Usefulness of paired samples for the Serodiagnosis of toxoplasmosis infection in a tertiary teaching Hospital in Malaysia

Abstract

Background Accurate diagnosis of Toxoplasma gondii ( T. gondii) infection remains elusive and requires a comprehensive assessment through laboratory and clinical investigation. In this study, a diagnostic algorithm based on paired serum samples and clinical data was developed and evaluated. Methods A total of 1267 suspected cases of Toxoplasma infection were enrolled in this study from January 2016 to December 2016. The cases were screened for anti- Toxoplasma IgM and IgG by electrochemiluminiscence immunoassay (ECLIA) method. Based on the serological profiles, all cases with first seropositive serum samples were considered as suggestive cases of Toxoplasma infection. Thus, second serum samples were obtained after an interval of 2 weeks. The diagnosis was made based on laboratory results and clinical data. Results A total of 482 T. gondii seroreactive cases were selected. The patient’s records were traced and the data were analysed. Accordingly, 152 cases were diagnosed as clinically confirmed cases; 198 cases were clinically asymptomatic and 132 cases were newborn babies or infants who did not have toxoplasmosis and only acquired passive immunity from their mothers. The paired serum algorithm allowed classifying the seroreactive cases as follows: early (0.6%), acute (1.9%), reactivation (13.5%), recent (1.5%), passive immunity from mother (27.3%) and possible congenital infections (1.2%). In addition, cases of reactivated toxoplasmosis were detected among the pregnant mothers (13/82; 15.8%), children aged above 1 year (2/8; 25.0%) and immunocompetent mothers (5/135; 3.7%). Furthermore, the application of the paired serum analysis resulted in remarkably improved treatment initiation. Conclusions Toxoplasmosis diagnosis and treatment can be improved through the use of paired serum diagnostic algorithm.

Assessment of Geographical Distribution of Emerging Zoonotic Toxoplasma gondii Infection in Women Patients Using Geographical Information System (GIS) in Various Regions of Khyber Pakhtunkhwa (KP) Province, Pakistan

“…The clinician could not differentiate early, active, latent, chronic, congenital, or reactivated infection from serological assays, such as latex agglutination assay (LAT), immunochromatographic techniques (ICT), and enzyme linked immunosorbant assay (ELISA) (Table 7), which are used for qualitative and quantitative detection of IgM and IgG antibodies, but cannot differentiate between acute and chronic persistent infection of T. gondii parasite. Contreras [45] and Thangarajah et al [46] also support our views and stated that it always remained a diagnostic challenge for clinicians, while Liu et al [47] and Grzybowski et al [48], suggested development of specific molecular markers for clinical differentiation of acute stage of T. gondii infection from chronic stages. The asymptomatic and chronic nature of T. gondii infection poses various diagnostic, therapeutic and preventive challenges.…”

Cytomegalovirus (CMV) Infection in Infants: Two Case Reports and Review of Literature

“…Previous literatures showed that the presence of Toxoplasma IgG titer in a newborn without significant four-fold increment could be due to passive transfer of maternal toxoplasma IgG from the placenta. 19,20 In terms of clinical presentations, bilateral cataracts are commonly due to several causes, such as TORCH infection and prematurity, seen in the second patient. 21 CMV viral load is important before starting preemptive therapy and after completed treatment for monitoring response to therapy.…”

A novel rapid visual detection assay for Toxoplasma gondii combining recombinase-aided amplification and lateral flow dipstick coupled with CRISPR-Cas13a fluorescence (RAA-Cas13a-LFD)

“…Toxoplasma gondii , an obligate intracellular protozoan parasite ubiquitous worldwide, is of medical and veterinary importance because it can cause toxoplasmosis that threatens warm-blooded animals and human health [ 21 ]. More than 30% of the world’s population is thought to have specific anti- T. gondii antibodies, though infection rates vary considerably by geographic region [ 26 ]. In China, antibody-positive rates for T. gondii were described to be 8.20% in the general population and 8.60% in pregnant women [ 11 ].…”