1
|
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.
Collapse
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
| |
Collapse
|
2
|
Seeber F. Past and present seroprevalence and disease burden estimates of Toxoplasma gondii infections in Germany: An appreciation of the role of serodiagnostics. Int J Med Microbiol 2023; 313:151592. [PMID: 38056090 DOI: 10.1016/j.ijmm.2023.151592] [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: 10/12/2023] [Revised: 11/21/2023] [Accepted: 11/28/2023] [Indexed: 12/08/2023] Open
Abstract
Toxoplasmosis is one of the major foodborne parasitic diseases in Germany, with 49% of its population chronically infected with its causative agent, Toxoplasma gondii. Although the acute disease is usually benign in immunocompetent individuals, it is a threat for immunocompromised patients as well as for fetuses of seronegative mothers. As a result of infection, congenital and ocular toxoplasmosis can have serious lifelong consequences. Here I will highlight the epidemiologic situation, from its past in the two separate parts of Germany, to its unification 30 years ago and up to the present day. The main identified risk factor for infection in Germany is thought to be the consumption of undercooked or raw meat or sausages. However, the relative impact of this risky eating habit as well as that of other risk factors are changing and are discussed and compared to the situation in the Netherlands. Finally, the importance of robust and efficient high-throughput serological assays for obtaining reliable epidemiological data, on which public health decisions can be made, is highlighted. The potential of bead-based multiplex assays, which allow the incorporation of multiple antigens with different analytical properties and thus yield additional information, are described in this context. It illustrates the interdependence of new analytic assay developments and sound epidemiology, a foundation that decades-old data from Germany did not have.
Collapse
Affiliation(s)
- Frank Seeber
- FG 16 - Mycotic and parasitic agents and mycobacteria, Robert Koch-Institut, Seestrasse 10, D-13353 Berlin, Germany.
| |
Collapse
|
3
|
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.
Collapse
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.
| |
Collapse
|
4
|
Márquez-Mauricio A, Caballero-Ortega H, Gómez-Chávez F. Congenital Toxoplasmosis Diagnosis: Current Approaches and New Insights. Acta Parasitol 2023; 68:473-480. [PMID: 37368128 DOI: 10.1007/s11686-023-00693-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 06/07/2023] [Indexed: 06/28/2023]
Abstract
PURPOSE The aim of this study is to describe and discuss current disadvantages in congenital toxoplasmosis (CT) diagnosis, and what can be improved or changed through new perspectives and technological advances. METHODS We used Pubmed, Cochrane, and EBSCO databases to research publications from 10 years to date describing current diagnostic methods for CT. The keywords used for this Mini-Review were Toxoplasma gondii, congenital toxoplasmosis, diagnosis, and prospects using Boolean operators such as AND, OR, identifying scientific publications highlighting the importance of implementing new diagnostic methods. RESULTS Current diagnosis methods have several disadvantages, i.e., time-consuming, low sensitivity or specificity, and non-cost effective, that bring up the necessity of improving or developing new approaches. Recombinant proteins can help improve specificity by generating tests that use circulating strains in a specific geographical region, SAG1 and BAG1, as they are expressed during a particular stage of the disease (acute or chronic, respectively), for its use in serological diagnoses, such as capture ELISA and immunochromatography. Point of Care (POC) tests are methods performed at the patient care site, which leads to rapid patient treatment; despite the advantages, several improvements and perspectives are necessary to be implemented globally. CONCLUSIONS Although already established diagnosis methods for CT may be sufficient in some regions, there is still a persistent demand to develop tests with higher throughput, cost, and time reduction in developing countries, where prevalence is high. New approaches in CT diagnosis, such as recombinant proteins, capture ELISA, immunochromatography, and POC tests methods, can increase performance in terms of specificity and sensitivity simplifying diagnostic tests' requirements.
Collapse
Affiliation(s)
| | | | - Fernando Gómez-Chávez
- Laboratorio de Enfermedades Osteoarticulares e Inmunológicas, Sección de Estudios de Posgrado e Investigación, ENMyH-Instituto Politécnico Nacional, Mexico City, Mexico.
| |
Collapse
|
5
|
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.
