal treatment. A 2-fold reduction in the sensitivity of neosynthesized IgG by WB was also observed in the case of treatment during pregnancy (37.7% versus 82.3%). Interestingly, the effect of treatment was shown to be duration dependent, especially for IgM detection, when the treatment course exceeded 8 weeks, whatever the therapy. The sensitivity of Toxoplasma PCR in blood was also lowered by maternal treatment from 39.1% to 23.2%. These results highlight that anti-Toxoplasma therapy during pregnancy may set back biological evidence of neonatal infection at birth and underline the need for a careful serological follow-up of infants with normal workup.
Collapse
|
6
|
Peverengo LM, Rodeles LM, Maldonado C, Ballering G, Pujato N, D'Amico I, Vicco MH, Garcia L, Jurado L, Altcheh J, Marcipar I. Congenital chagas disease: Development and assessment of a specific IgM capture-based assay for diagnosis of transmission. Acta Trop 2021; 213:105738. [PMID: 33159901 DOI: 10.1016/j.actatropica.2020.105738] [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: 07/27/2020] [Revised: 09/22/2020] [Accepted: 09/28/2020] [Indexed: 11/29/2022]
Abstract
Transplacental transmission by Trypanosoma cruzi (T. cruzi) infection can be effectively treated if parasiticide drugs are administered as early as possible during childhood. Furthermore, an ideal situation would be to diagnose the infection near birth in order to avoid the loss of patients during the subsequent follow-up. These situation are desirable due to the maximum benefit of drugs in early stages which, consequently, implies a relevant contribution to eliminate mother-to-child transmission. However, available techniques for that purpose have limitations as being operator-dependent (microhematocrit), require several months follow-up (IgG detection) or specialized laboratories (PCR). In this study we propose to detect specific IgM antibodies (Ab) by developing a capture-based ELISA employing an improved antigen (Ag) to diagnose the transplacental transmission of T. cruzi, and in consequence, to enhance access to effective treatment. Firstly, a new chimera Ag (CP4) was obtained from the fusion of CP1 and CP3 protein, carrying FRA, SAPA, MAP, TSSAII/V/VI and TcD Ag from T. cruzi. Then, we optimized the assay by capturing IgM Ab with a polyclonal anti-IgM Ab and evaluating three Ag formulations to detect specific IgM bound. The formulations were formed as follows: i) F1: CP1 and CP3; ii) F2: CP1, CP3, B13 and P2β; iii) F3: by CP4. Detection of Ab-binding Ag was carried out using an anti-His Ab since all Ag were expressed with a His-tag. The evaluation panel consisted of sera from vertically infected children under 1-year-old (6 younger than 15 days, 7 older) and samples from non-infected children of women with chronic Chagas Disease. The ELISA assay employing CP4 showed better performance with notable high sensitivity and specificity (92.3% and 93.9%, respectively). Positive and negative likelihood ratios of the test (15.2 and 0.082) suggest its potential clinical relevance in term of post-test probability of infection. In conclution, we developed a standardized and non-operator dependent test to detect specific anti-T. cruzi IgM Ab. Although increased sample size is needed for its validation, our results indicate that this capture-based technique employing CP4 Ag can certainly improve the diagnosis of connatal infection.
