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Nguyen MN, Yeo SJ, Park H. Identification of novel biomarkers for anti- Toxoplasma gondii IgM detection and the potential application in rapid diagnostic fluorescent tests. Front Microbiol 2024; 15:1385582. [PMID: 38894968 PMCID: PMC11184589 DOI: 10.3389/fmicb.2024.1385582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 05/03/2024] [Indexed: 06/21/2024] Open
Abstract
Toxoplasmosis, while often asymptomatic and prevalent as a foodborne disease, poses a considerable mortality risk for immunocompromised individuals during pregnancy. Point-of-care serological tests that detect specific IgG and IgM in patient sera are critical for disease management under limited resources. Despite many efforts to replace the T. gondii total lysate antigens (TLAs) by recombinant antigens (rAgs) in commercial kits, while IgG detection provides significant specificity and sensitivity, IgM detection remains comparatively low in sensitivity. In this study, we attempted to identify novel antigens targeting IgM in early infection, thereby establishing an IgM on-site detection kit. Using two-dimensional gel electrophoresis (2DE) and mouse serum immunoblotting, three novel antigens, including EF1γ, PGKI, and GAP50, were indicated to target T. gondii IgM. However, rAg EF1γ was undetectable by IgM of mice sera in Western blotting verification experiments, and ELISA coated with PGKI did not eliminate cross-reactivity, in contrast to GAP50. Subsequently, the lateral flow reaction employing a strip coated with 0.3 mg/mL purified rAg GAP50 and exhibited remarkable sensitivity compared with the conventional ELISA based on tachyzoite TLA, which successfully identified IgM in mouse sera infected with tachyzoites, ranging from 103 to 104 at 5 dpi and 104 at 7 dpi, respectively. Furthermore, by using standard T. gondii-infected human sera from WHO, the limit of detection (LOD) for the rapid fluorescence immunochromatographic test (FICT) using GAP50 was observed at 0.65 IU (international unit). These findings underline the particular immunoreactivity of GAP50, suggesting its potential as a specific biomarker for increasing the sensitivity of the FICT in IgM detection.
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Affiliation(s)
- Minh-Ngoc Nguyen
- Department of Infection Biology, School of Medicine, Zoonosis Research Center, Wonkwang University, Iksan, Republic of Korea
| | - Seon-Ju Yeo
- Department of Tropical Medicine and Parasitology, Department of Biomedical Sciences, College of Medicine, Seoul National University, Seoul, Republic of Korea
- Department of Tropical Medicine and Parasitology, Medical Research Center, Institute of Endemic Diseases, Seoul National University, Seoul, Republic of Korea
| | - Hyun Park
- Department of Infection Biology, School of Medicine, Zoonosis Research Center, Wonkwang University, Iksan, Republic of Korea
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Zhou Y, Leahy K, Grose A, Lykins J, Siddiqui M, Leong N, Goodall P, Withers S, Ashi K, Schrantz S, Tesic V, Abeleda AP, Beavis K, Clouser F, Ismail M, Christmas M, Piarroux R, Limonne D, Chapey E, Abraham S, Baird I, Thibodeau J, Boyer KM, Torres E, Conrey S, Wang K, Staat MA, Back N, L’Ollivier C, Mahinc C, Flori P, Gomez-Marin J, Peyron F, Houzé S, Wallon M, McLeod R. Novel paradigm enables accurate monthly gestational screening to prevent congenital toxoplasmosis and more. PLoS Negl Trop Dis 2024; 18:e0011335. [PMID: 38805559 PMCID: PMC11132520 DOI: 10.1371/journal.pntd.0011335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 04/01/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND Congenital toxoplasmosis is a treatable, preventable disease, but untreated causes death, prematurity, loss of sight, cognition and motor function, and substantial costs worldwide. OBJECTIVES We asked whether high performance of an Immunochromatographic-test (ICT) could enable accurate, rapid diagnosis/treatment, establishing new, improved care-paradigms at point-of-care and clinical laboratory. METHODS Data were obtained in 12 studies/analyses addressing: 1-feasibility/efficacy; 2-false-positives; 3-acceptability; 4-pink/black-line/all studies; 5-time/cost; 6-Quick-Information/Limit-of-detection; 7, 8-acute;-chronic; 9-epidemiology; 10-ADBio; 11,12-Commentary/Cases/Chronology. FINDINGS ICT was compared with gold-standard or predicate-tests. Overall, ICT performance for 1093 blood/4967 sera was 99.2%/97.5% sensitive and 99.0%/99.7% specific. However, in clinical trial, FDA-cleared-predicate tests initially caused practical, costly problems due to false-positive-IgM results. For 58 persons, 3/43 seronegative and 2/15 chronically infected persons had false positive IgM predicate tests. This caused substantial anxiety, concerns, and required costly, delayed confirmation in reference centers. Absence of false positive ICT results contributes to solutions: Lyon and Paris France and USA Reference laboratories frequently receive sera with erroneously positive local laboratory IgM results impeding patient care. Therefore, thirty-two such sera referred to Lyon's Reference laboratory were ICT-tested. We collated these with other earlier/ongoing results: 132 of 137 USA or French persons had false-positive local laboratory IgM results identified correctly as negative by ICT. Five false positive ICT results in Tunisia and Marseille, France, emphasize need to confirm positive ICT results with Sabin-Feldman-Dye-test or western blot. Separate studies demonstrated high performance in detecting acute infections, meeting FDA, CLIA, WHO REASSURED, CEMark criteria and patient and physician satisfaction with monthly-gestational-ICT-screening. CONCLUSIONS/SIGNIFICANCE This novel paradigm using ICT identifies likely false positives or raises suspicion that a result is truly positive, rapidly needing prompt follow up and treatment. Thus, ICT enables well-accepted gestational screening programs that facilitate rapid treatment saving lives, sight, cognition and motor function. This reduces anxiety, delays, work, and cost at point-of-care and clinical laboratories. TRIAL REGISTRATION NCT04474132, https://clinicaltrials.gov/study/NCT04474132 ClinicalTrials.gov.
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Affiliation(s)
- Ying Zhou
- Departments of Ophthalmology and Visual Science, The University of Chicago, Chicago, Illinois, United States of America
| | - Karen Leahy
- Department of Obstetrics and Gynecology, The University of Chicago, Chicago, Illinois, United States of America
| | - Andrew Grose
- Departments of Ophthalmology and Visual Science, The University of Chicago, Chicago, Illinois, United States of America
- Pritzker School of Medicine, Division of Infectious Diseases, The University of Chicago, Chicago, Illinois, United States of America
| | - Joseph Lykins
- Departments of Ophthalmology and Visual Science, The University of Chicago, Chicago, Illinois, United States of America
- Pritzker School of Medicine, Division of Infectious Diseases, The University of Chicago, Chicago, Illinois, United States of America
| | - Maryam Siddiqui
- Department of Obstetrics and Gynecology, The University of Chicago, Chicago, Illinois, United States of America
| | - Nicole Leong
- Department of Obstetrics and Gynecology, The University of Chicago, Chicago, Illinois, United States of America
| | - Perpetua Goodall
- Department of Obstetrics and Gynecology, The University of Chicago, Chicago, Illinois, United States of America
| | - Shawn Withers
- Departments of Ophthalmology and Visual Science, The University of Chicago, Chicago, Illinois, United States of America
| | - Kevin Ashi
- Departments of Ophthalmology and Visual Science, The University of Chicago, Chicago, Illinois, United States of America
- Pritzker School of Medicine, Division of Infectious Diseases, The University of Chicago, Chicago, Illinois, United States of America
| | - Stephen Schrantz
- Pritzker School of Medicine, Division of Infectious Diseases, The University of Chicago, Chicago, Illinois, United States of America
- Chicago Medicine, The University of Chicago, Chicago, Illinois, United States of America
- Department of Pediatrics, Division of Infectious Diseases, The University of Chicago, Chicago, Illinois, United States of America
- Department of Medicine, The University of Chicago, Chicago, Illinois, United States of America
| | - Vera Tesic
- Pritzker School of Medicine, Division of Infectious Diseases, The University of Chicago, Chicago, Illinois, United States of America
- Chicago Medicine, The University of Chicago, Chicago, Illinois, United States of America
- Department of Pathology, The University of Chicago, Chicago, Illinois, United States of America
| | - Ana Precy Abeleda
- Chicago Medicine, The University of Chicago, Chicago, Illinois, United States of America
- Department of Pathology, The University of Chicago, Chicago, Illinois, United States of America
| | - Kathleen Beavis
- Pritzker School of Medicine, Division of Infectious Diseases, The University of Chicago, Chicago, Illinois, United States of America
- Chicago Medicine, The University of Chicago, Chicago, Illinois, United States of America
- Department of Pathology, The University of Chicago, Chicago, Illinois, United States of America
| | - Fatima Clouser
- Departments of Ophthalmology and Visual Science, The University of Chicago, Chicago, Illinois, United States of America
| | - Mahmoud Ismail
