Download PDF
J Pediatr Infect Dis 2017; 12(04): 194-201
DOI: 10.1055/s-0037-1604170
Review Article
Georg Thieme Verlag KG Stuttgart · New York

Congenital Toxoplasmosis: The Unknown Disease Burden of Pregnant Women in Southeast Asia

Cristina Cabanacan Salibay
1   Biological Sciences Department, College of Science and Computer Studies, De La Salle University-Dasmariñas, Cavite, Philippines
2   Graduate Studies Department, College of Science and Computer Studies, De La Salle University-Dasmarinas, Dasmariñas City, Cavite, Philippines
,
Mario S. Torres
1   Biological Sciences Department, College of Science and Computer Studies, De La Salle University-Dasmariñas, Cavite, Philippines
,
Steven Paulo C. Salibay
2   Graduate Studies Department, College of Science and Computer Studies, De La Salle University-Dasmarinas, Dasmariñas City, Cavite, Philippines
3   Department of Biological Sciences, College of Arts and Sciences, Cavite State University, Indang, Cavite, Philippines
,
Veeranoot Nissapatorn
4   Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
5   School of Allied Health Sciences, Walailak University, Nakhon Si Thammarat, Thailand
› Author Affiliations
Further Information

Publication History

06 February 2017

12 April 2017

Publication Date:
27 July 2017 (online)

Also available at
   Permissions and Reprints

Abstract

Congenital toxoplasmosis (CT) is caused by Toxoplasma gondii which is an Apicomplexa parasite that requires a cat for its sexual cycle and a wide array of warm-blooded animals, including man for its asexual cycle. CT develops due to vertical transmission of the parasite from an infected mother to the child. It is in this manner when the unborn child becomes susceptible to infection. The literature review revealed that 26.0% of infants born from T. gondii infected mother are subclinically infected at birth and 10.0% are either mildly or severely clinically affected, while 3.0% of neonates die. Predominant manifestation of CT is encephalomyelitis, initiated by formation of microglial nodules in the brain. However, the most remarkable classical triad signs of toxoplasmosis are hydrocephalus or microcephalus, intracranial calcification, and retinochoroiditis. Hence, this review focused on the risks of the child from developing CT, the role of the pregnant women on the transmission of the parasite, and the risks of acquiring the parasite by the expectant mothers from Southeast Asia vis-à-vis transmitting the same to the unborn child. Likewise, this review also included the methods used for the diagnosis of CT and its importance in early detection and management of the disease by assessing practical means of controlling the incidence and preventing further transmission of the parasite.

