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Ka'e AC, Sosso SM, Fokam J, Simo RK, Essama SR, Nka AD, Yagai B, Dzukou CJN, Tchouaket MCT, Chenwi C, Abba A, Fainguem N, Zam MKN, Yimga JF, Colizzi V, Ndjolo A. Anti-Toxoplasmic Immunoglobulin G Quantitation Correlates with Immunovirological Parameters of HIV-Infected Cameroonians. Curr HIV Res 2021; 19:73-83. [PMID: 32885755 DOI: 10.2174/1570162x18666200903172523] [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: 05/06/2020] [Revised: 07/14/2020] [Accepted: 08/05/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Toxoplasmosis is still a neglected common opportunistic infection in immunocompromised individuals, who are mainly people living with HIV (PLHIV) in whom reactivation of toxoplasmosis may occur with advanced HIV conditions in resource-limited settings (RLS). OBJECTIVE The objective was to assess the correlation between anti-toxoplasmic immunoglobulin G (anti-Toxo IgG) concentration and the immuno-virological status of PLHIV. METHODS A cross-sectional study was conducted in the year 2018 among 100 PLHIV aged ≥18 years in Yaounde-Cameroon. For each participant, anti-Toxo IgG, CD4-T lymphocytes, and plasma viral load (PVL) were measured using ELISA, flow cytometry, and real-time PCR, respectively. RESULTS Overall, 56% of the participants were seropositive for anti-Toxo IgG, while 33% were negative and 11% were equivocal. All (n=19) those with PVL>1000 copies/mL were seropositive to anti-Toxo IgG versus 52.85% (37/70) with PVL<1000 copies/mL; p<0.0001. Interestingly, all (n=11) those with severe immunodeficiency (T-CD4<200 cells/μL) were positive to anti-Toxo IgG versus 57.69% (45/78) with T-CD4>200 cells/μL; p<0.0001. Most importantly, PVL and anti- Toxo IgG concentration were positively correlated (r = 0.54; p<0.0001), while T-CD4 and anti- Toxo IgG concentration were negatively correlated (r = - 0.70; p<0.0001). Adjusting age, gender, immune status, and virological profile in logistic regression shows that only immune status was independently associated with the serological status of toxoplasmosis (p=0.0004). CONCLUSION In Cameroon, about half of PLHIV might be seropositive to anti-Toxo IgG, with decreasing immunity appearing as a risk of toxoplasmosis relapse. Thus, in the context of immunodeficiency, routine quantification of anti-Toxo IgG would alleviate the programmatic burden of this opportunistic infection in RLS with the generalized HIV epidemic.
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Affiliation(s)
- Aude Christelle Ka'e
- Chantal BIYA International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | - Samuel Martin Sosso
- Chantal BIYA International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | - Joseph Fokam
- Chantal BIYA International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | - Rachel Kamgaing Simo
- Chantal BIYA International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | - Sara Riwom Essama
- Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
| | - Alex Durand Nka
- Chantal BIYA International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | - Bouba Yagai
- Chantal BIYA International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | | | - Michel Carlos Tommo Tchouaket
- Chantal BIYA International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | - Collins Chenwi
- Chantal BIYA International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | - Aissatou Abba
- Chantal BIYA International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | - Nadine Fainguem
- Chantal BIYA International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | - Marie Krystel Nnomo Zam
- Chantal BIYA International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | - Junie Flore Yimga
- Chantal BIYA International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
| | | | - Alexis Ndjolo
- Chantal BIYA International Reference Center for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
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2
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Lachkhem A, Lahmar I, Galal L, Babba O, Mezhoud H, Hassine M, Lachkhem A, Dardé ML, Mercier A, Babba H. Seroprevalence of Toxoplasma gondii among healthy blood donors in two locations in Tunisia and associated risk factors. Parasite 2020; 27:51. [PMID: 32955429 PMCID: PMC7504876 DOI: 10.1051/parasite/2020049] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 09/05/2020] [Indexed: 11/15/2022] Open
Abstract
Toxoplasma gondii is a protozoan parasite that can be transmitted to humans through a variety of routes including blood transfusion. This study aimed to investigate the seroprevalence of T. gondii infection and associated risk factors in healthy blood donors in Tunisia. A total of 800 healthy blood donors from two blood centers in south and coastal Tunisia were analyzed for anti-T. gondii IgG and IgM antibodies by indirect immunofluorescence assay (IFA) and enzyme-linked immunoassays (ELISA), respectively. Structured questionnaires were used to gather information on risk factors for T. gondii infection during collection. The overall seroprevalence was 44.4% of which 352 (44%) and 3 (0.4%) were positive for IgG and both IgG and IgM anti-T. gondii antibodies, respectively. Multivariate analysis showed that T. gondii seropositivity was significantly associated with the birth place (adjusted odds ratio [OR] = 2.72; 95% confidence interval [CI]: 1.49–4.94) and the age of the donors (adjusted OR = 4.98; 95% CI: 1.50–16.58) which are independent risk factors. In addition, the variables of hand washing before eating (adjusted OR = 0.52; 95% CI: 0.37–0.74) and living in an urban environment (adjusted OR = 0.30; 95% CI: 0.13–0.71) are two protective factors. This study provided the first data on the seroprevalence and epidemiology of T. gondii infection in healthy blood donors in Tunisia.