- Department of Obstetrics and Gynecology, The University of Chicago, Chicago, Illinois, United States of America
- Pritzker School of Medicine, Division of Infectious Diseases, The University of Chicago, Chicago, Illinois, United States of America
- Chicago Medicine, The University of Chicago, Chicago, Illinois, United States of America
| | - Monica Christmas
- Department of Obstetrics and Gynecology, The University of Chicago, Chicago, Illinois, United States of America
- Pritzker School of Medicine, Division of Infectious Diseases, The University of Chicago, Chicago, Illinois, United States of America
- Chicago Medicine, The University of Chicago, Chicago, Illinois, United States of America
| | | | | | - Emmanuelle Chapey
- Institut des agents infectieux, Hôpital de la Croix-Rousse, Lyon, France
| | - Sylvie Abraham
- Laboratory of Parasitologie, Bichat-Claude Bernard Hôpital, Paris, France
| | - Isabelle Baird
- The College, The University of Chicago, Chicago, Illinois, United States of America
- Global Health Center, The University of Chicago, Chicago, Illinois, United States of America
| | - Juliette Thibodeau
- The College, The University of Chicago, Chicago, Illinois, United States of America
- Global Health Center, The University of Chicago, Chicago, Illinois, United States of America
| | - Kenneth M. Boyer
- Department of Pediatrics, Division of Infectious Diseases, Rush Presbyterian Hospital and Medical Center, Chicago, Illinois, United States of America
| | - Elizabeth Torres
- Group of Molecular Parasitology (GEPAMOL), Center of Biomedical Research, Faculty of Health Sciences, University of Quindio, Armenia (Quindio), Colombia
| | - Shannon Conrey
- University of Cincinnati and Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, United States of America
| | - Kanix Wang
- Carl H. Lindner College of Business, The University of Cincinnati, Cincinnati, Ohio, United States of America
| | - Mary Allen Staat
- University of Cincinnati and Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, United States of America
| | - Nancy Back
- University of Cincinnati and Cincinnati Children’s Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, United States of America
| | - Coralie L’Ollivier
- Centre National de Référence Toxoplasmose—Pôle Sérologie, Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- IHU-Méditerranée Infection, Assistance Publique Hôpitaux de Marseille (AP-HM), Marseille, France; Aix Marseille University, IRD, AP-HM, SSA, VITROME, IHU Méditerranée, Marseille, France
| | - Caroline Mahinc
- Parasitology and Mycology Laboratory, Pôle de Biologie-Pathologie, University Hospital of Saint Etienne, Saint Etienne, France
| | - Pierre Flori
- Parasitology and Mycology Laboratory, Pôle de Biologie-Pathologie, University Hospital of Saint Etienne, Saint Etienne, France
| | - Jorge Gomez-Marin
- Group of Molecular Parasitology (GEPAMOL), Center of Biomedical Research, Faculty of Health Sciences, University of Quindio, Armenia (Quindio), Colombia
| | - Francois Peyron
- Institut des agents infectieux, Hôpital de la Croix-Rousse, Lyon, France
| | - Sandrine Houzé
- Laboratory of Parasitologie, Bichat-Claude Bernard Hôpital, Paris, France
| | - Martine Wallon
- Institut des agents infectieux, Hôpital de la Croix-Rousse, Lyon, France
| | - Rima McLeod
- Departments of Ophthalmology and Visual Science, The University of Chicago, Chicago, Illinois, United States of America
- Pritzker School of Medicine, Division of Infectious Diseases, The University of Chicago, Chicago, Illinois, United States of America
- Department of Pediatrics, Division of Infectious Diseases, The University of Chicago, Chicago, Illinois, United States of America
- Department of Medicine, The University of Chicago, Chicago, Illinois, United States of America
- The College, The University of Chicago, Chicago, Illinois, United States of America
- Global Health Center, The University of Chicago, Chicago, Illinois, United States of America
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Abraham S, Piarroux R, Zhou Y, Tesic V, Abeleda A, Houhou-Fidouh N, Nicaise-Rolland P, Landraud L, McLeod R, Houzé S. Performances of ICT Toxoplasma IgG-IgM test in comparison with Vidas® toxo competition to determine the immune status against Toxoplasma gondii. Eur J Clin Microbiol Infect Dis 2023; 42:1327-1335. [PMID: 37749274 DOI: 10.1007/s10096-023-04669-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 09/18/2023] [Indexed: 09/27/2023]
Abstract
Toxoplasmosis is a ubiquitous parasitic infection caused by Toxoplasma gondii (Tg). In immunocompetent people, the infection may be asymptomatic with the induction of an immune response that may prevent reinfection or transmission to the fetus in immune pregnant woman. In immunocompromised persons or seronegative pregnant woman with a primary infection during pregnancy, the infection may result in the loss of life, sight, cognition, and motor function in the immune-compromised person or immunologically immature fetus. The objective of this study was to evaluate a new immunochromatographic test Toxoplasma ICT IgG-IgM (ICT) that allows detection of specific anti-Tg immunoglobulins G (Ig G) and M (Ig M). We included 1145 prospectively obtained sera and 376 samples selected for specificity or sensitivity studies. The performance of ICT was compared using Vidas® Toxo Competition (TXC) and Toxoscreen®. In case of discrepancy, Vidas® Toxo Ig G or Ig M and LDBIO Toxo II IgG western blot were used to establish definitive results by additional methods. Sensitivity and specificity of ICT were respectively 99.3% and 100%. In comparison, Toxoscreen®'s sensitivity was 100% and the specificity was 99.8%. TXC had a sensitivity of 98.7% with a specificity of 99.1%. ICT has excellent performance even for low Ig G titers, especially in immunocompromised patients, and confirms the specificity of isolated Ig M. This ICT provides reliable results easily and quickly. This screening technique is not designed to differentiate the Ig M from Ig G. When positive, additional tests may be necessary.
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Affiliation(s)
- Sylvie Abraham
- Laboratory of Parasitology, Toxoplasma National Reference Center, Bichat-Claude Bernard Hospital, APHP Nord, 46 Rue Henri Huchard, 75018, Paris, France
| | - Raphael Piarroux
- LD Bio Diagnostics, Lyon, France
- Efor-CVO, Champagne Aux Monts d'Or, France
| | - Ying Zhou
- Department of Ophthalmology and Visual Sciences, The University of Chicago, Chicago, IL, USA
- Toxoplasmosis Center, The University of Chicago, AMB N310, Chicago, IL, USA
| | - Vera Tesic
- Department of Pathology, The University of Chicago, Chicago, IL, USA
| | - Ana Abeleda
- Department of Pathology, The University of Chicago, Chicago, IL, USA
| | - Nadhira Houhou-Fidouh
- Laboratory of Virology, Bichat-Claude Bernard Hospital, APHP Nord, 46 Rue Henri Huchard, 75018, Paris, France
| | - Pascale Nicaise-Rolland
- Laboratory of Immunology, Bichat-Claude Bernard Hospital, APHP Nord, 46 Rue Henri Huchard, 75018, Paris Paris, France
| | - Luce Landraud
- Laboratory of Microbiology, Louis Mourier Hospital, APHP Nord, 178 Rue Des Renouillers, 92700, Colombes, France
| | - Rima McLeod
- Department of Ophthalmology and Visual Sciences, The University of Chicago, Chicago, IL, USA
- Toxoplasmosis Center, The University of Chicago, AMB N310, Chicago, IL, USA
- Department of Pediatrics, Division of Infectious Diseases, The University of Chicago, Chicago, IL, USA
| | - Sandrine Houzé
- Laboratory of Parasitology, Toxoplasma National Reference Center, Bichat-Claude Bernard Hospital, APHP Nord, 46 Rue Henri Huchard, 75018, Paris, France.
- Université Paris Cité, IRD, 75006, MERITParis, France.
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Fan Y, Long Y, Gong Y, Gao X, Zheng G, Ji H. Systemic Immunomodulatory Effects of Codonopsis pilosula Glucofructan on S180 Solid-Tumor-Bearing Mice. Int J Mol Sci 2023; 24:15598. [PMID: 37958581 PMCID: PMC10649278 DOI: 10.3390/ijms242115598] [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: 09/24/2023] [Revised: 10/13/2023] [Accepted: 10/22/2023] [Indexed: 11/15/2023] Open
Abstract
The immune functions of the body are intricately intertwined with the onset and advancement of tumors, and immunotherapy mediated by bioactive compounds has exhibited initial effectiveness in overcoming chemotherapy resistance and inhibiting tumor growth. However, the comprehensive interpretation of the roles played by immunologic components in the process of combating tumors remains to be elucidated. In this study, the Codonopsis pilosula glucofructan (CPG) prepared in our previous research was employed as an immunopotentiator, and the impacts of CPG on both the humoral and cellular immunity of S180 tumor-bearing mice were investigated. Results showed that CPG administration of 100 mg/kg could effectively inhibit tumor growth in mice with an inhibitory ratio of 45.37% and significantly improve the expression of Interleukin-2 (IL-2), Interferon-γ (IFN-γ), and Tumor Necrosis Factor-α (TNF-α). Additionally, CPG clearly enhanced B-cell-mediated humoral immunity and immune-cell-mediated cellular immunity, and, finally, induced S180 cell apoptosis by arresting cells in the G0/G1 phase, which might result from the IL-17 signaling pathway. These data may help to improve comprehension surrounding the roles of humoral and cellular immunity in anti-tumor immune responses.
