État actuel de la toxoplasmose dans la région de Sfax, Tunisie

Abstract

The frequency of toxoplasmosis depends on life-style and environment. Our objective was to study different epidemiological, clinical and biological aspects of toxoplasmosis in the Sfax area (Tunisia). This retrospective study has been performed on seria of 40,566 pregnant women in the Parasitology-Mycology Laboratory of Habib-Bourguiba Sfax hospital-Tunisia for 13 years from 1994 to 2006; 1,691 patients presenting with lymphadenopathy; 191 immunocompromised patients (78 HIV infected patients and 113 transplanted patients) and 21 patients presenting clinical signs of ocular toxoplasmosis. In pregnant women, the seroprevalence was 39.3% (15,952/40,567). Among 24,089 seronegative women, only 6,890 (28.6%) had been followed up during their pregnancy. An active toxoplasmosis possibly acquired during pregnancy was detected in 1.3% of cases. Sixteen congenital toxoplasmosis were detected. Toxoplasmosis was confirmed in 13.7% of the 169 patients with lymphadenitis. For HIV positive patients, 11.7% had cerebral toxoplasmosis. It revealed the HIV infection in four cases. Among transplant recipients, one case of active toxoplasmosis was diagnosed in a renal transplant recipient who received transplant from a seronegative donor. Twenty-one patients presenting toxoplasmic retinochoroiditis were treated by subconjonctival injections of clindamycin and systemic corticotherapy at a dose of 1 mg/kg per day. This clinical toxoplasmosis diversity explains the need for bioclinical confrontation to establish diagnosis.

Seroprevalence of Toxoplasma gondii among healthy blood donors in two locations in Tunisia and associated risk factors

“…Our overall seroprevalence finding is consistent with that found in Tunis, North Tunisia, (47.7%) in a cross-sectional study including all pregnant women who presented for serological testing of toxoplasmosis [11]. A retrospective study in the Sfax region, East Tunisia, showed that the seroprevalence rate of pregnant women was 46.1% during the years 1994-1997, 41.3% from 1998 to 2001, and 36.9% from 2002 to 2006 [34]. An earlier study showed that the seroprevalence in the general population from Tunisia was 45.9% [3].…”

Toxoplasma gondii infection and toxoplasmosis in North Africa: a review

“…Other surveys focused on pregnant women and congenital toxoplasmosis [19,25,114]. The seroprevalence rates range from 39.3% in the southern regions to 47.7% in the northern regions using ELISA [26,56,111]. Most of the Tunisian authors suspected consumption of undercooked meat and unwashed vegetables as the two main contamination routes [56].…”

“…Toxoplasmosis is regularly diagnosed in immunocompromized patients in Tunisia. Before highly active antiretroviral therapy (HAART), cerebral toxoplasmosis was reported as one of the most prevalent infections in patients with HIV [111].…”

Solid Organ Transplant and Parasitic Diseases: A Review of the Clinical Cases in the Last Two Decades

“…One case, after duplicate, was removed, and 36 cases were excluded according to exclusion criteria i (out of scope) and iv (insufficient available data). In the present review we only analyzed cases regarding SOT recipients published from 1996 to 2016 and available on the PubMed database with sufficient data for inclusion on synthesis of results (n 907) [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , ...…”

“…In published and available reviewed literature, we found 162 case reports of toxoplasmosis occurring after SOT [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 ]. Of interest, in SOT recipients, toxoplasmosis results more frequently from transmission of the parasite with the transplanted organ from a Toxoplasma -seropositive donor (D+) to a Toxoplasma -seronegative recipient (R−).…”