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Affiliation(s)
- Arwa Lachkhem
- Laboratoire de Parasitologie-Mycologie Médicale et Moléculaire, Département de Biologie Clinique B, Faculté de Pharmacie de Monastir, Université de Monastir, 5000 Monastir, Tunisia
| | - Ibtissem Lahmar
- Laboratoire de Parasitologie-Mycologie Médicale et Moléculaire, Département de Biologie Clinique B, Faculté de Pharmacie de Monastir, Université de Monastir, 5000 Monastir, Tunisia
| | - Lokman Galal
- INSERM, Université Limoges, CHU Limoges, IRD, U1094 Neuroépidémiologie Tropicale, Institut d'Epidémiologie et de Neurologie Tropicale, GEIST, 87000 Limoges, France
| | - Oussama Babba
- Laboratoire de Parasitologie-Mycologie Médicale et Moléculaire, Département de Biologie Clinique B, Faculté de Pharmacie de Monastir, Université de Monastir, 5000 Monastir, Tunisia - Centre de Maternité et de Néonatologie de Monastir, 5000 Monastir, Tunisia
| | - Habib Mezhoud
- Laboratoire de Parasitologie-Mycologie Médicale et Moléculaire, Département de Biologie Clinique B, Faculté de Pharmacie de Monastir, Université de Monastir, 5000 Monastir, Tunisia
| | - Mohssen Hassine
- Hématologie - Banque du Sang de Monastir, 5000 Monastir, Tunisia
| | - Ahmed Lachkhem
- Centre de Transfusion Sanguine de Gafsa, 2100 Gafsa, Tunisia
| | - Marie-Laure Dardé
- INSERM, Université Limoges, CHU Limoges, IRD, U1094 Neuroépidémiologie Tropicale, Institut d'Epidémiologie et de Neurologie Tropicale, GEIST, 87000 Limoges, France - Centre National de Référence (CNR) Toxoplasmose/Toxoplasma Biological Center (BRC), Centre Hospitalier-Universitaire Dupuytren, 87000 Limoges, France
| | - Aurélien Mercier
- INSERM, Université Limoges, CHU Limoges, IRD, U1094 Neuroépidémiologie Tropicale, Institut d'Epidémiologie et de Neurologie Tropicale, GEIST, 87000 Limoges, France - Centre National de Référence (CNR) Toxoplasmose/Toxoplasma Biological Center (BRC), Centre Hospitalier-Universitaire Dupuytren, 87000 Limoges, France
| | - Hamouda Babba
- Laboratoire de Parasitologie-Mycologie Médicale et Moléculaire, Département de Biologie Clinique B, Faculté de Pharmacie de Monastir, Université de Monastir, 5000 Monastir, Tunisia - Centre de Maternité et de Néonatologie de Monastir, 5000 Monastir, Tunisia
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3
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Lahmar I, Lachkhem A, Babba O, Slama D, Trabelsi A, Passebosc-Faure K, Dardé ML, Babba H. First isolation and molecular characterization of Toxoplasma gondii strains from human congenital toxoplasmosis cases in Monastir, Tunisia. Sci Rep 2020; 10:1963. [PMID: 32029843 PMCID: PMC7004985 DOI: 10.1038/s41598-020-59060-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 01/21/2020] [Indexed: 12/04/2022] Open
Abstract
Toxoplasma gondii is a protozoon parasite that can cause severe clinical problems such as congenital toxoplasmosis. The distribution of T. gondii genotypes varies from one geographic area to another. So far, little is known about the parasite genotypes in Tunisia, North Africa. The present study aimed isolating and genotyping T. gondii from the amniotic fluid (AF) and placenta of pregnant women in Monastir, Tunisia. Amniotic fluid and/or placenta from 80 women who acquired toxoplasma infection during pregnancy were tested by PCR and/or mouse bioassay. Genotyping of T. gondii isolates from these samples was performed with 15 microsatellite markers. Four viable T. gondii strains were isolated from either the AF or placenta of four women. Specifically, strains TUN001-MON1 and TUN002-MON2 were isolated from both the AF and placenta, TUN003-AHA from only the placenta, and TUN004-NEL from only the AF. The four viable strains were not virulent for mice. Genotyping revealed that the four strains were type II strains. This is the first report on isolation and genotyping of T. gondii from AF human samples in Tunisia. Further studies focused on T. gondii genotyping on a larger number of human cases and on animals in Tunisia are needed to improve the knowledge and epidemiology of toxoplasmosis.