Collapse
|
6
|
Abdul Ameer Jaber K, Aamer Noori R. Comparisons of Toxoplasma gondii Prevalence in Rural and Urban Areas of Al-Najaf Province of Iraq Using Serological Methods. ARCHIVES OF RAZI INSTITUTE 2021; 76:1695-1701. [PMID: 35546971 PMCID: PMC9083856 DOI: 10.22092/ari.2021.356315.1822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Accepted: 10/29/2021] [Indexed: 06/15/2023]
Abstract
Toxoplasma gondii (T. gondii) is an intracellular protozoan parasite that multiplies within the host cell and causes the disease toxoplasmosis. T. gondii is distributed worldwide and is capable of infecting almost all warm-blooded animals. The current study was conducted in several urban and rural regions in AL-Najaf province of Iraq from September 2020 to April 2021. In total, 190 blood samples were collected and screened for T. gondii IgG and IgM antibodies using Rapid Diagnostic immunochromatographic test and the enzyme-linked immunosorbent assay (ELISA). These two tests were performed on 5 ml of blood samples. The results of the ICT test showed that 80 (42.1%) samples were positive for IgG; however, no IgM positive sample was recorded. The results of ELISA revealed that 27 (33.7%) and 4 (5%) samples were positive for T. gondii IgG and IgM antibodies, respectively. The estimated incidence of toxoplasmosis increased significantly in the 21-30 years age group and females (P<0.05), compared to other groups. The wide prevalence of toxoplasmosis was observed in Iraq, especially in Najaf province, which was reflected in the results of the study after taking random samples from different places with no symptoms of the disease. Therefore, all members of the community should undergo periodic examinations to diagnose possible infection through the most accurate tests.
Collapse
|
7
|
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.
Collapse
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
| |
Collapse
|
8
|
Robert-Gangneux F, Guegan H. Anti-Toxoplasma IgG assays: What performances for what purpose? A systematic review. Parasite 2021; 28:39. [PMID: 33904818 PMCID: PMC8078101 DOI: 10.1051/parasite/2021035] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 03/31/2021] [Indexed: 12/27/2022] Open
Abstract
Chronic infection with Toxoplasma gondii is attested by the detection of specific anti-Toxoplasma IgG. A wide panel of serologic methods is currently marketed, and the most suitable method should be chosen according to the laboratory resources and the screened population. This systematic review of evaluation studies aimed at establishing an overview of the performances, i.e. sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of marketed anti-Toxoplasma IgG assays, and discussing their technical characteristics to guide further choice for routine diagnostic use. According to PRISMA guidelines, the search performed in PubMed and Web of Science databases recovered 826 studies, of which 17 were ultimately included. Twenty commercial anti-Toxoplasma IgG assays were evaluated, in comparison with an accepted reference method. Most of them were enzyme-immunoassays (EIAs, n = 12), followed by agglutination tests (n = 4), immunochromatographic tests (n = 3), and a Western-Blot assay (WB, n = 1). The mean sensitivity of IgG assays ranged from 89.7% to 100% for standard titers and from 13.4% to 99.2% for low IgG titers. A few studies pointed out the ability of some methods, especially WB to detect IgG early after primary infection. The specificity of IgG assays was generally high, ranging from 91.3% to 100%; and higher than 99% for most EIA assays. The PPV was not a discriminant indicator among methods, whereas significant disparities (87.5%-100%) were reported among NPVs, a key-parameter assessing the ability to definitively rule out a Toxoplasma infection in patients at-risk for opportunistic infections.