Keywords

congenital toxoplasmosis - pregnancy - Toxoplasma gondii - Southeast Asia
 

  • References

  • 1 Dubey JP, Rajendran C, Ferreira LR. , et al. High prevalence and genotypes of Toxoplasma gondii isolated from goats, from a retail meat store, destined for human consumption in the USA. Int J Parasitol 2011; 41 (08) 827-833
    CrossrefPubMedSearch in Google Scholar
  • 2 Petersen E, Vesco G, Villari S, Buffolano W. What do we know about risk factors for infection in humans with Toxoplasma gondii and how can we prevent infections?. Zoonoses Public Health 2010; 57 (01) 8-17
    CrossrefPubMedSearch in Google Scholar
  • 3 Salibay CC, Claveria FG. Serologically confirmed Toxoplasma gondii infection in Philippine Rattus spp. and its histopathology in Mus musculus . Philipp J Sci 2005; 134 (02) 95-104
    PubMedSearch in Google Scholar
  • 4 Dubey JP, Hill DE, Jones JL. , et al. Prevalence of viable Toxoplasma gondii in beef, chicken, and pork from retail meat stores in the United States: risk assessment to consumers. J Parasitol 2005; 91 (05) 1082-1093
    CrossrefPubMedSearch in Google Scholar
  • 5 Opsteegh M, Kortbeek TM, Havelaar AH, van der Giessen JWB. Intervention strategies to reduce human Toxoplasma gondii disease burden. Clin Infect Dis 2015; 60 (01) 101-107
    CrossrefPubMedSearch in Google Scholar
  • 6 Brüggmann D, Handl V, Klingelhöfer D, Jaque J, Groneberg DA. Congenital toxoplasmosis: an in-depth density-equalizing mapping analysis to explore its global research architecture. Parasit Vectors 2015; 8: 646-659
    CrossrefPubMedSearch in Google Scholar
  • 7 Weiss LM, Dubey JP. Toxoplasmosis: a history of clinical observations. Int J Parasitol 2009; 39 (08) 895-901
    CrossrefPubMedSearch in Google Scholar
  • 8 Kravetz J. Congenital toxoplasmosis. BMJ Clin Evid 2013; 2013: 0906
    PubMedSearch in Google Scholar
  • 9 Robert-Gangneux F, Dardé ML. Epidemiology of and diagnostic strategies for toxoplasmosis. Clin Microbiol Rev 2012; 25 (02) 264-296
    CrossrefPubMedSearch in Google Scholar
  • 10 Sarkari B, Abdolahi Khabisi S. Severe congenital toxoplasmosis: a case report and strain characterization. Case Rep Infect Dis 2015; 2015: 851085
    PubMedSearch in Google Scholar
  • 11 de Melo Inagaki AD, Carvalheiro CG, Cipolotti R. , et al. Birth prevalence and characteristics of congenital toxoplasmosis in Sergipe, North-east Brazil. Trop Med Int Health 2012; 17 (11) 1349-1355
    CrossrefPubMedSearch in Google Scholar
  • 12 Nissapatorn V, Lau Y, Fong M. Toxoplasma gondii: the parasite in trend. Lim YALVythilingam I, eds. Parasites and their vectors. Chapter 8. Heidelberg, Springer; 2013
    PubMedSearch in Google Scholar
  • 13 Salibay CC, Dungca JZ, Claveria FG. Serological survey of Toxoplasma gondii infection among urban (Manila) and suburban (Dasmariñas, Cavite) residents, Philippines. J Protozool Res 2008; 18: 26-33
    PubMedSearch in Google Scholar
  • 14 Kawashima T, Khin-Sane-Win T, Kawabata M, Barzaga N, Matsuda H, Konishi E. Prevalence of antibodies to Toxoplasma gondii among urban and rural residents in the Philippines. Southeast Asian J Trop Med Public Health 2000; 31 (04) 742-746
    PubMedSearch in Google Scholar
  • 15 Sakae C, Natphopsuk S, Settheetham-Ishida W, Ishida T. Low prevalence of Toxoplasma gondii infection among women in northeastern Thailand. J Parasitol 2013; 99 (01) 172-173
    CrossrefPubMedSearch in Google Scholar
  • 16 Andiappan H, Nissapatorn V, Sawangjaroen N. , et al. Knowledge and practice on Toxoplasma infection in pregnant women from Malaysia, Philippines, and Thailand. Front Microbiol 2014; 5 (291) 291
    PubMedSearch in Google Scholar
  • 17 Andiappan H, Nissapatorn V, Sawangjaroen N. , et al. Comparative study on Toxoplasma infection between Malaysian and Myanmar pregnant women. Parasit Vectors 2014; 7 (564) 564
    CrossrefPubMedSearch in Google Scholar
  • 18 Nissapatorn V, Suwanrath C, Sawangjaroen N, Ling LY, Chandeying V. Toxoplasmosis-serological evidence and associated risk factors among pregnant women in southern Thailand. Am J Trop Med Hyg 2011; 85 (02) 243-247
    CrossrefPubMedSearch in Google Scholar
  • 19 Nissapatorn V, Noor Azmi MA, Cho SM. , et al. Toxoplasmosis: prevalence and risk factors. J Obstet Gynaecol 2003; 23 (06) 618-624
