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Fulltext Comparison of nested and ELISA based polymerase chain reaction assays for detecting Chlamydia trachomatis in pregnant women with preterm complications

Sulaiman S, Chong PP, Mokhtarudin R, Lye MS, Wan Hassan WH

Trop Biomed, 2014 Mar;31(1):36-45.
PMID: 24862043 MyJurnal

Identification of pregnant women infected with Chlamydia trachomatis is essential to allow early antibiotic treatment in order to prevent adverse pregnancy outcomes. In this study, two nucleic acid amplification tests (NAAT) namely nested PCR (BioSewoom, Korea) and Amplicor CT/NG (Roche Diagnostic, USA) were evaluated in terms of sensitivity and specificity for the detection of C. trachomatis DNA in pregnant women with preterm complications. A cross-sectional study was carried out in two public hospitals in Southern Selangor, Malaysia. Endocervical swabs obtained were subjected to DNA amplification using nested PCR (BioSewoom, Korea) and Amplicor CT/NG (Roche Diagnostic, USA). A total of 83 endocervical swabs obtained from pregnant women of less than 37 weeks gestation and presented with preterm complications were subjected to chlamydial DNA detection using both assays. The study shows that Amplicor CT/NG assay is more effective in the detection of C. trachomatis DNA from endocervical swabs compared to Biosewoom nested PCR kit. Agreement between the two assays were poor (kappa=0.094) with nested PCR showing a low sensitivity of 10.81% and a 97.83% specificity when compared to Amplicor CT/NG. The results obtained indicated that BioSewoom nested PCR was less sensitive than Amplicor CT/ NG for detecting C. trachomatis in endocervical specimens and that another more reliable test is required for confirmatory result.

Matched MeSH terms: Pregnancy; Pregnancy Complications, Infectious/diagnosis*; Pregnancy Complications, Infectious/microbiology
Detection of acute Toxoplasma gondii infection in pregnant women by IgG avidity and PCR analysis

Roozbehani M, Gharavi MJ, Moradi M, Razmjou E

Trop Biomed, 2018 Dec 01;35(4):908-914.
PMID: 33601840

During pregnancy, Toxoplasma gondii can be transmitted from mother to foetus and trigger a primary infection that may be symptomatic. It is important to distinguish between recently acquired and past infections to ensure proper treatment to minimize irreversible foetal injury. We used PCR of the B1 gene to evaluate the accuracy of T. gondii IgG antibody avidity testing in discriminating recent from past infection. In a cross-sectional study, T. gondii IgG and IgM antibodies were detected by enzyme linked fluorescence assay (ELFA) in 2120 serum samples from pregnant women referred to Karaj medical laboratories, February 2013 through March 2015 with 40 samples found positive. IgM-positive samples were evaluated by IgG avidity testing and PCR to amplify the B1 gene. Avidity studies indicated 20 samples with high IgG avidity, 15 with low IgG avidity, and five showing borderline values. The B1 gene was amplified in the borderline samples, with nine of the 15 showing low avidity. The B1 gene was not amplified in the high avidity sera. Our findings suggest that IgG avidity alone may not be sufficient to discriminate recent from past T. gondii infection and should not be used as the sole confirmatory test in pregnant women with IgG and IgM T. gondii antibodies. IgG avidity testing in combination with PCR may be more reliable for distinguishing between high- and low-risk infection and decrease the frequency of unnecessary treatment of pregnant women.

Matched MeSH terms: Pregnancy
Prevalence and risk factors of Toxoplasma infection - an update in Malaysian pregnant women

Chemoh W, Nur Farhana MN, Noor Azmi MA, Si Lay K, Sawangjaroen N, Tan TC, et al.

