Aysun KARABULUT, Yusuf POLAT, Meral TÜRK, Yasemin İşik BALCI

Denizli bölgesinde gebe kadınlarda rubella, Toxoplasma gondii ve sitomegalovirus seroprevalansının değerlendirilmesi

Amaç: Türkiye’de gebe kadınlarda rubella, Toxoplasma gondii ve sitomegalovirus (CMV) enfeksiyonları için, ulusal birtarama programı yoktur. Bu çalışmanın amacı, bölgemizde gebe kadınlarda rubella, Toxoplasma gondii ve CMVseroprevalansını belirlemek ve ülkemizin farklı bölgelerinden seroprevalans değerlerini bildiren ilgili literatürü gözdengeçirmektir.Yöntem ve gereç: Nisan 2008 ve Nisan 2009 tarihleri arasında, gebeliğin ilk trimesterindeki 1268 kadın rubella, 1102kadın toxoplasma, 1000 kadın da CMV seroprevalansı açısından incelendi. Toxoplasma ve rubella IgM ve IgG antikorlarıimmünometrik tekniğe dayalı otomatik Vitros ECiQ sistemi ile, CMV IgM ve IgG antikorları ise Chorus enzimimmünoassay yöntemi ile değerlendirildi. Türkiye’nin farklı bölgelerinden seroprevalans değerlerini bildiren ilgili literatürgözden geçirildi.Bulgular: Bin-ikiyüz-altı (% 95,1) kadında rubella IgG pozitif saptanırken hiçbir kadında IgM pozitifliği saptanmadı.CMV IgG ve IgM pozitifliği sırasıyla 987 (% 98,7) ve 12 (% 1,2) hastada saptandı. Toksoplazma için incelenen 1102kadından, 408’inde (% 37) toksoplazma IgG, 15’inde (% 1,4) toksoplazma IgM pozitifti. Türkiye’den bildirilen literatürgözden geçirildiğinde rubella seropozitifliğinin % 92,6 - 97,3 arasında, CMV seropozitifliğinin %93,5 - 96,1 arasında vetoxoplasma seropozitifliğinin % 30,7 - 69,5 arasında değiştiği gözlendi.Sonuç: Türkiye’deki yüksek rubella ve CMV seropozitifliği, kadınların çoğunun doğurganlık yaşından önce bu virüsleremaruz kaldığını göstermektedir. Rubella ve CMV seroprevalansı rölatif olarak homojen bir dağılım gösterirken,toxoplasma seroprevalansı bölgesel farklılıklar göstermektedir.

Anahtar Kelimeler:

Gebelik, rubella, sitomegalovirus, Toxoplasma gondii, seroprevalans

Evaluation of rubella, Toxoplasma gondii, and cytomegalovirus seroprevalences among pregnant women in Denizli province

There is no national screening program for rubella, Toxoplasma gondii, and cytomegalovirus (CMV) infections for pregnant women in Turkey. The purpose of this study was to determine the prevalence of these infections among pregnant women in Denizli province, and to review seroprevalences reported from different regions of Turkey. Materials and methods: Between April 2008 and April 2009, 1268 women were investigated for rubella, 1102 for toxoplasma, and 1000 women for CMV seroprevalences in the first trimester of pregnancy. Toxoplasma and rubella IgM and IgG antibodies were assayed by the automated Vitros ECiQ system based on an immunometric technique. Cytomegalovirus IgM and G antibodies were tested using the Chorus enzyme immune assay. We also reviewed the relevant literature reporting seroprevalences from different regions of Turkey. Results: Rubella IgG seropositivity was found in 1206 patients (95.1%) with no IgM seropositivity. CMV IgG and IgM positivities were detected in 987 (98.7%) and 12 (1.2%) subjects, respectively. Of 1102 women evaluated for toxoplasmosis, 408 (37%) were positive for IgG and 15 (1.4%) were positive for IgM. The review of the relevant literature reported from Turkey showed seroprevalence rates in the range of 92.6%-97.3% for rubella, 93.5%-96.1% for CMV, and 30.7%-69.5% for toxoplasma. Conclusion: High seropositivity rates for rubella and CMV in Turkey indicate that most of the women were exposed to these viruses before child-bearing age. Although rubella and CMV seroprevalences show a relatively homogeneous distribution throughout Turkey, toxoplasma prevalence varies greatly according to the geographic region.

Keywords:

rubella, cytomegalovirus, toxoplasma gondii, seroprevalence, Pregnancy,

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