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Serological screening for TORCH(Toxoplasma gondii [TOX], Rubella virus [RV], Cytomegalovirus [CMV], and Herpes simplex virus [HSV]) infections is an effective method for preventing congenital infections caused by TORCH pathogens.In this study, we retrospectively analyzed the characteristics of TORCH infections in 17,807 infertile women of childbearing age in northwest China.We conducted serological detection of TORCH-pathogen-specific IgM and IgG antibodies. The seroprevalence of TORCH infections was statistically analyzed by applying χ2 and Fisher exact-probability tests to evaluate the differences among ages and across quarters of the year. The overall IgM/IgG seroprevalences of TOX, RV, CMV, HSV-1, and HSV-2 were 0.46/3.4%, 0.77/84.93%, 0.68/97.54%, 1.2/82.83%, and 0.62/10.04%, respectively. The positive rates for RV-IgM in women ≥ 40 years old were significantly higher than those for women 25-39 (P < 0.05) years of age. The seroprevalence of HSV1-IgM was higher in the third and fourth quarters of the year (seasons) (P < 0.001), and the seroprevalence of CMV-IgG was statistically significant between differences quarters (P = 0.017), and the seroprevalence of CMV-IgG in the first quarter was lower than that in the third and fourth quarters (Bonferroni correction, P = 0.009 > 0.0083), suggesting no statistically significant difference between the latter two groups. This study showed that in northwestern China the risk of acquiring primary infection by a TORCH pathogen among infertile women of childbearing age were still high, especially Toxoplasma gondii and Herpesvirus type 2 infection. Therefore, effective prevention strategies that include serological screening for TORCH should be implemented., (© 2024. The Author(s), under exclusive licence to Society for Reproductive Investigation.)

Introduction and Aim: Toxoplasma gondii is an intracellular protozoan parasite infecting approximately 30% of the global human population. It has often been suggested that chronic infection with T. gondii is related to personality changes and various mental disorders including depression. It is not known whether this includes post-partum blues or depression. In this study, we test the hypothesis that there is a relationship between T. gondii infection and post-partum blues by measuring the association between infection and postpartum blues.Methods: A total of 475 Chinese women who have just given birth were detected serology for Toxoplasma IgG and IgM antibodies, and evaluated the degree of depression by Hamilton Depression Scale (HAMD) score. Data were analyzed by Chi-square or Fisher's Exact tests using SPSS software.Results: We found an overall Toxoplasma seroprevalence of 5.68% (27/475; 95% CI: 3.59-7.77) which was broken down into a prevalence of 6.60% (7/106; 95% CI: 1.80-11.41) in mothers with post-partum blues and 5.42% (20/369; 95% CI: 3.10-7.74) in non-affected mothers. There was no significant association between infection and post-partum blues (p = 0.64).Conclusion: The results suggest that there is no relationship between T. gondii infection and postpartum blues, at least in this sample of patients from China. [ABSTRACT FROM AUTHOR]

Background. Toxoplasmosis is caused by an intracellular parasite Toxoplasma gondii, which can infect many hosts including humans. Methods. In order to estimate whether dustmen are more susceptible to T. gondii, a case-control study was conducted containing 332 dustmen from Jilin and Heilongjiang in Northeastern China, as well as 332 general populations from the same regions as control subjects. Serum samples were tested IgG and IgM antibodies to T. gondii using the enzyme-linked immunosorbent assay (ELISA). Results. The overall anti-T. gondii IgG was 15.06% (50/332) in dustmen compared with 9.64% (32/332) in the controls (P = 0.0337). Also, 5 (1.51%) dustmen had anti-T. gondii IgM antibodies compared with 2 (0.60%) control individuals (P = 0.2543). A significant association was only found between dustmen and level of T. gondii IgG in comparison with the control subjects. Seroprevalence of T. gondii IgG antibodies in male dustmen was significant higher than male control subjects (P = 0.0399). Dustmen from Jilin had the significant higher T. gondii IgG rate (P = 0.0143), in comparison with the control subjects from Jilin. Moreover, dustmen raising cat at home had the significant higher T. gondii IgG rate (P = 0.0097), in comparison with the control subjects. Risk factor analysis suggested that raising cat at home and not having habits of washing hand before eating were mainly related to the T. gondii infection in dustmen. Conclusions. This is the first record of seroprevalence of T. gondii infection in dustmen in Jilin and Heilongjiang provinces in Northeastern China. These findings also suggest that the government departments should pay close attention to the toxoplasmosis in dustmen in Northeastern China. [ABSTRACT FROM AUTHOR]

