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Suker A, Li Y, Robson D, Marren A. Australasian recurrent pregnancy loss clinical management guideline 2024, part II. Aust N Z J Obstet Gynaecol 2024. [PMID: 38934293 DOI: 10.1111/ajo.13820] [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: 09/28/2023] [Accepted: 04/03/2024] [Indexed: 06/28/2024]
Abstract
Part II of the Australasian guideline for the investigation and management of recurrent pregnancy loss (RPL) provides evidence-based guidance on the management of RPL provided. The implications of inherited and acquired thrombophilia with respect to RPL and suggestions for clinical management are provided. Autoimmune factors, including human leukocyte antigen, cytokines, antinuclear antibodies and coeliac antibodies, and guidance for management are discussed. Infective, inflammatory and endometrial causes of RPL are discussed in detail. Environmental and lifestyle factors, male factor and unexplained causes are outlined. Levels of evidence and grades of consensus are provided for all evidence-based statements.
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Affiliation(s)
- Adriana Suker
- Department of Obstetrics and Gynaecology, Liverpool Hospital, Sydney, New South Wales, Australia
| | - Ying Li
- Department of Reproductive Endocrinology and Infertility, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Danielle Robson
- Department of Reproductive Endocrinology and Infertility, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
| | - Anthony Marren
- Department of Reproductive Endocrinology and Infertility, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
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Shoukat T, Awan UA, Mahmood T, Afzal MS, Wasif S, Ahmed H, Cao J. Epidemiology of Toxoplasmosis among the Pakistani Population: A Systematic Review and Meta-Analysis. Pathogens 2022; 11:pathogens11060675. [PMID: 35745528 PMCID: PMC9227424 DOI: 10.3390/pathogens11060675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2022] [Revised: 05/22/2022] [Accepted: 05/25/2022] [Indexed: 11/23/2022] Open
Abstract
Toxoplasma gondii is an intracellular obligate parasite that causes toxoplasmosis, a zoonotic infection that affects warm-blooded animals and humans worldwide. To comprehensively characterize the disease condition in Pakistan for future reference, we ascertained the prevalence of Toxoplasma infection and predisposing factors in the Pakistani population over a 20-year period. We systematically reviewed research articles published in English (2000−2020) from PubMed and Google Scholar. The search results 26 publications involving 10,924 people and 2611 seropositive cases. The toxoplasmosis seropositivity rate was higher in women (25.44%) as compared to men (21.48%) and were statistically significant (p < 0.001). Furthermore, seropositivity was high among people with direct contact with cats, who consumed uncooked meat and raw vegetables, had poor education, and lived in rural areas. The 35−65-year age group had the highest prevalence rate of T. gondii infection. Toxoplasma infection was significantly more prevalent in Khyber Pakhtunkhwa province (25.87%) than in Punjab (20.42%) (p < 0.001). This is the first comprehensive analysis of T. gondii infection epidemiology in Pakistan. It reveals a high frequency of infection among women. We strongly encourage further research to aid patient care and the development of more efficient diagnostic tests and preventative techniques.
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Affiliation(s)
- Tehniat Shoukat
- Department of Biosciences, COMSATS University Islamabad (CUI), Islamabad 45550, Pakistan;
| | - Usman Ayub Awan
- Department of Medical Laboratory Technology, The University of Haripur, Haripur 22620, Pakistan;
| | - Tahir Mahmood
- Industrial and Systems Engineering Department, College of Computing and Mathematics, King Fahd University of Petroleum and Minerals, Dhahran 31261, Saudi Arabia;
- Interdisciplinary Research Center for Smart Mobility & Logistics, King Fahd University of Petroleum and Minerals, Dhahran 31261, Saudi Arabia
| | - Muhammad Sohail Afzal
- Department of Life Sciences, School of Science, University of Management and Technology (UMT), Lahore 54770, Pakistan;
| | - Samia Wasif
- Department of Humanities, COMSATS University Islamabad (CUI), Islamabad 45550, Pakistan;
| | - Haroon Ahmed
- Department of Biosciences, COMSATS University Islamabad (CUI), Islamabad 45550, Pakistan;
- Correspondence: (H.A.); (J.C.)
| | - Jianping Cao
- National Institute of Parasitic Diseases, Chinese Center for Disease Control and Prevention, (Chinese Center for Tropical Diseases Research), Shanghai 200025, China
- Key Laboratory of Parasite and Vector Biology, National Health Commission of the People’s Republic of China, Shanghai 200025, China
- WHO Collaborating Center for Tropical Diseases, Shanghai 200025, China
- The School of Global Health, Chinese Center for Tropical Diseases Research, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China
- Correspondence: (H.A.); (J.C.)