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Affiliation(s)
- Ibtissem Lahmar
- Laboratoire de Parasitologie-Mycologie Médicale et Moléculaire (code LR12ES08), Département de Biologie Clinique B, Faculté de Pharmacie de Monastir, Université de Monastir, Monastir, Tunisia.
| | - Arwa Lachkhem
- Laboratoire de Parasitologie-Mycologie Médicale et Moléculaire (code LR12ES08), Département de Biologie Clinique B, Faculté de Pharmacie de Monastir, Université de Monastir, Monastir, Tunisia
| | - Oussama Babba
- Laboratoire de Parasitologie-Mycologie Médicale et Moléculaire (code LR12ES08), Département de Biologie Clinique B, Faculté de Pharmacie de Monastir, Université de Monastir, Monastir, Tunisia
| | - Darine Slama
- Laboratoire de Parasitologie-Mycologie Médicale et Moléculaire (code LR12ES08), Département de Biologie Clinique B, Faculté de Pharmacie de Monastir, Université de Monastir, Monastir, Tunisia
| | - Aida Trabelsi
- Centre de Maternité et de Néonatologie de Monastir, Monastir, Tunisia
| | - Karine Passebosc-Faure
- Centre National de Référence (CNR) Toxoplasmose/Toxoplasma Biological Center (BRC), Centre Hospitalier-Universitaire Dupuytren, Limoges, France
| | - Marie Laure Dardé
- Centre National de Référence (CNR) Toxoplasmose/Toxoplasma Biological Center (BRC), Centre Hospitalier-Universitaire Dupuytren, Limoges, France.,Université de Limoges, Faculté de Médecine, INSERM UMR 1094, Neuroépidémiologie tropicale, Limoges, France
| | - Hamouda Babba
- Laboratoire de Parasitologie-Mycologie Médicale et Moléculaire (code LR12ES08), Département de Biologie Clinique B, Faculté de Pharmacie de Monastir, Université de Monastir, Monastir, Tunisia.,Centre de Maternité et de Néonatologie de Monastir, Monastir, Tunisia
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4
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Rouatbi M, Amairia S, Amdouni Y, Boussaadoun MA, Ayadi O, Al-Hosary AAT, Rekik M, Ben Abdallah R, Aoun K, Darghouth MA, Wieland B, Gharbi M. Toxoplasma gondii infection and toxoplasmosis in North Africa: a review. ACTA ACUST UNITED AC 2019; 26:6. [PMID: 30767889 PMCID: PMC6376878 DOI: 10.1051/parasite/2019006] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 02/01/2019] [Indexed: 11/14/2022]
Abstract
Toxoplasmosis is an important zoonosis caused by an obligate intracellular parasitic protozoan, Toxoplasma gondii. The disease is distributed worldwide and can affect all warm-blooded vertebrates, including humans. The present review aimed to collect, compile and summarize the data on the prevalence of T. gondii infection in humans and animals in the five North African countries (Morocco, Algeria, Tunisia, Libya and Egypt). Published data from national and international databases were used. Distribution patterns and risk factors for T. gondii infection are discussed, focusing on biotic and abiotic factors. This review is a comprehensive epidemiological analysis of T. gondii infection in North Africa and will therefore be a useful tool for researchers. It can also be used to propose or enhance appropriate national toxoplasmosis control programs.
