A FIVE-YEAR INVESTIGATION OF THE

SEROPOSITIVITY OF TOXOPLASMA

GONDİİ IN KARS STATE HOSPITAL

(KARS, TURKEY)

Neriman Mor¹ Atila Akça²

Kafkas University Kars School of Health, 36100, Kars-TurkeyKafkas University Faculty of Veterinary Medicine, Department of Parasitology,

36100, Kars- TurkeyTel: +90-474-225-1150, E-mail: nery.man@hotmail.com

Toxoplasmosis is one of the zoonotic diseases.

Etiologic agent = Toxoplasma gondii.

Toxoplasma gondii is an obligate intracellular

parasite

Definitive host=Mainly domestic and wild cats.

Intermediate host= Human, birds, pigs,

rodents, cattle and sheep

Tissue phase (intermediate hosts).

Intermediate host gets infected by

ingesting sporulated oocysts.

The oocyte is excreted in the feces of the cat. Oocytes do not

become infectious until they sporulate in the environment,

sporulation occurs within 1 to 5 days.

Intermediate host

Human, cattle, birds,

rodents, pigs, and sheep.

Sources of infection :

_ Contaminated water or food by oocysts_ Undercooked meat._ Mother to fetus._ Organ transplant (rare)._ Blood transfusion (rare).

DEFINITIVE HOST

INTERMEDIATE HOST

TOXOPLASMA TRANSMISSION

Ingestion of tachyzoites and

bradyzoites (cysts) in flesh of infected

host.

Symptoms Infection is usually asymyomatic in healthy individuals. In acute infection:Lymphadenitis is the most common in humans.Flu-like symptoms (Headache, fever, muscle pain) the

infection is generally self limited & symptom usually resolve in a few months.

Causes Encephalitis, hiptitis in the immunosuppressed patients and people infected with HIV.

Congenital neurological defects in infants.Abortion.

In chronic infections:visual problems or blindness may occur over time.

DiagnosisBiopsy of humans.(SFDT) Sabin-Feldman Dye Test.(ELISA) Enzyme-Linked Immuno sorbent

Assays.(IFAT) Indirect Fluorescent Antibody tests.

TreatmentUsually not required.Sulfadiazine and pyrimethamine are two drugs

widely used to treat toxoplasmosis in humans.Patients allergic to sulfa drugs may take

Clindamycin, Clarithromycin, Azithromycin

Prevention & ControlHands should be washed after contact with

raw meat or in contact with soil.Vegetables should be washed well . Avoid undercooked meats. •If you have a cat

– Keep it inside if possible.– Don’t feed it with raw meat.

–Avoid contact with cat if you are pregnant.

The aim of this studyThere is no such data as to the

seroprevalence of toxoplasmosis in humans in our region including Kars province and its districts. Thus, the purpose of this study is to investigate the prevalence and age group distribution of Toxoplasma antibodies, in serum samples which were taken from patients who applied to gynecology polyclinic in State Hospital in the 5-year-period between 2008 and 2012, within the scope of routine screenings.

MATERIAL and METHOD

The blood samples taken from 7827 female patients, who applied to microbiology laboratory in Kars Maternity and Children Hospital between January 2008 and December 2012, were examined retrospectively in terms of Toxoplasma gondii IgG and IgM antibodies.

Abbott ARCHITECT Toxo- IgG and IgM commercial kits were used in this study.

IgG test were considered as; if the result is less then 1.60: negative Values between 1.60 and 3.00: suspicious Values more then 3.10: positive

For the IgM test: The values less then 0.50: negative Values between 0.50 and 0.60 : suspicious Values more then 0.60: positive

FINDINGS

Table 1. Seroprevalence of Anti-Toxoplasma gondii IgM and IgG by Years

YearsAnti-Toxoplasma IgM Anti-Toxoplasma IgG

Totaln Positive suspicious n positive suspicious

2008 1007 37 (3.6%) 11 (1.1%) 968 380 (39.3%) 0 (0.0%) 1975

2009 981 25 (2.5%) 23 (2.3%) 1117 428 (38.3%) 28 (2.5%) 2098

2010 633 12 (1.9%) 1 (0.2%) 428 156 (36.5%) 18 (4.2%) 1061

2011 773 16 (2.1%) 5 (0.6%) 420 147 (35.0%) 12 (2.9%) 1193

2012 818 12 (1.5%) 5 (0.6%) 682 220 (32.3%) 20 (2.9%) 1500

Total 4212 102 (2.5%) 45 (1.1%) 3615 1331(36.8%) 78 (2.2%) 7827

Table 2. Seroprevalence of Anti-Toxoplasma gondii IgM and IgG by Ages

AgesAnti-Toxoplasma IgM Anti-Toxoplasma IgG

Totaln Positive suspicious n positive suspicious

15-24 1592 48 (3.0%) 18 (1.1%) 1314 405 (30.8%) 19 (1.4%) 2906

25-34 188341 (2.2%) 18 (0.9%)

1643 577 (35.1%) 40 (2.4%) 3526

35-44 5098 (1.6%) 8 (1.6%)

445 211 (47.4%) 17 (3.8%) 954

45 ve üstü228 5 (2.2%) 1 (0.4%)

213 138 (64.8%) 2 (0.9%) 441

Total 4212 102 (2.5%) 45 (1.0%) 3615 1331(36.8%) 78 (2.2%) 7827

CONCLUSION

In conclusion; toxoplasmosis is a zoonosis which has a high seroprevalence in almost every region of our country as well as all over the world.

In Kars, toxoplasmosis was diagnosed at 51.4-95.7% in sheep, 49.6-93.5% in cattles, 20.6% in horses and 83.8-96.1% in dogs.

Our findings are remarkable since they serve as the first preliminary study in regard to the seroprevalence of toxoplasmosis in human beings in Kars province.

Study results show that toxoplasmosis has a high prevalence rate in animals and humans in the region, and this situation should not be ignored. Besides, necessary steps should be taken in order to inform and take necessary precautions by women under risk of infection.

nery.man@hotmail.com