Collapse
Affiliation(s)
- Luz María Peverengo
- Laboratorio de Tecnología Inmunológica (Facultad de Bioquímica y Ciencias Biológicas Universidad Nacional del Litoral)- Santa Fe - Argentina
| | - Luz María Rodeles
- Centro de Estudios en Salud Global (Facultad de Ciencias Médicas - Universidad Nacional del Litoral)-Santa Fe- Argentina
| | - Camila Maldonado
- Laboratorio de Tecnología Inmunológica (Facultad de Bioquímica y Ciencias Biológicas Universidad Nacional del Litoral)- Santa Fe - Argentina
| | - Griselda Ballering
- Hospital de Niños Ricardo Gutiérrez, IMIPP (Instituto multidisciplinario de Investigación en Patologías Pediátricas) CONICET-GCBA, Buenos Aires, Argentina
| | - Nazarena Pujato
- Laboratorio de Leptospirosis (Facultad de Bioquímica y Ciencias Biológicas Universidad Nacional del Litoral) - Santa Fe - Argentina
| | - Indira D'Amico
- Hospital de Niños Ricardo Gutiérrez, IMIPP (Instituto multidisciplinario de Investigación en Patologías Pediátricas) CONICET-GCBA, Buenos Aires, Argentina
| | - Miguel Hernán Vicco
- Centro de Estudios en Salud Global (Facultad de Ciencias Médicas - Universidad Nacional del Litoral)-Santa Fe- Argentina
| | - Luciana Garcia
- Hospital de Niños Ricardo Gutiérrez, IMIPP (Instituto multidisciplinario de Investigación en Patologías Pediátricas) CONICET-GCBA, Buenos Aires, Argentina
| | - Laura Jurado
- Hospital de Niños Ricardo Gutiérrez, IMIPP (Instituto multidisciplinario de Investigación en Patologías Pediátricas) CONICET-GCBA, Buenos Aires, Argentina
| | - Jaime Altcheh
- Hospital de Niños Ricardo Gutiérrez, IMIPP (Instituto multidisciplinario de Investigación en Patologías Pediátricas) CONICET-GCBA, Buenos Aires, Argentina
| | - Iván Marcipar
- Laboratorio de Tecnología Inmunológica (Facultad de Bioquímica y Ciencias Biológicas Universidad Nacional del Litoral)- Santa Fe - Argentina.
| |
Collapse
|
7
|
Strang AG, Ferrari RG, do Rosário DK, Nishi L, Evangelista FF, Santana PL, de Souza AH, Mantelo FM, Guilherme ALF. The congenital toxoplasmosis burden in Brazil: Systematic review and meta-analysis. Acta Trop 2020; 211:105608. [PMID: 32615081 DOI: 10.1016/j.actatropica.2020.105608] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Revised: 06/04/2020] [Accepted: 06/25/2020] [Indexed: 12/28/2022]
Abstract
Congenital toxoplasmosis is a zoonosis caused by the intracellular Apicomplexa protozoan Toxoplasma gondii. This infection causes subclinical or clinical lesions, such as retinochoroiditis and central nervous system lesions. The severity of fetal infection is related to the stage of pregnancy and the efficacy of the gestational treatment on fetal infection, whether it is achieved, or if it starts early. South America is the region with the highest burden of congenital toxoplasmosis and the most pathogenic genotypes. Here, we present the results of a comprehensive systematic review and meta-analysis of the congenital toxoplasmosis in Brazil. PubMed, Web of Science, and CAPES databases were used to search for relevant studies that were published between 1 January 2007 and 31 December 2018. The final searching process yielded 21 papers. The studies accounted for 469 children with congenital toxoplasmosis. Of these, 269 (57%) had a diagnosis in the postnatal period. Concerning mothers, 209 (44.6%) underwent prenatal care, but 47 (22.5%) did not receive any drug for toxoplasmosis treatment. There were 226 (48.2%) children with retinochoroiditis; 83 (17.7%) with brain calcifications; 9 (1.9%) with neurosensory auditory dysfunction; and 2 (0.42%) with human immunodeficiency virus coinfection. A total of 460 (98%) children had a medical and multidisciplinary follow-up for at least one year and the most frequent genotype was #11(BRII), found in seven children. There was a statistical correlation between the mother's treatment and asymptomatic children. The gestational treatment seems to protects the fetus since children of mothers who received anti-T. gondii medications have a better prognosis. The retinochoroiditis was the main finding among children, followed by brain calcifications.