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Affiliation(s)
- Yuting Fan
- Center for Mitochondria and Healthy Aging, College of Life Sciences, Yantai University, Yantai 264005, China; (Y.F.); (Y.L.); (Y.G.); (X.G.)
| | - Yan Long
- Center for Mitochondria and Healthy Aging, College of Life Sciences, Yantai University, Yantai 264005, China; (Y.F.); (Y.L.); (Y.G.); (X.G.)
| | - Youshun Gong
- Center for Mitochondria and Healthy Aging, College of Life Sciences, Yantai University, Yantai 264005, China; (Y.F.); (Y.L.); (Y.G.); (X.G.)
| | - Xiaoji Gao
- Center for Mitochondria and Healthy Aging, College of Life Sciences, Yantai University, Yantai 264005, China; (Y.F.); (Y.L.); (Y.G.); (X.G.)
| | - Guoqiang Zheng
- Center for Functional Factors and Body Immune Regulation Research, College of Food Science and Engineering, Tianjin University of Science and Technology, Tianjin 300457, China;
| | - Haiyu Ji
- Center for Mitochondria and Healthy Aging, College of Life Sciences, Yantai University, Yantai 264005, China; (Y.F.); (Y.L.); (Y.G.); (X.G.)
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Zhou Y, Leahy K, Grose A, Lykins J, Siddiqui M, Leong N, Goodall P, Withers S, Ashi K, Schrantz S, Tesic V, Abeleda AP, Beavis K, Clouser F, Ismail M, Christmas M, Piarroux R, Limonne D, Chapey E, Abraham S, Baird I, Thibodeau J, Boyer K, Torres E, Conrey S, Wang K, Staat MA, Back N, Gomez Marin J, Peyron F, Houze S, Wallon M, McLeod R. Novel paradigm enables accurate monthly gestational screening to prevent congenital toxoplasmosis and more. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.04.26.23289132. [PMID: 37162985 PMCID: PMC10168490 DOI: 10.1101/2023.04.26.23289132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Background Congenital toxoplasmosis is a treatable, preventable disease, but untreated causes death, prematurity, loss of sight, cognition and motor function, and substantial costs worldwide. Methods/Findings In our ongoing USA feasibility/efficacy clinical trial, data collated with other ongoing and earlier published results proved high performance of an Immunochromatographic-test(ICT) that enables accurate, rapid diagnosis/treatment, establishing new paradigms for care. Overall results from patient blood and/or serum samples tested with ICT compared with gold-standard-predicate-test results found ICT performance for 4606 sera/1876 blood, 99.3%/97.5% sensitive and 98.9%/99.7% specific. However, in the clinical trial the FDA-cleared-predicate test initially caused practical, costly problems due to false-positive-IgM results. For 58 persons, 3/43 seronegative and 2/15 chronically infected persons had false positive IgM predicate tests. This caused substantial anxiety, concerns, and required costly, delayed confirmation in reference centers. Absence of false positive ICT results contributes to solutions: Lyon and Paris France and USA Reference laboratories frequently receive sera with erroneously positive local laboratory IgM results impeding patient care. Therefore, thirty-two such sera referred to Lyon's Reference laboratory were ICT-tested. We collated these with other earlier/ongoing results: 132 of 137 USA or French persons had false positive local laboratory IgM results identified correctly as negative by ICT. Five false positive ICT results in Tunisia and Marseille, France, emphasize need to confirm positive ICT results with Sabin-Feldman-Dye-test or western blot. Separate studies demonstrated high performance in detecting acute infections, meeting FDA, CLIA, WHO ASSURED, CEMark criteria and patient and physician satisfaction with monthly-gestational-ICT-screening. Conclusions/Significance This novel paradigm using ICT identifies likely false positives or raises suspicion that a result is truly positive, rapidly needing prompt follow up and treatment. Thus, ICT enables well-accepted gestational screening programs that facilitate rapid treatment saving lives, sight, cognition and motor function. This reduces anxiety, delays, work, and cost at point-of-care and clinical laboratories. Author’s Summary Toxoplasmosis is a major health burden for developed and developing countries, causing damage to eyes and brain, loss of life and substantial societal costs. Prompt diagnosis in gestational screening programs enables treatment, thereby relieving suffering, and leading to > 14-fold cost savings for care. Herein, we demonstrate that using an ICT that meets WHO ASSURED-criteria identifying persons with/without antibody to Toxoplasma gondii in sera and whole blood with high sensitivity and specificity, is feasible to use in USA clinical practice. We find this new approach can help to obviate the problem of detection of false positive anti- T.gondii IgM results for those without IgG antibodies to T.gondii when this occurs in present, standard of care, predicate USA FDA cleared available assays. Thus, this accurate test facilitates gestational screening programs and a global initiative to diagnose and thereby prevent and treat T.gondii infection. This minimizes likelihood of false positives (IgG and/or IgM) while maintaining maximum sensitivity. When isolated IgM antibodies are detected, it is necessary to confirm and when indicated continue follow up testing in ∼2 weeks to establish seroconversion. Presence of a positive ICT makes it likely that IgM is truly positive and a negative ICT makes it likely that IgM will be a false positive without infection. These results create a new, enthusiastically-accepted, precise paradigm for rapid diagnosis and validation of results with a second-line test. This helps eliminate alarm and anxiety about false-positive results, while expediting needed treatment for true positive results and providing back up distinguishing false positive tests.
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Toxoplasmosis diagnostic techniques: Current developed methods and biosensors. Talanta 2023; 252:123828. [DOI: 10.1016/j.talanta.2022.123828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/03/2022] [Accepted: 08/07/2022] [Indexed: 11/22/2022]
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Londoño-Martinez JC, Velasco-Velasquez S, Cordero-Lopez S, Osorio MF, Celis-Giraldo D, Thibodeau J, Baird I, McLeod R, Gomez-Marin J. Evaluation of the acceptability of point of care diagnostic test for prenatal toxoplasmosis (translational research phase III). J Infect Public Health 2022; 16:15-24. [PMID: 36446203 DOI: 10.1016/j.jiph.2022.11.023] [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: 09/26/2022] [Revised: 11/07/2022] [Accepted: 11/16/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND A new point of care test (POC) was developed that is promising as a tool to enhance impact of prenatal care programs for toxoplasmosis, however, no reports exist about its use or acceptability for healthcare personnel and mothers in Colombia. METHODS This was a translational research - phase III study of the acceptability of a new POC test (Toxoplasma ICT IgG-IgM, LDBio) for qualitative diagnosis of toxoplasmosis in 783 pregnant women and 30 health personnel in primary health care sites in the city of Armenia, Quindío (Colombia). Along with collection of the results of diagnostic POC and confirmatory test and demographic information, we evaluated acceptability through measure of the willingness, credibility, and satisfaction by using questionnaires with a Likert scale during routine prenatal care visits. RESULTS POC positivity was 46.5% among pregnant participants and was significantly related to socioeconomic factors, including education level (p = 0.00000000) and insurance status (p = 0.00000015). A total of 93-97% of healthcare personnel indicated agreement to positive statements regarding total satisfaction and total credibility of the LDBio test, but qualitative questions identified "Difficulty in the test procedure" as the most common response about barriers to apply the test. Greater than 90% of pregnant participants agree that POC test should be routine for all pregnant woman and permanently implemented. CONCLUSIONS The test had near complete acceptability. In future studies it is necessary to examine the effect of non-differentiation between IgG and IgM isotypes.
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Affiliation(s)
- Juan Camilo Londoño-Martinez
- Grupo Parasitología Molecular (GEPAMOL), Centro de Investigaciones Biomédicas, Facultad de Ciencias de la Salud, Universidad del Quindio, Armenia, Colombia
| | - Stefany Velasco-Velasquez
- Grupo Parasitología Molecular (GEPAMOL), Centro de Investigaciones Biomédicas, Facultad de Ciencias de la Salud, Universidad del Quindio, Armenia, Colombia
| | - Sara Cordero-Lopez
- Grupo Parasitología Molecular (GEPAMOL), Centro de Investigaciones Biomédicas, Facultad de Ciencias de la Salud, Universidad del Quindio, Armenia, Colombia
| | | | - Daniel Celis-Giraldo
- Grupo Parasitología Molecular (GEPAMOL), Centro de Investigaciones Biomédicas, Facultad de Ciencias de la Salud, Universidad del Quindio, Armenia, Colombia
| | - Juliette Thibodeau
- The College, The University of Chicago, Chicago, IL, USA; Center for Global Health, University of Chicago, Chicago, IL, USA
| | - Isabelle Baird
- The College, The University of Chicago, Chicago, IL, USA; Center for Global Health, University of Chicago, Chicago, IL, USA
| | - Rima McLeod
- Department of Pediatrics (Infectious Diseases Division, University of Chicago, Chicago, IL, USA; CHESSU, Committee on Immunology, University of Chicago, Chicago, IL, USA; Chicago Medicine University of Chicago, Chicago, IL, USA
| | - Jorge Gomez-Marin
- Grupo Parasitología Molecular (GEPAMOL), Centro de Investigaciones Biomédicas, Facultad de Ciencias de la Salud, Universidad del Quindio, Armenia, Colombia.
