弓形虫感染母婴垂直传播的研究

探讨先天性弓形虫感染的传播途径及有关的危险因素。方法采用整群抽样的方法，对２８４例产妇及其新生儿，采集产妇静脉血３ｍｌ及其新生儿脐血３ｍｌ，用ＥＬＩＳＡ法一次性检测弓形虫循环抗原ＣＡｇ、弓形虫特异性ＩｇＧ和ＩｇＭ抗体。结论母婴垂直传播是新生儿先天性弓形虫感染的主要途径，对孕妇弓形虫感染的检测具有重要的优生学意义。     

孕妇弓形虫感染与新生儿疾病关系的临床研究

我们用ＩＨＡ和ＥＬＩＳＡ方法检测弓形虫抗体，共检孕妇１０８５例，非孕育龄妇女２００例，患病新生儿１０９例，下沉新生儿８０例，结果：孕妇较非孕妇感染率和总阳性均明显增高，且随孕期延增高，证实妊娠期感染弓形虫的相对危险度大，新生儿疾病组总阳性率高于正常组，差异有显著意义，说明有些新生疾病与弓形虫感染有关，以先天畸形，ＴＯＲＣＨ感染关系最密切，ＩｇＭ母亲的新生儿感染率和总阳性率均明显高于ＩｇＭ者，感染母     

孕妇弓形虫感染与新生儿疾病关系的临床研究

我们用ＩＨＡ和ＥＬＩＳＡ方法检测弓形虫抗体。共检孕妇１０８５例，非孕育龄妇女２００例，患病新生儿１０９例，正常新生儿８０例。结果，孕妇较非孕妇感染率和总阳性率均明显增高，且随孕期延长增高，证实妊娠期感染弓形虫的相对危险度大。新生儿疾病组总阳性率高于正常组，差异有显著意义，说明有些新生儿疾病与弓形虫感染有关，以先天畸形、ＴＯＲＣＨ感染关系最密切。ＩｇＭ（＋）母亲的新生儿感染率和总阳性率均明显高于ＩｇＭ（－）者，感染母亲的新生儿感染率和总阳性率均明显高于低滴度者，故对高滴度和／或ＩｇＭ（＋）母亲要特别重视，最妇作胎儿监测。抗体低滴度有一定价值，要注意复查随防     

用PCR法检测早产、死胎及先天畸形儿组织中的弓形虫DNA

用多聚酶链反应（ＰＣＲ）检测７２例早产、死胎及先天性畸形儿尸检组织中的弓形虫ＤＮＡ。结果示，ＰＣＲ阳性９例（１２．５％），包括早产１例、死胎３例、脑积水１例、畸形儿４例。１０例对照标本均为阴性。提示在人类早产、死胎及先天性畸形儿病例中可能存在弓形虫感染现象。弓形虫感染可能是导致人类异常妊娠结局和先天性畸形的原因之一。     

280例住院患儿弓形虫抗体检验分析

目的 探讨弓形虫感染与儿科疾病各系统的。方法 用酶联免疫（ＥＬＩＳＡ）方法检测２８０例住院患儿血清中弓形虫ＩｇＭ抗体,同时抽查５５例健康儿童作为对照,对患儿阳性病例进行病种分组分析。结果 患儿弓形虫感染纺为２２．９％,明显高于健康儿童９７．３％）,Ｐ〈０．０５,其中神经疾病组３４．０％,呼吸疾病组为２６．９％,淋巴结疾病组为３３．０％,恶性肿瘤组占３８．１％。上述疾病中弓形虫感染率明显高于正常儿童     

小儿脑瘫与弓形虫感染关系的研究

目的 探讨海南小儿不明原因脑瘫与弓形虫感染的关系,为诊治小儿脑瘫提供依据,方法 以住院确诊不明原因脑瘫患儿为研究组,体检正常的小儿为对照组,比较两组弓形虫抗体ＩｇＧ和ＩｇＭ、循环抗原（ＣＡｇ）、ＤＮＡ的四项检测,分析弓形虫感染与脑瘫的关系。结果 研究组检测 ７９例脑瘫患儿中,弓形虫阳性３３例,感染率为４１．８％,对照组检测２６９例中,弓形虫阳性２３例,感染率为８．６％,两组对比差别非常显著（Ｐ＜０．００１）。结论 弓形虫感染是海南不明原因脑瘫患儿的主要原因之一,对于孕妇、新生儿和婴幼儿的弓形虫感染检测,是防治脑瘫发生的手段之一。     

