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  1. Fulltext Toxoplasmosis in HIV/AIDS: a living legacy
    Nissapatorn V
    Southeast Asian J. Trop. Med. Public Health, 2009 Nov;40(6):1158-78.
    PMID: 20578449
    Toxoplasmosis has historically been considered one of the most important opportunistic infections detected in HIV/AIDS patients. The prevalence rates of latent Toxoplasma infections in HIV-infected patients has been found to vary greatly from 3% to 97%. Prevalence has been found to be related to ethnicity, certain risk factors, and reactivation of toxoplasmosis. Prior to antiretroviral therapy, toxoplasmic encephalitis (TE) was the most common focal cerebral lesion detected in AIDS patients with Toxoplasma infection, occurring in approximately half of Toxoplasma-seropositive patients. Other forms of dissemination have also been reported in AIDS patients in sites such as the eyes, lungs, heart and spinal cord. Anti-Toxoplasma therapy and chemoprophylaxis have shown effectiveness in reducing the incidence of TE, while noncompliance has been identified as a cause of relapse in these settings. Toxoplasmosis is one of the most common neuropathological complications found at autopsy. Rapid progress in the development of highly active antiretroviral therapy (HAART) has changed the observed patterns with TE, for which there has been a marked decrease in overall incidence. Subsequently, TE has been found to be significantly associated with the so-called "neurological immune restoration inflammatory syndrome" (NIRIS). Toxoplasma screening programs are recommended for all newly diagnosed HIV-positive patients. Chemoprophylaxis should be considered in HIV-infected patients who have a CD4 < 200 cells/mm3, particularly in settings where resources are limited and there is not access to HAART. TE remains a cause of morbidity and mortality among AIDS patients.
    Matched MeSH terms: Toxoplasmosis/parasitology*
  2. Seroprevalence of toxoplasmosis among migrant workers from different Asian countries working in Malaysia
    Chan BT, Amal RN, Hayati MI, Kino H, Anisah N, Norhayati M, et al.
    Southeast Asian J. Trop. Med. Public Health, 2008 Jan;39(1):9-13.
    PMID: 18567437
    A serologic study of Toxoplasma antibodies among 501 foreign migrant workers in Malaysia was conducted in a plantation and detention camp. The highest prevalence rate of 46.2% was among Nepalese workers. Statistical analysis indicated the IgG positivity rate among local residents was significantly higher than the migrants studied (p < 0.05). The IgM positivity rate showed no significant difference between the two groups (p > 0.05). No significant difference in the prevalence rate was noted between the migrants and the local workers when grouped by agricultural and non-agricultural occupations (p > 0.05). The continuous introduction of these infections may influence the epidemiology and further compromise efforts in control and prevention. It is therefore important to monitor of non-notifiable diseases.
    Matched MeSH terms: Toxoplasmosis/parasitology
  3. 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/parasitology
  4. Identification of Host Proteins Interacting with Toxoplasma gondii SAG1 by Yeast Two-Hybrid Assay
    Lai MY, Abdul-Majid N, Lau YL
    Acta Parasitol, 2019 Sep;64(3):575-581.
    PMID: 31165984 DOI: 10.2478/s11686-019-00066-4
    Toxoplasma gondii is one of the most successful human pathogens. To eliminate the infection, identification of receptors or binding partners from humans is indeed urgent. T. gondii surface antigen is the ultimate component involved during the attachment of parasite into host cell. However, mechanism of invasion between SAG and host-cell membrane remains unclear. Yeast two-hybrid experiment was used to identify the binding partners from cDNA human library by using T. gondii SAG1 as bait. Mated yeast cells were plated on DDO/X plates to confirm only prey plasmid that expressing interacting protein was selected. We detected 39 clones interacted with SAG1 based on a series of the selection procedures. After colony PCR, only 29 clones were positive and subsequently sent for sequencing. The yeast plasmids for true positive clones were rescued by transformation into E. coli TOP 10F' cells. Twenty-two clones were further examined by small-scale Y2H experiment. The results indicated that a strong interaction existed between Homo sapiens lysine-rich coil-coiled and SAG1 protein, which could activate the expressions of the reporter genes in diploid yeast. Co-immunoprecipitation experiment result indicated the binding between this prey and SAG1 protein was significant (Mann-Whitney U test, Z = - 1.964, P = 0.05). H. sapiens lysine-rich coil-coiled protein was found to be interacted with SAG1. This prey protein may serve as the potential drug target in vaccination study.
    Matched MeSH terms: Toxoplasmosis/parasitology
  5. Fulltext In vitro anti-Toxoplasma gondii activity of root extract/fractions of Eurycoma longifolia Jack
    Kavitha N, Noordin R, Chan KL, Sasidharan S
    BMC Complement Altern Med, 2012;12:91.
