Displaying publications 81 - 100 of 141 in total

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  1. Fulltext Unusual manifestation of cutaneous toxoplasmosis in a HIV-positive patient
    Fong MY, Wong KT, Rohela M, Tan LH, Adeeba K, Lee YY, et al.
    Trop Biomed, 2010 Dec;27(3):447-50.
    PMID: 21399585 MyJurnal
    We report a case of unusual cutaneous toxoplasmosis manifestation in a HIV-positive patient. He presented with hard and painful nodular lesions on the arms, hands and chest. Serology tests for anti-Toxoplasma antibody were negative. However, histopathologic examination of the lesion revealed foci of macrophages containing crescent-shaped organisms resembling the zoites of the protozoan parasite Toxoplasma gondii. Ultrastructure examination under electron microscopy and PCR confirmed the organism as T. gondii.
    Matched MeSH terms: Toxoplasmosis/diagnosis*; Toxoplasmosis/pathology*
  2. Fulltext Identification, production and assessment of two Toxoplasma gondii recombinant proteins for use in a Toxoplasma IgG avidity assay
    Teh AY, Amerizadeh A, Osman S, Yunus MH, Noordin R
    Pathog Glob Health, 2016 Oct-Dec;110(7-8):277-286.
    PMID: 27697019
    The IgG avidity assay is an important tool in the management of suspected toxoplasmosis in pregnant women. This study aimed to produce new Toxoplasma gondii recombinant proteins and to assess their usefulness in an IgG avidity assay. Toxoplasma positive and negative serum samples were used, the former were categorized into low (LGA) and high (HGA) IgG avidity samples. Immunoblots were performed on 30 T. gondii cDNA clones to determine the reactivity and IgG avidity to the expressed proteins. Two of the clones were found to have diagnostic potential and were analyzed further; AG12b encoded T. gondii apical complex lysine methyltransferase (AKMT) protein and AG18 encoded T. gondii forkhead-associated (FHA) domain-containing protein. The His-tagged recombinant proteins, rAG12b and rAG18, were expressed and tested with LGA and HGA samples using an IgG avidity western blot and ELISA. With the IgG avidity western blot, rAG12b identified 86.4% of LGA and 90.9% of HGA samples, whereas rAG18 identified 81.8% of both LGA and HGA samples. With the IgG avidity ELISA, rAG12b identified 86.4% of both LGA and HGA samples, whereas rAG18 identified 77.3% of LGA and 86.4% of HGA serum samples. This study showed that the recombinant antigens were able to differentiate low avidity and high avidity serum samples, suggesting that they are potential candidates for use in the Toxoplasma IgG avidity assay.
    Matched MeSH terms: Toxoplasmosis/immunology*; Toxoplasmosis/parasitology
  3. Fulltext Seroprevalence of Toxoplasma gondii Infection in Refugee and Migrant Pregnant Women along the Thailand-Myanmar Border
    van Enter BJD, Lau YL, Ling CL, Watthanaworawit W, Sukthana Y, Lee WC, et al.
    Am J Trop Med Hyg, 2017 Jul;97(1):232-235.
    PMID: 28719309 DOI: 10.4269/ajtmh.16-0999
    Toxoplasma gondii primary infection in pregnancy is associated with poor obstetric outcomes. This study aimed to determine the seroprevalence of Toxoplasma infection in pregnant migrant and refugee women from Myanmar attending antenatal care in Thailand. A random selection of 199 residual blood samples from first antenatal screen in 2014-2015 was tested for Toxoplasma IgG and IgM antibodies. Seroprevalence of Toxoplasma infection was 31.7% (95% confidence interval = 25.6-38.4). Avidity testing in the three positive IgM cases indicated all were past infections. Multiparity (≥ 3 children) was significantly associated with higher Toxoplasma seropositivity rates. Seroprevalence of T. gondii infection in this pregnant population is similar to the only other report from Myanmar, where multiparity was also identified as a significant association. Toxoplasma infection is important in pregnant women. Nevertheless, in this marginalized population, this infection may be given less priority, due to resource constraints in providing the most basic components of safe motherhood programs.