应用PCR技术诊断新生儿隐匿型先天性弓形虫病

目的 早期、快速诊断新生儿隐匿型先天性弓形虫病，以便早期实施干预治疗，减少或减轻先天性弓形虫病的后发症状。方法 采用聚合酶链反应（ＰＣＲ）技术检测８６例孕中、晚期血弓形虫ＤＮＡ（ＴＯＸ－ＤＮＡ）阳性孕妇所生新生儿脐血、静脉血、尿液和母乳中ＴＯＸ－ＤＮＡ。结果 脐血、静脉血和尿液ＴＯＸ－ＤＮＡ阳性率分别为５３．４９％、４８．８６％和４１．８６％，而母乳中无１例阳性。结论 应用ＰＣＲ技术早期诊断新生儿     

孕妇弓形虫感染及其可能导致的宫内传播

目的：探讨弓形虫感染与优生的关系，摸索早期诊断弓形虫感染的方法。方法：通过聚合酶链反应（ＰＣＲ）、血清学试验及部分动物接种，对３６７名各孕期孕妇外周静脉血、脐血及死胎组织进行弓形虫检测。结果：ＰＣＲＤＮＡ阳性７例，循环抗原（ＣＡｇ）阳性２例，特异性ＩｇＭ阳性１例。总阳性率１９％。对其中１例ＰＣＲＤＮＡ、ＣＡｇ阳性的孕妇血进行动物接种，结果阳性。２８例死胎组织中，发现一死胎心、肺、肝、肾、眼、脑组织弓形虫ＤＮＡ均阳性。结论：孕妇弓形虫感染的危害在我国（省）并非少见。开展对孕妇弓形虫感染的检测，将有利于优生优育工作的开展。ＰＣＲ较其它方法更具特异性及敏感性，且操作简便、快速，适合于孕妇弓形虫感染的监测。     

用PCR法检测早产,死胎及先天畸形儿组织中的弓形虫DNA

用多聚酶链反应（ＰＣＲ）检测７２例早产、死胎及先天性畸形儿尸检组织中的弓形状ＤＮＡ。结果表示，ＰＣＲ阳性９例（１２．５％），包括早产１例，死胎３例、脑积水１例，畸形儿４例。１０例对照标本均为阴性。提示在人类早产，死胎及先天性畸形儿病例中可能存在弓形虫感染现象。弓形虫感染可能是导致人类异常妊娠结局和先天性畸形的原因之一。     

新生儿TORCH感染的检测

为探讨弓形虫（ＴＯＸ）、巨细胞病毒（ＣＭＶ）、单纯疮疹病毒（ＨＳＶ）及风疹病毒（ＲＶ）（总称ＴＯＲＣＨ）在新生儿中的感染情况，采用聚合酶链反应法及捕获－ＥＬＩＳＡ法，对１２６例新生儿进行了检测。产科组９３例，儿科组３３例。结果：儿科组ＴＯＲＣＨ感染阳性总检出率为７２．７％（２４例），其中ＴＯＸ１５例（４５．５％）、ＲＶ４例（１２．１％）、ＣＭＶ３例（９．１％）、ＨＳＶ２例（６．１％）；产科组总阳性率５２．７％（４９例）：ＴＯＸ３３例（３５．５％）、ＲＶ３例（３．２％）、ＣＭＶ３例（３．２％）、ＨＳＶ１０例（１０，８％）。两组总检出率经统计学处理有显著性差异（Ｘ２＝４．０１４，Ｐ＜０．０５），但各单项之间无显著性差异（Ｐ均＞０．０５）。两组中有１１例（８．７％）同时查出两种病原体，因此，两组总的ＴＯＲＣＨ感染阳性率为４９．２％（６２例）。ＴＯＲＣＨ感染新生儿中临床出现各种疾病者：ＴＯＸ３１．３％、ＲＶ５７．１％、ＣＭＶ５０．０％、ＨＳＶ１６．７％。ＴＯＲＣＨ感染阳性组与阴性组在母亲年龄、职业、胎次及胎龄之间无显著性差异。提示：ＴＯＲＣＨ感染在新生儿中阳性率较高，尤其在患有各种疾病的新生儿中较突出，应引起高度重     