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Abstract
Purpose of Review Review building of programs to eliminate Toxoplasma infections. Recent Findings
Morbidity and mortality from toxoplasmosis led to programs in USA, Panama, and Colombia to facilitate understanding, treatment, prevention, and regional resources, incorporating student work. Summary Studies foundational for building recent, regional approaches/programs are reviewed. Introduction provides an overview/review of programs in Panamá, the United States, and other countries. High prevalence/risk of exposure led to laws mandating testing in gestation, reporting, and development of broad-based teaching materials about Toxoplasma. These were tested for efficacy as learning tools for high-school students, pregnant women, medical students, physicians, scientists, public health officials and general public. Digitized, free, smart phone application effectively taught pregnant women about toxoplasmosis prevention. Perinatal infection care programs, identifying true regional risk factors, and point-of-care gestational screening facilitate prevention and care. When implemented fully across all demographics, such programs present opportunities to save lives, sight, and cognition with considerable spillover benefits for individuals and societies. Supplementary Information The online version contains supplementary material available at 10.1007/s40124-022-00269-w.
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Building Programs to Eradicate Toxoplasmosis Part IV: Understanding and Development of Public Health Strategies and Advances “Take a Village”. CURRENT PEDIATRICS REPORTS 2022; 10:125-154. [PMID: 35991908 PMCID: PMC9379243 DOI: 10.1007/s40124-022-00268-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/29/2022] [Indexed: 11/12/2022]
Abstract
Purpose of Review Review international efforts to build a global public health initiative focused on toxoplasmosis with spillover benefits to save lives, sight, cognition and motor function benefiting maternal and child health. Recent Findings Multiple countries’ efforts to eliminate toxoplasmosis demonstrate progress and context for this review and new work. Summary Problems with potential solutions proposed include accessibility of accurate, inexpensive diagnostic testing, pre-natal screening and facilitating tools, missed and delayed neonatal diagnosis, restricted access, high costs, delays in obtaining medicines emergently, delayed insurance pre-approvals and high medicare copays taking considerable physician time and effort, harmful shortcuts being taken in methods to prepare medicines in settings where access is restricted, reluctance to perform ventriculoperitoneal shunts promptly when needed without recognition of potential benefit, access to resources for care, especially for marginalized populations, and limited use of recent advances in management of neurologic and retinal disease which can lead to good outcomes. Supplementary Information The online version contains supplementary material available at 10.1007/s40124-022-00268-x.
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10
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Petersen E, Meroni V, Vasconcelos-Santos DV, Mandelbrot L, Peyron F. Congenital toxoplasmosis: Should we still care about screening? Food Waterborne Parasitol 2022; 27:e00162. [PMID: 35782022 PMCID: PMC9249550 DOI: 10.1016/j.fawpar.2022.e00162] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 05/02/2022] [Accepted: 05/06/2022] [Indexed: 11/18/2022] Open
Abstract
Prenatal systematic screening for congenital toxoplasmosis has been performed in Austria and France since 1975 and neonatal screening for congenital toxoplasmosis has been part of the New England Newborn screening program since 1986. In this narrative review we review the data leading up to the systematic screening programs in Austria and France, highlighting the main finding of the European Union funded research in the 1990s and early 2000s. Different descriptive studies of the effect of pre- or postnatal treatment are discussed. Toxoplasma gondii has different genetic lineages with different pathogenicity in humans. This means that results in areas with a low pathogenic lineage cannot be extrapolated to an area with highly pathogenic lineages. The importance of meat as a source of infection is discussed in the light of an increased prevalence of T.gondii in organic livestock production .
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Affiliation(s)
- Eskild Petersen
- Institute for Clinical Medicine, Faculty of Health Science, University of Aarhus, Denmark
- European Society for Clinical Microbiology and Infectious Diseases, Emerging Infections Task Force, Basel, Switzerland
- Correspondong author at: Institute for Clinical Medicine, University of Aarhus, Denmark.
| | - Valeria Meroni
- Molecular Medicine Department, University of Pavia, Pavia, Italy
| | | | - Laurent Mandelbrot
- Assistance Publique-Hôpitaux de Paris, Service de Gynécologie-Obstétrique, Hôpital Louis Mourier, Colombes, France; Université de Paris; Inserm IAME-U1137, Paris, France; FHU PREMA, Paris, France
| | - Francois Peyron
- Institut de Parasitologie et de Mycologie Médicale Hôpital de la Croix Rousse, Lyon, France
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11
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El Mansouri B, Amarir F, Peyron F, Adlaoui EB, Piarroux R, Lykins J, El Abbassi M, Nekkal N, Bouhlal N, Makkaoui K, Barkat A, Lyaghfouri A, Zhou Y, Rais S, Oudghiri M, Elkoraichi I, Zekri M, Belkadi N, Mellouk H, Rhajaoui M, Boutajangout A, Sadak A, Limonne D, McLeod R, El Bissati K. High performance of a novel point-of-care blood test for Toxoplasma infection in women from diverse regions of Morocco. Emerg Microbes Infect 2021; 10:1675-1682. [PMID: 34165384 PMCID: PMC8381951 DOI: 10.1080/22221751.2021.1948359] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Point-of-care (POC) testing for Toxoplasma infection has the potential to revolutionize diagnosis and management of toxoplasmosis, especially in high-risk populations in areas with significant environmental contamination and poor health infrastructure precluding appropriate follow-up and preventing access to medical care. Toxoplasmosis is a significant public health challenge in Morocco, with a relatively heavy burden of infection and, to this point, minimal investment nationally to address this infection. Herein, we analyse the performance of a novel, low-cost rapid test using fingerstick-derived whole blood from 632 women (82 of whom were pregnant) from slums, educational centres, and from nomad groups across different geographical regions (i.e. oceanic, mountainous) of Morocco. The POC test was highly sensitive and specific from all settings. In the first group of 283 women, sera were tested by Platelia ELISA IgG and IgM along with fingerstick whole blood test. Then a matrix study with 349 women was performed in which fingerstick – POC test results and serum obtained by venipuncture contemporaneously were compared. These results show high POC test performance (Sensitivity: 96.4% [IC95 90.6–98.9%]; Specificity: 99.6% [IC95 97.3–99.9%]) and high prevalence of Toxoplasma infection among women living in rural and mountainous areas, and in urban areas with lower educational levels. The high performance of POC test confirms that it can reduce the need for venipuncture and clinical infrastructure in a low-resource setting. It can be used to efficiently perform seroprevalence determinations in large group settings across a range of demographics, and potentially expands healthcare access, thereby preventing human suffering.
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Affiliation(s)
- Bouchra El Mansouri
- Institut National d'Hygiène, Rabat, Morocco.,Faculty of Sciences, Laboratory of Zoology and General Biology, Rabat, Morocco
| | - Fatima Amarir
- Laboratory of Immunity and Biodiversity, Department of Biology, Faculty of Sciences Aïn Chock, Hassan II University, Casablanca, Morocco
| | - François Peyron
- Institut de Parasitologie et de Mycologie Médicale Hôpital de la Croix Rousse, Lyon, France
| | | | | | - Joseph Lykins
- Department of Internal Medicine, Virginia Commonwealth University Health System, Richmond, VA, USA.,Department of Emergency Medicine, Virginia Commonwealth University Health System, Richmond, VA, USA
| | | | - Nesma Nekkal
- Mohamed VI Polytechnic University, CIAM, Benguerir, Morocco
| | - Nadia Bouhlal
- Service de Réseaux des Etablissements Santaires (SRES), Tinghir, Morocco
| | - Kamar Makkaoui
- The Toxoplasmosis Study Group, Obstetrics and Gynecology, Rabat, Morocco
| | - Amina Barkat
- Research Team on Mother-Child Health and Nutrition, Faculty of Medicine & Pharmacy, Mohamed V University, Rabat, Morocco
| | - Aziza Lyaghfouri
- Service de la Protection de la Santé Infantile, Direction de la Population, Rabat, Morocco
| | - Ying Zhou
- Department of Ophthalmology and Visual Sciences, Pediatrics (Infectious Diseases), Global Health Center, Toxoplasmosis Center, University of Chicago Medical Center, Chicago, IL, USA
| | - Samira Rais
- Laboratory of Immunity and Biodiversity, Department of Biology, Faculty of Sciences Aïn Chock, Hassan II University, Casablanca, Morocco
| | - Mounia Oudghiri
- Laboratory of Immunity and Biodiversity, Department of Biology, Faculty of Sciences Aïn Chock, Hassan II University, Casablanca, Morocco
| | - Ismail Elkoraichi
- Laboratory of Immunity and Biodiversity, Department of Biology, Faculty of Sciences Aïn Chock, Hassan II University, Casablanca, Morocco
| | - Mustapha Zekri
- High Institute for Nursing Professions and Health Techniques (ISPITS), Casablanca, Morocco
| | - Nezha Belkadi
- High Institute for Nursing Professions and Health Techniques (ISPITS), Casablanca, Morocco
| | - Hajar Mellouk
- High Institute for Nursing Professions and Health Techniques (ISPITS), Casablanca, Morocco
| | | | - Allal Boutajangout
- Department of Neurology & Physiology and Neuroscience, New York University Langone Health, New York, USA
| | - Abderrahim Sadak
- Faculty of Sciences, Laboratory of Zoology and General Biology, Rabat, Morocco
| | | | - Rima McLeod
- Department of Ophthalmology and Visual Sciences, Pediatrics (Infectious Diseases), Global Health Center, Toxoplasmosis Center, University of Chicago Medical Center, Chicago, IL, USA
| | - Kamal El Bissati
- Institute of Molecular Engineering, University of Chicago Medical Center, Chicago, IL, USA.,Department of Biological and Forensic Sciences, Fayetteville State University, Fayetteville, NC, USA.,University Polytechnic Benguerir, CIPEM, Ben Guerir, Morocco
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12
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Rym B, Yasmine K, Hedia B, Nesrine I, Olfa S, Rania M, Karim A, Aïda B. Contribution of the Toxoplasma ICT IgG IgM ® test in determining the immune status of pregnant women against toxoplasmosis. J Clin Lab Anal 2021; 35:e23749. [PMID: 33720427 PMCID: PMC8128306 DOI: 10.1002/jcla.23749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 02/08/2021] [Accepted: 02/17/2021] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND An immunochromatography technology (ICT) rapid diagnostic test, the Toxoplasma ICT IgG-IgM® , was recently developed. Our aim was to study its contribution to establish accurately the Toxoplasma immune status in Tunisian pregnant women using Western blot (WB) Toxo II IgG® as a reference technique. METHODS Thirty-nine sera were selected for the study from among 2,615 which were already tested by IgG and IgM ELISA. They displayed equivocal IgG titres (4.4-9 IU/ml) in absence of IgM (19 sera) or IgM anti-Toxoplasma antibodies in absence of IgG (titre <4.4 IU/ml) (20 sera). All these sera were additionally tested by WB Toxo II IgG® . RESULTS Immunochromatography technology Sensitivity in the detection either of low IgG titres in absence of IgM or of specific anti-Toxoplasma IgM was 100%. Only one serum with equivocal IgG titre by ELISA and negative with Toxo II IgG® test revealed positive in ICT. However, this serum showed a P30 band in WB analysis. On the other hand, three sera positive in ELISA IgM and negative in ELISA IgG revealed positive in ICT and negative in WB Toxo II IgG® , the reference test. CONCLUSION Results confirm the high sensitivity of Toxoplasma ICT IgG-IgM® in detecting both specific anti-Toxoplasma IgG and IgM, and highlight the usefulness of this rapid test as a first or second-line Toxoplasma serological test in pregnant women.