Collapse
Affiliation(s)
- Florence Robert-Gangneux
-
Université de Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé Environnement Travail), UMR_S 1085 35000 Rennes France
| | - Hélène Guegan
-
Université de Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé Environnement Travail), UMR_S 1085 35000 Rennes France
| |
Collapse
|
9
|
Tosa N, Ishida T, Yoshimatsu K, Hayashimoto N, Shiokawa K, Takakura A, Arikawa J. Simultaneous serodetection of major rat infectious pathogens by a multiplex immunochromatographic assay. Exp Anim 2020; 70:161-168. [PMID: 33177250 PMCID: PMC8150241 DOI: 10.1538/expanim.20-0099] [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] [Indexed: 11/05/2022] Open
Abstract
Rapid and simple serologic tests that require only a small amount of blood without the euthanization of animals are valuable for microbial control in colonies
of laboratory animals. In this study, we developed a multiplex immunochromatographic assay (ICA) for detection of antibodies to Sendai virus (also known as
hemagglutinating virus of Japan), hantavirus, and sialodacryoadenitis virus, which are causative agents of major infectious diseases in rats. For this assay, an
ICA strip was placed into a microtube containing 150 µl PBS and either 0.75 µl of rat serum or 1.5 µl of
whole blood. Binding antibodies were visualized by using anti-rat IgG antibody-conjugated colloidal gold. Under these conditions, the multiplex ICA
simultaneously and specifically detected antibodies to multiple antigens. Positive serum samples for each infectious disease were used to evaluate the
sensitivity and specificity of the multiplex ICA. The sensitivities of the multiplex ICA for Sendai virus, hantavirus, and sialodacryoadenitis virus were 100%,
100%, and 81%, respectively. No nonspecific reactions were observed in any of the 52 positive sera against heterologous antigens. In addition, 10 samples of
uninfected sera did not show any bands except for the control line. These observations indicate high specificity of the multiplex ICA. Moreover, the multiplex
ICA could be applied to diluted blood. These results indicate that the multiplex ICA is appropriate for rapid and simple serological testing of laboratory
rats.
Collapse
Affiliation(s)
- Noriko Tosa
- Institute for Animal Experimentation, Faculty of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, Hokkaido 060-8638, Japan
| | - Tomoko Ishida
- ICLAS Monitoring Center, Central Institute for Experimental Animals, 3-25-12 Tonomachi, Kawasaki, Kanagawa 210-0821, Japan
| | - Kumiko Yoshimatsu
- Laboratory of Animal Experimentation, Institute for Genetic Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, Hokkaido 060-0815, Japan
| | - Nobuhito Hayashimoto
- ICLAS Monitoring Center, Central Institute for Experimental Animals, 3-25-12 Tonomachi, Kawasaki, Kanagawa 210-0821, Japan
| | - Kanae Shiokawa
- Department of Microbiology and Immunology, Faculty of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, Hokkaido 060-8638, Japan
| | - Akira Takakura
- ICLAS Monitoring Center, Central Institute for Experimental Animals, 3-25-12 Tonomachi, Kawasaki, Kanagawa 210-0821, Japan
| | - Jiro Arikawa
- Department of Microbiology and Immunology, Faculty of Medicine, Hokkaido University, Kita 15, Nishi 7, Kita-ku, Sapporo, Hokkaido 060-8638, Japan
| |
Collapse
|
10
|
Ybañez RHD, Nishikawa Y. Serological detection of T. gondii infection in humans using an immunochromatographic assay based on dense granule protein 7. Parasitol Int 2020; 76:102089. [PMID: 32092466 DOI: 10.1016/j.parint.2020.102089] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Revised: 02/05/2020] [Accepted: 02/19/2020] [Indexed: 01/18/2023]
Abstract
Toxoplasma gondii causes toxoplasmosis, one of the world's most common parasitic diseases. It secretes large amounts of dense granule antigens (TgGRAs), which are crucial to the parasite's survivability. TgGRA7 is found abundantly on the surface of host cells, within the parasitophorous vacuole lumen and membrane, and the host cell cytosol. It stimulates a strong antibody response during acute and chronic infections. While it has been well utilized as an antigen for enzyme-linked immunosorbent assay (ELISA), only one report has documented its efficacy as an antigen for an immunochromatographic test (ICT) in pigs. To date, there is no study yet documenting its use for ICT in human toxoplasmosis. Here, we validated the efficacy of the TgGRA7-ICT we developed by testing 88 human sera. Results were compared with those obtained by ELISA based on TgGRA7, a commercial ELISA, and latex agglutination test (LAT). With high sensitivity, specificity, and kappa values, our TgGRA7-ICT results revealed very good agreement with standard test results. We also found a strong correlation between the relative ICT band intensity and absorbance values in the ELISA. Altogether, our data suggest that the current ICT with TgGRA7 is a reliable test for the diagnosis of human toxoplasmosis, which produced results similar to conventional serological methods. Thus, this can be used as a screening tool for routine testing of toxoplasmosis and a good option for point of care application. The present study also documents the first utilization of TgGRA7 as an antigen for ICT for the serodiagnosis of human toxoplasmosis.