    Matched MeSH terms: Toxoplasmosis/blood*; Toxoplasmosis/epidemiology
  4. Fulltext Occurrence of Toxoplasma gondii antibodies and associated risk factors in women in selected districts of Punjab province, Pakistan
    Ali S, Amjad Z, Khan TM, Maalik A, Iftikhar A, Khan I, et al.
    Parasitology, 2020 Sep;147(10):1133-1139.
    PMID: 32517832 DOI: 10.1017/S0031182020000967
    Toxoplasmosis is a parasitic zoonotic disease caused by Toxoplasma (T.) gondii. Limited data are available on the occurrence of T. gondii in women especially pregnant women in Pakistan. The present study aimed to determine the occurrence and risk factors associated with T. gondii in pregnant and non-pregnant women in Punjab Province, Pakistan. A cross-sectional study was conducted and 593 samples were collected from pregnant (n = 293) and non-pregnant (n = 300) women of District Headquarter Hospitals of Chiniot, Faisalabad, Jhang and Okara, Pakistan. Data related to demographic parameters and risk factors were collected using a pretested questionnaire on blood sampling day. Serum samples were screened for antibodies (IgG) against T. gondii using ELISA. A univariant and binomial logistic regression was applied to estimate the association between seropositive and explanatory variables considering the 95% confidence interval. P value ⩽0.05 was considered statistically significant for all analysis. Out of 593, 44 (7.42%) women were seropositive for T. gondii IgG antibodies. Occupation, age, sampling location, socioeconomic status, contact with cat, pregnancy status and trimester of pregnancy were significantly associated with seropositivity for T. gondii antibodies. Location and trimester of pregnancy were identified as potential risk factors for T. gondii seropositivity based on binomial logistic regression. Toxoplasma gondii is prevalent in pregnant and non-pregnant women. Therefore, now a necessitated awareness is required to instruct the individuals about these infectious diseases (toxoplasmosis) and their control strategies to maintain the health of human population. Moreover, health awareness among public can help the minimization of T. gondii infection during pregnancy and subsequent risk of congenital toxoplasmosis.
    Matched MeSH terms: Toxoplasmosis/epidemiology*; Toxoplasmosis/parasitology
  5. Fulltext Evaluation of the Protective Effect of Deoxyribonucleic Acid Vaccines Encoding Granule Antigen 2 and 5 Against Acute Toxoplasmosis in BALB/c Mice
    Ching XT, Fong MY, Lau YL
    Am J Trop Med Hyg, 2017 Jun;96(6):1441-1447.
    PMID: 28719288 DOI: 10.4269/ajtmh.16-0548
    AbstractToxoplasma gondii infects a broad range of warm-blooded hosts, including humans. Important clinical manifestations include encephalitis in immunocompromised patients as well as miscarriage and fetal damage during early pregnancy. Toxoplasma gondii dense granule antigen 2 and 5 (GRA2 and GRA5) are essential for parasitophorous vacuole development of the parasite. To evaluate the potential of GRA2 and GRA5 as recombinant DNA vaccine candidates, these antigens were cloned into eukaryotic expression vector (pcDNA 3.1C) and evaluated in vaccination experiments. Recombinant DNA vaccines constructed with genes encoding GRAs were validated in Chinese hamster ovary cells before evaluation using lethal challenge of the virulent T. gondii RH strain in BALB/c mice. The DNA vaccines of pcGRA2 and pcGRA5 elicited cellular-mediated immune response with significantly higher levels of interferon-gamma, interleukin-2 (IL-2), IL-4, and IL-10 (P < 0.05) compared with controls. A mixed T-helper cell 1 (Th1)/Th2 response was associated with slightly prolonged survival. These findings provide evidence that DNA vaccination with GRA2 and GRA5 is associated with Th1-like cell-mediated immune responses. It will be worthwhile to construct recombinant multiantigen combining full-length GRA2 or/and GRA5 with various antigenic proteins such as the surface antigens and rhoptry antigens to improve vaccination efficacy.