Collapse
|
8
|
Storchilo HR, Rezende HHA, Gomes TC, de Souza JY, Gomes AR, Avelino MM, do Amaral WN, de Castro AM. Basic heel prick test: inclusion of screening, diagnosis and criteria for early confirmation of congenital infection by Toxoplasma gondii. Rev Inst Med Trop Sao Paulo 2019; 61:e30. [PMID: 31241659 PMCID: PMC6592012 DOI: 10.1590/s1678-9946201961030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 05/15/2019] [Indexed: 11/22/2022] Open
Abstract
Toxoplasma gondii can cross the placental barrier, causing fetal infection with potentially severe sequelae. The aim of this study was to evaluate whether the serological screening for toxoplasmosis should be included in the basic neonatal heel prick test in order to establish criteria for the confirmation and/or exclusion of the diagnosis of congenital infection in newborns treated at three public health units in the metropolitan region of Goiania, Goias State, Brazil. Blood samples were collected on filter paper from newborns and later, peripheral blood samples from the mothers and their respective children were obtained to confirm or exclude the diagnosis of suspected congenital infection, by means of an enzyme-linked immunosorbent assay (IgM and IgG) and a polymerase chain reaction assay. From a total of 1,159 blood samples collected on filter paper, 43.92% were reactive to IgG and 0.17% to anti-T. gondii IgM and IgG. One hundred and twenty-seven paired samples (mother and child) were collected following consensual protocols for peripheral blood collection. Results obtained from the filter paper and peripheral blood of the newborns were 90.55% concordant. A comparison of the mother and child blood test results showed agreement regarding the detection of IgG in 90.48% of the samples. The parasite DNA was detected in the peripheral blood of one child. In view of the results obtained in this study, the inclusion of the serological screening for toxoplasmosis in the newborn heel prick test proved to be effective for the early detection of congenital T. gondii infection.
Collapse
Affiliation(s)
- Heloisa Ribeiro Storchilo
- Universidade Federal de Goiás, Instituto de Patologia Tropical e
Saúde Pública, Goiânia, Goiás, Brazil
| | | | - Taynara Cristina Gomes
- Universidade Federal de Goiás, Instituto de Patologia Tropical e
Saúde Pública, Goiânia, Goiás, Brazil
| | - Jéssica Yonara de Souza
- Universidade Federal de Goiás, Instituto de Patologia Tropical e
Saúde Pública, Goiânia, Goiás, Brazil
| | - Antonio Roberto Gomes
- Universidade Federal de Goiás, Instituto de Patologia Tropical e
Saúde Pública, Goiânia, Goiás, Brazil
| | - Mariza Martins Avelino
- Universidade Federal de Goiás, Faculdade de Medicina, Hospital das
Clínicas, Goiânia, Goiás, Brazil
| | - Waldemar Naves do Amaral
- Universidade Federal de Goiás, Faculdade de Medicina, Hospital das
Clínicas, Goiânia, Goiás, Brazil
| | - Ana Maria de Castro
- Universidade Federal de Goiás, Instituto de Patologia Tropical e
Saúde Pública, Goiânia, Goiás, Brazil
| |
Collapse
|
9
|
Sarvi S, Nayeri Chegeni T, Sharif M, Montazeri M, Hosseini SA, Amouei A, Hosseininejad Z, Anvari D, Saberi R, Gohardehi S, Daryani A. Congenital toxoplasmosis among Iranian neonates: a systematic review and meta-analysis. Epidemiol Health 2019; 41:e2019021. [PMID: 31096746 PMCID: PMC6635660 DOI: 10.4178/epih.e2019021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 05/17/2019] [Indexed: 11/25/2022] Open
Abstract
Toxoplasmosis is a serious zoonotic disease that can lead to abortion and congenital disorders and has a widespread global distribution in humans and animals. The objective of this review was to investigate the incidence of toxoplasmosis in Iranian neonates in order to obtain a comprehensive assessment of the overall situation of the disease for use in developing future interventions. Original studies investigating the incidence of Toxoplasma gondii infections in Iranian neonates were systematically searched in a number of English-language and Persian-language electronic databases. The search process resulted in the inclusion of a total of 11 studies in the systematic review, 10 of which were entered into the meta-analysis. The reviewed articles included 2,230 Iranian neonates investigated through January 1, 2018. Based on the retrieved studies, the overall weighted incidence rates of toxoplasmosis in the Iranian neonatal population and neonates with suspected congenital toxoplasmosis were estimated to be 0.64% (95% confidence interval [CI], 0.31 to 1.09) and 4.10% (95% CI, 2.68 to 5.77), respectively, using a fixed-effects model. The findings of the reviewed studies demonstrate that the incidence of toxoplasmosis is high in Iranian neonates. Accordingly, it can be concluded that toxoplasmosis is a serious public health concern that has been ignored by the Ministry of Health. Therefore, it is essential to perform further studies, in addition to implementing screening and detection programs, using standardized methods to estimate the incidence of toxoplasmosis in Iran and to determine its associated risk factors.
