Seroprevalence of toxoplasmosis in women with repeated abortions in Kashmir.

Abstract

Toxoplasmosis caused by an obligate intracellular protozoan parasite Toxoplasma gondii is a very common infection among young adults in diVerent parts of the world. 1 Most of the toxoplasma infections are asymptomatic, the diagnosis relies mainly on the results of serological tests. The clinical implications of toxoplasma infection in pregnant patients are manifold. Such patients may have spontaneous abortions, still births or premature delivery in addition to various fetal anomalies. 2 Ideally every woman should know her toxoplasma status before conception.Toxoplasma antibodies may persist in the serum of an asymptomatic people for years at higher titres. 3 In this study we screened women with repeated abortions for prevalence of toxoplasma antibodies (IgM) to determine any possible aetiological relation between abortions and toxoplasma infection. Methods Two hundred and eighty five consecutive women who attended our endocrine clinic at Institute of Medical Sciences, Soura, Srinagar, for repeated abortions (two or more) were studied for serological evidence of toxoplasmosis in the form of IgM antibodies.Abortion was defined as the termination of pregnancy before 20 weeks of gestation or below a fetal weight of 500 grams. 4 One hundred and sixty nine, age matched, multiparous controls were also studied simultaneously. To ensure a uniform socioeconomic group, all the controls were selected randomly from subjects attending the associated Maternity Hospital of the Institute for routine antenatal and postnatal visits. In 62 controls, blood samples for IgM toxoplasma were taken in immediate postpartum period while in the 107 controls samples were taken during pregnancy. These 107 subjects subsequently had normal deliveries. The serum samples were separated and stored in aliquots at ˛10°C till assayed. Samples were tested for toxoplasma IgM by ELISA kits, commercially available from Diagnostic Automation Inc, Calabasas, California, USA. Samples were tested strictly according to the manufacturer’s instruction.The results are read by a microwell reader compared in a parallel manner with calibrator and controls. INTERPRETATION Toxo M index of less than 0.80 is taken as negative, between 0.80 to 1.00 is equivocal, and 1.00 or greater is positive for IgM antibody toToxoplasma gondiiand indicates the probability of current or recent toxoplasmosis.