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Abdul Hafeez M, Mehdi M, Aslam F, Ashraf K, Aleem MT, Khalid AR, Sattar A, Waheed SF, Alouffi A, Alharbi OO, Shabbir MAB, Chaudhry U, Almutairi MM. Molecular Characterization of Toxoplasma gondii in Cats and Its Zoonotic Potential for Public Health Significance. Pathogens 2022; 11:pathogens11040437. [PMID: 35456112 PMCID: PMC9026455 DOI: 10.3390/pathogens11040437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/18/2022] [Accepted: 03/28/2022] [Indexed: 11/26/2022] Open
Abstract
Toxoplasmosis is a globally distributed disease of warm-blooded animals. It is caused by the opportunistic parasite Toxoplasma gondii (T. gondii). One-third of the global human population is believed to be infected with T. gondii. Cats serve as final host of T. gondii and are the main source of contamination of soil and water. This study aimed to detect genotypes of T. gondii in cats. Fecal samples (n = 400) were collected from districts of South Punjab (Khanewal and Sahiwal), and were processed by polymerase chain reaction (PCR) followed by sequencing and phylogenetic analysis. The obtained oligonucleotide sequences (T. gondii) were submitted to the GenBank database, and the evolutionary tree was constructed using MEGA-X software. Seven fecal samples (3.5%) from cats were positive. Five out of thirteen fecal samples (38.46%) found to be positive for T. gondii with microscopy were confirmed by PCR. After phylogenetic analysis with 3 clonal types and atypical strains, isolates of T. gondii in current study were more closely linked to a typical strain (AF249696). Besides genotyping from cats, seroprevalence from humans and ruminants is still considered to be the best and easiest way to identify the Toxoplasma. Blood samples were collected from sheep and goats (n = 2000 each), and human blood samples (n = 400) were collected from the same vicinity. Seroprevalence was determined using a commercial enzyme-linked immunosorbent assay (ELISA) kit. In Khanewal, the blood samples of 292 goats (29.2%) and 265 sheep (26.5%), and 6 fecal samples from cats (3%) were positive. Out of 200 human blood samples, 52 were positive, with a seroprevalence of 26%. In the Sahiwal district, the blood samples from 49 humans, 235 sheep and 348 goats were positive, with seroprevalence of 24.5%, 23.5% and 34.8%, respectively. The present study revealed the current circulating genotype of T. gondii from cats in the districts Khanewal and Sahiwal and the seroprevalence of the organism in small ruminants and humans living in the same vicinity. Further genotype analyses of the organism from ruminants and humans are needed.
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Affiliation(s)
- Mian Abdul Hafeez
- Department of Parasitology, University of Veterinary and Animal Sciences, Lahore 54000, Pakistan; (M.M.); (K.A.)
- Correspondence: (M.A.H.); (M.M.A.)
| | - Muntazir Mehdi
- Department of Parasitology, University of Veterinary and Animal Sciences, Lahore 54000, Pakistan; (M.M.); (K.A.)
| | - Faiza Aslam
- Department of Pathology, University of Veterinary and Animal Sciences, Lahore 54000, Pakistan; (F.A.); (S.F.W.)
| | - Kamran Ashraf
- Department of Parasitology, University of Veterinary and Animal Sciences, Lahore 54000, Pakistan; (M.M.); (K.A.)
| | - Muhammad Tahir Aleem
- MOE Joint International Research Laboratory of Animal Health and Food Safety, College of Veterinary Medicine, Nanjing Agricultural University, Nanjing 210095, China;
| | - Abdur Rauf Khalid
- Department of Livestock and Poultry Production, Faculty of Veterinary Sciences, Bahauddin Zakariya University, Multan 60000, Pakistan;
| | - Adeel Sattar
- Department of Pharmacology and Toxicology, University of Veterinary and Animal Sciences, Lahore 54000, Pakistan;
| | - Syeda Fakhra Waheed
- Department of Pathology, University of Veterinary and Animal Sciences, Lahore 54000, Pakistan; (F.A.); (S.F.W.)
| | - Abdulaziz Alouffi
- King Abdulaziz City for Science and Technology, Riyadh 12354, Saudi Arabia;
| | - Omar Obaid Alharbi
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia;
| | | | - Umer Chaudhry
- Department of Veterinary Epidemiology and Public Health, School of Veterinary Medicine, University of Surrey, Surrey GU27XH, UK;
| | - Mashal M. Almutairi
- Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh 11451, Saudi Arabia;
- Correspondence: (M.A.H.); (M.M.A.)