Collapse
Affiliation(s)
- Rochelle Haidee D Ybañez
- National Research Center for Protozoan Diseases, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Hokkaido 080-8555, Japan
| | - Yoshifumi Nishikawa
- National Research Center for Protozoan Diseases, Obihiro University of Agriculture and Veterinary Medicine, Obihiro, Hokkaido 080-8555, Japan.
| |
Collapse
|
11
|
Picone O, Fuchs F, Benoist G, Binquet C, Kieffer F, Wallon M, Wehbe K, Mandelbrot L, Villena I. Toxoplasmosis screening during pregnancy in France: Opinion of an expert panel for the CNGOF. J Gynecol Obstet Hum Reprod 2020; 49:101814. [PMID: 32428782 DOI: 10.1016/j.jogoh.2020.101814] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 05/12/2020] [Indexed: 11/15/2022]
Abstract
Prenatal screening to prevent congenital toxoplasmosis as performed in France for several decades has been questioned in view of the decreasing incidence of this infection and the cost of testing. The French College of Obstetrics and Gynecology mandated a multidisciplinary panel of experts to perform a reassessment of the screening program in accordance with international good practice. In France, about 70% of pregnant women are not immune to T. gondii, and 0.2-0.25% become infected during pregnancy. The risk of maternal-fetal transmission of infection is on average 25-29% and depends greatly on the gestational age at seroconversion. In case of fetal transmission, the outcome is livebirth in 95% of cases, with latent congenital toxoplasmosis in 90% of cases and symptomatic forms in 10% of cases, of which 1/3 are severe and 2/3 moderate. Biological techniques have satisfactory performance regarding serologies for the diagnosis of maternal infections and PCR on amniotic fluid for the prenatal diagnosis of congenital toxoplasmosis. Primary prevention of toxoplasmosis is based on hygiene measures that are relatively simple, but poorly implemented. In case of maternal seroconversion, there is a strong case for prenatal prophylactic treatment as soon as possible (ideally within 3 weeks of seroconversion), spiramycin before 14 weeks of gestation (WG), and with a tendency to superiority of the pyrimethamine/sulfadiazine association over spiramycin beyond 14 W G, in order to reduce the risk of symptomatic congenital toxoplasmosis. In case of congenital toxoplasmosis, prompt initiation of treatment reduces the occurrence of cerebral signs and symptoms, as well as retinal lesions. Several medico-economic evaluations of the French toxoplasmosis screening program have been conducted including an individual cost-effectiveness approach with decision analysis which concluded on the profitability of prenatal screening as carried out in France (monthly surveillance of seronegative women, prenatal treatment in case of seroconversion, termination of pregnancy in severe forms). Though most international societies do not recommend systematic screening for mainly financial reasons, if congenital toxoplasmosis appears benign in France today, it is probably thanks to screening and the possibility of early treatment of fetuses and/or newborns. Thus, the panel recommends continuing for now the program in France for prevention of congenital toxoplasmosis.