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Affiliation(s)
- Mariem Rouatbi
- Laboratoire de Parasitologie, Univ. Manouba, École Nationale de Médecine Vétérinaire de Sidi Thabet, 2020 Sidi Thabet, Tunisia
| | - Safa Amairia
- Laboratoire de Parasitologie, Univ. Manouba, École Nationale de Médecine Vétérinaire de Sidi Thabet, 2020 Sidi Thabet, Tunisia
| | - Yosra Amdouni
- Laboratoire de Parasitologie, Univ. Manouba, École Nationale de Médecine Vétérinaire de Sidi Thabet, 2020 Sidi Thabet, Tunisia
| | - Mohamed Anis Boussaadoun
- Laboratoire de Parasitologie, Univ. Manouba, École Nationale de Médecine Vétérinaire de Sidi Thabet, 2020 Sidi Thabet, Tunisia
| | - Ouarda Ayadi
- Université des Frères Mentouri, Constantine 1, Institut des Sciences Vétérinaires, Route de Batna, El Khroub 25100, Constantine, Algérie
| | - Amira Adel Taha Al-Hosary
- Department of Animal Medicine (Infectious Diseases), Faculty of Veterinary Medicine, Assiut University, 71526 Assiut, Egypt
| | - Mourad Rekik
- International Center for Agricultural Research in the Dry Areas (ICARDA), P.O. Box, 950764 Amman 11195, Jordan
| | - Rym Ben Abdallah
- Laboratoire de Parasitologie Médicale, Biotechnologie et Biomolécules, Institut Pasteur de Tunis, Université Tunis El Manar, BPO 74, 1002 Tunis, Tunisia
| | - Karim Aoun
- Laboratoire de Parasitologie Médicale, Biotechnologie et Biomolécules, Institut Pasteur de Tunis, Université Tunis El Manar, BPO 74, 1002 Tunis, Tunisia
| | - Mohamed Aziz Darghouth
- Laboratoire de Parasitologie, Univ. Manouba, École Nationale de Médecine Vétérinaire de Sidi Thabet, 2020 Sidi Thabet, Tunisia
| | - Barbara Wieland
- International Livestock Research Institute (ILRI), P.O. Box 5689, Addis Ababa, Ethiopia
| | - Mohamed Gharbi
- Laboratoire de Parasitologie, Univ. Manouba, École Nationale de Médecine Vétérinaire de Sidi Thabet, 2020 Sidi Thabet, Tunisia
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5
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Fabiani S, Fortunato S, Bruschi F. Solid Organ Transplant and Parasitic Diseases: A Review of the Clinical Cases in the Last Two Decades. Pathogens 2018; 7:pathogens7030065. [PMID: 30065220 PMCID: PMC6160964 DOI: 10.3390/pathogens7030065] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 07/17/2018] [Accepted: 07/18/2018] [Indexed: 12/18/2022] Open
Abstract
The aim of this study was to evaluate the occurrence of parasitic infections in solid organ transplant (SOT) recipients. We conducted a systematic review of literature records on post-transplant parasitic infections, published from 1996 to 2016 and available on PubMed database, focusing only on parasitic infections acquired after SOT. The methods and findings of the present review have been presented based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) checklist. From data published in the literature, the real burden of parasitic infections among SOT recipients cannot really be estimated. Nevertheless, publications on the matter are on the increase, probably due to more than one reason: (i) the increasing number of patients transplanted and then treated with immunosuppressive agents; (ii) the “population shift” resulting from immigration and travels to endemic areas, and (iii) the increased attention directed to diagnosis/notification/publication of cases. Considering parasitic infections as emerging and potentially serious in their evolution, additional strategies for the prevention, careful screening and follow-up, with a high level of awareness, identification, and pre-emptive therapy are needed in transplant recipients.
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Affiliation(s)
- Silvia Fabiani
- Infectious Disease Department, Azienda Ospedaliera Pisana, 56124 Pisa, Italy.
