Gebelerde toksoplazma antikor seroprevalansı: Tarama yapalım mı?

Amaç: Bizim bu çalışmadaki amacımız, kurumumuza prenatal takip için başvurmuş ve toksoplazma için serolojik testler uygulanmış gebelerde seroprevalans değerini ortaya koyarak, prenatal takipte toksoplazma taramasının güncel yerini belirlemektir.Gereç ve Yöntemler: Bu retrospektif çalışmaya 15-49 yaş aralığında olup, prenatal takip amacıyla kliniğimize başvurmuş ve Toxoplasma gondii (t.gondii) serolojik testleri uygulanmış gebeler alındı. Olguların yaş, doğum yerleri, ve anti-t.gondii immunglobulin (Ig) M ve G verileri hastane kayıtları taranarak elde edildi. Olgular doğum yerlerine göre gruplandırıldı ve toksoplazma seropozitivitesi açısından karşılaştırılarak analiz edildi.Bulgular: Çalışmaya alınan 817 gebenin 296’sında (%36,2) anti-t.gondii IgG pozitifti. Anti-t.gondii IgG seropozitivitesi bakımından Ege Bölgesi kökenli hasta grubu (%30,1) ile Güneydoğu Anadolu kökenli hasta grubu (%47,1) arasında anlamlı fark vardı (p<0,05). Ayrıca toksoplazma seroprevalansı Türkiye’ nin batısından kökenli hasta grubunda (%29,5) Suriyeli hasta grubuna göre (%45,7) anlamlı derecede düşüktü (p<0,05).Sonuçlar: Türkiye’nin batısında, doğuya kıyasla düşük toksoplazma seroprevalansı ile ilişkili yüksek toksoplazma enfeksiyonu duyarlılığı nedeniyle, konjenital toksoplazmoz riskini önleme amaçlı, en azından bölge tabanlı prenatal toksoplazma taraması yapılmalıdır.

Anahtar Kelimeler:

toksoplazmozis, doğumsal, seroepidemiyolojik çalışmalar

Seroprevalence of toxoplasma antibody in pregnant women: Should we screen?

Aim: Our aim in this study was to determine the current location of toxoplasma screening in prenatal follow-up by presenting seroprevalence in pregnant women who applied for prenatal follow-up and applied serological tests for toxoplasma.Material and Methods: This retrospective study was conducted between the ages of 15-49 and pregnant women who applied to our clinic for prenatal follow-up and who underwent Toxoplasma gondii (t.gondii) serological tests. Age, place of birth, and anti-t.gondii immunoglobulin (Ig) M and G data were obtained by screening hospital records. Cases were grouped according to their place of birth and analyzed for toxoplasma seropositivity.Results: Of the 817 pregnant women included in the study, 296 (36.2%) had anti-t.gondii IgG positive. In terms of seropositivity of anti-t.gondii IgG, there was a significant difference between the patients of Aegean Region (30.1%) and patients of Southeast Anatolia (47.1%) (p <0.05). Also toxoplasmosis seroprevalence Turkey’s west of the origin of the patient group (29.5%) compared to the Syrians patients (45.7%) was significantly lower (p <0.05).Conclusion: In west of Turkey, due to the high sensitivity of toxoplasma infection associated with lower toxoplasma seroprevalence compared to the east, intended to prevent the risk of congenital toxoplasmosis can be increased we recommend at least region-based prenatal toxoplasma scanning.

Keywords:

