EJMS

Abstract

Toxoplasmosis is a disease of zoonotic nature; being reported to be widespread in animals and humans. Serological diagnosis represents the first and the most widely used approach to define the stage and to detect both primary and late infection of toxoplasmosis in pregnancy. This study aimed to evaluate both indirect haemagglutination (IHA) and enzyme linked immunosorbant assay (ELISA) as the diagnostic tests for maternal toxoplasmosis. In addition, the histopathological lesions and immunochemical staining of placental samples from women with complicated obstetric history for detection of apoptosis developed during toxoplasma infection were performed. The study included 100 pregnant females and were selected from females attending the Obstetrics and Gynecology Department, Faculty of Medicine, Menoufiya University for their antenatal care. They aged between 16-42 years old. Venous blood samples were collected and processed for sera separation. Serological detection of IgM and IgG anti-Toxoplasma antibodies by ELISA and IHA were performed. Placental samples were taken and stained histopathologically by H&E and histochemically to detect apoptotic changes by using Fas Ligand. The results showed that the overall detection rate of anti-Toxoplasma IgG was 53% and anti-Toxoplasma IgM was detected in 24% by ELISA .There was no statistical significant association between seroprevalence with age (p<0.05). The peak age for acquisition of the infection in females was between 20-30 years (47.2% and 62.5% respectively for IgG and IgM). The present study revealed a higher prevalence of anti-toxoplasma IgG (30.2%) and IgM (6.3%) antibodies in women with abortions .The difference was statistically highly significant in relation to IgM seropositivity (p<0.001). Placental apoptosis was detected in 53.8% of examined sections from seropositive IgG and in 61.5% of examined sections from seropositive IgM. It was concluded that the antenatal screening is important for early diagnosis and treatment of primary Toxoplasma infection and preventing the damaging effect of toxoplasmosis on the fetus. IHA and ELISA are the important screening tests. Histopathological changes in toxoplasmosis may be suggestive but they are not confirmatory for the diagnosis . Apoptotic changes in placental tissues infected with Toxoplasma is marked in acute infection (IgM) as the parasite causes severe degree of tissue damage, while in chronic infections (IgG), the parasite inhibits apoptosis to remain dominant in the cells from which it takes its nutrition.