Trop Biomed, 2019 Sep 01;36(3):694-702.
PMID: 33597491

Toxoplasma gondii is a protozoan parasite that is capable of causing a zoonotic disease, known as toxoplasmosis. Vertical transmission of T. gondii from the mother to the fetus, during pregnancy may cause severe complications to the developing fetus. This current study aimed to determine the seroprevalence and investigate the associated risk factors of Toxoplasma infection in pregnant women (n=219) visiting the antenatal clinic at UMMC. While the elevated level of anti-Toxoplasma IgG and IgM antibodies indicates the presence of infection, it fails to differentiate between a past and a recent infection. Thus, the study also demonstrates the usefulness of IgG avidity in validating the timing of infection. The serum samples were tested for the presence of anti-Toxoplasma IgG and IgM antibodies by ELISA test, and the seropositive samples for both anti-Toxoplasma IgG and IgM antibodies were further evaluated by IgG avidity. The results showed that the overall prevalence of T. gondii seropositivity was 34.7%. Of these, 30.6% (67/219) were positive for anti-Toxoplasma IgG antibody only, 2.3% (5/219) were positive for anti-Toxoplasma IgM only, and the remaining 1.8% (4/219) was positive for both anti-Toxoplasma IgG and IgM antibodies. All of the pregnant women who were positive for both anti-Toxoplasma IgG and IgM antibody were found to have past infection when evaluated by IgG avidity. In this study, Malay ethnicity and the number of existing previous children were significantly associated with T. gondii seropositivity (p<0.05). Based on these findings, information and education on the transmission and prevention of congenital toxoplasmosis are very crucial as a public health effort towards a healthier society.

Matched MeSH terms: Pregnancy; Pregnancy Complications, Parasitic/epidemiology*
Sero-prevalence of toxoplasmosis among pregnant women attending an ante-natal clinic at a teaching hospital in Al Kharj, Saudi Arabia

Qamer S, Rizvi SSR, Raoof S, Kamal SM, Khan S

Trop Biomed, 2020 Mar 01;37(1):186-193.
PMID: 33612729

Toxoplasma gondii (T. gondii) is a zoonotic infection that may be transmitted to human beings either by consumption of raw or uncooked meat or by ingesting oocysts. Toxoplasma organisms can cross blood placenta barrier and may result in congenital toxoplasmosis. About 80% of immunocompetent individuals do not show any clinical manifestations and are silent carriers of this disease. Pregnant women especially in highly prevalent areas are recommended to be screened for this disease in order to prevent the potential vertical transmission. To our knowledge no such study has been conducted in this region of Saudi Arabia. This study attempted to carry out two objectives: first, to find out the seroprevalence of T. gondii infection in pregnant women attending prenatal care services in our hospital; second, to find out risk factors associated with T. gondii seroprevalence in our patients. It was carried out in Teaching Hospital in Al-Kharj over a period of one year. All 306 pregnant women attending antenatal clinic were involved in the study. A pretested selfexplanatory questionnaire was filled out by the patients and their sera were collected to be tested for IgG and/or IgM against T. gondii. The results were then statistically analyzed using SPSS software and p-value was calculated using Pearson Chi Square test. Out of the 306 blood samples tested, 99 (32.4%) were seropositive for specific anti T. gondii IgG antibodies and 3(1%) were seropositive for IgM. This show that seroprevalence of T. gondii antibodies was high among pregnant women and the prevalence showed a significant association with age. The study recommends conducting educational programs to raise awareness among women about risk factors and precautions to be taken.

Matched MeSH terms: Pregnancy; Pregnancy Complications, Parasitic/epidemiology*
Toxoplasma gondii infection among selected indigenous community in Sarawak, East Malaysia

Ngui R, Hassan NA, Chang LY, Teh SJC, Chua KH, Kee BP, et al.

Trop Biomed, 2020 Mar 01;37(1):155-164.
PMID: 33612726

Toxoplasma gondii is an obligate intracellular protozoan parasite that causes toxoplasmosis in humans. To date, little is known about T. gondii infection among the indigenous community, particularly in East Malaysia. This study was conducted to determine the status of T. gondii infection and to investigate associated risk factors among the indigenous community of Sarawak, East Malaysia. The sociodemographic data was obtained using a pretested questionnaire. A serological test was done to detect the presence of specific IgM and IgG antibodies against T. gondii in serum samples. A nested polymerase chain reaction (PCR) was used to determine acute infection among seropositive individuals. The overall seroprevalence of T. gondii infection was 50% (95% CI = 43.3 - 56.7). From this subset, 40.1%, 5.7%, and 4.2% were positive for anti-T. Gondii IgG antibodies, IgM, and both IgG and IgM, respectively. Four seropositive samples were amplified through PCR. None of the pregnant women tested positive for T. gondii infection based on the serological and PCR assays. A significant association was found between age, low monthly household income, unemployment, usage of untreated water and close contact with T. gondii seropositive cats. These results provide basic information on T. gondii infection and may be useful for policymakers to initiate prevention and control programs, especially amongst pregnant women and women of childbearing age in the indigenous community.

