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[Evaluation of the toxoplasmosis seroprevalence in pregnant women and creating a diagnostic algorithm].
[congenital toxoplasmosis]
Toxoplasma
gondii
,
an
obligatory
intracellular
protozoon
is
widely
distributed
around
the
world
and
can
infect
all
mammals
and
birds
.
While
acquired
toxoplasmosis
is
usually
asymptomatic
in
healthy
subjects
,
acute
infection
during
pregnancy
may
lead
to
abortion
,
stillbirth
,
fetal
neurological
and
ocular
damages
.
For
the
prevention
of
congenital
toxoplasmosis
it
is
recommended
that
a
screening
programme
and
a
diagnostic
algorithm
in
pregnant
women
should
be
implemented
while
considering
the
cost
effectiveness
.
Thus
,
it
is
necessary
to
determine
the
seroprevalence
of
toxoplasmosis
in
pregnant
women
and
the
actual
risk
of
T
.
gondii
transmission
during
pregnancy
in
a
certain
area
.
The
aims
of
this
study
were
to
detect
the
T
.
gondii
seropositivity
in
the
pregnant
women
admitted
to
our
hospital
and
to
create
a
diagnostic
algorithm
in
order
to
solve
the
problems
arising
from
interpretation
of
the
serological
test
results
.
A
total
of
6140
women
aged
15
-
49
years
who
were
admitted
to
our
hospital
between
April
1
st
,
2010
to
July
31
st
,
2013
,
were
evaluated
retrospectively
.
In
the
serum
samples
,
T
.
gondii
IgM
,
IgG
and
IgG
avidity
tests
were
performed
by
VIDAS
automated
analyzer
using
TOXO
IgM
,
TOXO
IgG
II
and
TOXO
IgG
avidity
kits
(
bioMerieux
,
France
)
.
It
was
noted
that
,
both
T
.
gondii
IgM
and
IgG
tests
were
requested
from
4758
(
77
.
5
%
)
of
the
pregnant
women
,
while
only
IgM
test
from
1382
(
22
.
5
%
)
cases
.
Sole
IgM
positivity
was
found
as
0
.
2
%
(
11
/
6140
)
,
IgG
as
26
.
4
%
(
1278
/
4758
)
and
both
IgM
+
IgG
as
0
.
9
%
(
44
/
4758
)
.
T
.
gondii
IgG
avidity
tests
were
requested
from
12
of
44
women
who
were
found
both
IgM
and
IgG
positive
and
eight
of
them
revealed
high
avidity
and
four
low
avidity
.
Avidity
test
was
ordered
for
the
91
(
7
.
1
%
)
of
1278
sole
IgG
positive
cases
and
four
of
them
were
found
to
have
low
avidity
.
IgG
avidity
test
was
ordered
for
554
(
16
.
2
%
)
of
IgM
and
/
or
IgG
negative
subjects
,
however
,
the
test
was
not
performed
according
to
rejection
criteria
of
the
laboratory
.
It
was
noticed
that
no
re
-testing
was
requested
for
none
of
the
seronegative
cases
(
3428
/
4758
;
72
%
)
during
their
follow-up
.
In
our
study
,
total
Toxoplasma
seropositivity
rate
among
pregnant
women
was
detected
as
28
%
(
1330
/
4758
)
,
showing
statistically
significant
increase
(
p
<
0
.
05
)
with
age
.
There
was
no
significant
difference
(
p
>
0
.
05
)
in
the
seropositivity
rate
between
the
years
(
2010
-
2013
)
.
Following
the
evaluation
of
the
test
orders
,
the
problems
related
to
test
orders
and
interpretation
of
the
test
results
were
determined
and
a
diagnostic
algorithm
to
be
used
in
our
hospital
,
was
established
to
minimize
such
problems
in
toxoplasma
serology
.
It
was
concluded
that
a
diagnostic
algorithm
related
to
toxoplasmosis
serology
should
be
implemented
for
the
appropriate
evaluation
of
the
risk
of
acute
toxoplasmosis
during
pregnancy
.
Such
an
approach
is
necessary
to
support
the
clinical
diagnosis
and
to
minimize
the
anxiety
in
pregnant
women
about
congenital
toxoplasmosis
.
Diseases
Validation
Diseases presenting
"four low avidity"
symptom
congenital toxoplasmosis
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