Seroepidemiological evaluation of Toxoplasma gondii immunity among the general population in southwest of Iran

Toxoplasmosis is a cosmopolitan zoonotic infection, caused by a unicellular protozoan parasite known as Toxoplasma gondii (T. gondii) that belongs to the phylum Apicomplexa. The present investigation was aimed to evaluate the seroprevalence of T. gondii infection in the general population of Abadan city. In this cross-sectional study, a total of 496 subjects were participated. Anti-T. gondii IgG and IgM antibodies were tested using commercially available enzyme-linked immunosorbent assay (ELISA). Moreover, a structured questionnaire was completed for each person. Out of 496 subjects, 188 (37.9%) and 30 (6.05%) samples were seropositive for IgG and IgM, respectively. The more seroprevalence was found during spring season, among female subjects, in rural inhabitants, in persons with the education level of diploma or lower, from the subjects with a history of contact with cat, in individuals who consumed raw/undercooked meat, and amongst who drink unpurified water. The results showed that inhabitants of tropical areas, may be moderately exposed to T. gondii. Increase of knowledge of people about toxoplasmosis, certainly affects in reduction of the infection.

A systematic review and meta-analysis of the prevalence of toxoplasmosis in hemodialysis patients in Iran

OBJECTIVES

Toxoplasmosis is a parasitic disease that occurs worldwide, with a wide range of complications in immunocompromised patients. This systematic review and meta-analysis was performed to evaluate the seroprevalence of Toxoplasma gondii among patients undergoing hemodialysis in Iran.

METHODS

We searched English and Persian databases for studies reporting T. gondii seroprevalence in Iranian hemodialysis patients through December 31, 2017. Inclusion and exclusion criteria were applied.

RESULTS

A total of 10 studies containing 1,865 participants (1,048 patients and 817 controls) met the eligibility criteria. Immunoglobulin G (IgG) antibodies against T. gondii were found in 58% (95% confidence interval [CI], 46 to 70) of hemodialysis patients and 40% (95% CI, 31 to 50) of healthy controls, while immunoglobulin M (IgM) antibodies were found in 2% (95% CI, 0 to 6) of hemodialysis patients and 0% (95% CI, 0 to 1) of healthy controls. The meta-analysis showed that hemodialysis patients were significantly more likely to be seropositive for IgG (odds ratio [OR], 2.04; 95% CI, 1.54 to 2.70; p<0.001) and IgM (OR, 2.53; 95% CI, 1.23 to 5.22; p<0.001) antibodies against T. gondii infection than healthy individuals.

CONCLUSIONS

The current study revealed a high prevalence of T. gondii infection in hemodialysis patients. Since hemodialysis patients are immunocompromised and T. gondii can cause serious clinical complications, we recommend that periodic screenings for T. gondii infection should be incorporated into the routine clinical care of these patients.

Seroprevalence and molecular evaluation of toxoplasmosis in children with cancer in Khuzestan province, Southwest of Iran

Toxoplasma gondii is an intracellular parasite with global distribution. Toxoplasmosis in individuals with normal immune system is usually asymptomatic, but in immunocompromised patients may lead to death if not cured. In this study, the prevalence rate of acute and chronic toxoplasmosis in children with cancer was investigated using serological and molecular methods. Blood samples were taken from 372 children with cancer in Shafa hospital in Ahvaz, southwest of Iran. Anti-T. gondii IgG and IgM antibodies were investigated by ELISA. The presence of Toxoplasma in the blood samples was evaluated by Nested PCR. Among 372 children with cancer, 155 (41.7%) were positive for anti-T. gondii IgG antibodies and 24 (6.4%) were positive for anti-T. gondii IgM antibodies, as well. In IgG avidity test, 34 (22%) had antibodies indicating acute phase and 121 (78%) had antibodies indicating chronic phase. The Nested PCR results were showed T. gondii parasite in 34 (100%) patients among 34 IgG antibody-positive patients with acute infection, among 16 IgG antibody-positive patients with chronic infection, 10 patients were indicative of T. gondii and 6 patients were not indicative of T. gondii. A total of 50 cases, 44 (88%) were T. gondii-positive and 6 (12%) were T. gondii-negative in Nested PCR. This study showed high prevalence of toxoplasmosis in children with cancer. Results of serological techniques (ELISA and IgG avidity) had a higher overlap with Nested PCR in identifying T. gondii of seropositive patients.

Toxoplasma gondii Infection in Immunocompromised Patients: A Systematic Review and Meta-Analysis

Toxoplasma gondii has been suggested as an important opportunistic pathogen in immunocompromised patients. We conducted a global meta-analysis to assess the prevalence and odds ratios (ORs) of T. gondii infection in immunocompromised individuals. Electronic databases were reviewed for T. gondii infection in HIV/AIDS patients, cancer patients, and transplant recipients, and meta-analyses were conducted to calculate overall estimated prevalence and ORs using random or fixed-effects models. Totally, 72 eligible studies were included. The estimated pooled prevalence of T. gondii infection in immunocompromised patients and the control was 35.9 and 24.7% (p < 0.001), with an OR of 2.24, i.e., 42.1 and 32.0% for HIV/AIDS patients and the control (p < 0.05), 26.0 and 12.1% for cancer patients and the control (p < 0.001), and 42.1 and 34.5% for transplant recipients and the control (p > 0.05), whose estimated pooled ORs were 1.92 (95% CI, 1.44-2.55), 2.89 (95% CI, 2.36-3.55), and 1.51 (95% CI, 1.16-1.95), respectively. This study is the first to demonstrate that the immunocompromised patients are associated with higher odds of T. gondii infection, and appropriate prevention and control measures are highly recommended for these susceptible populations.

Seroprevalence of toxoplasmosis in diabetic pregnant women in southwestern of Iran

To investigate anti-Toxoplasma gondii IgG and IgM antibodies in diabetic pregnant women in Ahvaz, southwest of Iran this experiment was performed. In current study the sera of 110 diabetic pregnant women as well as 110 non diabetic pregnant women referred to the hospitals affiliated with the Ahvaz Jundishapur University of Medical Sciences were assessed for anti-T. gondii IgG and IgM antibodies by ELISA and IFA methods. The ELISA assessments showed that 47 (42.7 %) and 3 (2.7 %) of diabetic women were positive for IgG and IgM antibodies, respectively. However, in the control group, 24 individuals (21.81 %) were positive for IgG antibody but no detection for IgM antibody. According to IFA method, 46 (41.8 %) and 3 (2.7 %) of diabetic women were positive for IgG and IgM antibodies, respectively, while in control group, 21 individuals (19.09 %) were positive for IgG antibody. In this method, IgM antibody was negative for all samples of control group (0 %). In both methods, the values obtained in the case group were significantly higher than those in the control group (p < 0.05). Prevalence of anti-Toxoplasma IgG and IgM antibodies in diabetic pregnant women was higher than that in non-diabetic pregnant women. It seems that screening tests for seeking patients and teaching the transmission routes should be considered as prenatal cares for diabetic women.