Matched MeSH terms: Pregnancy
Seroprevalence of low avidity anti-Toxoplasma IgG in pregnant women and its relationship with their age and contact with cats

Khan K, Khan W, Khan T, Naaz G, Naheda A, Aqeel S

Trop Biomed, 2020 Dec 01;37(4):1038-1049.
PMID: 33612756 DOI: 10.47665/tb.37.4.1038

Toxoplasma gondii is a protozoan parasite that can infect all mammals, serving as intermediate hosts. The cause of congenital toxoplasmosis is transplacental transmission of the parasite to the foetus, resulting in wide range of manifestations from mild chorioretinitis to miscarriage. Its frequency can be reduced by early screening of pregnant women which is based mainly on tests for anti-Toxoplasma antibodies. We collected serum samples of 594 pregnant women (subjects) after taking their consent over a period of two years (2016-2018) and analyzed them for anti-Toxoplasma IgG by ELISA. The positive samples were then analyzed for IgG avidity test which could differentiate between recent and past infections. The seroprevalence was also correlated with the age of the subjects and their contact with cats. 162 subjects were found positive out of which only three showed a recent infection. After following up until delivery, one of them delivered a baby who had jaundice and was diagnosed with anti-Toxoplasma IgM at birth. The foetus of the second subject died in-utero, while the third woman delivered a normal baby after being given spiramycin when diagnosed with toxoplasmosis in the first trimester. It was found that most of the positive subjects had frequent contact with cats. Invasion of the parasite during third trimester resulted in death in-utero and jaundice. Most common cause of pregnancy wastage during our study was spontaneous abortions while pregnancy loss due to congenital anomalies was rare.

Matched MeSH terms: Pregnancy
Ovarian activity in beef and dairy cows with prolonged postpartum period and heifers that fail to conceive

Yimer N, Rosnina Y, Wahid H, Saharee AA, Yap KC, Ganesamurthi P

Trop Anim Health Prod, 2010 Apr;42(4):607-15.
PMID: 19809886 DOI: 10.1007/s11250-009-9464-y

The primary objectives of this study were to investigate incidence of abnormal ovarian cyclicity (AOC) and its type in dairy and beef cows with prolonged postpartum period (>90 days) and in heifers that fail to conceive. A total of 53 animals were included in the study: 17 Friesian crosses, 16 Braford crosses, eight Brangus crosses, and 12 local Kedah-Kelantan (KKX) crosses. These animals were initially checked for absence of pregnancy via palpation per rectum. Blood samples for progesterone analysis were obtained twice a week for 2 to 3 months following their spontaneous oestrous cycle, and all animals were rechecked for pregnancy at the end of the study. Progesterone analysis indicated that 33.9% of the total animals were having AOC: 18.9% with cessation of ovarian cyclicity, 9.4% with prolonged luteal phases (PLP), and 5.7% short luteal phases. The highest incidence was observed in Brangus crosses (62.5%), followed by Braford crosses (43.8%), and Friesian crosses (35.3%). In contrast, no AOC was observed in the local KKX breeds, and all of them were found to be pregnant at the end of the study. A significant difference (p < 0.05) in the incidence of AOC and its type was observed between Kedah-Kelantan crosses and the other breeds. Although not significant (p > 0.05), Friesian crosses showed a higher percentage incidence of AOC than beef cows (40% vs 36.4%), with major types being PLP (26.7%) in dairy and cessation of ovarian cycle (27.3%) in beef cows. Compared with beef heifers, beef cows showed a higher percentage of AOC (36.4% vs 28.6%) where again, cessation of cyclicity was the predominant abnormality. In conclusion, AOC reflected by abnormal endocrine pattern is a possible cause of reduction in fertility for dairy and beef cows beyond 90 days postpartum and heifers that fail to conceive.

