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ORIGINAL ARTICLE
Year : 2001  |  Volume : 8  |  Issue : 1  |  Page : 45-48  

Sero-prevalence of toxoplasmosis in pregnant mothers and new born infants in eastern province, Saudi Arabia


1 Department of Obstetrics/Gynecology, College of Medicine, King Faisal University, Dammam, Saudi Arabia
2 Department of Microbiology, College of Medicine, King Faisal University, Dammam, Saudi Arabia

Date of Web Publication30-Jul-2012

Correspondence Address:
Abdulaziz A Al-Mulhim
College of Medicine, King Faisal University, P.O. Box 40093, Al-Khobar 31952
Saudi Arabia
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Source of Support: None, Conflict of Interest: None


PMID: 23008638

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   Abstract 

Background: Toxoplasma gondii is an obligate intracellular protozoa of worldwide distribution. In immunocompetent adults, it is usually the cause of asymptomatic infection. However, infection during pregnancy poses a special risk because of the teratogenic effect of toxoplasma.
Objective: D etermine the sero-prevalence of toxoplasmosis in pregnant women and newborn infants in King Fahd Hospital of the University, Al-Khobar, Eastern Province.
Methods: In this hospital-based study, sera from 175 pregnant females were screened for toxoplasma IgG and IgM.
Results and Conclusion: A very low number (N=1/175, 0.57%) of pregnant mothers seroconverted during pregnancy, although many (N=69/175, 39.4%) were recorded with inactive toxoplasmosis during pregnancy. Delivery was normal in all cases except for a small number (N=1/175, 0.57%) of newborns (as recorded from cord blood) who were positive for toxoplasmosis.

Keywords: Toxoplasma, pregnant women


How to cite this article:
Al-Mulhim AA, Al-Qurashi AM. Sero-prevalence of toxoplasmosis in pregnant mothers and new born infants in eastern province, Saudi Arabia. J Fam Community Med 2001;8:45-8

How to cite this URL:
Al-Mulhim AA, Al-Qurashi AM. Sero-prevalence of toxoplasmosis in pregnant mothers and new born infants in eastern province, Saudi Arabia. J Fam Community Med [serial online] 2001 [cited 2020 Oct 23];8:45-8. Available from: https://www.jfcmonline.com/text.asp?2001/8/1/45/98128


   Introduction Top


Toxoplasma infection is universal in all countries of the world. [1] The definitive host is the domestic cat, its feces being the main source of infection. Human infection is acquired mainly through contact with an infected cat, ingestion of tissue cyst, under­cooked or raw livestock meat. [2] Studies con­ducted on the prevalence of toxoplasmosis in Saudi Arabia are mainly hospital-based. No community-based studies on the sero­prevalence of toxoplasmosis in humans in Saudi Arabia have so far been conducted. The current study was motivated by the fact that though some work on toxoplasmosis in pregnant mothers in Saudi Arabia has been conducted, [3],[4],[5],[6],[7] the new technique of micro­particle enzymes immunoassay (MEIA) was not used in any of these except two. [8],[9] However, the latter were not community-based.

The study aimed at determining the seroprevalence of toxoplasmosis in pregnant mothers (seroconversion during pregnancy) and infants born to these mothers. It is a part of a larger study of seroprevalence of toxoplasmosis in males and females of all ages in the Eastern Province.


   Material and Methods Top


This was a hospital-based study conducted at King Fahd Hospital of the University (KFHU). The study population comprised pregnant mothers and later their infants attending the antenatal clinic at KFHU. Sera from pregnant mothers in their second and third trimesters (a sample of 175) and later from the cord blood of the infants of these mothers were collected to determine IgM. Blood specimens were collected by vena­puncture by trained medical personnel under the supervision of members of the research team. The specimens were taken to the nearest primary health care center; serum was prepared and stored at 20 o C for further analysis by the MEIA for IgG and IgM. [10]

In this test, IMX Toxo IgG assay results of less than 2.94 IU/mL were considered negative for IgG antibody to T. gondii. IMX Toxo IgG assay results of greater than or equal to 2.94 IU/mL were considered posi­tive for IgG antibody to T. gondii and may indicate past inactive infection. Sera from subjects who were positive for IgG were tested for IgM using the same technique: IMX Toxo IgM (MEIA) for IgM. IMX Toxo IgM assay indexes of less than 0.500 are negative for IgM antibody to T. gondii. IMX Toxo IgM antibody to T. gondii in­di­cates acute active infection. Ma­ternal blood was collected from a peri­­pheral vein by vena­puncture and cord blood was collected from a large vein on the fetal side of the placenta immediately after delivery.

Data were analyzed by computer, using SPSS version 6. Analysis of variance, Chi-square and T-tests were used as appropriate, taking significant values of p to be < 0.05.