The association between Toxoplasma gondii (T. gondii) infection and diabetes mellitus remains controversial. With the improvement of living standards, the prevalence rate of diabetes is steadily increasing in China. Thus, it is necessary to explore the possible association between toxoplasmosis and diabetes mellitus in China. Hence, case-control studies were conducted to explore the T. gondii seroprevalence and identify the risk factors and possible transmission routes of T. gondii infection in different types of diabetes, including type 1 diabetes (T1DM), type 2 diabetes (T2DM), and gestational diabetes (GDM) patients in China. Four hundred serum samples for each type of diabetes mellitus, matched with 400 control subjects for each group, were collected and examined for anti-T. gondii IgG and IgM antibodies using commercially available enzyme immunoassay kits. The total T. gondii seroprevalence in T1DM, T2DM, and GDM patients was 16.50%, 23.50%, and 21.25%, respectively. Each type of diabetes mellitus patients had a significantly higher T. gondii seroprevalence than the control subjects. Multivariate regression identified three variables as risk factors for T. gondii infection in diabetes patients, including keeping cats at home and consumption of raw oysters for T1DM patients and consumption of raw/undercooked meat and raw oysters for T2DM patients, which may help to guide future research and control policies in diabetes mellitus patients. [ABSTRACT FROM AUTHOR]

Abstract: Aim: The aims of this study were to investigate the regional differences in seroepidemiology of toxoplasmosis in preconception period among Chinese women of reproductive age and to evaluate associated risk factors. Methods: This national, population‐based, cross‐sectional serosurvey covered all 31 provinces and province‐level municipalities in Mainland China. Married women intending to get pregnant within 6 months between 2010 and 2012 were recruited. Information on demographic characteristics (age, place of residence, occupation, dietary habits and exposure to cat) was obtained using interviews, and venous blood samples were collected to screen for Toxoplasma gondii infection. Results: Of 2 008 561 women recruited to the study, 45 405 (2.3%) were Toxoplasma gondii IgG positive, and 6884 (0.3%) were IgM positive. Geographical variation for seropositivity ranged from 0.2% in Heilongjiang to 11.2% in Tianjing for IgG and from 0% in Tibet to 0.9% in Anhui for IgM. Advanced maternal age, occupation of a farmer, vegetarian diet and exposure to cat was significantly associated with Toxoplasma gondii IgM seropositivity, and its association with occupation of farmer and exposure to cat was significant after adjusting for province of residence (P < 0.05). Conclusion: There were significant regional variations in Toxoplasma gondii seropositivity and associated risk factors among Chinese women of reproductive age during preconception period. This calls for a targeted primary prevention strategy. Screening and treatment before conception and preconception health education may have potential for reducing congenital Toxoplasmosis in China. [ABSTRACT FROM AUTHOR]