Collapse
Affiliation(s)
- Shahabeddin Sarvi
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Tooran Nayeri Chegeni
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.,Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mehdi Sharif
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Parasitology, School of Medicine, Sari Branch, Islamic Azad University, Sari, Iran
| | - Mahbobeh Montazeri
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Seyed Abdollah Hosseini
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Afsaneh Amouei
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Zahra Hosseininejad
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.,Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Davood Anvari
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.,Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Reza Saberi
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.,Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Shaban Gohardehi
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ahmad Daryani
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| |
Collapse
|
10
|
Soares JAS, Caldeira AP. Congenital toxoplasmosis: the challenge of early diagnosis of a complex and neglected disease. Rev Soc Bras Med Trop 2019; 52:e20180228. [DOI: 10.1590/0037-8682-0228-2018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Accepted: 12/18/2018] [Indexed: 11/22/2022] Open
|
11
|
Evaluation of serological and molecular tests used to identify Toxoplasma gondii infection in pregnant women attended in a public health service in São Paulo state, Brazil. Diagn Microbiol Infect Dis 2017; 89:13-19. [PMID: 28689893 DOI: 10.1016/j.diagmicrobio.2017.06.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 06/07/2017] [Accepted: 06/09/2017] [Indexed: 11/23/2022]
Abstract
Toxoplasmosis during pregnancy can have severe consequences. The use of sensitive and specific serological and molecular methods is extremely important for the correct diagnosis of the disease. We compared the ELISA and ELFA serological methods, conventional PCR (cPCR), Nested PCR and quantitative PCR (qPCR) in the diagnosis of Toxoplasma gondii infection in pregnant women without clinical suspicion of toxoplasmosis (G1=94) and with clinical suspicion of toxoplasmosis (G2=53). The results were compared using the Kappa index, and the sensitivity, specificity, positive predictive value and negative predictive value were calculated. The results of the serological methods showed concordance between the ELISA and ELFA methods even though ELFA identified more positive cases than ELISA. Molecular methods were discrepant with cPCR using B22/23 primers having greater sensitivity and lower specificity compared to the other molecular methods.
Collapse
|
12
|
Evaluation of the Western blotting method for the diagnosis of congenital toxoplasmosis. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2016. [DOI: 10.1016/j.jpedp.2016.08.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
|
13
|
Evaluation of the Western blotting method for the diagnosis of congenital toxoplasmosis. J Pediatr (Rio J) 2016; 92:616-623. [PMID: 27504975 DOI: 10.1016/j.jped.2016.02.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Revised: 02/15/2016] [Accepted: 02/16/2016] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To evaluate the Western blotting method for the detection of IgG anti-Toxoplasma gondii (T. gondii) (IgG-WB) in the serum of children with suspected congenital toxoplasmosis. METHODS We accompanied 47 mothers with acquired toxoplasmosis in pregnancy and their children, between June of 2011 and June of 2014. The IgG-WB was done in house and the test was considered positive if the child had antibodies that recognized at least one band on IgG blots different from the mother's or with greater intensity than the corresponding maternal band, during the first three months of life. RESULTS 15 children (15.1%) met the criteria for congenital toxoplasmosis and 32 (32.3%) had the diagnosis excluded. The symptoms were observed in 12 (80.0%) children and the most frequent were cerebral calcification in 9 (60.0%), chorioretinitis in 8 (53.3%), and hydrocephalus in 4 (26.6%). IgM antibodies anti-T. gondii detected by chemiluminescence (CL) were found in 6 (40.0%) children and the polymerase chain reaction (PCR) for detection of T. gondii DNA was positive in 5 of 7 performed (71.4%). The sensitivity of IgG-WB was of 60.0% [95% confidence interval (CI) 32.3-83.7%] and specificity 43.7% (95% CI 26.7-62.3%). The sensitivity of IgG-WB increased to 76.0 and 89.1% when associated to the research of IgM anti-T. gondii or PCR, respectively. CONCLUSIONS The IgG-WB showed greater sensitivity than the detection of IgM anti-T. gondii; therefore, it can be used for the diagnosis of congenital toxoplasmosis in association with other congenital infection markers.