Matched MeSH terms: Pregnancy
Epidemiology of Trypanosoma evansi infection in crossbred dairy cattle in Malaysia

Cheah TS, Sani RA, Chandrawathani P, Bahri S, Dahlan I

Trop Anim Health Prod, 1999 Feb;31(1):25-31.
PMID: 10399814

An investigation into the epidemiology of Trypansoma evansi infection in crossbred dairy cattle was conducted for a period of 12 months on a dairy cattle farm in Penninsular Malaysia. The prevalence of parasitaemia was highest in lactating animals (13.4%), followed by those in the dry herd (8.8%), late pregnant animals (8.1%), early pregnant animals (4.7%), calves (0.3%) and heifers (0.2%). The prevalence of antigenaemia was highest in the lactating animals (54.7%), followed by that in dry animals (53.7%), heifers (51.1%), late pregnant animals (47.7%), early pregnant animals (46.5%) and calves (24.2%).

Matched MeSH terms: Pregnancy
Development of smallholder dairy units in Malaysia

Wan Hassan WE, Phipps RH, Owen E

Trop Anim Health Prod, 1989 Aug;21(3):175-82.
PMID: 2799944

In experiments conducted over a four-year period the effect of pasture type (Setaria sphacelata and a Brachiaria decumbens/Leucaena leucocephala mixture), management system (rotational grazing and cut and carry) and level of concentrate supplement (0, 4 and 6 kg fresh weight/cow per day) on milk production in smallholder dairy units was examined. All units were 1 ha in size and stocked with five Sahiwal X Friesian cows. Milk yields/ha were higher from rotational grazing and the brachiaria/leucaena pasture when compared with the cut and carry system and the setaria pasture respectively. In subsequent experiments smallholder units were based on brachiaria/leucaena and rotational grazing. A supplement of 4 kg fresh weight of concentrate (11 MJ/kg DM and 150 g/kg DM CP) increased milk yield/ha from 7,760 to 13,045 kg while in a third trial milk yield/ha was further increased from 14,148 to 16,760 kg when concentrate level was raised from 4 to 6 kg fresh weight/day. The results indicate that smallholder dairy units in Malaysia could be economically viable and competitive with other agricultural enterprises such as rubber and oil palm.

Matched MeSH terms: Pregnancy
Effect of age at first calving and milking system on the lactation performance of F1 Bos indicus/Bos taurus crossbreds in Sabah

Edwards MD

Trop Anim Health Prod, 1985 Nov;17(4):201-8.
PMID: 4089967 DOI: 10.1007/BF02356977

This paper examines the effect of age at first calving and milking system on the overall lactation performance and incidence of lactation failure of 442 F1 Bos indicus/Bos taurus dairy crossbreds in Sabah. The two types of crossbred used in the study were imported F1 Sahiwal x Friesian and locally bred Friesian x Local Indian Dairy. Heifers which did not lactate for at least 120 days or produced less than 20 kg of milk during the fourteenth week of lactation were considered to have failed to establish a lactation. The imported and locally bred heifers recorded failure rates of 23.4 and 21.4% respectively. Three milking systems were examined namely machine milking without calf, machine milking with calf and hand milking. They produced failure rates of 30, 12 and 5.6% respectively. The cows that passed recorded 120 day milk production figures of 878, 1,134 and 1,054 kg respectively. The three age groups of less than 30 months, 30 to 34 months and greater than 34 months recorded failure rates of 37, 22 and 10% respectively. The heifers machine milked without their calf which calved at less than 30 months of age recorded a failure rate of 44% while those which calved at greater than 34 months recorded a failure rate of only 17%.
Study site: Tawau and Sebrang Livestock Breeding Centres, Sabah, Malaysia

Matched MeSH terms: Pregnancy; Pregnancy, Animal*
Observations on Banteng cattle in Sabah

Copland RS

Trop Anim Health Prod, 1974 May;6(2):89-94.
PMID: 4414876
Matched MeSH terms: Pregnancy
Fulltext Review of clinical aspects, epidemiology and diagnosis of haemotropic Mycoplasma ovis in small ruminants: current status and future perspectives in tropics focusing on Malaysia

Paul BT, Jesse FFA, Chung ELT, Che-Amat A, Mohd Lila MA, Hashi HA, et al.

