Toxoplasma gondii, an obligate intracellular and opportunistic parasite, is one of the most widely spread infections all over the globe, affecting about 30% of the world population [1]. Unlike many other parasitic disorders, its distribution is not merely restricted to developing countries, but it also afflicts developed nations such as France, which is known for having a high incidence of toxoplasmosis [2]. The wide range of this infection is attributed to the multiplicity of its modes of infection. Besides, being a zoonosis, T. gondii oocysts shed by the feline definitive host can be acquired by the mammalian intermediate host through the ingestion of contaminated food and water. Also, improperly cooked meat containing tissue cysts constitute a potential source of infection. Additional modes of infection include organ transplantation, blood transfusion and congenital transmission from mother to fetus [3]. The clinical range includes acute toxoplasmosis presenting with a variety of nonspecific symptoms such as sore throat and lymphadenitis, opportunistic

Background: Toxoplasmosis is one of the most common causes of latent infections in humans and animals. Its important clinical aspect is the probable danger of congenital transmission and its severe effects on the fetus. Infection is typically asymptomatic at birth, or is associated with serious neurological or ocular sequelae later in life with a broad spectrum of clinical presentations. Serologic screening detects acute infection in pregnant women which if unrecognized may be transmitted to the unborn. Objective: To investigate serologically the prevalence of toxoplasmosis as a hidden cause of mental retardation (MR) in a sample of children from urban and surrounding rural areas attending the New Children Hospital of Cairo University (Abu Reesh Hospital), Cairo. Material and Methods: The present study was conducted on 200 children diagnosed as MR attending neurology outpatient clinics as a case group; and 200 samples as a control group from non-MR children attending other outpatient clinics with minor complaints such as skin manifestations in dermatology clinic, upper respiratory infections and minor gastrointestinal complaints. Venous blood samples from the two groups of children were serologically tested for specific IgG by indirect hemagglutination test (IHAT). Relevant sociodemographic and clinical data related to the children and their mothers was collected using a designed sheet. Results: Our results showed that the prevalence of toxoplasmosis in the MR children was significantly positive in 84/200 (42.0%) of the case group (P <0.001). The number of positive sera was 35/200 (17.5%) among control group. Associated clinical manifestations in the case group (MR) included convulsions in 53.5%, eye problems in 22.5%, splenomegaly in 16.5% and hepatomegaly in 9.5% of cases. There was no significant difference between urban and rural residences; and relevant risk factors in mothers included history of previous toxoplasmosis (13.5%), history of abortion and still birth (each 36.5%) and premature deliveries (19.5%). History of contact with cats and consumption of undercooked meat rated 58% and 77.7% respectively. Conclusion: Screening females who are at risk for acquired toxoplasmosis is essential, before and during pregnancy to detect Toxoplasma seroconversion. Conversion from negative to positive testing would indicate exposure to infection, requiring the implementation of early treatment of infection to protect the unborn fetuses from transplacental transmission.

Background School Health insurance (SHI) is working in Egypt since 2003. However, there were no impact indicators that inform policy makers about health status of school children. Therefore, the school health project was conducted by Arab Medical Union (AMU) Medical Syndicate in cooperation with Ministry of Education (MOE), Ministry of Health and Population (MOHP) and Public Health Department, Cairo University to conduct comprehensive medical services to primary school children and to assess the impact of the SHI and the efficiency of AMU project to promote health of children. Methods In‐depth interview with policy makers in MOHP, MOE, SHI and secondary analysis of AMU documents. A systematic random sample of 7000 students (7–10 years) was selected which formed 10% of the examined children in AMU project and proportionally distributed in 355 schools in seven Districts in Fayoum Governorate. Results SHI was ineffective in providing preventive services to school children. The AMU project was efficient in covering 82% of the targeted students with clinical, preventive and referral services with estimated cost per student were 54.8LE. Clinical findings showed anaemia the major problem (84%), dental (33%), hair/scalp (9%) and visual errors (6%). Conclusion The current Primary Health Care facilities needs to improve the quality preventive and curative health services provided to school children. Also, providing health services through medical conveys was of high cost and unsustainable.

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