Toxoplasma gondii infection in clinical cases of rheumatic diseases is increasing, whereas, the relationship between T. gondii infection and rheumatic diseases is still ambiguous and contradictory. Thus, the present case-control study based on serological diagnosis was carried out to identify the underlying relationship between T. gondii infection and rheumatic diseases in China. Serological results showed that rheumatic patients (17.25%, 79/458) had a significantly higher T. gondii seroprevalence than control subjects (10.70%, 49/458) (p = 0.004). However, the difference in T. gondii seroprevalence among clinical rheumatic disease forms was insignificant. Moreover, disease duration not effect the T. gondii seroprevalence in the included clinical rheumatic patients. Three risk factors (presence of cats at home, blood transfusion history, and consumption of raw shellfish) were identified through multivariate analysis to affect the T. gondii seroprevalence in the included clinical rheumatic patients. In conclusion, these results indicate that the latent T. gondii infection in clinical rheumatic patients should cause alarm and attention in the course of future scientific research or clinical treatment., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Toxoplasma gondii is a worldwide prevalent parasite, affecting a wide range of mammals and human beings. Little information is available about the distribution of genetic diversity of T. gondii infection in minks (Neovison vison). This study was conducted to estimate the prevalence and genetic characterization of T. gondii isolates from minks in China. A total of 418 minks brain tissue samples were collected from Jilin and Hebei provinces, northern China. Genomic DNA were extracted and assayed for T. gondii infection by semi-nested PCR of B1 gene. The positive DNA samples were typed at 10 genetic markers (SAG1, SAG2 (5'+3' SAG2, alter.SAG2), SAG3, BTUB, GRA6, c22-8, c29-2, L358, PK1, and Apico) using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technology. 36 (8.6%) of 418 DNA samples were overall positive for T. gondii. Among them, 5 samples were genotyped at all loci, and 1 sample was genotyped for 9 loci. In total, five samples belong to ToxoDB PCR-RFLP genotype#9, one belong to ToxoDB genotye#3. To our knowledge, this is the first report of genetic characterization of T. gondii in minks in China. Meanwhile, these results revealed a distribution of T. gondii infection in minks in China. These data provided base-line information for controlling T. gondii infection in minks. [ABSTRACT FROM AUTHOR]

Toxoplasmosis, a neglected tropical disease caused by the protozoan parasite Toxoplasma gondii, occurs throughout the world. Human T. gondii infection is asymptomatic in 80% of the population; however, the infection is lifethreatening and causes substantial neurologic damage in immunocompromised patients such as HIV-infected persons. The major purpose of this study was to investigate the seroprevalence of T. gondii infection in subjects infected with HIV/ AIDS in eastern China. Our findings showed 9.7% prevalence of anti-T. gondii IgG antibody in HIV/AIDS patients, which was higher than in intravenous drug users (2.2%) and healthy controls (4.7%), while no significant difference was observed in the seroprevalence of anti-Toxoplasma IgM antibody among all participants (P>0.05). Among all HIV/AIDS patients, 15 men (7.7%) and 10 women (15.9%) were positive for anti-T. gondii IgG antibody; however, no significant difference was detected in the seroprevalence of anti-Toxoplasma IgG antibody between males and females. The frequency of anti-Toxoplasma IgG antibody was 8.0%, 13.2%, 5.5%, and 0% in patients with normal immune function (CD4+ T-lymphocyte count =500 cells/ml), immunocompromised patients (cell count =200 and <500 cells/ml), severely immunocompromised patients (cell count =50 and <200 cells/ml), and advanced AIDS patients, respectively (cell count <50 cells/ml), while only 3 immunocompromised patients were positive for anti-T. gondii IgM antibody. The results indicate a high seroprevalence of T. gondii infection in HIV/AIDS patients in eastern China, and a preventive therapy for toxoplasmosis may be given to HIV/AIDS patients based on CD4+ T lymphocyte count. [ABSTRACT FROM AUTHOR]

Toxoplasma gondii is widely distributed in humans and other animals including birds throughout the world. However, little is known of the molecular epidemiology and genotypes of T. gondii infecting quails in China. Therefore, the present study was conducted to characterize T. gondii genotypes in common quails in China. During December 2014 to October 2015, a total of 390 muscle tissue samples of common quails were collected and the T. gondii B1 gene was amplified using a nested PCR, and the positive samples were genotyped at 11 genetic markers (SAG1, 5′-and 3′-SAG2, alternative SAG2, SAG3, BTUB, GRA6, L358, PK1, c22-8, c29-2, and Apico) using multilocus polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) technology. Twenty-five of the 390 common quails (6.41%) were tested positive by nested PCR. Three DNA samples from the 25 positive samples were typed completely and were identified as ToxoDB Genotype #9 ( http://toxodb.org/toxo/ ). The results of the present study indicated that T. gondii infection in common quails was common in China, which provided the information of T. gondii genetic diversity in this host species. This is the first genetic characterization of T. gondii isolates from quails in China, which is useful for monitoring and controlling the T. gondii infection in quails, other animals and humans. [ABSTRACT FROM AUTHOR]