Collapse
|
14
|
Shimokawa PT, Targa LS, Yamamoto L, Rodrigues JC, Kanunfre KA, Okay TS. HLA-DQA1/B1 alleles as putative susceptibility markers in congenital toxoplasmosis. Virulence 2016; 7:456-64. [PMID: 26856406 DOI: 10.1080/21505594.2016.1150401] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
Host and parasite genotypes are among the factors associated with congenital toxoplasmosis pathogenesis. As HLA class II molecules play a key role in the immune system regulation, the aim of this study was to investigate whether HLA-DQA1/B1 alleles are associated with susceptibility or protection to congenital toxoplasmosis. One hundred and twenty-two fetuses with and 103 without toxoplasmosis were studied. The two study groups were comparable according to a number of socio-demographic and genetic variables. HLA alleles were typed by PCR-SSP. In the HLA-DQA1 region, the allele frequencies showed that *01:03 and *03:02 alleles could confer susceptibility (OR= 3.06, p = 0.0002 and OR= 9.60, p= 0.0001, respectively) as they were more frequent among infected fetuses. Regarding the HLA-DQB1 region, the *05:04 allele could confer susceptibility (OR = 6.95, p < 0.0001). Of the 122 infected fetuses, 10 presented susceptibility haplotypes contrasting with only one in the non-infected group. This difference was not statistically significant after correction for multiple comparison (OR = 9.37, p=0.011). In the casuistic, there were two severely damaged fetuses with high parasite loads determined in amniotic fluid samples and HLA-DQA1 susceptibility alleles. In the present study, a discriminatory potential of HLA-DQA1/B1 alleles to identify susceptibility to congenital toxoplasmosis and the most severe cases has been shown.
Collapse
Affiliation(s)
- Paulo Tadashi Shimokawa
- a Laboratory of Seroepidemiology and Immunobiology, Institute of Tropical Medicine, University of São Paulo , São Paulo , Brazil
| | - Lília Spaleta Targa
- a Laboratory of Seroepidemiology and Immunobiology, Institute of Tropical Medicine, University of São Paulo , São Paulo , Brazil
| | - Lidia Yamamoto
- a Laboratory of Seroepidemiology and Immunobiology, Institute of Tropical Medicine, University of São Paulo , São Paulo , Brazil
| | - Jonatas Cristian Rodrigues
- a Laboratory of Seroepidemiology and Immunobiology, Institute of Tropical Medicine, University of São Paulo , São Paulo , Brazil.,b LIM 48- Laboratory of Immunology, Department of Infectious and Parasitic Diseases, School of Medicine, University of São Paulo , São Paulo , Brazil
| | - Kelly Aparecida Kanunfre
- a Laboratory of Seroepidemiology and Immunobiology, Institute of Tropical Medicine, University of São Paulo , São Paulo , Brazil.,b LIM 48- Laboratory of Immunology, Department of Infectious and Parasitic Diseases, School of Medicine, University of São Paulo , São Paulo , Brazil
| | - Thelma Suely Okay
- a Laboratory of Seroepidemiology and Immunobiology, Institute of Tropical Medicine, University of São Paulo , São Paulo , Brazil
| |
Collapse
|
15
|
Gontijo da Silva M, Clare Vinaud M, de Castro AM. Prevalence of toxoplasmosis in pregnant women and vertical transmission of Toxoplasma gondii in patients from basic units of health from Gurupi, Tocantins, Brazil, from 2012 to 2014. PLoS One 2015; 10:e0141700. [PMID: 26558622 PMCID: PMC4641701 DOI: 10.1371/journal.pone.0141700] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2015] [Accepted: 10/12/2015] [Indexed: 12/21/2022] Open
Abstract