Collapse
Affiliation(s)
- Olivier Picone
- Assistance Publique-Hôpitaux de Paris, Service de Gynécologie-Obstétrique, Hôpital Louis Mourier, Colombes, France; Université de Paris; Inserm IAME-U1137, Paris, France; FHU PREMA; Groupe de Recherche sur les Infections pendant la grossesse (GRIG)
| | - Florent Fuchs
- Service de Gynécologie Obstétrique CHU de Montpellier, Hopital Arnaud de Villeneuve, Montpellier, France; Inserm, CESP Centre de recherche en Epidémiologie et Santé des Populations, U1018, Reproduction et Développement de l'enfant, 94807 Villejuif, France; EA2415: Aide à la décision médicale Personnalisée, Axe B: Méthode en épidémiologie Clinique, Université de Montpellier
| | | | - Christine Binquet
- Inserm, CIC1432, module Epidémiologie Clinique, Dijon, France; CHU Dijon-Bourgogne, Centre d'Investigation Clinique, Module Epidémiologie Clinique/Essais Cliniques, Dijon, France
| | - François Kieffer
- Assistance Publique-Hôpitaux de Paris, Service de néonatologie, Hôpital Armand Trousseau, Paris, France
| | - Martine Wallon
- Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Service de Parasitologie - Mycologie Médicale, Lyon, France; Université Lyon-1, Equipe Waking, Physiologie Intégrée du Système d'éveil, Centre de Recherche en Neurosciences de Lyon (INSERM U1028 - CNRS UMR 5292), Bron, France
| | - Karl Wehbe
- Centre Hospitalier Universitaire de Strasbourg, Service de Gynécologie-Obstétrique, Strasbourg, France
| | - 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; Groupe de Recherche sur les Infections pendant la grossesse (GRIG)
| | - Isabelle Villena
- Université Reims Champagne -Ardenne, EA7510 et Centre National de Référence de la Toxoplasmose, Centre de Ressources Biologiques Toxoplasma, Service de Parasitologie-Mycologie, Centre Hospitalier Universitaire de Reims, Reims, France
| |
Collapse
|
12
|
Simon L, Fillaux J, Guigon A, Lavergne RA, Villard O, Villena I, Marty P, Pomares C. Serological diagnosis of Toxoplasma gondii: analysis of false-positive IgG results and implications. Parasite 2020; 27:7. [PMID: 32031519 PMCID: PMC7006501 DOI: 10.1051/parasite/2020006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 01/29/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Primary infection by Toxoplasma gondii in pregnant women can result in serious outcomes for the foetus. A false-positive IgG result during pregnancy can lead to a misdiagnosis of past infection and to stopping preventive measures. We collected 189 sera with positive Architect® Toxo IgG assay (Abbott Laboratories) and negative IgG results with at least two other serological tests, in order to find an explanation for the suspected false-positive IgG results. We used the recomLine Toxoplasma IgG® immunoblot (Mikrogen Diagnostik) to search for specific antigenic reactivities of the sera, and the LDBio Toxo II IgG® immunoblot (LDBio Diagnostics) as a confirmatory test. RESULTS The bands GRA8 and/or GRA7 were positive for 148 samples (78.3%). GRA8 was the most frequent band, appearing in 133 patterns (70.4%), whereas GRA7 was present for 49 samples (25.9%). Of the 81 samples tested with LDBio®, 23 (28.4%) turned out to be positive. Of the 58 negative LDBio® tests (71.6%) (real false-positive Architect® IgG), 23 samples (39.6%) did not show either a GRA8 or p30 band by recomLine®. Their false positivity with Architect® remains unexplained since Abbott uses these two recombinant antigens for their assay. CONCLUSIONS The Architect® IgG false positivity for T. gondii seems to be due to reactivity against GRA8 for the majority of the sera and GRA7 to a lesser extent. The hypothesis of past contact with parasites genetically close to T. gondii such as Hammondia hammondi or Neospora caninum seems promising and should be assessed further.