- School of Infectious Diseases, Università di Pisa, 56124 Pisa, Italy.
| | - Simona Fortunato
- School of Infectious Diseases, Università di Pisa, 56124 Pisa, Italy.
| | - Fabrizio Bruschi
- School of Infectious Diseases, Università di Pisa, 56124 Pisa, Italy.
- Department of Translational Research, N.T.M.S., Università di Pisa, 56124 Pisa, Italy.
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6
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Boudaouara Y, Aoun K, Maatoug R, Souissi O, Bouratbine A, Abdallah RB. Congenital Toxoplasmosis in Tunisia: Prenatal and Neonatal Diagnosis and Postnatal Follow-up of 35 Cases. Am J Trop Med Hyg 2018; 98:1722-1726. [PMID: 29663900 DOI: 10.4269/ajtmh.17-0580] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Congenital toxoplasmosis (CT) results from transplacental passage of Toxoplasma gondii to the fetus during acute maternal infection. Our study aims to report clinical and biological patterns of 35 cases of CT diagnosed at the department of the Parasitology of the Pasteur Institute of Tunis and to access the performance of prenatal and early postnatal diagnosis techniques. Serological screening of maternal infection was performed by Immunoglobulin (Ig) M and IgG detection and IgG avidity determination. Prenatal diagnosis was based on both Toxoplasma DNA detection in the amniotic fluid and monthly ultrasound examinations. polymerase chain reaction analysis on amniotic fluid, performed only in 15 cases, detected Toxoplasma's DNA in five cases (33.3%). Ultrasound examination did not reveal any morphological abnormalities. Thirty newborns had serological criteria of Toxoplasma infection. Congenital toxoplasmosis diagnosis was confirmed in 23 cases (76.6%) by immunoblot. Among the 35 born-infants, five (14.3%) were symptomatic: three had chorioretinitis at the first clinical ocular examination, one had neurological symptoms (seizures) with positive parasite DNA in cerebral spinal fluid, and one had both ophthalmological and neurological damages- chorioretinitis and intracranial calcifications in the computed tomography scan. Thirty-four of 35 infected children were treated with pyrimethamine-sulfadiazine combination. Four (11.7%) of the treated infants showed abnormal hematological values because of the treatment side effect. Serological rebound was observed in seven infants. A screening program and a diagnostic algorithm in pregnant women should be implemented in Tunisia to improve the follow-up of seronegative ones and to prevent CT cases.
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Affiliation(s)
- Yosr Boudaouara
- Research Laboratory Medical Parasitology, Biotechnology and Biomolecule LR11IPT-06, Institute Pasteur of Tunis, Tunis, Tunisia
| | - Karim Aoun
- Department of Parasitology, Institute Pasteur of Tunis, Tunis, Tunisia.,Research Laboratory Medical Parasitology, Biotechnology and Biomolecule LR11IPT-06, Institute Pasteur of Tunis, Tunis, Tunisia
| | - Rania Maatoug
- Department of Parasitology, Institute Pasteur of Tunis, Tunis, Tunisia
| | - Olfa Souissi
- Department of Parasitology, Institute Pasteur of Tunis, Tunis, Tunisia
| | - Aïda Bouratbine
- Department of Parasitology, Institute Pasteur of Tunis, Tunis, Tunisia.,Research Laboratory Medical Parasitology, Biotechnology and Biomolecule LR11IPT-06, Institute Pasteur of Tunis, Tunis, Tunisia
| | - Rym Ben Abdallah
- Research Laboratory Medical Parasitology, Biotechnology and Biomolecule LR11IPT-06, Institute Pasteur of Tunis, Tunis, Tunisia.,Department of Parasitology, Institute Pasteur of Tunis, Tunis, Tunisia
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7
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Amdouni Y, Rjeibi MR, Rouatbi M, Amairia S, Awadi S, Gharbi M. Molecular detection of Toxoplasma gondii infection in slaughtered ruminants (sheep, goats and cattle) in Northwest Tunisia. Meat Sci 2017; 133:180-184. [DOI: 10.1016/j.meatsci.2017.07.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 06/21/2017] [Accepted: 07/02/2017] [Indexed: 11/29/2022]
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8