    PMID: 22781137 DOI: 10.1186/1472-6882-12-91
    Toxoplasma gondii infection causes toxoplasmosis, an infectious disease with worldwide prevalence. The limited efficiency of drugs against this infection, their side effects and the potential appearance of resistant strains make the search of novel drugs an essential need. We examined Eurycoma longifolia root extract and fractions as potential sources of new compounds with high activity and low toxicity. The main goal of this study was to investigate the anti-T. gondii activity of crude extract (TACME) and four fractions (TAF 273, TAF 355, TAF 191 and TAF 401) from E. longifolia, with clindamycin as the positive control.
    Matched MeSH terms: Toxoplasmosis/parasitology
  6. Fulltext Design and evaluation of a recombinant multi-epitope antigen for serodiagnosis of Toxoplasma gondii infection in humans
    Hajissa K, Zakaria R, Suppian R, Mohamed Z
    Parasit Vectors, 2015;8:315.
    PMID: 26062975 DOI: 10.1186/s13071-015-0932-0
    Serological investigation remains the primary approach to achieve satisfactory results in Toxoplasma gondii identification. However, the accuracy of the native antigen used in the current diagnostic kits has proven to be insufficient as well as difficult to standardize, so significant efforts have been made to find alternative reagents as capture antigens. Consequently, multi-epitope peptides are promising diagnostic markers, with the potential for improving the accuracy of diagnostic kits. In this study, we described a simple, inexpensive and improved strategy to acquire such diagnostic markers. The study was aimed at producing novel synthetic protein consisting of multiple immunodominant epitopes of several T. gondii antigens.
    Matched MeSH terms: Toxoplasmosis/parasitology
  7. 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/parasitology
  8. 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/parasitology
  9. Fulltext Seropositivity and serointensity of Toxoplasma gondii antibodies and DNA among patients with schizophrenia
    Omar A, Bakar OC, Adam NF, Osman H, Osman A, Suleiman AH, et al.
    Korean J Parasitol, 2015 Feb;53(1):29-34.
    PMID: 25748706 DOI: 10.3347/kjp.2015.53.1.29
    The aim of this cross sectional case control study was to examine the serofrequency and serointensity of Toxoplasma gondii (Tg) IgG, IgM, and DNA among patients with schizophrenia. A total of 101 patients with schizophrenia and 55 healthy controls from Sungai Buloh Hospital, Selangor, Malaysia and University Malaya Medical Center (UMMC) were included in this study. The diagnosis of schizophrenia was made based on the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). The presence of Tg infection was examined using both indirect (ELISA) and direct (quantitative real-time PCR) detection methods by measuring Tg IgG and IgM and DNA, respectively. The serofrequency of Tg IgG antibodies (51.5%, 52/101) and DNA (32.67%, 33/101) among patients with schizophrenia was significantly higher than IgG (18.2%, 10/55) and DNA (3.64%, 2/55) of the controls (IgG, P=0.000, OD=4.8, CI=2.2-10.5; DNA, P=0.000, OD=12.9, CI=2.17-10.51). However, the Tg IgM antibody between patients with schizophrenia and controls was not significant (P>0.005). There was no significant difference (P>0.005) in both serointensity of Tg IgG and DNA between patients with schizophrenia and controls. These findings have further demonstrated the strong association between the active Tg infection and schizophrenia.
    Matched MeSH terms: Toxoplasmosis/parasitology*
  10. Fulltext Protective immune response in BALB/c mice induced by DNA vaccine of the ROP8 gene of Toxoplasma gondii
    Parthasarathy S, Fong MY, Ramaswamy K, Lau YL
    Am J Trop Med Hyg, 2013 May;88(5):883-7.
    PMID: 23509124 DOI: 10.4269/ajtmh.12-0727
    Toxoplasmosis in humans and other animals is caused by the protozoan parasite Toxoplasma gondii. During the process of host cell invasion and parasitophorous vacuole formation by the tachyzoites, the parasite secretes Rhoptry protein 8 (ROP8), an apical secretory organelle. Thus, ROP8 is an important protein for the pathogenesis of T. gondii. The ROP8 DNA was constructed into a pVAX-1 vaccine vector and used for immunizing BALB/c mice. Immunized mice developed immune response characterized by significant antibody responses, antigen-specific proliferation of spleen cells, and production of high levels of IFN-γ (816 ± 26.3 pg/mL). Challenge experiments showed significant levels of increase in the survival period (29 days compared with 9 days in control) in ROP8 DNA vaccinated mice after a lethal challenge with T. gondii. Results presented in this study suggest that ROP8 DNA is a promising and potential vaccine candidate against toxoplasmosis.
    Matched MeSH terms: Toxoplasmosis/parasitology
  11. 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/parasitology
  12. Fulltext Seroepidemiology of toxoplasmosis in renal patients
    Nissapatorn V, Leong TH, Lee R, Init-Ithoi, Ibrahim J, Yen TS
    Southeast Asian J. Trop. Med. Public Health, 2011 Mar;42(2):237-47.