Congenital toxoplasmosis: a large survey in western Australia

OBJECTIVE: To determine the birth prevalence of congenital toxoplasmosis in Western Australia. DESIGN: A prospective serological study of randomly selected pregnant women and their newborn infants. Paired sera collected from the mothers at their first antenatal visit and cord blood specimens taken from their infants were tested for toxoplasmosis by the direct agglutination test and Toxoplasma IgM-capture enzyme-linked immunosorbent assay. SETTING: A major Perth metropolitan obstetric teaching hospital where approximately one-quarter of infants born in Western Australia during January 1986 to December 1989 inclusive were delivered. PARTICIPANTS: Sera were obtained from 10,207 pregnant women presenting for routine clinical evaluation at their first antenatal visit. Cord blood specimens were taken from 18,908 infants; 7523 of these could be paired to maternal specimens. MAIN OUTCOME MEASURES: Maternal infection was indicated in cases where Toxoplasma specific IgM antibody was present or where an initial maternal specimen gave negative results for Toxoplasma antibody but the paired cord blood specimen gave positive results. Toxoplasma specific IgM antibody in a cord blood specimen indicated fetal infection. RESULTS: Of the 10,207 women 3544 (35%) were Toxoplasma immune at their first antenatal visit; in 11 Toxoplasma specific IgM antibody was detected. There was no serological or clinical evidence of congenital toxoplasmosis in any of the offspring of these 11 mothers. The rate of maternal infection in susceptible pregnancies was 1.6 per 1000; the maternal-fetal transmission rate was estimated to be no greater than 24%. Three of the 18,908 cord blood specimens tested gave positive results for Toxoplasma specific IgM antibody giving a birth prevalence of congenital infection of 0.23 per 1000 births to non-immune mothers. There were no clinical features of congenital infection in these three infants but they will require long-term follow-up. Thirteen of the 14 mothers infected during pregnancy were interviewed retrospectively and in only three was a known risk factor for infection present. CONCLUSIONS: a toxoplasmosis screening programme for pregnant mothers is not justifiable in Western Australia. A public education programme is also likely to have limitations.     

Lack of awareness of risk factors for primary toxoplasmosis in pregnancy

Background

The overall seroprevalence of toxoplasma antibodies in women of childbearing age in Ireland is 25% [1]. Hence, 75% of women remain susceptible to primary toxoplasma infection during pregnancy, which if transmitted to the foetus can cause ocular, neurological and other sequelae. Toxoplasma exposure during pregnancy can be avoided if there is an awareness of the potential sources of infection, mainly contaminated food, water, soil and cat faeces.

Aims

To determine risk factor exposure in a cohort of women with congenitally infected infants and to assess maternal risk awareness prior to diagnosis of infection.

Methods

Data, prospectively gathered during 2 years of pilot newborn screening for congenital toxoplasmosis in Ireland, was retrospectively analysed. Known risk factors for acquisition of infection were identified. Women were questioned regarding risk awareness and implementation of avoidance measures, if any, during pregnancy.

Results

Fifteen congenitally infected infants were identified by newborn screening. Seventy-three percent of their mothers (11/15) reported lack of knowledge concerning risk factors for toxoplasma infection or its potential threat to the foetus. Ingestion of raw or undercooked meat during pregnancy was the predominant source of toxoplasma cyst exposure identified. Contact with cats was reported in just one case.

Conclusions

Most women were uneducated about the risks posed by Toxoplasma gondii exposure during pregnancy. There is a clear need for better educational programmes regarding primary prevention of congenital toxoplasmosis if neonatal infection is to be avoided.     