Trop Anim Health Prod, 2020 Nov;52(6):2829-2844.
PMID: 32712811 DOI: 10.1007/s11250-020-02357-9

Mycoplasma ovis (formerly Eperythrozoon ovis) is an epierythrocytic parasitic bacterium of small ruminants known as haemotropic mycoplasma, which is transmitted mechanically by biting flies and contaminated instruments. Acute mycoplasmosis causes severe haemolytic anaemia and mortality in young animals. At the same time, chronic disease may produce mild anaemia and varying degrees of morbidity depending on several factors, including age, reproductive status, the plane of nutrition, immunological status and the presence of concurrent infection. Haemotropic Mycoplasma ovis is currently recognised as an emerging zoonotic pathogen which is widely distributed in the sheep and goat producing areas of tropics and subtropics, where the disease is nearly endemic. Human infection has been reported in pregnant women, immunocompromised patients and people exposed to animals and arthropods. The current diagnosis of haemoplasma relies on microscopic evaluation of Giemsa-stained blood smear and PCR. Although there are few published reports on the incidence of haemotropic Mycoplasma ovis infection of small ruminants in Malaysia, information on its prevalence, risk factors, severity and economic impacts is grossly inadequate. Therefore, a large-scale survey of small ruminant flocks is necessary to elucidate the current seroprevalence status and molecular characteristics of haemotropic M. ovis infection in Malaysia using ELISA and PCR sequencing technologies. In the future, surveillance programs, including vector forecast, quarantine, monitoring by periodic surveys and public enlightenment, will limit the internal and transboundary spread of M. ovis, enhance control efforts and mitigate production losses in Malaysia.

Matched MeSH terms: Pregnancy
An analysis of customs related to childbirth in rural Malay culture

Chen PC

Trop Geogr Med, 1973 Jun;25(2):197-204.
PMID: 4717277
Matched MeSH terms: Pregnancy
Incorporating the traditional birth attendant into the health team: the Malaysian example

Chen PC

Trop Geogr Med, 1977 Jun;29(2):192-6.
PMID: 906079

Domiciliary deliveries have always been the responsibility of traditional birth attendants. Since Independence, acquired in 1957, educated young women have been trained as auxiliary midwives and sent to serve in rural communities where they usually are met with resistance by the established traditional birth attendants. To counter this and to incorporate the traditional birth attendants into the health team, new roles were developed for each so that the two would be able to cooperate and support each other rather than rival and antagonise each other. A specific experience in one area of Malaysia is examined as an example.

Matched MeSH terms: Pregnancy
Providing maternal and child care in rural Malaysia

Chen PC

Trop Geogr Med, 1977 Dec;29(4):441-8.
PMID: 610030

Since Independence, gained in 1957, major changes have occurred in the rural areas of Malaysia not least amongst which has been the provision of maternal and child care services to hitherto neglected areas. In the first part of this paper, the demographic and disease patterns are described. The second part outlines the general development efforts and describes in greater detail the rural health services that have been organized in Malaysia. In the concluding section, changes in mortality and morbidity are examined.

Matched MeSH terms: Pregnancy
Obstetrical data in Malaysian aborigine women

Ong HC

Trop Geogr Med, 1974 Dec;26(4):384-8.
PMID: 4456697
Matched MeSH terms: Pregnancy*; Pregnancy Complications/epidemiology; Pregnancy Complications, Hematologic/epidemiology; Pregnancy Complications, Infectious/epidemiology
Characterisation of maternal human leukocyte antigen class I antibodies in suspected foetal and neonatal alloimmune thrombocytopenia

Refsum E, Mörtberg A, Dahl J, Meinke S, Auvinen MK, Westgren M, et al.