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Affiliation(s)
- Ben‐Abdallah Rym
- Department of ParasitologyPasteur Institute of TunisTunisTunisia
- Research Laboratory Medical Parasitology, Biotechnology and Biomolecule LR 11IPT‐06Pasteur Institute of TunisUniversity Tunis El‐ManarTunisTunisia
| | | | - Bellali Hedia
- Department of EpidemiologyAbderrahmane Mami HospitalArianaTunisia
| | - Issaoui Nesrine
- Department of ParasitologyPasteur Institute of TunisTunisTunisia
| | - Souissi Olfa
- Department of ParasitologyPasteur Institute of TunisTunisTunisia
| | - Maatoug Rania
- Department of ParasitologyPasteur Institute of TunisTunisTunisia
| | - Aoun Karim
- Department of ParasitologyPasteur Institute of TunisTunisTunisia
- Research Laboratory Medical Parasitology, Biotechnology and Biomolecule LR 11IPT‐06Pasteur Institute of TunisUniversity Tunis El‐ManarTunisTunisia
| | - Bouratbine Aïda
- Department of ParasitologyPasteur Institute of TunisTunisTunisia
- Research Laboratory Medical Parasitology, Biotechnology and Biomolecule LR 11IPT‐06Pasteur Institute of TunisUniversity Tunis El‐ManarTunisTunisia
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13
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Almeria S, Dubey JP. Foodborne transmission of Toxoplasma gondii infection in the last decade. An overview. Res Vet Sci 2020; 135:371-385. [PMID: 33148402 DOI: 10.1016/j.rvsc.2020.10.019] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 10/14/2020] [Accepted: 10/20/2020] [Indexed: 01/07/2023]
Abstract
Toxoplasmosis is a zoonotic disease of global distribution and importance. It is caused by the protozoan parasite Toxoplasma gondii, the only species in the Toxoplasma genus. This parasite can infect most warm-blooded animals, including humans and livestock. Main routes of transmission are by ingestion of tissue cysts in raw or undercooked meat of infected animals, ingestion of raw vegetables or water contaminated with T. gondii oocysts from cat feces, and transplacental. Around one-third of human beings are chronically infected with T. gondii. Most infections appear to be asymptomatic in immunocompetent persons, but toxoplasmosis can be fatal to the fetus and immunocompromised adults. Water and foodborne outbreaks have been caused by this parasite worldwide, but few are well documented. Importantly, T. gondii is a parasite of high importance in animal health, causing reproductive failure, particularly in small ruminants, and clinical toxoplasmosis in many species. This overview discusses the knowledge of T. gondii infections in the last decade focusing on the foodborne transmission of this parasite.
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Affiliation(s)
- S Almeria
- Department of Health and Human Services, Food and Drug Administration, Center for Food Safety and Nutrition, Office of Applied Research and Safety Assessment, Division of Virulence Assessment, Laurel, MD 20708, USA.
| | - J P Dubey
- USA Department of Agriculture, Agricultural Research Service, Beltsville Agricultural Research Service, Animal Parasitic Disease Laboratory, Building 1001, BARC-East, Beltsville, MD 20705-2350, USA
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14
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Abstract
Toxoplasmosis is a global health threat in which occurrence in pregnant women poses grave consequences to fetal wellbeing. Studies on prenatal Toxoplasma gondii infection are generally limited in sub-Saharan African countries, including Nigeria. The risk of transmission of toxoplasmosis is very high in Nigeria due to the favourable climatic conditions and prevailing behavioural and socio-economic factors that could aid transmission. Currently, there are no systematic and organized procedures for diagnosis and treatment of maternal toxoplasmosis in Nigeria. These conditions forecast possible unabated transmission in many areas and exponential impact on associated adverse events of the disease during pregnancy. This paper highlights the importance of early diagnosis and treatment during pregnancy which may forestall subsequent development of infection in children delivered by infected mothers. Inclusion of toxoplasmosis control policy in the routine antenatal care of pregnant women is therefore strongly recommended.
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15
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Bobić B, Villena I, Stillwaggon E. Prevention and mitigation of congenital toxoplasmosis. Economic costs and benefits in diverse settings. Food Waterborne Parasitol 2019; 16:e00058. [PMID: 32095628 PMCID: PMC7034037 DOI: 10.1016/j.fawpar.2019.e00058] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 05/13/2019] [Accepted: 05/13/2019] [Indexed: 11/27/2022] Open
Abstract
Congenital toxoplasmosis (CT), the result of a primary infection of pregnant women with Toxoplasma gondii which was transmitted to the fetus, may result in mild to deep injuries occurring in the newborn or later in its development or in adolescence. The visual and cognitive impairment that can result imposes substantial economic costs on the individual and society. Numerous observational studies favor the conclusion that, with preventive measures currently available, it is possible to reduce the incidence of infections in pregnant women, the incidence of fetal infection by preventing transplacental transmission, and the gravity of injury in infected newborns. Treatment of infected newborns can also reduce the severity of consequences and the frequency of their occurrence later in life. Prevention programs, however, are applied in only a few countries; in most countries implementation of a national prevention program has not been considered or has been thought to be too expensive. This article lists the methods of prevention of CT and describes existing national prevention programs in France and Austria. It analyzes the economic costs and benefits of maternal screening for CT prevention and mitigation for society and for health systems. The economic feasibility of implementing national screening in low-prevalence, high-cost countries is illustrated with the example of the United States. New diagnostic tools are discussed and the implication of lower costs is considered, for countries with well-established screening programs as well as those with inadequate prenatal care networks.
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Affiliation(s)
- Branko Bobić
- Institute for Medical Research, University of Belgrade, Centre of Excellence for Food- and Vector-borne Zoonoses, National Reference Laboratory for Toxoplasmosis, Serbia
| | - Isabelle Villena
- EA 7510, UFR Médecine, University Reims Champagne-Ardenne, National Reference Center on Toxoplasmosis, Hospital Reims, France
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16
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Serological and molecular rapid diagnostic tests for Toxoplasma infection in humans and animals. Eur J Clin Microbiol Infect Dis 2019; 39:19-30. [PMID: 31428897 PMCID: PMC7087738 DOI: 10.1007/s10096-019-03680-2] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 08/11/2019] [Indexed: 02/07/2023]
Abstract
Infection by Toxoplasma gondii is prevalent worldwide. The parasite can infect a broad spectrum of vertebrate hosts, but infection of fetuses and immunocompromised patients is of particular concern. Easy-to-perform, robust, and highly sensitive and specific methods to detect Toxoplasma infection are important for the treatment and management of patients. Rapid diagnostic methods that do not sacrifice the accuracy of the assay and give reproducible results in a short time are highly desirable. In this context, rapid diagnostic tests (RDTs), especially with point-of-care (POC) features, are promising diagnostic methods in clinical microbiology laboratories, especially in areas with minimal laboratory facilities. More advanced methods using microfluidics and sensor technology will be the future trend. In this review, we discuss serological and molecular-based rapid diagnostic tests for detecting Toxoplasma infection in humans as well as animals.
