Seroepidemiological study on toxoplasmosis among women with history of abortion

number: 
811
إنجليزية
Degree: 
Imprint: 
Medicine
Author: 
May Mohe Al-Deen Abbas
Supervisor: 
Dr.Amjad D. Niazi
year: 
2002
Abstract:

A cross-sectional study was conducted on 330 women with a history of abortion ( first abortion and repeated abortion), and 40 women with no abortion. Their age ranged between (16-50) years, referred to Al- N :•:: General Hospital and Al- Adel primary health care centre in Baghdad during the period between 21th of July 2001 to the 14 January 2002. AV. women were examined by ELISA technique for demonstration of Toxoplasma gondii antibodies (IgM, IgG), and to study the positivity rate of toxoplasmosis in the community among groups of women with a history of abortion ( first and repeated abortion) and women with no abortion and to see the effect of other risk factors on the positivity rate of the disease in the community. Women with first abortion were screened for acute toxoplasmosis by specific IgM detection. While other groups (women with repeated abortion and no abortion) were screened for toxoplasmosis by specific IgG detection in their sera. Results demonstrate that toxo IgM antibodies were significantly observed in (21.5%) of women with first abortion. The positivity rate were raised to (40.3%) when equivocal results were included. For women with repeated abortion, the positivity rate were (48.9%) and were raised to (60.2%) when equivocal results were included. While for women with no abortion, the positivity rate were ( 7.5%) and raised to (10%) when equivocal results were included. Women with acute toxoplasmosis were mainly distributed among age groups of (25-34) years with a positivity rate of (41.66%). Women with repeated abortion were mainly distributed among age groups of (25-34 years) with positivity rate of (43%). A significant percentage of (26.8%) of women with first abortion were also significantly associated with first trimester abortion. The positivity rat were raised to (39.8%) when equivocal results were included, p= 0.01, p= 0.004 respectively. The positivity rate of acute toxoplasmosis was (26.2%) among unemployed women with a history of first abortion, and was raised to (39.7%) when equivocal results were included, p=0.04, p=0.001 respectively. Unemployment was considered as risk factors for women with repeated abortion, with a positivity rate of (56.9%) which were raised to (61.4%) when equivocal results were included, p=0.0001, p=0.04 respectively. The positivity rate of acute toxoplasmosis was statistically significant as compared to women with no abortion at a low level of education. With a positivity rate of (36.7%) when equivocal results were included, p=0.01, for women with repeated abortion, the positivity rate were ( 54.6%), which were raised to (59.4%) when equivocal results were included, p=0.0007, p=0.00007 respectively. For women with a history of first abortion, the positivity rate was (30.3%) of parity (1-4), p=0.04. and when equivocal results were included the positivity rate were raised to (44.6%), p=0.003. Regarding women with repeated abortion, the positivity rate was (54.3%) among parity (1-4), p=0.01. The positivity rate was raised to (60.9%) when equivocal results were included, p=0 .0005. In general the means of IgM and IgG titers among women with first abortion and repeated abortion not increase with age, P=0.07, p=0.1 respectively. The means of IgM titers in women with a history of first abortion were inversely proportional to the level of education, p=0.01 . with highest titers at low level of education. The means of IgG titers in women with a history of first abortion increased with the decrease in the level of education, p=0.02. The means of IgG titers in women with a history of repeated abortion increased with the decrease in the level of education, p=0.03. The positivity rate of acute toxoplasmosis regarding duration since last abortion were (32.5%) at G, (1-60 ) days, p=0.02 . The means of IgG titers in women with a history of repeated abortion increased with the increase in the duration since last abortion, p=0.03. The means of IgG titers in women with a history of first abortion decrease with the increase in the duration since last abortion. There was no statistical significant difference between rural and urban area for women with a history of first and repeated abortion and for women with no abortion. Factors such as animal contact, family history of abortion shows no risk effect on women wfith a history of first and repeated abortion. The relation between animal contact and family history of abortion for women with a history of first abortion was statistically significant, the positivity rate was (87.5%) and were raised to (92.3%) when equivocal results were included, p=0.01, p=0.018 respectively .while for women with repeated abortion, the positivity rate were (73.8%) and were raised to (74.1%) when equivocal result were included. p=0.0004, p=0.0001 respectively. The avidity of specific IgG was a recent serological technique in the diagnosis of acute acquired toxoplasmosis. The serological tests were evaluated bytesting (32) sera from women aged (16-45) years. 20 cases of women with acute T. gondii infection with IgM positive , IgG positive. Their avidity indices ranged from (2.4%-52.6%) which indicates a low avidity. 12 cases who were seronegative for specific IgM, but seropositive for specific IgG, had avidity indices ranged from (35.7%-96.6%) which indicates high avidity indices. The sensitivity of this new technique was (100%), while its' specificity was (83.3%).