    CrossrefPubMedSearch in Google Scholar
  • 20 Suhardjo, Utomo PT, Agni AN. Clinical manifestations of ocular toxoplasmosis in Yogyakarta, Indonesia: a clinical review of 173 cases. Southeast Asian J Trop Med Public Health 2003; 34 (02) 291-297
    PubMedSearch in Google Scholar
  • 21 Petersen E, Kijlstra A, Stanford M. Epidemiology of ocular toxoplasmosis. Ocul Immunol Inflamm 2012; 20 (02) 68-75
    CrossrefPubMedSearch in Google Scholar
  • 22 Torgerson PR, Mastroiacovo P. The global burden of congenital toxoplasmosis: a systematic review. Bull World Health Organ 2013; 91 (07) 501-508
    CrossrefPubMedSearch in Google Scholar
  • 23 Sikndra H, Tasawar Z, Akhtar T. Seroprevalence of human toxoplasmosis in Kallarwali village of district Muzaffar Garh, Pakistan. Gomal J Med Sci 2014; 12 (03) 127-131
    PubMedSearch in Google Scholar
  • 24 Tasawar Z, Ali Raza A, Aziz F, Hussain Lashari M. Prevalence of human toxoplasmosis in district Muzaffargarh, Punjab, Pakistan. Gomal J Med Sci 2012; 10 (01) 37-41
    PubMedSearch in Google Scholar
  • 25 Hua HY, Tang F, Liu YX. , et al. [Survey of Toxoplasma gondii infection among pregnant women in Jiangsu Province, China]. Chinese Journal of Schistosomiasis Control 2013; 25 (01) 56-58, 79
    PubMedSearch in Google Scholar
  • 26 Sakikawa M, Noda S, Hanaoka M. , et al. Anti-toxoplasma antibody prevalence, primary infection rate, and risk factors in a study of toxoplasmosis in 4,466 pregnant women in Japan. Clin Vaccine Immunol 2012; 19 (03) 365-367
    CrossrefPubMedSearch in Google Scholar
  • 27 Saadatnia G, Golkar M. A review on human toxoplasmosis. Scand J Infect Dis 2012; 44 (11) 805-814
    CrossrefPubMedSearch in Google Scholar
  • 28 Tenter AM. Toxoplasma gondii in animals used for human consumption. Mem Inst Oswaldo Cruz 2009; 104 (02) 364-369
    CrossrefPubMedSearch in Google Scholar
  • 29 Jones JL, Dubey JP. Waterborne toxoplasmosis--recent developments. Exp Parasitol 2010; 124 (01) 10-25
    CrossrefPubMedSearch in Google Scholar
  • 30 de Moura L, Bahia-Oliveira LM, Wada MY. , et al. Waterborne toxoplasmosis, Brazil, from field to gene. Emerg Infect Dis 2006; 12 (02) 326-329
    CrossrefPubMedSearch in Google Scholar
  • 31 Jiménez-Coello M, Acosta-Viana K, Guzmán-Marín E, Puerto-Solís M, Ortega-Pacheco A. Toxoplasmosis: a relevant zoonotic food borne disease in tropical conditions. Afr J Microbiol Res 2012; 6 (12) 2956-2964
    PubMedSearch in Google Scholar
  • 32 Tenter AM, Heckeroth AR, Weiss LM. Toxoplasma gondii: from animals to humans. Int J Parasitol 2000; 30 (12-13): 1217-1258
    CrossrefPubMedSearch in Google Scholar
  • 33 Salibay C, Claveria F. Toxoplasma gondii infection in Philippines Rattus spp. confirmed through bioassay in Mus musculus . Vet Arhiv 2006; 76 (04) 351-361
    PubMedSearch in Google Scholar
  • 34 Yan C, Liang LJ, Zheng KY, Zhu XQ. Impact of environmental factors on the emergence, transmission and distribution of Toxoplasma gondii . Parasit Vectors 2016; 9: 137
    CrossrefPubMedSearch in Google Scholar
  • 35 Advincula JK, Iewida SY, Cabanacan-Salibay C. Serologic detection of Toxoplasma gondii infection in stray and household cats and its hematologic evaluation. Sci Med (Porto Alegre) 2010; 20 (01) 76-82
    PubMedSearch in Google Scholar
  • 36 Jones JL, Ogunmodede F, Scheftel J. , et al. Toxoplasmosis-related knowledge and practices among pregnant women in the United States. Infect Dis Obstet Gynecol 2003; 11 (03) 139-145
    CrossrefPubMedSearch in Google Scholar
  • 37 Cook AJ, Gilbert RE, Buffolano W. , et al; European Research Network on Congenital Toxoplasmosis. Sources of toxoplasma infection in pregnant women: European multicentre case-control study. BMJ 2000; 321 (7254): 142-147
    CrossrefPubMedSearch in Google Scholar
  • 38 Kijlstra A, Eissen OA, Cornelissen J, Munniksma K, Eijck I, Kortbeek T. Toxoplasma gondii infection in animal-friendly pig production systems. Invest Ophthalmol Vis Sci 2004; 45 (09) 3165-3169
    CrossrefPubMedSearch in Google Scholar
  • 39 Alvarado-Esquivel C, Alvarado-Esquivel D, Dubey JP. Prevalence of Toxoplasma gondii antibodies in domestic donkeys (Equus asinus) in Durango, Mexico slaughtered for human consumption. BMC Vet Res 2015; 11: 6
    CrossrefPubMedSearch in Google Scholar