Collapse
Affiliation(s)
- Loïc Simon
-
Service de Parasitologie-Mycologie, CHU de Nice, Université Côte d’Azur 06202 Nice France
-
Inserm U1065, C3M 06204 Nice France
| | - Judith Fillaux
-
Service de Parasitologie-Mycologie, CHU de Toulouse 31300 Toulouse France
-
PharmaDev, IRD UMR 152, Université de Toulouse 31062 Toulouse France
| | - Aurélie Guigon
-
Service de Microbiologie, Hôpital La Source, CHR d’Orléans 45100 Orléans France
| | - Rose-Anne Lavergne
-
Parasitologie-Mycologie, CHU de Nantes 44093 Nantes France
-
Université de Nantes, Nantes Atlantique Universités, EA1155-IICiMed, Institut de Recherche en Santé 2 44200 Nantes France
| | - Odile Villard
-
Institut de Parasitologie et de Pathologie Tropicale, EA 7292, Fédération de Médecine Translationnelle, Université de Strasbourg 67000 Strasbourg France
| | - Isabelle Villena
-
EA7510, ESCAPE, Laboratoire de Parasitologie-Mycologie, Université de Reims Champagne-Ardenne, SFR Cap Santé FED 4231 51096 Reims France
| | - Pierre Marty
-
Service de Parasitologie-Mycologie, CHU de Nice, Université Côte d’Azur 06202 Nice France
-
Inserm U1065, C3M 06204 Nice France
| | - Christelle Pomares
-
Service de Parasitologie-Mycologie, CHU de Nice, Université Côte d’Azur 06202 Nice France
-
Inserm U1065, C3M 06204 Nice France
| |
Collapse
|
13
|
Tosa N, Ishida T, Yoshimatsu K, Hayashimoto N, Shiokawa K, Takakura A, Arikawa J. Multiplex Immunochromatographic Assay for Serologic Diagnosis of Major Infectious Diseases in Laboratory Mice. JOURNAL OF THE AMERICAN ASSOCIATION FOR LABORATORY ANIMAL SCIENCE 2019; 58:790-795. [PMID: 31519225 DOI: 10.30802/aalas-jaalas-19-000008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Serologic monitoring of infectious diseases is important for microbial control in colonies of laboratory mice. Rapid and simple tests that do not require killing animals are valuable for this purpose. In this study, we developed a multiplex immunochromatographic assay (ICA) for detection of antibodies to mouse hepatitis virus (MHV), Sendai virus (also known as hemagglutinating virus of Japan [HVJ]), and Clostridium piliforme (The pathogen that causes Tyzzer disease), which are major infectious diseases in mice. For this assay, an ICA strip was put into a microtube containing 150 μL PBS and either 0.75 μL mouse serum or 1.5 μL whole blood. Binding antibodies were visualized by using protein A-conjugated colloidal gold. Under these conditions, multiplex ICA simultaneously and specifically detected antibodies to multiple antigens. To evaluate the sensitivity and specificity of multiplex ICA, positive serum samples for each infectious disease were used. Sensitivities of the multiplex ICA test for MHV, HVJ, and C. piliforme were 100%, 100%, and 90%, respectively. No nonspecific reaction was observed in any of the 30 positive sera. In addition, 10 samples of uninfected sera did not show any bands except for the control line. These observations indicate high specificity of the multiplex ICA test. Moreover, the multiplex ICA could be applied to diluted blood. These results indicate that the multiplex ICA is appropriate for rapid, simple, and safe serologic testing of laboratory mice.
Collapse
Affiliation(s)
- Noriko Tosa
- Institute for Animal Experimentation, Department of Microbiology, Faculty of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Tomoko Ishida
- ICLAS Monitoring Center, Central Institute for Experimental Animals, Kawasaki, Japan
| | - Kumiko Yoshimatsu
- Department of Microbiology, Faculty of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan;,
| | - Nobuhito Hayashimoto
- Department of Microbiology, Faculty of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Kanae Shiokawa
- Department of Microbiology, Faculty of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| | - Akira Takakura
- ICLAS Monitoring Center, Central Institute for Experimental Animals, Kawasaki, Japan
| | - Jiro Arikawa
- Institute for Animal Experimentation, Department of Microbiology, Faculty of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan; Department of Microbiology, Faculty of Medicine, Hokkaido University, Sapporo, Hokkaido, Japan
| |
Collapse
|
14
|
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: 24] [Impact Index Per Article: 4.8] [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.
Collapse
|
15
|
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.
Collapse
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
| |
Collapse
|
16
|
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.
Collapse
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
| | | |
Collapse
|
17
|
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.
Collapse
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
| |
Collapse
|
18
|
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:
| |
Collapse
|