toxoplasma toxoplasmosis, congenital, seroepidomiologic studies,

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Cortina-Borja M, Tan HK, Wallon M, ve ark. Prenatal treatment for serious neurological sequelae of congenital toxoplasmosis: An observational prospective cohort study. The European Multicentre Study on Congenital Toxoplasmosis (EMSCOT). Plos Med. 2010; 7 (10): e10000351.
American College of Obstetricians and Gynecologists. Practice bulletin no. 151: Cytomegalovirus, parvovirus B19, varicella zoster, and toxoplasmosis in pregnancy. Obstet Gynecol. 2015; 125: 1510-25.
Bénard A, Petersen E, Salamon R, ve ark. Survey of european programmes for the epidemiological surveillance of congenital toxoplasmosis. Eurosurveill. 2008; 13(15): 1-7.
Prusa A-R, Kasper DC, Sawers L, Walter E, Hayde M, Stillwaggon E Congenital toxoplasmosis in Austria: Prenatal screening for prevention is cost-saving. PLoS Negl Trop Dis. 2017; 11(7): e0005648. (doi: 10.1371/journal.pntd.0005648).
Harita Genel Müdürlüğü Türkiye Coğrafi Bölgeler Haritası, 2019. Dikimevi, Ankara. www.harita.gov.tr
Türkiye İstatistik Kurumu, Yıllık sanayi ve hizmet istatistikleri, 2016, Çankaya, Ankara. https://biruni.tuik.gov.tr/bolgeselistatistik/anaSayfa.do
Dubey JP, Edelhofer R, Marcet P, Vianna MCB, Kwok OCH, Lehmann T. Genetic and biologic characteristics of Toxoplasma gondii infections in free-range chickens from Austria. Vet. Parasitol. 2005; 133: 299–306.
Edelhofer R, Prossinger H. Infection with toxoplasma gondii during pregnancy: Seroepidemiological studies in Austria. Zoonoses Public Health. 2010; 57: 18–26
Montoya JG, Remington JS, 2000. Toxoplasma gondii. Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas and Bennett’s principles and practice of infectious disease. 5 th ed. Churchill Livingstone. p.2858–2888.
Remington JS, McLeod R, Thulliez P, Desmonts G (2010). Toxoplasmosis. In: Remington JS, Klein G, Wilson C, Baker C, editors. Infectious Disease of the Fetus and Newborn Infant. 6th ed. Philadelphia: W.B. Saunders. pp. 947-1091.
Tekay F, Ozbek E. The seroprevalence of toxoplasma gondii in women from Sanliurfa, a province with a high raw meatball consumption. Turk J Parasitol. 2007; 31(3): 176-179.
Ocak S, Zeteroglu S, Ozer C, Dolapcioglu K, Gungoren A. Seroprevalence of Toxoplasma gondii, rubella and cytomegalovirus among pregnant women in southern Turkey. Scand J Infect Dis. 2007; 39(3): 231-234. (doi: 10.1080/00365540600978880).
Republic of Turkey Ministry of Health, General Directorate of Public Health, Women and Reproductive Health Department. Prenatal care management guide. Page: 40, 2018.
Bakacak M, Bostanci MS, Kostu B, ve ark. Seroprevalance of Toxoplasma gondii, rubella and cytomegalovirus among pregnant women. Dicle Med J. 2014; 41 (2):326-331. (doi: 10.5798/diclemedj.0921.2014.02.0425).
Efe S, Kurdoglu Z, Korkmaz G. Seroprevalence of cytomegalovirus, rubella and toxoplasma antibodies in pregnant women in Van. Van Tıp Derg. 2009; 16(1): 6-9
Sirin MC, Agus N, Yilmaz N, ve ark. Seroprevalence of Toxoplasma gondii, Rubella virus and Cytomegalovirus among pregnant women and the importance of avidity assays. Saudi Med J. 2017; 38(7): 727-732. (doi: 10.15537/smj.2017.7.18182).
Karacan M, Batukan M, Cebi Z, ve ark. Screening cytomegalovirus, rubella and toxoplasma infections in pregnant women with unknown pre-pregnancy serological status. Arch Gynecol Obstet. 2014; 290: 1115–1120. (doi: 10.1007/s00404-014-3340-3).
Pekinturk N, Cekin Y, Gur N. Retrospective Evaluation of the Results of Women Patients of Childbearing Age Investigated at a Microbiology Laboratory for Screening Toxoplasma gondii, in Antalya. Turkiye Parazitol Derg. 2012; 36: 96-9.
Mumcuoglu I, Toyran A, Cetin F, ve ark. Evaluation of the toxoplasmosis seroprevalence in pregnant women and creating a diagnostic algorithm. Mikrobiyol Bul. 2014; 48(2): 283-291.
Inci M, Yagmur G, Aksebzeci T, Kaya E, Yazar S. The Investigation of Toxoplasma gondii Seropositivity in Women in the Kayseri Province Türkiye Parazitoloji Dergisi. 2009; 33(3): 191-194.
İnci A, Yener C, Güven D. The investigation of toxoplasma, rubella and cytomegalovirus seroprevalancies in pregnant women in a state hospital. Pam Med J 2014; 7(2): 143-146.
Bakacak M, Serin S, Aral M, ve ark. Seroprevalance differences of toxoplasma between Syrian refugees pregnants and indigenous Turkish pregnants in Kahramanmaras. Turkiye Parazitol Derg. 2015; 39(2): 94-97. (doi: 10.5152/tpd.2015.3668).
Cekin Y, Kizilates F, Gur N, Senol Y. Investigation of Toxoplasma gondii seropositivity in pregnant women attending the Antalya Training and Research Hospital for the last four years. Turkiye Parazitol Derg. 2011; 35(4): 181-4.