  • 40 Berghold C, Herzog SA, Jakse H, Berghold A. Prevalence and incidence of toxoplasmosis: a retrospective analysis of mother-child examinations, Styria, Austria, 1995 to 2012. Euro Surveill 2016; 21 (33) 30317
    CrossrefPubMedSearch in Google Scholar
  • 41 Jones JL, Dargelas V, Roberts J, Press C, Remington JS, Montoya JG. Risk factors for Toxoplasma gondii infection in the United States. Clin Infect Dis 2009; 49 (06) 878-884
    CrossrefPubMedSearch in Google Scholar
  • 42 Conrad PA, Miller MA, Kreuder C. , et al. Transmission of Toxoplasma: clues from the study of sea otters as sentinels of Toxoplasma gondii flow into the marine environment. Int J Parasitol 2005; 35 (11-12): 1155-1168
    CrossrefPubMedSearch in Google Scholar
  • 43 Centers for Disease Control and Prevention (CDC). Parasites, toxoplasmosis, biology. Available at: http://www.cdc.gov/parasites/toxoplasmosis/biology.html . Accessed December 31, 2016
    PubMed
  • 44 Mastrobuoni S, Dell'aquila AM, Herreros J. Fatal Toxoplasma gondii dissemination in a heart transplant recipient: description of a case. Case Rep Transplant 2012; 2012: 524279
    PubMedSearch in Google Scholar
  • 45 Sarkari B, Shafiei R, Zare M, Sohrabpour S, Kasraian L. Seroprevalence and molecular diagnosis of Toxoplasma gondii infection among blood donors in southern Iran. J Infect Dev Ctries 2014; 8 (04) 543-547
    PubMedSearch in Google Scholar
  • 46 Hill D, Dubey JPT. Toxoplasma gondii: transmission, diagnosis and prevention. Clin Microbiol Infect 2002; 8 (10) 634-640
    CrossrefPubMedSearch in Google Scholar
  • 47 Uysal A, Cüce M, Tañer CE. , et al. Prevalence of congenital toxoplasmosis among a series of Turkish women. Rev Med Chil 2013; 141 (04) 471-476
    PubMedSearch in Google Scholar
  • 48 Pengsaa K, Hattasingh W. Congenital toxoplasmosis: an uncommon disease in Thailand. Paediatr Int Child Health 2015; 35 (01) 56-60
    CrossrefPubMedSearch in Google Scholar
  • 49 Gontijo da Silva M, Clare Vinaud M, de Castro AM. Prevalence of toxoplasmosis in pregnant women and vertical transmission of Toxoplasma gondii in patients from basic units of health from Gurupi, Tocantins, Brazil, from 2012 to 2014. PLoS One 2015; 10 (11) e0141700
    CrossrefPubMedSearch in Google Scholar
  • 50 Avelino MM, Amaral WN, Rodrigues IM. , et al. Congenital toxoplasmosis and prenatal care state programs. BMC Infect Dis 2014; 14 (33) 33
    CrossrefPubMedSearch in Google Scholar
  • 51 Carellos EV, de Andrade GM, Vasconcelos-Santos DV. , et al; UFMG Congenital Toxoplasmosis Brazilian Group. Adverse socioeconomic conditions and oocyst-related factors are associated with congenital toxoplasmosis in a population-based study in Minas Gerais, Brazil. PLoS One 2014; 9 (02) e88588
    CrossrefPubMedSearch in Google Scholar
  • 52 Ahmada QI, Choha SA, Charooa BA. , et al. Clinicoepidemiological profile of maternal and congenital toxoplasmosis in Kashmir valley: a hospital based study. J Pediat Infect Dis 2010; 5: 333-337
    PubMedSearch in Google Scholar
  • 53 Ferguson DJ, Bowker C, Jeffery KJ, Chamberlain P, Squier W. Congenital toxoplasmosis: continued parasite proliferation in the fetal brain despite maternal immunological control in other tissues. Clin Infect Dis 2013; 56 (02) 204-208
    CrossrefPubMedSearch in Google Scholar
  • 54 Onichandran S, Kumar T, Lim YA. , et al. Waterborne parasites and physico-chemical assessment of selected lakes in Malaysia. Parasitol Res 2013; 112 (12) 4185-4191
    CrossrefPubMedSearch in Google Scholar
  • 55 Amin TT, Ali MN, Alrashid AA, Al-Agnam AA, Al Sultan AA. Toxoplasmosis preventive behavior and related knowledge among Saudi pregnant women: an exploratory study. Glob J Health Sci 2013; 5 (05) 131-143
    PubMedSearch in Google Scholar
  • 56 Pereboom MT, Manniën J, Spelten ER, Schellevis FG, Hutton EK. Observational study to assess pregnant women's knowledge and behaviour to prevent toxoplasmosis, listeriosis and cytomegalovirus. BMC Pregnancy Childbirth 2013; 13: 98
    CrossrefPubMedSearch in Google Scholar
  • 57 Alvarado-Esquivel C, Sifuentes-Álvarez A, Estrada-Martínez S, Rojas-Rivera A. Knowledge and practices on toxoplasmosis in physicians attending pregnant women in Durango, Mexico [in Spanish]. Gac Med Mex 2011; 147 (04) 311-324
    PubMedSearch in Google Scholar