Prevalence of HIV infection in childbearing women in the United States. Surveillance using newborn blood samples

A national, population-based survey was initiated in 1988 to measure the prevalence of human immunodeficiency virus (HIV) infection in women giving birth to infants in the United States. Following standardized procedures, residual dried-blood specimens collected on filter paper for newborn metabolic screening were tested anonymously in state public health laboratories for maternal antibody to HIV. As of September 1990, annual survey data were available from 38 states and the District of Columbia. The highest HIV seroprevalence rates were observed in New York (5.8 per 1000), the District of Columbia (5.5 per 1000), New Jersey (4.9 per 1000), and Florida (4.5 per 1000). Nationwide, an estimated 1.5 per 1000 women giving birth to infants in 1989 were infected with HIV. Assuming a perinatal transmission rate of 30%, we estimate that approximately 1800 newborns acquired HIV infection during one 12-month period. Preventing transmission of HIV infection to women and infants is an urgent public health priority.     

Serological survey and risk factors associated with Toxoplasma gondii infection among HIV-infected pregnant women attending Abuja Tertiary Hospital,Nigeria

BackgroundToxoplasmosis in pregnancy could induce miscarriage, congenital anomalies in foetuses and encephalitis in HIV-infected people. Hence, there is a need to determine the prevalence of toxoplasmosis in HIV-infected pregnant women to inform clinicians about the significance of maternal toxoplasmosis in antenatal care.AimThis study aimed to determine the seroprevalence of Toxoplasma gondii infection, associated CD4+ T-cell profile and sociodemographic risk factors among pregnant women with or without HIV infection attending the University of Abuja Teaching Hospital, Abuja, Nigeria.MethodsThis hospital-based cross-sectional study involved blood samples collected from 160 HIV-infected and 160 HIV-seronegative pregnant women. These samples were analysed for anti-T. gondii (IgG and IgM) and CD4+ T-cell count using ELISA and flow cytometry, respectively. Sociodemographic variables of participants were collected using structured questionnaires.ResultsThe overall seroprevalence of anti-T. gondii IgG and IgM was 28.8% and 3.8%, respectively. The seroprevalence of anti-T. gondii IgG and IgM was 29.4% and 4.4%, respectively, among HIV-seropositive pregnant women and 28.1% and 3.1%, respectively, among HIV-seronegative women. There was no significant association between the seroprevalence of anti-T. gondii-IgG and anti-T. gondii-IgM with age, gestational age, education level, parity or place of residence of HIV-infected pregnant women (P > 0.05). However, there was significant association between the seroprevalence of anti-T. gondii-IgG (P = 0.03) and anti-T. gondii-IgM (P = 0.01) with education level. CD4+ T-cell count varied significantly between HIV-infected and HIV-uninfected pregnant women (P = 0.035).ConclusionIn this study, the seroprevalence of anti-T. gondii IgG and IgM did not differ in HIV-seropositive or HIV-seronegative pregnant women. However, women with primary T. gondii and HIV coinfection had lower CD4+ T-cell count than those with toxoplasmosis monoinfection.     

先天性巨细胞病毒、乙型肝炎病毒和弓形体感染的研究

对青岛市276例产妇及其新生儿脐血巨细胞病毒(HCMV)抗体,乙型肝炎病毒(HBV)标记物及弓形体抗体进行了检测。产妇HCMV感染率为98.91%,活动性感染率为18.48%;HBV感染率为39.13%;弓形体感染率仅为1.81%。HCMV,HBV和弓形体的先天性感染率分别为3.99%,2.17%和0。从新生儿出生时情况看,HCMV先天性感染所致危害远大于HBV和弓形体。     

Seroprevalence of toxoplasma infection among primigravid women attending antenatal clinic at a secondary level hospital in North India

A study was carried out among primigravid women attending a secondary level hospital in a district of North India. The objective of the study was to determine seroprevalence rate of Toxoplasma gondii infection using enzyme-linked immunosorbent assay (ELISA) test. Associations between toxoplasma seropositivity and selected variables (socio-demographic and biologically plausible variables) were also studied. Five hundred three women were enrolled from the antenatal clinic between August, 1996 and September, 1997. Of these, 210 women (41.75%) were seropositive for Toxoplasma gondii infection. These results indicate that a large number of the study subjects were vulnerable to toxoplasma infection. If these infections had occurred during the pregnancy, their foetuses would have been at high risk of infection. There was no statistically significant association between toxoplasma seropositivity and the variables studied except, in the case of type of meat usually consumed. There is a need to provide health education to pregnant women in order to prevent primary toxoplasma infection during pregnancy.     