    Matched MeSH terms: Toxoplasmosis/immunology*; Toxoplasmosis, Animal/blood; Toxoplasmosis, Animal/immunology; Toxoplasmosis, Animal/prevention & control*
  6. Toxoplasma gondii excretory secretory antigenic proteins of diagnostic potential
    Saadatnia G, Mohamed Z, Ghaffarifar F, Osman E, Moghadam ZK, Noordin R
    APMIS, 2012 Jan;120(1):47-55.
    PMID: 22151308 DOI: 10.1111/j.1600-0463.2011.02810.x
    Infection with Toxoplasma gondii is widespread and important in humans, especially pregnant women and immunosuppressed patients. A panel of tests is usually required for diagnosis toxoplasmosis. Excretory secretory antigen (ESA) is highly immunogenic, and thus it is a good candidate for investigation into new infection markers. ESA was prepared from tachyzoites of RH strain of T. gondii by mice intraperitoneal infection. Sera were obtained from several categories of individuals who differed in their status of anti-Toxoplasma IgM, IgG and IgG avidity antibodies. The ESA was subjected to SDS-PAGE, two-dimensional gel electrophoresis and Western blot analysis. Antigenic bands of approximate molecular weights of 12, 20 and 30 kDa, when probed with anti-human IgM-HRP and IgA-HRP, showed good potential as infection markers. The highest sensitivity of the bands was 98.7% with combination of IgM and IgA blots with sera of patients with anti-Toxoplasma IgM+ IgG+. The specificities were 84% and 70% with sera from other infections and healthy controls in IgM blots and IgA blots respectively. By mass spectrometry, the 12 kDa protein was identified as thioredoxin. The two top proteins identified for 20 kDa molecule were microneme protein 10 and dense granule protein 7; whereas that for 30 kDa were phosphoglycerate mutase 1 and phosphoglycerate mutase.
    Matched MeSH terms: Toxoplasmosis/complications; Toxoplasmosis/diagnosis*; Toxoplasmosis/immunology; Toxoplasmosis/parasitology
  7. Fulltext A community-based survey of Toxoplasma gondii infection among pregnant women in rural areas of Taiz governorate, Yemen: the risk of waterborne transmission
    Mahdy MA, Alareqi LM, Abdul-Ghani R, Al-Eryani SM, Al-Mikhlafy AA, Al-Mekhlafi AM, et al.
    Infect Dis Poverty, 2017 Feb 13;6(1):26.
    PMID: 28190399 DOI: 10.1186/s40249-017-0243-0
    BACKGROUND: Toxoplasma gondii is a zoonotic coccidian parasite causing morbidity and mortality. In Yemen, T. gondii infection has been reported among pregnant women seeking healthcare in the main cities. However, no data are available on the prevalence of T. gondii infection and its associated risk factors among pregnant women in the rural communities of the country. Thus, the present study aimed to determine the seroprevalence of T. gondii and identify its risk factors among pregnant women in the rural communities of Taiz governorate, Yemen.

    METHODS: A total of 359 pregnant women living in the rural communities of Taiz governorate were enrolled in this study by house-to-house visits. Data were collected using a pre-designed questionnaire, and blood samples were collected and tested for the detection of anti- T. gondii IgM and IgG antibodies by enzyme-linked immunosorbent assay.

    RESULTS: The prevalence of T. gondii infection among pregnant women in this study was 46.2% (166/359). Bivariate analysis identified the age of  ≥ 30 years (odds ratio [OR] = 1.7; 95% confidence interval [CI] = 1.09-2.65, P = 0.019) and unimproved water sources (OR = 2.2; 95% CI = 1.10-4.55, P = 0.023) as factors associated with T. gondii infection among pregnant women. The multivariable analysis, however, identified unimproved water sources as an independent risk factor (adjusted OR = 2.4; 95% CI = 1.16-5.0, P = 0.018) associated with T. gondii infection among pregnant women.

    CONCLUSIONS: Pregnant women in the rural communities of Taiz, Yemen are at high risk of contracting T. gondii infection. Unimproved water sources (wells, water streams and water tanks) are significantly associated with T. gondii infection and should be considered in prevention and control strategies, especially among pregnant women.