Introduction Toxoplasmosis is a parasitary disease that presents high rates of gestational and congenital infection worldwide being therefore considered a public health problem and a neglected disease. Objective To determine the prevalence of toxoplasmosis amongst pregnant women and vertical transmission of Toxoplasma gondii in their newborns attended in the Basic Units of Health (BUH) from the city of Gurupi, state of Tocantins, Brazil. Methods A prevalence study was performed, including 487 pregnant women and their newborns attended in the BUH of the urban zone of the city of Gurupi, state of Tocantins, Brazil, during the period from February 2012 to February 2014. The selection of the pregnant women occurred by convenience. In the antenatal admission they were invited to participate in this study. Three samples of peripheral blood were collected for the detection of specific anti-T. gondii IgG, IgM and IgA through ELISA, for the polimerase chain reaction (PCR) and IgG avidity during pregnancy. When IgM antibodies were detected the fetal and newborn infection investigation took place. The newborn was investigated right after birth and after one year of age through serology and PCR to confirm/exclude the vertical transmission. The analyses were performed in the Studies of the Host-Parasite Relationship Laboratory (LAERPH, IPTSP-UFG), Goiania, state of Goias, Brazil. The results were inserted in a data bank in Epi-Info 3.3.2 statistic software in which the analysis was performed with p≤5%. Results The toxoplasmosis infection was detected in 68.37% (333/487, CI95%: 64.62–72.86). The toxoplasmosis chronic infection prevalence was of 63.03% (307/487, CI95%: 58.74–67.32). The prevalence of maternal acute infection was of 5.33% (26/487; CI95%: 3.3–7.3) suspected by IgM antibodies detection in the peripheral blood. The prevalence of confirmed vertical transmission was of 28% (7/25; CI95%: 10.4–45.6). Conclusions These results show an elevated prevalence of toxoplasmosis in pregnant women and vertical transmission of T. gondii in the city of Gurupi, state of Tocantins, Brazil.
Collapse
Affiliation(s)
- Marcos Gontijo da Silva
- University Center UNIRG, Parasitology Laboratory, Av. Rio de Janeiro entre ruas 9 e 10, Centro, Gurupi—TO, Brazil
- * E-mail:
| | - Marina Clare Vinaud
- Federal University of Goias (UFG), Tropical Medicine and Public Health Institute (IPTSP), Tropical Medicine and Public Health Post-Graduation Programme, Studies of the Host-Parasite Relationship Laboratory (LAERPH), Rua 235 esq. 1a. Av. s/n Setor Leste Universitário, CEP 74605–050, Goiânia, Brazil
| | - Ana Maria de Castro
- Federal University of Goias (UFG), Tropical Medicine and Public Health Institute (IPTSP), Tropical Medicine and Public Health Post-Graduation Programme, Studies of the Host-Parasite Relationship Laboratory (LAERPH), Rua 235 esq. 1a. Av. s/n Setor Leste Universitário, CEP 74605–050, Goiânia, Brazil
| |
Collapse
|
16
|
|
17
|
McLeod R. Utility and limitations of T. gondii-specific IgM serum antibodies in the diagnosis of congenital toxoplasmosis in Porto Alegre. J Pediatr (Rio J) 2014; 90:329-31. [PMID: 24726454 DOI: 10.1016/j.jped.2014.04.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Accepted: 04/03/2014] [Indexed: 11/29/2022] Open
|
18
|
McLeod R. Utility and limitations of T. gondii-specific IgM serum antibodies in the diagnosis of congenital toxoplasmosis in Porto Alegre. JORNAL DE PEDIATRIA (VERSÃO EM PORTUGUÊS) 2014. [DOI: 10.1016/j.jpedp.2014.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
|