Transfus Med, 2017 Feb;27(1):43-51.
PMID: 27862486 DOI: 10.1111/tme.12375

OBJECTIVES: To investigate the specificities and level of HLA class I antibodies in selected cases referred for suspected foetal and neonatal alloimmune thrombocytopenia (FNAIT).
BACKGROUND: FNAIT occurs in 1 : 1-2000 live births, whereas maternal immunisation against human leukocyte antigen (HLA) class I is common. Whether HLA class I antibodies alone can cause FNAIT is debatable.
MATERIAL AND METHODS: A total of 260 patient samples were referred between 2007 and 2012. Referrals with maternal HLA class I antibodies and no other cause for the neonatal thrombocytopenia were included for analysis (cases, n = 23). HPA-1a negative mothers were excluded. Control groups were screened positive mothers of healthy neonates (controls, n = 33) and female blood donors (blood donors, n = 19). LABScreen single antigen HLA class I beads was used for antibody analysis. Clinical records were reviewed for cases.
RESULTS: All groups had broad antibody reactivity. Cases had more antibodies with high SFI levels compared with the controls (SFI>9999; medians 26, 6 and 0; P

Matched MeSH terms: Pregnancy
Erythrocyte Alloimmunity and Genetic Variance: Results from the Collaborative Study of Alloimmunity to Antigen Diversity in Asian Populations (All ADP)

Takeshita A, Watanabe H, Yamada C, Nadarajan VS, Permpikul P, Sinkitjasub A, et al.

Transfus Apher Sci, 2020 Oct;59(5):102944.
PMID: 33228922 DOI: 10.1016/j.transci.2020.102944

As an East-Asian international study, we evaluated erythrocyte alloimmunity by gender and history of transfusion or pregnancy. In total, data from more than 1,826,000 patients were analyzed, from whom 26,170 irregular erythrocyte antibodies were detected in 22,653 cases. Antibody frequencies in these cases were as follows: anti-E, 26.8%; anti-Lea, 20.0%; anti-P1, 7.1%; anti-M, 6.4%; anti-Mia, 5.6%; anti-c + E, 5.6%; anti-Leb, 4.6%; anti-D, 2.8%; anti-Fyb, 2.6%; anti-Lea+Leb, 2.5%; anti-Dia, 2.0%; and others. For pregnant patients, anti-D (12.7%) was statistically more frequent. For transfused patients, anti-E (37.3%), anti-c + E (9.5%), anti-C + e (3.3%) and anti-Jka (3.1%) were significantly more frequent.

Matched MeSH terms: Pregnancy
Further observations in an area with an exceptionally low prevalence of Helicobacter pylori infection

Raj SM, Lee YY, Choo KE, Noorizan AM, Zulkifli A, Radzi M, et al.

Trans R Soc Trop Med Hyg, 2008 Nov;102(11):1163-4.
PMID: 18678380 DOI: 10.1016/j.trstmh.2008.06.015
Matched MeSH terms: Pregnancy
Thoughts about populations with unexpected low prevalences of Helicobacter pylori infection

Graham DY, Yamaoka Y, Malaty HM

Trans R Soc Trop Med Hyg, 2007 Sep;101(9):849-51.
PMID: 17658569

Helicobacter pylori is one of the few remaining major pathogens that accompanied humans on their travels from Africa. A recently published study reports the unexpected finding of a low H. pylori prevalence among pregnant women in Zanzibar (Farag, T.H., Stolzfus, R.J., Khalfan, S.S., Tielsch, J.M., 2007. Unexpectedly low prevalence of Helicobacter pylori infection among pregnant women on Pemba Island, Zanzibar. Trans. R. Soc. Trop. Med. Hyg. 101). The apparent epidemiology of higher prevalence with higher socioeconomic status and decrease with age are unprecedented. As with many 'unexpected' events, a search of the literature reveals evidence of low prevalence populations in Java and Malaysia, with clues dating back to the mid-twentieth century. Why some populations apparently lost H. pylori infection remains an open question. However, the tools needed to resolve the dilemma are readily available and we hope investigators will soon rise to the challenge.

Matched MeSH terms: Pregnancy; Pregnancy Complications, Infectious/epidemiology*

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