    Matched MeSH terms: Toxoplasmosis/epidemiology*; Toxoplasmosis/parasitology; Toxoplasmosis/prevention & control; Toxoplasmosis/transmission*
  8. Fulltext Socio-demographic determinants of Toxoplasma gondii seroprevalence in migrant workers of Peninsular Malaysia
    Sahimin N, Lim YAL, Ariffin F, Behnke JM, Basáñez MG, Walker M, et al.
    Parasit Vectors, 2017 May 15;10(1):238.
    PMID: 28506241 DOI: 10.1186/s13071-017-2167-8
    BACKGROUND: The number of migrants working in Malaysia has increased sharply since the 1970's and there is concern that infectious diseases endemic in other (e.g. neighbouring) countries may be inadvertently imported. Compulsory medical screening prior to entering the workforce does not include parasitic infections such as toxoplasmosis. Therefore, this study aimed to evaluate the seroprevalence of T. gondii infection among migrant workers in Peninsular Malaysia by means of serosurveys conducted on a voluntary basis among low-skilled and semi-skilled workers from five working sectors, namely, manufacturing, food service, agriculture and plantation, construction and domestic work.

    METHODS: A total of 484 migrant workers originating from rural locations in neighbouring countries, namely, Indonesia (n = 247, 51.0%), Nepal (n = 99, 20.5%), Bangladesh (n = 72, 14.9%), India (n = 52, 10.7%) and Myanmar (n = 14, 2.9%) were included in this study.

    RESULTS: The overall seroprevalence of T. gondii was 57.4% (n = 278; 95% CI: 52.7-61.8%) with 52.9% (n = 256; 95% CI: 48.4-57.2%) seropositive for anti-Toxoplasma IgG only, 0.8% (n = 4; 95% CI: 0.2-1.7%) seropositive for anti-Toxoplasma IgM only and 3.7% (n = 18; 95% CI: 2.1-5.4%) seropositive with both IgG and IgM antibodies. All positive samples with both IgG and IgM antibodies showed high avidity (> 40%), suggesting latent infection. Age (being older than 45 years), Nepalese nationality, manufacturing occupation, and being a newcomer in Malaysia (excepting domestic work) were positively and statistically significantly associated with seroprevalence (P 

    Matched MeSH terms: Toxoplasmosis/immunology*; Toxoplasmosis/epidemiology*; Toxoplasmosis/parasitology; Toxoplasmosis/transmission
  9. Fulltext Comparative study on Toxoplasma infection between Malaysian and Myanmar pregnant women
    Andiappan H, Nissapatorn V, Sawangjaroen N, Nyunt MH, Lau YL, Khaing SL, et al.
    Parasit Vectors, 2014;7:564.
    PMID: 25498432 DOI: 10.1186/s13071-014-0564-9
    Toxoplasma gondii, an obligate intracellular protozoan parasite, causes a disease called toxoplasmosis which can sometimes be acquired congenitally by a newborn from an infected mother. This study aimed to determine the seroprevalence of Toxoplasma infection and its associated risks among 219 and 215 pregnant women from Malaysia and Myanmar, respectively.
    Matched MeSH terms: Toxoplasmosis/blood; Toxoplasmosis/epidemiology*
  10. Fulltext CNS toxoplasmosis presenting with obstructive hydrocephalus in patients of retroviral disease--a case series
    Basavaprabhu A, Mahalingam S, Deepak M, Satish R
    Med J Malaysia, 2012 Apr;67(2):214-6.
    PMID: 22822648
    CNS toxoplasmosis presenting as hydrocephalus is a very rare entity. We present three cases of HIV positive patients whose brain imaging revealed hydrocephalus and who improved with anti toxoplasma medication along with intravenous steroids and did not require any CSF shunting procedures. The mechanism of hydrocephalus in CNS toxoplasmosis is usually due to compression of CSF outflow pathway by ring enhancing lesions but even in their absence hydrocephalus can be rarely seen due to ventriculitis. Hence in HIV positive patients with unexplained hydrocephalus CNS toxoplasmosis should be considered and such patients if started on treatment early have a good prognosis without requiring neurosurgical intervention.