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Hammond-Aryee K, Esser M, Van Helden PD. Toxoplasma gondii seroprevalence studies on humans and animals in Africa. S Afr Fam Pract (2004) 2014. [DOI: 10.1080/20786204.2014.10855349] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022] Open
Affiliation(s)
- K Hammond-Aryee
- Division of Molecular Biology and Human Genetics, Stellenbosch University
| | - M Esser
- NHLS Immunology Unit, Tygerberg; Division of Medical Microbiology, Department of Pathology, Stellenbosch University
- Pediatrics Clinical Immunology and Rheumatology Clinics, Department of Pediatrics and Child Health, Tygerberg Hospital
- Primary Immunodeficiency Register of South Africa
| | - PD Van Helden
- Division of Molecular Biology and Human Genetics, Stellenbosch University
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9
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Siala E, Ben Abdallah R, Laouiti F, Maatoug R, Souissi O, Aoun K, Bouratbine A. [Toxoplasmic infections in pregnancy: about 94 cases diagnosed at the Pasteur Institute of Tunis]. ACTA ACUST UNITED AC 2014; 42:312-6. [PMID: 24787608 DOI: 10.1016/j.gyobfe.2014.01.020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2012] [Accepted: 12/30/2013] [Indexed: 10/25/2022]
Abstract
OBJECTIVES The objectives of this study were to estimate the risk of maternal-fetal transmission of toxoplasmosis and its consequences on the fetus and to emphasize the importance of follow-up of newborns in Tunisia. PATIENTS AND METHODS It was a retrospective study of 94 cases of pergravidic toxoplasmic seroconversion who were diagnosed and followed in the Laboratory of Parasitology of Pasteur Institute of Tunis between 2005 and 2010. RESULTS In our series, amniocentesis was performed for 60 parturients. Among the amniotic fluid tested, research of toxoplasmosis DNA by PCR was positive in 12 cases (12/60, 20 %). Twenty-six cases of congenital toxoplasmosis were diagnosed with 14 postnatal cases. The rate of maternal-fetal transmission of Toxoplasma gondii was 27.6 % (26/94). This risk increases with gestational age, from 19 % at seroconversion of the 1st quarter to 29.4 % in the 2nd quarter and 44.4 % in the 3rd trimester. Monitoring of newborns with congenital toxoplasmosis showed that only 3 children were symptomatic. There were 2 cases of toxoplasmic chorioretinitis and a case of brain damage. Under serological monitoring of newborns, 21 cases were lost to follow-up and monitoring was stopped for 29 after decrease of anti-toxoplasmic IgG. DISCUSSION AND CONCLUSION The prenatal diagnosis allowed to decrease the severe forms of congenital toxoplasmosis in Tunisia. Nevertheless, it is always necessary to raise the problem of the significant number of newborn children whose follow-up is incomplete.
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Affiliation(s)
- E Siala
- Laboratoire de parasitologie-mycologie, institut Pasteur de Tunis, 13, place Pasteur, BP 74, 1002 Tunis, Tunisie.
| | - R Ben Abdallah
- Laboratoire de parasitologie-mycologie, institut Pasteur de Tunis, 13, place Pasteur, BP 74, 1002 Tunis, Tunisie
| | - F Laouiti
- Laboratoire de parasitologie-mycologie, institut Pasteur de Tunis, 13, place Pasteur, BP 74, 1002 Tunis, Tunisie
| | - R Maatoug
- Laboratoire de parasitologie-mycologie, institut Pasteur de Tunis, 13, place Pasteur, BP 74, 1002 Tunis, Tunisie
| | - O Souissi
- Laboratoire de parasitologie-mycologie, institut Pasteur de Tunis, 13, place Pasteur, BP 74, 1002 Tunis, Tunisie
| | - K Aoun
- Laboratoire de parasitologie-mycologie, institut Pasteur de Tunis, 13, place Pasteur, BP 74, 1002 Tunis, Tunisie
| | - A Bouratbine
- Laboratoire de parasitologie-mycologie, institut Pasteur de Tunis, 13, place Pasteur, BP 74, 1002 Tunis, Tunisie
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10