    PMID: 21710842
    Toxoplasmosis is an important parasitic disease in immunosuppressed patients. This prospective study was conducted to determine the seroprevalence, associated risk factors and the incidence of clinically confirmed toxoplasmosis among renal patients at the University of Malaya Medical Center, Kuala Lumpur, Malaysia. We interviewed 247 renal patients, each of whom answered an epidemiological questionnaire, and collected blood samples for measurement of anti-Toxoplasma IgG and IgM antibodies by ELISA. Overall seroprevalence of latent toxoplasmosis was observed in 126 (51%) renal patients. Race (Malays), marital status (married) and primary level of education, were all factors associated with a greater chance of Toxoplasma infection. A case of clinically confirned toxoplasmosis was diagnosed in a renal transplant recipient as a result of immunosuppression. Based on the findings obtained, this preliminary study shows a high prevalence of latent toxoplasmosis in renal patients. Risk factors may have significantly contributed to Toxoplasma acquisition in these patients. We recommend further studies be carried out to monitor for trends in toxoplasmosis among immunosuppressed patients.
    Matched MeSH terms: Toxoplasmosis/parasitology
  13. Fulltext Significant reduction of brain cysts caused by Toxoplasma gondii after treatment with spiramycin coadministered with metronidazole in a mouse model of chronic toxoplasmosis
    Chew WK, Segarra I, Ambu S, Mak JW
    Antimicrob Agents Chemother, 2012 Apr;56(4):1762-8.
    PMID: 22271863 DOI: 10.1128/AAC.05183-11
    Toxoplasma gondii is a parasite that generates latent cysts in the brain; reactivation of these cysts may lead to fatal toxoplasmic encephalitis, for which treatment remains unsuccessful. We assessed spiramycin pharmacokinetics coadministered with metronidazole, the eradication of brain cysts and the in vitro reactivation. Male BALB/c mice were fed 1,000 tachyzoites orally to develop chronic toxoplasmosis. Four weeks later, infected mice underwent different treatments: (i) infected untreated mice (n = 9), which received vehicle only; (ii) a spiramycin-only group (n = 9), 400 mg/kg daily for 7 days; (iii) a metronidazole-only group (n = 9), 500 mg/kg daily for 7 days; and (iv) a combination group (n = 9), which received both spiramycin (400 mg/kg) and metronidazole (500 mg/kg) daily for 7 days. An uninfected control group (n = 10) was administered vehicle only. After treatment, the brain cysts were counted, brain homogenates were cultured in confluent Vero cells, and cysts and tachyzoites were counted after 1 week. Separately, pharmacokinetic profiles (plasma and brain) were assessed after a single dose of spiramycin (400 mg/kg), metronidazole (500 mg/kg), or both. Metronidazole treatment increased the brain spiramycin area under the concentration-time curve from 0 h to ∞ (AUC(0-∞)) by 67% without affecting its plasma disposition. Metronidazole plasma and brain AUC(0-∞) values were reduced 9 and 62%, respectively, after spiramycin coadministration. Enhanced spiramycin brain exposure after coadministration reduced brain cysts 15-fold (79 ± 23 for the combination treatment versus 1,198 ± 153 for the untreated control group [P < 0.05]) and 10-fold versus the spiramycin-only group (768 ± 125). Metronidazole alone showed no effect (1,028 ± 149). Tachyzoites were absent in the brain. Spiramycin reduced in vitro reactivation. Metronidazole increased spiramycin brain penetration, causing a significant reduction of T. gondii brain cysts, with potential clinical translatability for chronic toxoplasmosis treatment.
    Matched MeSH terms: Toxoplasmosis/parasitology
  14. Fulltext Development of triplex real-time PCR and detection of Toxoplasma gondii DNA in infected mice tissues and spiked human samples
    Rahumatullah A, Khoo BY, Noordin R
    Trop Biomed, 2015 Jun;32(2):376-85.
    PMID: 26691266 MyJurnal
    Toxoplasma gondii is an important pathogen in veterinary and human medicine. In this study, a new multiplex TaqMan real-time PCR for detection of T. gondii DNA was developed. This assay consisted of new sets of primers and probes which targeted B1 gene and ITS-1 region of T. gondii, with Vibrio cholera gene as internal control. The B1 gene primers were designed to detect T. gondii RH strain, while the ITS-1 region primers detected most T. gondii strains. Specificity test using common protozoal and bacterial DNA revealed that the assay was very specific to T. gondii. Standard curves constructed using human body fluids spiked with T. gondii (RH and ME49 strains) showed that the sensitivity of the assay was one parasite, with R² value of 0.975 to 0.999 and efficiency of 97% to 99% for all types of samples. The assay performed on DNA extracted from tissues of mice infected with T. gondii showed that liver contained the highest parasite load for both strains of T. gondii. The multiplex real-time PCR developed in this study would be potentially useful for detection of T. gondii in human and animal samples.
    Matched MeSH terms: Toxoplasmosis/parasitology
  15. 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/parasitology
  16. 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/parasitology
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