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17
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Wassef R, Abdel-Malek R. Validity of a new immunochromatographic test in detection of Toxoplasma gondii in cancer patients. J Parasit Dis 2018; 43:83-86. [PMID: 30956450 DOI: 10.1007/s12639-018-1063-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Accepted: 11/24/2018] [Indexed: 11/29/2022] Open
Abstract
Screening of toxoplasmosis in cancer patients is mandatory especially before starting treatment to guard against life-threatening disseminated disease. Diagnosis of toxoplasmosis rely mainly on serology. The most widely used method for detection of anti-Toxoplasma gondii (T. gondii) antibodies is the enzyme linked immunosorbent assay (ELISA), being available and reliable. Immunochromatographic tests (ICT) attracted a lot of attention recently being one of the high quality, rapid and easy to perform tests. Available data comparing the performance of ICT versus ELISA techniques have yielded inconsistent results and none compared their performance among the immunocompromised cancer patients. Therefore, we designed this study to compare the performance of a new ICT (the OnSite Toxo IgG/IgM Combo Rapid test) and ELISA techniques for the detection of anti-T. gondii antibody as a tool for screening for toxoplasmosis among cancer patients in Cairo-Egypt. Among 180 cancer patients, a total of 110 patients (61.1%) were positive for anti-T. gondii antibodies by one or both methods. Agreement between both methods was found in 78.8% of the samples. By using ELISA technique as a gold standard test for the detection of anti-T. gondii antibodies, our results showed 87.5% specificity and 74% sensitivity of ICT technique. Moreover, our results proved that ICT is more sensitive in detecting lower level of antibodies than ELISA, that makes it preferable as a screening test for the immunocompromised patients.
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Affiliation(s)
- Rita Wassef
- 1Parasitology Department, Faculty of Medicine, Helwan University, Cairo, Egypt
| | - Raafat Abdel-Malek
- 2Clinical Oncology Department, Faculty of Medicine, Cairo University, Giza, Egypt
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18
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Gomez CA, Budvytyte LN, Press C, Zhou L, McLeod R, Maldonado Y, Montoya JG, Contopoulos-Ioannidis DG. Evaluation of Three Point-of-Care Tests for Detection of Toxoplasma Immunoglobulin IgG and IgM in the United States: Proof of Concept and Challenges. Open Forum Infect Dis 2018; 5:ofy215. [PMID: 30393749 PMCID: PMC6204989 DOI: 10.1093/ofid/ofy215] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 10/24/2018] [Indexed: 11/12/2022] Open
Abstract
Background The cost of conventional serological testing for toxoplasmosis discourages universal adoption of prenatal monthly screening programs to prevent congenital toxoplasmosis. Point-of-care (POC) technology may constitute a cost-effective approach. Methods We evaluated the diagnostic accuracy of 3 Toxoplasma POC tests against gold-standard testing performed at Palo Alto Medical Foundation Toxoplasma Serology Laboratory (PAMF-TSL). The POC tests included the following: Toxo IgG/IgM Rapid Test (Biopanda) and the OnSite Toxo IgG/IgM Combo-Rapid-test that detect IgG and IgM separately, and the Toxoplasma ICT-IgG-IgM-bk (LDBIO) that detects either or both immunoglobulin IgG/IgM in combination. Samples were selected from PAMF-TSL biobank (n = 210) and Centers for Disease Control and Prevention Toxoplasma 1998 Human Serum Panel (n = 100). Based on PAMF-TSL testing, Toxoplasma-infection status was classified in 4 categories: acute infections (n = 85), chronic infections (n = 85), false-positive Toxoplasma IgM (n = 60), and seronegative (n = 80). The POC testing was performed in duplicate following manufacturer's instructions by investigators blinded to PAMF-TSL results. Sensitivity and specificity were calculated. Results A total of 1860 POC tests were performed. For detection of Toxoplasma IgG, sensitivity was 100% (170 of 170; 95% confidence interval [CI], 97.8%-100%) for all 3 POC kits; specificity was also comparable at 96.3% (77 of 80; 95% CI, 89.5%-98.9%), 97.5% (78 of 80; 95% CI, 91.3%-99.6%), and 98.8% (79 of 80; 95% CI, 93.2%-99.9%). However, sensitivity for detection of Toxoplasma IgM varied significantly across POC tests: Biopanda, 62.2% (51 of 82; 95% CI, 51.4%-71.9%); OnSite, 28% (23 of 82; 95% CI, 19.5%-38.6%); and LDBIO combined IgG/IgM, 100% (82 of 82; 95% CI, 95.5%-100%). Diagnostic accuracy was significantly higher for the LDBIO POC kit. The POC kits did not exhibit cross-reactivity for false-positive Toxoplasma-IgM sera. Conclusions The 3 evaluated POC kits revealed optimal sensitivity for Toxoplasma-IgG antibodies. The LDBIO-POC test exhibited 100% sensitivity for the combined detection of IgG/IgM in acute and chronic Toxoplasma infection. Biopanda and Onsite POC tests exhibited poor sensitivity for Toxoplasma-IgM detection.
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Affiliation(s)
- Carlos A Gomez
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, California.,Palo Alto Medical Foundation Toxoplasma Serology Laboratory, National Reference Center for the Study and Diagnosis of Toxoplasmosis, California
| | - Laura N Budvytyte
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, California.,Palo Alto Medical Foundation Toxoplasma Serology Laboratory, National Reference Center for the Study and Diagnosis of Toxoplasmosis, California
| | - Cindy Press
- Palo Alto Medical Foundation Toxoplasma Serology Laboratory, National Reference Center for the Study and Diagnosis of Toxoplasmosis, California
| | - Lily Zhou
- Palo Alto Medical Foundation Toxoplasma Serology Laboratory, National Reference Center for the Study and Diagnosis of Toxoplasmosis, California
| | - Rima McLeod
- Toxoplasmosis Center, Department of Pediatrics, Division of Infectious Diseases, Ophthalmology and Visual Sciences, University of Chicago, Illinois
| | - Yvonne Maldonado
- Department of Pediatrics, Division of Infectious Diseases, Stanford University School of Medicine, California
| | - Jose G Montoya
- Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, California.,Palo Alto Medical Foundation Toxoplasma Serology Laboratory, National Reference Center for the Study and Diagnosis of Toxoplasmosis, California
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19
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El Bissati K, Levigne P, Lykins J, Adlaoui EB, Barkat A, Berraho A, Laboudi M, El Mansouri B, Ibrahimi A, Rhajaoui M, Quinn F, Murugesan M, Seghrouchni F, Gómez-Marín JE, Peyron F, McLeod R. Global initiative for congenital toxoplasmosis: an observational and international comparative clinical analysis. Emerg Microbes Infect 2018; 7:165. [PMID: 30262847 PMCID: PMC6160433 DOI: 10.1038/s41426-018-0164-4] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 07/30/2018] [Accepted: 08/06/2018] [Indexed: 12/14/2022]
Abstract
Globally, congenital toxoplasmosis remains a significant cause of morbidity and mortality, and outbreaks of infection with T. gondii represent a significant, emerging public health burden, especially in the developing world. This parasite is a threat to public health. Disease often is not recognized and is inadequately managed. Herein, we analyze the status of congenital toxoplasmosis in Morocco, Colombia, the United States, and France. We identify the unique challenges faced by each nation in the implementation of optimal approaches to congenital toxoplasmosis as a public health problem. We suggest that developed and developing countries use a multipronged approach, modeling their public health management protocols after those in France. We conclude that education, screening, appropriate treatment, and the development of novel modalities will be required to intervene successfully in caring for individuals with this infection. Gestational screening has been demonstrated to be cost-effective, morbidity-sparing, and life-saving. Recognition of the value and promise of public health interventions to prevent human suffering from this emerging infection will facilitate better patient and societal outcomes.
