From the Department of Medical Parasitology Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Hematology/Oncology Unit, Department of Pediatrics, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Pediatr Infect Dis J. 2019 Mar;38(3):236-240. doi: 10.1097/INF.0000000000002111.
Children with β-thalassemia major who regularly receive blood transfusion are at risk of developing transfusion-transmitted infection. Toxoplasmosis is a common and a serious parasitic disease with high prevalence and could be transmitted through blood transfusion from healthy asymptomatic donors. However, screening Toxoplasma gondii before blood donation has not been considered. The objective of this study was to determine the prevalence of T. gondii antibodies among thalassemia children undergoing blood transfusion.
In a case-control study, serum samples from 211 thalassemia children and 100 control children were investigated for Toxoplasma IgM and IgG using the enzyme-linked immunosorbent assay. Positive serum samples for IgG antibodies to T. gondii were further subjected to IgG avidity enzyme-linked immunosorbent assay.
The seroprevalence of Toxoplasma infection among thalassemia children was 23.2% and 53.6% for IgM and IgG anti-Toxoplasma antibodies, respectively. Whereas in the control group, the prevalence was 5% and 18% for IgM and IgG anti-Toxoplasma antibodies, respectively. There is a significant statistical difference between thalassemia and control groups regarding the prevalence of toxoplasmosis. From these positive IgG samples, 65.5% have low avidity indicating recent infection while 38.73% have high avidity indicating past infection.
Due to the high serologic infection rate of toxoplasmosis among thalassemia pediatric population in this study with no existing effective therapies and no available T. gondii vaccine, appropriate strategies are critical for reducing the risk of that infection. Screening of blood for T. gondii antibodies should be considered before transmission to those children especially in countries with a high prevalence of toxoplasmosis.
经常接受输血的重型β地中海贫血儿童有感染输血传播感染的风险。弓形体病是一种常见且严重的寄生虫病，发病率很高，可通过来自健康无症状供体的输血传播。然而，献血前筛查弓形体病尚未被考虑。本研究旨在确定接受输血的地中海贫血儿童中弓形体病抗体的流行率。
在病例对照研究中，使用酶联免疫吸附试验检测 211 名地中海贫血儿童和 100 名对照儿童的血清样本中是否存在弓形体 IgM 和 IgG 抗体。对 IgG 抗体呈阳性的血清样本进一步进行 IgG 亲和力酶联免疫吸附试验。
地中海贫血儿童中弓形体感染的血清流行率分别为 IgM 和 IgG 抗弓形体抗体的 23.2%和 53.6%。而在对照组中，IgM 和 IgG 抗弓形体抗体的流行率分别为 5%和 18%。地中海贫血组和对照组在弓形体病的流行率方面存在显著的统计学差异。在这些阳性 IgG 样本中，65.5%具有低亲和力，表明近期感染，而 38.73%具有高亲和力，表明既往感染。
由于本研究中地中海贫血儿科人群的弓形体病血清学感染率较高，而目前尚无有效的治疗方法，也没有可用的弓形体病疫苗，因此采取适当的策略对于降低感染风险至关重要。在这些儿童中，特别是在弓形体病高发的国家，应考虑对血液进行弓形体病抗体筛查。