    Matched MeSH terms: Toxoplasmosis, Cerebral/diagnosis*; Toxoplasmosis, Cerebral/drug therapy
  11. Fulltext Evaluation of Pichia pastoris-expressed recombinant rhoptry protein 2 of Toxoplasma gondii for its application in diagnosis of toxoplasmosis
    Chang PY, Fong MY, Nissapatorn V, Lau YL
    Am J Trop Med Hyg, 2011 Sep;85(3):485-9.
    PMID: 21896809 DOI: 10.4269/ajtmh.2011.11-0351
    Rhoptry protein 2 (ROP2) of Toxoplasma gondii is a rhoptry-secreted protein that plays a critical role in parasitophorous vacuole membrane formation during invasion. In previous studies, ROP2 has been shown to be efficient in triggering humoral and cell-mediated responses. High immunogenicity of ROP2 makes it a potential candidate for diagnosis and vaccination against toxoplasmosis. In this study, the ROP2 gene was cloned into pPICZα A expression vector and extracellularly expressed in the yeast Pichia pastoris, which has numerous advantages over other expression systems for eukaryotic proteins expression. The effectiveness of the secreted recombinant ROP2 as a diagnosis agent was assessed by Western Blot with 200 human serum samples. Recombinant ROP2 reacted with toxoplasmosis-positive human serum samples and yielded an overall sensitivity of 90% and specificity of 95%. However, recombinant ROP2 is a better marker for detection of IgG (91.7%) rather than IgM (80%).
    Matched MeSH terms: Toxoplasmosis/blood; Toxoplasmosis/diagnosis*
  12. SEROPREVALENCE OF TOXOPLASMA GONDII IN RODENTS FROM VARIOUS LOCATIONS IN PENINSULAR MALAYSIA
    Normaznah Y, Azizah MA, Azuan MI, Latifah I, Rahmat S, Nasir MA
    Southeast Asian J. Trop. Med. Public Health, 2015 May;46(3):388-95.
    PMID: 26521512
    Numerous studies have reported the prevalence of toxoplasmosis among Malaysians and various domestic animals; but there is paucity of information on its prevalence among rodents which could potentially contribute to the transmission of Toxoplasma gondii in both domestic and sylvatic fauna. Five hundred twenty-six rodents were captured from six locations in Malaysia and identified to species. Serum samples were collected from these rodents and tested for T.gondii antibodies using an immunofluorescent antibody test (IFAT). T.gondii antibodies were found in 5.9% (31/526) of the tested samples. Most of the positive antibodies were from commensal rats: Rattus exulans (9/64, 14.0%), Rattus argentiventer (2/8, 25%), Rattus rattus diardii (10/166, 6.0%) and Rattus tiomanicus (6/215, 2.7%). Only two of the forest rats were positive: Maxomys rajah (1/9, 11.1%) and Rattus bowersi (1/12, 8.3%). Eighteen point one percent of ground squirrels (Tupaia glis) tested (2/11) were positive for antibodies. The highest antibodies titer (1:1024) was found in Rattus exulans followed by T.glis (1:256). Sabak Bernam, Selangor had the highest prevalence (10.8%) followed by Baling, Kedah (5.0%) and Bagan Terap, Selangor (4.0%). None of the serum samples of rodents collected from Gua Musang, Kelantan; Jasin, Malacca; or Labis, Johor were positive. Our study reports for the first time the serologic prevalence of T.gondii antibodies among rodents in Peninsular Malaysia. Further studies are needed to confirm T.gondii infection among wild rodents, such as a bioassay, to assess their potential role in transmission of the parasite.
    Matched MeSH terms: Toxoplasmosis, Animal/immunology; Toxoplasmosis, Animal/epidemiology*
  13. Toxoplasmosis in goats: a sero-epidemiological study in Peninsular Malaysia
    Dorny P, Casman C, Sani R, Vercruysse J
    Ann Trop Med Parasitol, 1993 Aug;87(4):407-10.