酶联免疫吸附试验检测孕妇弓形虫感染的临床研究

目的探讨吴江地区孕产妇弓形虫（TOX）感染率及感染状况。方法酶联免疫吸附试验（ELISA）检测孕妇血清中的TOX-IgM和TOX-IgG 2项指标,比较病理妊娠孕产妇和健康孕产妇的感染率以及病理妊娠孕产妇组中年龄、孕期、季节、是否接触动物等因素与TOX-IgM及TOX-IgG感染的关系。结果 103例病理妊娠的孕产妇中（实验组）TOX-IgM阳性11例（10.7%）,TOX-IgG阳性23例（22.3%）,而1 083例健康孕产妇（对照组）TOX-IgM阳性13例（1.2%）,TOX-IgG阳性42例（3.9%）。结论弓形虫引起围生期感染,是导致流产、死胎、早产、先天畸形、听力障碍和智力障碍等的主要原因之一;实验组弓形虫感染率明显高于对照组,差异有统计学意义（P〈0.01）,且在实验组中TOX-IgM和TOX-IgG阳性率随着产妇年龄增加而增加;早孕者感染率高于中晚孕者;夏季感染率明显高于其他季节;接触动物者感染率明显高于未接触动物者。     

延安市义务献血员弓形虫感染调查研究

目的:了解延安市无偿献血人群弓形虫感染和分布情况,为临床安全用血提供科学依据。方法:采用酶联法(ELISA)检测标本血清中抗弓形虫IgG、IgM抗体。结果:共检测368份血清,其中抗弓形虫IgG抗体阳性30例,阳性率为8.15%(30/368);抗弓形虫IgM抗体阳性3例,阳性率为0.82%(3/368);抗弓形虫IgG和IgM抗体阳性33例,阳性率为8.97%(33/368)。献血员的弓形虫感染率年龄、性别和血型之间无显著差异,而不同职业之间虽有显著性差异,但因检测例数偏少,尚不足以说明弓形虫感染与不同职业之间有关。结论:为预防输血后弓形虫病,各地中心血站务须将弓形虫感染指标作为献血员的必检项目。     

Congenital toxoplasmosis in two health institutions in Trinidad

Toxoplasmosis is the most widespread zoonosis and an important human disease particularly in children where it could cause visual and neurological impairment and mental retardation. This study was conducted to determine the prevalence of toxoplasmosis, especially congenital toxoplasmosis in patients at two health institutions in Trinidad A total of 504 cord blood samples of newborn babies were collected: 174 from a women's hospital and 330 from a general hospital. In order to elicit aternal and prenatal risk factors for toxoplasmosis, mothers of the newborns completed a questionnaire. Enzyme-immuno assay (EIA) was used to detect IgG and IgM to Toxoplasma gondii. Overall, of 504 serum samples tested, 220 (43.7%) were seropositive for IgG while the prevalence of congenital toxoplasmosis as reflected by IgM was 0.4%. The prevalence of IgG and IgM by health institutions was not significantly different (p > 0.05; chi-square). The prevalence of toxoplasmosis using IgG was highest in neonates of mothers who were of East Indian descent (54.1%), had four children (52.9%), kept cats in households (47.7%), practised outdoor gardening (50.8%), consumed raw meat (66.7%), had experienced miscarriage(s) (47.3%), stillbirths (66.7%), or who had eye problem(s) (52.9%) and mental retardation (50.0%). The study prevalence of congenital toxoplasmosis revealed a high seroprevalence oftoxoplasmosis in neonates but there was 0.4% serological evidence of congenital disease. It indicates a need for sensitization of the population and healthcare workers and for follow-up of infected children for clinical evidence of the disease. This would be necessary to fully appreciate the impact of toxoplasmosis in Trinidad and Tobago. The differences from comparison groups were however not statistically significant (p > 0.05; chi-square).