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Affiliation(s)
- Kamal El Bissati
- Department of Ophthalmology and Visual Sciences, University of Chicago, Chicago, IL, 60637, USA.
| | - Pauline Levigne
- Institut de Parasitologie et de Mycologie Médicale Hôpital de la Croix Rousse, 103 grande rue de la Croix Rousse, 69317, Lyon, France
| | - Joseph Lykins
- Department of Emergency Medicine, Department of Internal Medicine, Virginia Commonwealth University Health System, Richmond, VA, 23219, USA
| | | | - Amina Barkat
- Research Team on Mother-Child Health and Nutrition, Faculté de Médecine et de Pharmacie de Rabat, Université Mohammed V, Rabat, Morocco
| | - Amina Berraho
- Department d'Ophtalmologie, Hôpital des Spécialités, CHU, P6220, Rabat, Morocco
| | | | | | - Azeddine Ibrahimi
- Faculté de Médecine et de Pharmacie de Rabat, Université Mohammed V, Rabat, Morocco
| | | | - Fred Quinn
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA, 30602, USA
| | | | | | - Jorge Enrique Gómez-Marín
- Grupo de Estudio en Parasitología Molecular (GEPAMOL), Centro de Investigaciones Biomédicas, Universidad del Quindio, Av. Bolivar 12N, Armenia, Quindio, Colombia
| | - François Peyron
- Institut de Parasitologie et de Mycologie Médicale Hôpital de la Croix Rousse, 103 grande rue de la Croix Rousse, 69317, Lyon, France
| | - Rima McLeod
- Department of Ophthalmology and Visual Sciences, Department of Pediatrics (Infectious Diseases), Institute of Genomics, Genetics, and Systems Biology, Global Health Center, Toxoplasmosis Center, CHeSS, The College, University of Chicago, Chicago, IL, 60637, USA
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20
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Lykins J, Li X, Levigne P, Zhou Y, El Bissati K, Clouser F, Wallon M, Morel F, Leahy K, El Mansouri B, Siddiqui M, Leong N, Michalowski M, Irwin E, Goodall P, Ismail M, Christmas M, Adlaoui EB, Rhajaoui M, Barkat A, Cong H, Begeman IJ, Lai BS, Contopoulos-Ioannidis DG, Montoya JG, Maldonado Y, Ramirez R, Press C, Peyron F, McLeod R. Rapid, inexpensive, fingerstick, whole-blood, sensitive, specific, point-of-care test for anti-Toxoplasma antibodies. PLoS Negl Trop Dis 2018; 12:e0006536. [PMID: 30114251 PMCID: PMC6095485 DOI: 10.1371/journal.pntd.0006536] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
- Joseph Lykins
- Pritzker School of Medicine, University of Chicago, Chicago, Illinois, United States of America
| | - Xuan Li
- Rush Medical College, Rush University, Chicago, Illinois, United States of America
| | - Pauline Levigne
- Institut de Parasitologie et de Mycologie Médicale Hôpital de la Croix Rousse, Lyon, France
| | - Ying Zhou
- Department of Ophthalmology and Visual Sciences, University of Chicago, Chicago, Illinois, United States of America
| | - Kamal El Bissati
- Department of Ophthalmology and Visual Sciences, University of Chicago, Chicago, Illinois, United States of America
| | - Fatima Clouser
- Department of Ophthalmology and Visual Sciences, University of Chicago, Chicago, Illinois, United States of America
| | - Martine Wallon
- Institut de Parasitologie et de Mycologie Médicale Hôpital de la Croix Rousse, Lyon, France
| | - Florence Morel
- Institut de Parasitologie et de Mycologie Médicale Hôpital de la Croix Rousse, Lyon, France
| | - Karen Leahy
- Department of Obstetrics and Gynecology, University of Chicago, Chicago, Illinois, United States of America
| | | | - Maryam Siddiqui
- Department of Obstetrics and Gynecology, University of Chicago, Chicago, Illinois, United States of America
| | - Nicole Leong
- Department of Obstetrics and Gynecology, University of Chicago, Chicago, Illinois, United States of America
| | - Morgan Michalowski
- Department of Obstetrics and Gynecology, University of Chicago, Chicago, Illinois, United States of America
| | - Erin Irwin
- Department of Obstetrics and Gynecology, University of Chicago, Chicago, Illinois, United States of America
| | - Perpetua Goodall
- Department of Obstetrics and Gynecology, University of Chicago, Chicago, Illinois, United States of America
| | - Mahmoud Ismail
- Department of Obstetrics and Gynecology, University of Chicago, Chicago, Illinois, United States of America
| | - Monica Christmas
- Department of Obstetrics and Gynecology, University of Chicago, Chicago, Illinois, United States of America
| | | | | | - Amina Barkat
- Équipe de recherche en santé et nutrition du couple mère enfant, Faculté de Médecine et de Pharmacie de Rabat, Université Mohammed V, Rabat, Morocco
| | - Hua Cong
- Department of Ophthalmology and Visual Sciences, University of Chicago, Chicago, Illinois, United States of America
| | - Ian J. Begeman
- Department of Ophthalmology and Visual Sciences, University of Chicago, Chicago, Illinois, United States of America
| | - Bo Shiun Lai
- Department of Ophthalmology and Visual Sciences, University of Chicago, Chicago, Illinois, United States of America
| | - Despina G. Contopoulos-Ioannidis
- Department of Pediatrics, Division of Infectious Diseases, Stanford University School of Medicine, Stanford, California, United States of America
| | - Jose G. Montoya
- Palo Alto Medical Foundation Toxoplasma Serology Laboratory, Palo Alto, California, United States of America
- Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California, United States of America
| | - Yvonne Maldonado
- Department of Pediatrics, Division of Infectious Diseases, Stanford University School of Medicine, Stanford, California, United States of America
- Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California, United States of America
| | - Raymund Ramirez
- Palo Alto Medical Foundation Toxoplasma Serology Laboratory, Palo Alto, California, United States of America
| | - Cindy Press
- Palo Alto Medical Foundation Toxoplasma Serology Laboratory, Palo Alto, California, United States of America
| | - Francois Peyron
- Institut de Parasitologie et de Mycologie Médicale Hôpital de la Croix Rousse, Lyon, France
| | - Rima McLeod
- Pritzker School of Medicine, University of Chicago, Chicago, Illinois, United States of America
- Section of Infectious Diseases, Department of Pediatrics, Institute of Genomics, Genetics, and Systems Biology, Global Health Center, Toxoplasmosis Center, CHeSS, The College, University of Chicago, Chicago, Illinois, United States of America
- * E-mail:
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Momčilović S, Cantacessi C, Arsić-Arsenijević V, Otranto D, Tasić-Otašević S. Rapid diagnosis of parasitic diseases: current scenario and future needs. Clin Microbiol Infect 2018; 25:290-309. [PMID: 29730224 DOI: 10.1016/j.cmi.2018.04.028] [Citation(s) in RCA: 60] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Revised: 04/22/2018] [Accepted: 04/24/2018] [Indexed: 01/05/2023]
Abstract
BACKGROUND Parasitic diseases are one of the world's most devastating and prevalent infections, causing millions of morbidities and mortalities annually. In the past, many of these infections have been linked predominantly to tropical or subtropical areas. Nowadays, however, climatic and vector ecology changes, a significant increase in international travel, armed conflicts, and migration of humans and animals have influenced the transmission of some parasitic diseases from 'book pages' to reality in developed countries. It has also been noted that many patients who have never travelled to endemic areas suffer from blood-borne infections caused by protozoa. In the light of existing knowledge, this new trend can be explained by the fact that in the process of migration a large number of asymptomatic carriers become a part of the blood bank donor and transplant donor populations. Accurate and rapid diagnosis represents the crucial weapon in the fight against parasitic infections. AIMS To review old and new approaches for rapid diagnosis of parasitic infections. SOURCES Data for this review were obtained through searches of PubMed using combinations of the following terms: parasitological diagnostics, microscopy, lateral flow assays, immunochromatographic assays, multiplex-PCR, and transplantation. CONTENT In this review, we provide a brief account of the advantages and limitations of rapid methods for diagnosis of parasitic diseases and focus our attention on current and future research in this area. The approximate costs associated with the use of different techniques and their applicability in endemic and non-endemic areas are also discussed. IMPLICATIONS Microscopy remains the cornerstone of parasitological diagnostics, especially in the field and low-resource settings, and provides epidemiological assessment of parasite burden. However, increased use and availability of point-of-care tests and molecular assays in modern era allow more rapid and accurate diagnoses and increased sensitivity in the identification of parasitic infections.
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Affiliation(s)
- S Momčilović
- Department of Microbiology and Immunology, Faculty of Medicine, University of Niš, Serbia.
| | - C Cantacessi
- Department of Veterinary Medicine, University of Cambridge, UK
| | - V Arsić-Arsenijević
- Department for Microbiology and Immunology, Faculty of Medicine, University of Belgrade, Serbia
| | - D Otranto
- Dipartimento di Medicina Veterinaria, Università degli Studi di Bari, Italy
| | - S Tasić-Otašević
- Department of Microbiology and Immunology, Faculty of Medicine, University of Niš, Serbia; Center of Microbiology and Parasitology, Public Health Institute Niš, Serbia
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Wallon M, Peyron F. Congenital Toxoplasmosis: A Plea for a Neglected Disease. Pathogens 2018; 7:E25. [PMID: 29473896 PMCID: PMC5874751 DOI: 10.3390/pathogens7010025] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2018] [Revised: 02/15/2018] [Accepted: 02/17/2018] [Indexed: 11/16/2022] Open
Abstract
Maternal infection by Toxoplasma gondii during pregnancy may have serious consequences for the fetus, ranging from miscarriage, central nervous system involvement, retinochoroiditis, or subclinical infection at birth with a risk of late onset of ocular diseases. As infection in pregnant women is usually symptomless, the diagnosis relies only on serological tests. Some countries like France and Austria have organized a regular serological testing of pregnant women, some others have no prenatal program of surveillance. Reasons for these discrepant attitudes are many and debatable. Among them are the efficacy of antenatal treatment and cost-effectiveness of such a program. A significant body of data demonstrated that rapid onset of treatment after maternal infection reduces the risk and severity of fetal infection. Recent cost-effectiveness studies support regular screening. This lack of consensus put both pregnant women and care providers in a difficult situation. Another reason why congenital toxoplasmosis is disregarded in some countries is the lack of precise information about its impact on the population. Precise estimations on the burden of the disease can be achieved by systematic screening that will avoid bias or underreporting of cases and provide a clear view of its outcome.