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Messerer L, Bouzbid S, Gourbdji E, Mansouri R, Bachi F. [Seroprevalence of toxoplasmosis in pregnant women in Annaba, Algeria]. Rev Epidemiol Sante Publique 2014; 62:160-5. [PMID: 24661506 DOI: 10.1016/j.respe.2013.11.072] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2012] [Revised: 07/25/2013] [Accepted: 11/27/2013] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The aim of the study was to estimate the seroprevalence and risk factors of toxoplasmosis in pregnant women in the department of Annaba, Algeria. METHODS We performed a cross-sectional study with analytical purposes. The study was collaboration between the laboratory of Parasitology-Mycology, Faculty of Medicine of Annaba and Parasite Biology Department at the Pasteur Institute of Algeria. A total of 1028 pregnant women who underwent prenatal diagnosis/visit were included over a period of 4 years from January 2006 to December 2009. Immunoglobulin G and M were assayed, using the microparticle enzyme method. The avidity test was used to determine the date of contamination according to age of pregnancy. Search for the parasite was made by inoculation of the placenta and cord blood in white mice. The study compared mother-to-child serological profiles using Western Blot (WB) IgG and IgM. Direct (not well-cooked meat) and indirect (presence of cat, gardening) indicators were recorded to search for parasite exposure. RESULTS Seroprevalence was 47.8 % (95 % CI: 44.8 to 51.0) and the rate of active toxoplasmosis was 1.1 % (95 % CI 0.6 to 1.8). According to their immune status, this was the first serology for 41 % (CI95 %: 38.0-44.0) of women; 12 % (CI95 %: 10.5-14.6) of primiparous women had only one serology test during their entire pregnancy. Major risk factors were consumption of poorly-cooked meat and exposure to cats. CONCLUSION Toxoplasmosis during pregnancy is a serious issue and an effective prevention program is needed.
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Affiliation(s)
- L Messerer
- Laboratoire de parasitologie-mycologie, faculté de médecine, Annaba, Algérie.
| | - S Bouzbid
- Service d'épidémiologie et de médecine préventive, CHU d'Annaba, Annaba, Algérie
| | - E Gourbdji
- Service de biologie parasitaire, institut Pasteur d'Algérie, Alger, Algérie
| | - R Mansouri
- Laboratoire de parasitologie-mycologie, faculté de médecine, Annaba, Algérie
| | - F Bachi
- Service de biologie parasitaire, institut Pasteur d'Algérie, Alger, Algérie
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[Toxoplasmosis mother-to-child screening: study of cases followed in the Pasteur Institute of Tunis (2007-2010)]. ACTA ACUST UNITED AC 2013; 106:108-12. [PMID: 23576025 DOI: 10.1007/s13149-013-0287-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Accepted: 03/05/2013] [Indexed: 10/27/2022]
Abstract
Toxoplasmosis when occurring during pregnancy can be transmitted to the fetus and lead to congenital toxoplasmosis (CT). Therefore, pregnant women are a risk group, for which it is necessary to determine the serologic profile. The objective of this study is to determine the serologic profile of toxoplasmosis in pregnant women followed at the Parasitology Laboratory of the Pasteur Institute in Tunis, to establish the prevalence of toxoplasmic infections during pregnancy and the incidence of the CT, noting the difficulties faced in the interpretation of serological results. This is a retrospective study concerning 2833 toxoplasmic serologies practiced on 2070 pregnant women, followed at the Parasitology-Mycology Laboratory of the Pasteur Institute of Tunis, between 2007 and 2010. Serological diagnosis of toxoplasmosis was done by ELISA (Enzyme Linked Immunosorbent Assay) for the detection of Immunoglobulin (Ig) G and M and the study of toxoplasmosis IgG avidity. Prenatal diagnosis was performed for 58 women by amniotic fluid sampling. Toxoplasma gondii was detected by Polymerase Chain Reaction (PCR). At birth, the diagnosis of congenital toxoplasmosis was established based on serology. The toxoplasmic serologies carried out have shown that 45.6% of the pregnant women were formerly immunized while 49.6% had a negative serology. A toxoplasmosis primary infection acquired during pregnancy was detected in 79 cases (3.8%). Among them, 33% had a true seroconversion while 67% had a recent toxoplasmosis infection in view of the positivity of IgG and IgM on the first sample with a low index of avidity (IA). For 21 parturients whose serology showed the presence of IgG, IgM and an intermediate or high IA. Among the 58 parturients in whom prenatal diagnosis was performed, PCR was positive in four cases. After birth, six cases of congenital toxoplasmosis were detected by serology.
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