Serological Screening of TORCH Agents as an Etiology of Spontaneous Abortion in Dhulikhel Hospital, Nepal

Abstract

The role of TORCH infections as a cause of spontaneous abortions is still debatable with conflicting results where geographical variation may play a significant role. This study was undertaken to discover the association of TORCH infections in women with spontaneous abortions by serological testing. The descriptive case control study was conducted from January to December, 2012. A serological evaluation was carried out to determine the presence of Toxoplasma gondii, Rubella, Cytomegalovirus (CMV) and Herpes Simplex Virus (HSV) specific immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies, using commercial diagnostic kits by enzyme-linked immunosorbent assay (ELISA) technique. Mean age of the study and control subjects were 24.8+/-6.4 and 23.8+/-3.8 years respectively where 72.8% of the study subjects were of the age between 20 to 35 years and 23% of the women with spontaneous abortion were below 20 years. Most of the cases were of incomplete abortions (43%) followed by complete abortions (26%). Only 1.3% of both IgG and IgM seropositivity against TORCH agents were noted among the study subjects whereas highest IgG seropositivity was detected with Rubella (86.8%) followed by HSV-I (72.8%). An infection susceptibility rate of 77.9% to Toxoplasma gondii, 11.7% to Rubella, 51.9% to CMV, 36.4% to HSV-I and 84.4% to HSV-II was noted. No significant difference in relation to age and type of abortion was found in seropositivity between the study and the control subjects. This study, probably the first of its kind from Nepal, suggests that current infection with TORCH agents might not be the possible etiology of spontaneous abortion. Serological TORCH screening may not be conclusive.

Toxoplasma, Rubella, Cytomegalo and Herpes Viral Antibody Level in Patients at National Public Health Laboratory (NPHL), Kathmandu

“…None of the study has done yet to compare the sensitivity of the ELISA and CLIA. The sensitivity issue could be another reason for this large deviation.In another study done in 2012 at Dhulikhel, Kathmandu University, prevalence rates were estimated as 77.9% for T. gondii, 86.8% for Rubella, 51.9% for CMV and 84.4% for HSV (Acharya et al, 2014). The finding of this study was comparable to our study.…”

Serological and Molecular Comparison Study for Diagnosis of Cytomegalovirus Infection in aborted Pregnant Women in Iraq

“…In Africa and Asia, the reported incidences vary from (0.5%) in Japan to (1.38%) in Ivory Coast, and 1.8% in Taiwan in the presence of a very high rate (90-100%) of preexisting maternal immunity (Kenneson and Cannon 2007;Istas et al,1995). In a study in Nepal, an infection rate of (34%) is found (Acharya et al, 2014;Kumari et al, 2011).…”

Epidemiological and serological profiles of TORCH infection in pregnancy

“…Toxoplasmosis is an infection by obligate intracellular protozoan parasite Toxoplasma gondii. It is one of the most prevalent chronic infections affecting one third of world's population, [2][3][4] characterized by nonspecific symptoms like fever, malaise and lymphadenopathy. Maternal screening is recommended when fetal abnormalities like hydrocephaly, anatomic abnormalities of the central nervous system, symmetric fetal growth restriction, and nonimmune hydrops are observed.…”