Al-Yami Fatimah Salim, Dar Fazal Karim, Yousef Abdulrahman Ismaeel, Al-Qurouni Bader Hamad, Al-Jamea Lamiaa Hamad, Rabaan Ali A, Quiambao Jenifer Vecina, Arulanantham Zechariah Jebakumar, Woodman Alexander
Department of Medical Laboratory, King Fahad Military Medical Complex-Dhahran, Saudi Arabia.
College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain.
Saudi Pharm J. 2021 Apr;29(4):343-350. doi: 10.1016/j.jsps.2021.03.009. Epub 2021 Mar 25.
Globally, congenital toxoplasmosis remains a significant cause of morbidity and mortality, and outbreaks of T. gondii infection represent a major public health threat, especially in developing countries. Evidence in the literature indicates that only a few studies have been conducted on the incidence of maternal and congenital toxoplasmosis in Saudi Arabia. This prospective study aims to measure the overall incidence of congenital toxoplasmosis, both patent and 'silent' infection, among pregnant women in the Eastern Province of Saudi Arabia. The study would attempt to relate the cord blood results with the time of seroconversion in the mother, underlining the importance of early intervention in such cases.
Five hundred paired maternal/cord blood samples were tested for anti-Toxoplasma IgG or IgM antibodies. Samples were collected during delivery from mother and newborn (cord blood) from November 2011 to May 2012. Only positive for anti-Toxoplasma IgG or/and IgM cord blood was processed for real-time PCR for confirmation. The age of mothers ranged from 16 to 45 years.
The sample subjects were tested during child delivery for specific IgG and IgM antibodies against Toxoplasmosis, of which 21.0% (n = 105) mother/baby pairs were found serologically positive for anti-Toxoplasma IgG antibodies. The rate of maternal seropositivity for anti-Toxoplasma IgM antibodies was found among 4 participants (0.8%), who were also seropositive for anti-Toxoplasma IgG antibodies. None of the children tested positive for anti-Toxoplasma IgM antibodies, even those born to mothers with IgM positive. All 105 cord blood tests in the study sample were confirmed negative by real-time PCR. The seroprevalence of Toxoplasma IgG antibodies increased with maternal age, parity, and was significantly higher in women who gave birth to children with congenital anomalies (p = 0.008).
The findings of the current study indicate a dire need to develop and implement preventive programs against Toxoplasma gondii infection, as well as a health education program on how to avoid toxoplasmosis for all seronegative women during pregnancy.
在全球范围内，先天性弓形虫病仍然是发病和死亡的重要原因，弓形虫感染的爆发构成了重大的公共卫生威胁，尤其是在发展中国家。文献证据表明，关于沙特阿拉伯孕妇和先天性弓形虫病发病率的研究较少。这项前瞻性研究旨在测量沙特阿拉伯东部省孕妇中先天性弓形虫病（显性和“隐性”感染）的总体发病率。该研究将尝试将脐血结果与母亲血清转化时间相关联，强调在此类病例中早期干预的重要性。
对500对母婴配对样本进行抗弓形虫IgG或IgM抗体检测。样本于2011年11月至2012年5月分娩时从母亲和新生儿（脐血）中采集。仅对脐血抗弓形虫IgG或/和IgM呈阳性的样本进行实时PCR确认。母亲年龄在16至45岁之间。
在分娩时对样本对象进行了针对弓形虫病的特异性IgG和IgM抗体检测，其中21.0%（n = 105）的母婴对血清学检测抗弓形虫IgG抗体呈阳性。在4名参与者（0.8%）中发现抗弓形虫IgM抗体的母亲血清阳性，她们同时抗弓形虫IgG抗体也呈阳性。没有儿童抗弓形虫IgM抗体检测呈阳性，即使是母亲IgM呈阳性的儿童。研究样本中的所有105份脐血检测经实时PCR确认均为阴性。弓形虫IgG抗体的血清阳性率随母亲年龄、产次增加，并且在分娩出先天性异常儿童的女性中显著更高（p = 0.008）。
当前研究结果表明迫切需要制定和实施针对弓形虫感染的预防计划，以及为所有孕期血清阴性女性开展关于如何避免弓形虫病的健康教育计划。
