Summary

Toxoplasmosis is a disease caused by an obligate intracellular protozoan called Toxoplasma gondii. It is a highly neglected disease which is life-threatening especially to persons whose immune systems are compromised.

Pregnancy can be defined as the period in which an egg cell is fertilized by a sperm to form a new cell, called the zygote, which eventually develops into a new human organism, to be born. . All pregnancy tests depend on the measurement of human chorionic gonadotropins (HCG) in urine.

CHAPTER ONE

INTRODUCTION

1.1 Background

Toxoplasmosis is a disease caused by an obligate intracellular protozoan called Toxoplasma gondii. It is a highly neglected disease which is life-threatening especially to persons whose immune systems are compromised [1] .This parasite infects multiple warm blooded animals including humans, livestock, birds who act as their intermediate host. The only known definitive host of Toxoplasma gondii are members of the family felidae (cats and their relatives) [2].

The parasite has three infectious stages which are bradyzoites, tachyzoites and  sporozoites. The later are common to all hosts member of the cat family [3]. Humans can be infected through the ingestion of food, water contaminated with definitive host’s faeces containing Toxoplasma gondii oocysts, or through the ingestion of cysts in undercooked meat of intermediate hosts such as sheep, Pigs, and birds or mother to child transmission during pregnancy [4].

Usually the infection with Toxoplasma gondii is asymptomatic in healthy persons but it can lead to severe pathological effects in congenital cases and immunocompromised individuals. Vertical transmission from mother to fetus can lead to adverse outcomes such as fetal loss or congenital abnormalities [5].

The risk of vertical transmission and associated problems are determined by the gestational age at which the primary infection is acquired. Transmission to the fetus increases from the first trimester (10 to 24%) to the third trimester (60 to 90%), but the potential of congenital defect is more severe with earlier infections [6, 7]. Most pregnant women with acute acquired infection rarely experience obvious symptoms or signs. A few of them may experience malaise, low-grade fever, and lymphadenopathy [8].

Patients with weaken immune system like HIVAIDS , those on chemotherapy , those who have recently had an organ transplant may develop  more  severe signs and symptom like confusion, seizures poor coordination, blurred vision and lung problems resulting in tuberculosis [7]. Also, the involvement of the kidney during infection with Toxoplasma gondii leads to impairment of kidney function (Mahmood, 2016).

In parasitic invasions, lymphocytes synthesize many specific cytokines which play a significant role in the pathogenesis of parasitic diseases. IL-10 and IL-12 control the type of immune response. The prevalence of toxoplasmosis varies not only among countries but also among regions within one country and these variations are a product of climatic, geographic cultural differences lifestyle and diet. According to WHO Toxoplasmosis is the third burden of foodborne illness in Europe [2], while the American Centers for Disease Control and Prevention (CDC) considers it a neglected disease due to the scant attention paid to it in terms of surveillance, prevention and/or treatment [4].

However, over the past decades, the number of seropositive individuals has been decreasing globally. In line with this global trend, the prevalence of toxoplasmosis in southern and Southeastern European countries, including Serbia, has been continuously declining [8]. In Europe, the prevalence rate ranges from 20% to 85%; in the United States, the prevalence is 12% to 41%, while in Cameroon is 48.5%. Prevalence in other countries can vary from 18% to 65%. [2].

Toxoplasma infection during pregnancy is widely treated with oral spiramycin to reduce the risk of congenital toxoplasmosis in the infant [2]. The disease toxoplasmosis is an occupational risk for: animal care workers including breeders, zoo attendants, veterinarians or their associates, slaughterhouse workers, meat inspectors, line processors, butchers or cooks, agricultural workers, landscapers and gardeners.  Therefore, certain precautions can help prevent toxoplasmosis such as: wearing gloves when handling soil, avoid eating raw or undercooked meat, and thorough washing of fruits and vegetables prior to consumption [9,].

1.2 Objectives

1.2.1General objective

The main objective of this seminar is to outline current knowledge on etiological factors, clinical significance, treatment, prevention and control of toxoplasmosis amongst pregnant women.

1.2.2 Specific objectives

1. To outline current knowledge on toxoplasmosis among pregnant women.
2. To outline the etiological factors and clinical signs and symptoms of toxoplasmosis among pregnant women.
3. To outline the various ways to treat, prevent, and control toxoplasmosis among pregnant women.

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