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Chen L, Zhao ZJ, Meng QF. Detection of Specific IgG-Antibodies Against Toxoplasma gondii in the Serum and Milk of Domestic Donkeys During Lactation in China: A Potential Public Health Concern. Front Cell Infect Microbiol 2021; 11:760400. [PMID: 34746030 PMCID: PMC8566817 DOI: 10.3389/fcimb.2021.760400] [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] [Received: 08/18/2021] [Accepted: 09/27/2021] [Indexed: 11/20/2022] Open
Abstract
Toxoplasma gondii is a worldwide zoonotic protozoan. Donkeys are often susceptible to many pathological agents, acting as carriers of pathogens for other animal species and humans. However, data on the prevalence of T. gondii in donkeys during lactation and on the status of antibodies against T. gondii in donkey milk are lacking. A cross-sectional study evaluated the variation of the anti-T. gondii antibodies in the blood and milk of domestic donkeys during lactation. A total of 418 domestic donkeys were randomly selected from the Shandong province, eastern China from January 2019 to March 2020. The anti-T. gondii antibodies were found in 11.72% (49/418) serum and 9.81% (41/418) milk samples using a commercial ELISA kit, respectively. There was a very high consistency between the serum and milk (Spearman’s coefficient = 0.858, p-value < 0.0001 and Kendall’s tau = 0.688, p-value < 0.0001), particularly at the 45th to 60th day of lactation. The present results of the statistical analysis showed that the history of abortion (p = 0.026; adjusted OR = 2.20; 95% CI: 1.15–4.20) and cat in the house (p = 0.008; adjusted OR = 2.36; 95% CI: 1.26–4.44) were significantly associated with T. gondii infection in the domestic donkeys. This is the first report to detect antibodies against T. gondii in donkey milk in China. These results indicate a potential risk of humans contracting the infection through the consumption of raw milk from the naturally infected donkeys.
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Affiliation(s)
- Long Chen
- Institute of Animal Nutrition and Feed, Jilin Academy of Agricultural Sciences, Gongzhuling, China
| | - Zi-Jian Zhao
- Institute of Agro-food Technology, Jilin Academy of Agricultural Sciences, Changchun, China
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Yılmaz A, Yazıcı E, Turk C. Assessment of seroprevalence of Toxoplasma gondii in blood donors applied to the blood center of Gazi university hospital. IRANIAN JOURNAL OF MICROBIOLOGY 2021; 13:243-247. [PMID: 34540160 PMCID: PMC8408027 DOI: 10.18502/ijm.v13i2.5986] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Background and Objectives: Toxoplasmosis is a life-threatening zoonotic infection in immunosuppressive individuals. Determining the prevalence and seropositivity rates of toxoplasmosis in asymptomatic blood donors is crucial in terms of the risk status of the transmission of this infection to the blood recipients. Materials and Methods: In this study, the presence and level of the specific Toxoplasma IgG and IgM antibodies in blood donors was investigated by electrochemiluminescence immunoassay (ECLIA). The statistical significance levels between Toxoplasma seropositivity and demographic characteristics of the donors such as age, educational status, raw meat consumption, drinking water supply were examined. Results: Toxoplasma IgG seropositivity was found among the 225 (25.6%) of the donors present in the study group, while IgM seropositivity was detected in 20 donors (2.3%). The number of donors with only IgM (+) was 8 (0.9%). Both IgG and IgM seropositivities were found in 12 donors (1.4%). Conclusion: Our study provides information about Toxoplasma seropositivity based on the samples collected from the donors who were admitted to the blood center of a university hospital in Ankara, Turkey. This study demonstrates that Toxoplasma seropositivity is high in the rural areas and the regions where the education level is low.
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Affiliation(s)
- Ayşegül Yılmaz
- Department of Medical Microbiology, School of Medicine, Lokman Hekim University, Ankara, Turkey
| | - Engin Yazıcı
- Department of Immunology, School of Medicine, Gazi University, Ankara, Turkey
| | - Can Turk
- Department of Medical Microbiology, School of Medicine, Lokman Hekim University, Ankara, Turkey
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