   Results Top


Seroprevalence of toxoplasmosis in preg­nant mothers and their infants [Table 1] shows toxoplasma antibodies (IgG) in pregnant mothers during pregnancy. The ages of the pregnant women ranged from 25-35 (25±8) years. Of the 175 pregnant women included in the samples, 69 (39.4%) were found to be seropositive with values ranging from 0.6 to 300 IU/ml. Of these, only one mother was found to have active infection (0.57%).
Table 1: Toxoplasma antibodies IgG in pregnant mothers during pregnancy*

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[Table 2] shows the perinatal outcome and IgM levels in the cord blood of infants born to the mothers in the sample. One infant was found to have active toxoplasmosis (value of 0.5% for IgM). However, he had no abnormalities. The IgM values of the other cord samples were negative. The deliveries of the pregnant mothers were normal in all 175 cases: fetal weight ranged from 2.5-3.9 kg (mean=2.8 ± 1.2). There were no abor­tions, stillbirths or premature deliveries.
Table 2: Perinatal results of pregnant mothers and IgM levels in cord blood

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   Discussion Top


The diagnostic technique (MEIA) used in the present study is a relatively new tech­nique, but has been well docu­mented by other researchers. The technique was evaluated at 15 clinical locations in Europe and the USA. A high sensitivity of 97%, as well as a high specificity of 99.8%, was recorded. [10],[11],[12]

It has already been shown that for the general population in the Eastern Province, the inactive toxoplasmosis (IgG levels) was about 25%, which is rather high. [5] That for the pregnant mothers was even higher (39.4%).

It is, however, comparable to that re­corded for the Dammam area (42.1%) and higher than that for the Hofuf area (22.7%). [5],[13] Other investigators have recorded similar values in other areas of the Kingdom. [4],[5],[6],[7],[14] This seroprevalence in pregnant mothers of the present study is in accordance with epi­de­mi­ological surveys in the Eastern Re­gion. [13] However, there was a very low level (1 of 175) of seroconversion (active toxoplas­mosis), and congenital transmission occur­red in this study similar to that level recorded in the Dammam area (1/152) and that recorded over all of Saudi Arabia (9/1863). [5]

The perinatal outcome of the pregnancy in this study is remarkably favorable. There were no abortions, stillbirths or premature deliveries, or congenital anomalies. This has a significant bearing on screening and management. According to our findings only those at high risk need be screened, since it may not be cost effective to routinely screen all pregnant mothers.

 
   References Top

1.Frejj BJ, Sever JL. Toxoplasmosis: Paediatric in Review 1991;72:227-36.  Back to cited text no. 1
    
2.Heyneman D, Goldsmith R. Tropical Medicine and Parasitology. Prentice Hall International, 1992;942.  Back to cited text no. 2
    
3.Kandil OF, Gamal-Eddin FM, Hosni MA, El-Dasougi IT. Toxoplasmosis among healthy parous women in Saudi Arabia. J Egyp Soc Parasit 1979; 9:481-90.  Back to cited text no. 3
    
4.Basalamah A, Seribour F. Toxoplasmosis in pregnancy - a survey of 1000 pregnant Saudis and non-Saudis attending King Abdulaziz University, Jeddah. Saudi Med J 1981; 2:125-9.  Back to cited text no. 4
    
5.Abbas SA, Basalamah A, Serebour F, Alfonso M. The prevalence of Toxoplasma Gondii antibodies in Saudi women and the outcome of congenital infection among newborns in Saudi Arabia. Saudi Med J 1986;7:346-54.  Back to cited text no. 5
    
6.Al-Mesharim A, Chowdhury M, Chattopadhyaya S, De-Silva S. Screening for toxoplasmosis in pregnancy. Int J Gyn Obstet 1989; 29:39-45.  Back to cited text no. 6
    
7.El-Sebai MM. Study on toxoplamosis in Qasseem, Saudi Arabia. Journal of the Egyptian Soc Parasit 1991; 21:273-5.  Back to cited text no. 7
    
8.El-Hady HM. Toxoplasmosis among pregnant mothers in Abha, Saudi Arabia. J Egyptian Soc Parasit 1991; 21:811-5.  Back to cited text no. 8
    
9.Ikram HH. Antibody to toxoplasma gondii among pregnant women in Medina Munawara. J Pak Med Assoc 1992; 42:44-5.  Back to cited text no. 9
    
10.Valcavi PP, Natali A, Soliani L, Montalo S, Deltoic G, Cheezi C. Prevalence of anti-toxoplasma gondii antibodies in the population of the area of Parma (Italy). Europ J of Epidemiol 1995; 11:333-7.  Back to cited text no. 10
    
11.Lyasu V, Robert A, Schaefer L, Maciozek J. Multicenter evaluation of a new commercial assay for detection of immunoglobulin M antibodies to Toxoplasma gondii, Multicenter Study Group. Europ J of Clin Microb and Infect Dis 1995; 14:487-93.  Back to cited text no. 11
    
12.Pitothory JJ, Reiter OI, Berthelot F, Milgram M, Deloye J, Perlersen E. Performance of European laboratories testing serum samples for Toxoplasma gondii. Europ J Clin Microb Infect Dis 1996; 15:45-9.  Back to cited text no. 12
    
13.Yanaza A, Kumari P. Prevalence of toxoplasma antibodies in blood donors in Al-Hassa. Ann of Saudi Med 1994; 14:230-2.  Back to cited text no. 13
    
14.Al-Amari OM. Prevalence of antibodies to Toxoplasma gondii among blood donors in Abha, Asir region, South Western Arabia. J of the Egyp Pub Health Assoc 1994; 69:77-88.  Back to cited text no. 14
    



 
 
    Tables

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