    PMID: 8250633
    Matched MeSH terms: Toxoplasmosis, Animal/diagnosis; Toxoplasmosis, Animal/epidemiology*
  14. Food-borne parasitoses in Malaysia epidemiological assessment and research needs
    Shekhar KC
    J R Soc Health, 1995 Jun;115(3):178-85.
    PMID: 7643345
    Food-borne parasitic zoonoses have emerged as a major public health problem in many countries and are posing a medical challenge. They are not only important from the economic point of view but also because of their severe sequelae. In Malaysia, these parasitoses are a tip of an iceberg problem. The article documents all the food-borne parasitic zoonoses reported in Malaysia. An epidemiological assessment of the diseases with research needs is highlighted.
    Matched MeSH terms: Toxoplasmosis/epidemiology; Toxoplasmosis/parasitology
  15. Fulltext Review of toxoplasmosis in Malaysia
    Yahaya N
    Southeast Asian J. Trop. Med. Public Health, 1991 Dec;22 Suppl:102-6.
    PMID: 1822863
    Various studies on toxoplasmosis in Malaysia have shown that specific antibodies to Toxoplasma gondii are common among Malaysians. Among the ethnic groups, the Malays have the highest prevalence rate followed by Indians, Orang Aslis (aborigines) and Chinese. Antibody is acquired early in life and increases with age. There is no significant difference in the prevalence rate between males and females. The disease is apparently more prevalent among rural dwellers and those in the lower socioeconomic group. It appears that the prevalence rate is also influenced by environmental conditions, occupation, diet and cultural habits. Studies with animals have shown the presence of antibody to T. gondii, but this does not seem to be the source of infection since Malaysians normally cook their meat well.
    Matched MeSH terms: Toxoplasmosis/ethnology; Toxoplasmosis/epidemiology*
  16. Fulltext Cervical toxoplasma lymphadenitis: report of a case
    Siar CH, Foo GC
    Med J Malaysia, 1984 Dec;39(4):306-10.
    PMID: 6544939
    Toxoplasmosis is a parasitic infection of worldwide distribution. It is caused by an obligate intracellular parasite, Toxoplasma gondii. The commonest form of this disease is the acquired simple lymphadenopathy. Such a case is described and the clinicopathological significance of the disease is discussed.
    Matched MeSH terms: Toxoplasmosis/drug therapy; Toxoplasmosis/pathology*
  17. The role of toxoplasmosis in congenital disease in Malaysia
    Tan DS, Mak JW
    Southeast Asian J. Trop. Med. Public Health, 1985 Mar;16(1):88-92.
    PMID: 4023821
    Toxoplasmosis was found not to be an important cause of intrauterine infection in Malaysia as the rate of toxoplasma-specific IgM in 1,060 congenitally defective Malaysian children, 0 to 4 months old (0.4%) was lower than that in 405 normal children of the same age group (2.0%). A total of 8.2 intra-uterine toxoplasmic infections per 1,000 live births was detected of which one-third (2.7 per 1,000 live births) was overt, manifesting symptoms more of liver damage, than eye or brain damage. A comparison was made with the rates in U.S.A. and Europe. The role of toxoplasmosis in abortion needs to be studied.
    Matched MeSH terms: Toxoplasmosis, Congenital/immunology; Toxoplasmosis, Congenital/epidemiology*
  18. Infectious mononucleosis or toxoplasmosis?
    Tan DS, Zaman V, Lopes M
    Med J Malaysia, 1978 Sep;33(1):23-5.
    PMID: 750891
    Matched MeSH terms: Toxoplasmosis/diagnosis*; Toxoplasmosis/immunology
  19. Toxoplasma antibody survey in West Malaysia
    Tan DS, Zaman V
    Med J Malaysia, 1973 Mar;27(3):188-91.
    PMID: 4268921
    Matched MeSH terms: Toxoplasmosis/immunology*; Toxoplasmosis/epidemiology
  20. 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: Toxoplasmosis/diagnosis; Toxoplasmosis/epidemiology*
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