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Affiliation(s)
- Martine Wallon
- Hospices Civils de Lyon, Institut de Parasitologie et Mycologie Médicale, Hôpital de la Croix Rousse, F-69317 Lyon, France.
- Waking team, Lyon Neuroscience Research Center, INSERM U1028-CNRS UMR 5292, F-69008 Lyon, France.
| | - François Peyron
- Hospices Civils de Lyon, Institut de Parasitologie et Mycologie Médicale, Hôpital de la Croix Rousse, F-69317 Lyon, France.
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Evaluation of a New Immunochromatography Technology Test (LDBio Diagnostics) To Detect Toxoplasma IgG and IgM: Comparison with the Routine Architect Technique. J Clin Microbiol 2017; 55:3395-3404. [PMID: 28954897 DOI: 10.1128/jcm.01106-17] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 09/08/2017] [Indexed: 11/20/2022] Open
Abstract
A study comparing the ICT (immunochromatography technology) Toxoplasma IgG and IgM rapid diagnostic test (LDBio Diagnostics, France) with a fully automated system, Architect, was performed on samples from university hospitals of Marseille and Saint-Etienne. A total of 767 prospective sera and 235 selected sera were collected. The panels were selected to test various IgG and IgM parameters. The reference technique, Toxoplasma IgGII Western blot analysis (LDBio Diagnostics), was used to confirm the IgG results, and commercial kits Platelia Toxo IgM (Bio-Rad) and Toxo-ISAgA (bioMérieux) were used in Saint-Etienne and Marseille, respectively, as the IgM reference techniques. Sensitivity and specificity of the ICT and the Architect IgG assays were compared using a prospective panel. Sensitivity was 100% for the ICT test and 92.1% for Architect (cutoff at 1.6 IU/ml). The low-IgG-titer serum results confirmed that ICT sensitivity was superior to that of Architect. Specificity was 98.7% (ICT) and 99.8% (Architect IgG). The ICT test is also useful for detecting IgM without IgG and is both sensitive (100%) and specific (100%), as it can distinguish nonspecific IgM from specific Toxoplasma IgM. In comparison, IgM sensitivity and specificity on Architect are 96.1% and 99.6%, respectively (cutoff at 0.5 arbitrary units [AU]/ml). To conclude, this new test overcomes the limitations of automated screening techniques, which are not sensitive enough for IgG and lack specificity for IgM (rare IgM false-positive cases).
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Begeman IJ, Lykins J, Zhou Y, Lai BS, Levigne P, El Bissati K, Boyer K, Withers S, Clouser F, Noble AG, Rabiah P, Swisher CN, Heydemann PT, Contopoulos-Ioannidis DG, Montoya JG, Maldonado Y, Ramirez R, Press C, Stillwaggon E, Peyron F, McLeod R. Point-of-care testing for Toxoplasma gondii IgG/IgM using Toxoplasma ICT IgG-IgM test with sera from the United States and implications for developing countries. PLoS Negl Trop Dis 2017. [PMID: 28650970 PMCID: PMC5501679 DOI: 10.1371/journal.pntd.0005670] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Background Congenital toxoplasmosis is a serious but preventable and treatable disease. Gestational screening facilitates early detection and treatment of primary acquisition. Thus, fetal infection can be promptly diagnosed and treated and outcomes can be improved. Methods We tested 180 sera with the Toxoplasma ICT IgG-IgM point-of-care (POC) test. Sera were from 116 chronically infected persons (48 serotype II; 14 serotype I-III; 25 serotype I-IIIa; 28 serotype Atypical, haplogroup 12; 1 not typed). These represent strains of parasites infecting mothers of congenitally infected children in the U.S. 51 seronegative samples and 13 samples from recently infected persons known to be IgG/IgM positive within the prior 2.7 months also were tested. Interpretation was confirmed by two blinded observers. A comparison of costs for POC vs. commercial laboratory testing methods was performed. Results We found that this new Toxoplasma ICT IgG-IgM POC test was highly sensitive (100%) and specific (100%) for distinguishing IgG/IgM-positive from negative sera. Use of such reliable POC tests can be cost-saving and benefit patients. Conclusions Our work demonstrates that the Toxoplasma ICT IgG-IgM test can function reliably as a point-of-care test to diagnose Toxoplasma gondii infection in the U.S. This provides an opportunity to improve maternal-fetal care by using approaches, diagnostic tools, and medicines already available. This infection has serious, lifelong consequences for infected persons and their families. From the present study, it appears a simple, low-cost POC test is now available to help prevent morbidity/disability, decrease cost, and make gestational screening feasible. It also offers new options for improved prenatal care in low- and middle-income countries. Toxoplasmosis, a disease caused by the parasite Toxoplasma gondii, presents a major health burden in both the developed and developing world. Untreated congenital toxoplasmosis causes damage to the eye and brain, but early detection and treatment reduce transmission and disease. Fetal infection can be promptly diagnosed and treated and outcomes can be improved. Gestational screening for toxoplasmosis has international precedent. In this paper, we demonstrated that the new Toxoplasma ICT IgG-IgM test had 100% sensitivity and specificity in detecting Toxoplasma infection (N = 180 U.S. sera from uninfected persons and those with varying parasite serotypes). The use of an inexpensive, easy-to-use point-of-care test facilitates screening of pregnant women for T. gondii infection. In turn, this facilitates prompt treatment for the infection and thereby reduces the health burden caused by this disease. This provides an opportunity to improve maternal-fetal care by using approaches, diagnostic tools, and medicines already available.
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Affiliation(s)
- Ian J. Begeman
- Department of Ophthalmology and Visual Science, The University of Chicago, Chicago, Illinois, United States of America
| | - Joseph Lykins
- Pritzker School of Medicine, The University of Chicago, Chicago, Illinois, United States of America
| | - Ying Zhou
- Department of Ophthalmology and Visual Science, The University of Chicago, Chicago, Illinois, United States of America
| | - Bo Shiun Lai
- Department of Ophthalmology and Visual Science, The University of Chicago, Chicago, Illinois, United States of America
| | - Pauline Levigne
- Institut de Parasitologie et de Mycologie Médicale Hôpital de la Croix Rousse, Lyon, France
| | - Kamal El Bissati
- Department of Ophthalmology and Visual Science, The University of Chicago, Chicago, Illinois, United States of America
| | - Kenneth Boyer
- Department of Ophthalmology and Visual Science, The University of Chicago, Chicago, Illinois, United States of America
- Rush University and Medical Center, Chicago, Illinois, United States of America
| | - Shawn Withers
- Department of Ophthalmology and Visual Science, The University of Chicago, Chicago, Illinois, United States of America
| | - Fatima Clouser
- Department of Ophthalmology and Visual Science, The University of Chicago, Chicago, Illinois, United States of America
| | - A. Gwendolyn Noble
- Department of Ophthalmology and Visual Science, The University of Chicago, Chicago, Illinois, United States of America
- Lurie Children’s Hospital and Northwestern University, Chicago, Illinois, United States of America
| | - Peter Rabiah
- Department of Ophthalmology and Visual Science, The University of Chicago, Chicago, Illinois, United States of America
- Northshore Hospital, Evanston, Illinois, United States of America
| | - Charles N. Swisher
- Department of Ophthalmology and Visual Science, The University of Chicago, Chicago, Illinois, United States of America
- Lurie Children’s Hospital and Northwestern University, Chicago, Illinois, United States of America
| | - Peter T. Heydemann
- Department of Ophthalmology and Visual Science, The University of Chicago, Chicago, Illinois, United States of America
- Rush University and Medical Center, Chicago, Illinois, United States of America
| | - Despina G. Contopoulos-Ioannidis
- Department of Pediatrics, Division of Infectious Diseases, Stanford University School of Medicine, Stanford, California, United States of America
| | - Jose G. Montoya
- Palo Alto Medical Foundation Toxoplasma Serology Laboratory, Palo Alto, California, United States of America
- Department of Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California, United States of America
| | - Yvonne Maldonado
- Department of Pediatrics, Division of Infectious Diseases, Stanford University School of Medicine, Stanford, California, United States of America
- Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California, United States of America
| | - Raymund Ramirez
- Palo Alto Medical Foundation Toxoplasma Serology Laboratory, Palo Alto, California, United States of America
| | - Cindy Press
- Palo Alto Medical Foundation Toxoplasma Serology Laboratory, Palo Alto, California, United States of America
| | | | - François Peyron
- Institut de Parasitologie et de Mycologie Médicale Hôpital de la Croix Rousse, Lyon, France
| | - Rima McLeod
- Department of Ophthalmology and Visual Science, The University of Chicago, Chicago, Illinois, United States of America
- Department of Pediatrics (Infectious Diseases), Institute of Genomics, Genetics, and Systems Biology, Global Health Center, Toxoplasmosis Center, the Center for Health and the Social Sciences, CHeSS, the College, The University of Chicago, Chicago Medicine, Chicago, Illinois, United States of America
- * E-mail:
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