Seroprevalence of Toxoplasma, Rubella, CMV and HSV infection at a teaching hospital: A 7 year study from North India

Abstract

Objectives: The present study was aimed to find seroprevalence in different age group population to explore the burden of TORCH (toxoplasma, rubella virus, cytomegalovirus [(CMV] and herpes simplex virus [HSV]) infection in the North Indian Population. Materials and Methods: It is a retrospective study carried out in the Microbiology Department, Institute of Medical Science, Banaras Hindu University (IMS, BHU), a tertiary care centre of North India. The blood samples of the suspected population of either sex or age group from different departments were analysed over a period of 7 years. The samples were tested for TORCH infections by the IgM ELISA kit following the manufactures instruction. Results: Out of total 4044 samples, 1353 (33.46%) cases were seropositive with maximum cases from the obstetrics and gynaecology department 39.46%. The highest seropositivity of TORCH (43.15%) was in the age group 15–25 years followed by 36.33% in the age group 25–35 years. This study revealed an overall male and female ratio of the total positive cases as 0.12 while it was 2.2 for pediatric cases (0–15 years). The overall seroprevalence was contributed as toxoplasma 1.38%, rubella 1.14%, CMV 13.63% and herpes 17.43%. The overall seropositivity (IgM) contributed as toxoplasma gondii with 4%, rubella with 3%, cytomegalovirus with 41% and herpes simplex virus with 52%. The coinfection of HSV with CMV was most abundant with 246 cases. Conclusions: The seropositivity of toxoplasma and rubella were comparatively more in infants while CMV and herpes were more prevalent in adults. Though, the incidence of TORCH has reduced over the past few years. Furthermore, knowing the epidemiology is an important aspect to develop strategies and appropriate implementation for the prevention of infection.

Serum antibodies against ToRCH agents in pregnant women presenting at a tertiary hospital in Port Harcourt, Nigeria.

“…This observation was contrary to the reports of Manjunathachar et al (2020) and Sadik et al (2012), who respectively, found that women less than or equal to 24 years old, and women within 25 to 30 years old, had the highest levels of seropositivity. Dinkar and Singh (2020) reported that the highest seropositivity of ToRCH (43.15%) was in the age group 15-25 years. However, it agreed with an earlier study in Iran (Josheghani et al, 2015) and study by Dinkar and Singh (2020) in Northern India, where ages above 30 years were associated with a higher risk of positivity for ToRCH infections.…”

“…Dinkar and Singh (2020) reported that the highest seropositivity of ToRCH (43.15%) was in the age group 15-25 years. However, it agreed with an earlier study in Iran (Josheghani et al, 2015) and study by Dinkar and Singh (2020) in Northern India, where ages above 30 years were associated with a higher risk of positivity for ToRCH infections. This may be because most mothers in these age groups might have lived in endemic settings, which exposed them to ToRCH agents.…”

“…In most cases, maternal illness due to ToRCH infections is mild, but the impact on the developing fetus is more severe (Boyer & Boyer, 2004). They are transmitted either through the placenta, exposure to blood and vaginal secretions during birth, or rarely, through breastfeeding (Deka et al, 2022). It has been reported that prenatally transmitted ToRCH agents cause nearly 3% of all congenital syndromes (Numan et al, 2015).…”

Vertical Transmission and Discordance of Cytomegalovirus in Twin Pregnancies

“…The Picone study (2005) showed males and females to be equally infected with congenital CMV, but females had worse outcomes. A recent study by Dinkar and Singh (2020) noted more congenital and childhood infections in males than females for CMV and other congenitally transmitted infections as well. There may be a sex difference in susceptibility in male/female DZ twin pairs that deserves further attention and may even help to explain genetic susceptibilities.…”

“…With small numbers, these examinations are considered exploratory. Factors included: sex (possible for DZ twin pairs; Picone et al., 2005 ; Dinkar and Singh, 2020 ); whether the maternal infection was primary or non-primary ( Goncé et al., 2012 ); the gestational age at which the maternal infection occurred ( Samedi et al., 2016 ); prematurity ( Shmueli et al., 2017 ); and fetal growth discordance ( Ahlfors et al., 1988 ). We also examined CMV infection concordance according to whether a MZ twin pair was monochorionic or dichorionic ( Ahlfors et al., 1988 ).…”