Objectives: TORCH infections caused by Toxoplasma gondii (TOX), rubella virus (RV), cytomegalovirus (CMV) and herpes simplex virus 1,2 (HSV-1,2) are associated with congenital anomalies. The study aimed to analyze the characteristics of TORCH screening in reproductive age women., Methods: A total of 18,104 women (2015-2017) from a teaching hospital in Xi'an, China, were enrolled in the study. The characteristics of TORCH screening, i.e., the application of TORCH test, the seroprevalence, the impact of age, periods of gestation and woman with bad obstetric history (BOH) on the serological data were investigated., Results: In the study, 319 women (1.76%) performed dynamic TORCH test. 51.66, 20.44 and 3.83% of the population did the test in the pre-gestation period, the first and third trimester, respectively. Quite a few pre-gestation women (29.74%) ignored screening of IgG antibodies. The overall IgG/IgM seropositvity of TOX, RV, CMV, HSV-1 and HSV-2 was 4.35%/0.35, 90%/0.63, 96.79%/0.97, 81.11%/0.14 and 6.1%/0.19%, respectively. The age-specific distributions and periods of gestation had no significant effect on the seroprevalence of TORCH agents, p>0.05. However, BOH was significantly associated with higher seropositvity of IgM (RV, CMV, HSV-1 and HSV-2) and IgG (CMV and HSV-1) antibodies, p < 0.05., Conclusion: In Xi'an region, more attentions should be paid to TOX, CMV, HSV-2 and the women with BOH for TORCH screening. Meanwhile, a greater emphasis needs to be placed on TORCH test used inappropriately in China.

Epidemiological data for Toxoplasma gondii regarding malignancy have gained increasing attention; however, the information about T. gondii infection among children with malignant lymphoma (ML) in China is unclear. Therefore, 314 children with lymphoma and 314 healthy children, age- and gender-matched, were recruited to estimate the seroprevalence of T. gondii in the participants and identify the risk factors of infection. Blood samples from all participants were collected and examined for T. gondii IgG and IgM antibodies using ELISA. The results showed that the overall seroprevalence of T. gondii antibodies (including IgG and/or IgM) in ML patients and healthy controls was 19.8% and 9.9%, respectively. Contact with the cats, consumption of oysters and history of chemotherapy were estimated to be the risk factors for T. gondii infection in children with lymphoma by multivariable logistic regression analysis, whereas in healthy children, contact with cats and consumption of oysters were the risk factors. Moreover, among various histological types of lymphoma, individuals with NK/T-cell lymphoma, B-small lymphocytic lymphoma, marginal zone B-lymphoma and Hodgkin's lymphoma had a higher seroprevalence than healthy controls (P < 0.05). These findings indicated the high prevalence of T. gondii infection in children with lymphoma, and hence, efforts should be performed to evaluate the effect of the infection further in lymphoma patients.

Background: The prevalence of infection with Toxoplasma gondii (T. gondii) in humans has been increasing in China due to the growing number of cats in the country. Hand, foot and mouth disease (HFMD) is a serious public health issue in China and still one of the leading causes of child mortality. However, little is known about the epidemiology of T. gondii infection among HFMD patients., Methods: A case-control study of 281 HFMD patients from the First People's Hospital of Pingdingshan in Pingdingshan city, Henan province, central China, and 222 controls from Pingdingshan city was conducted. Anti-T. gondii antibodies were serologically detected using the enzyme-linked immunosorbent assay., Results: We found that the overall anti-T. gondii immunoglobulin G (IgG) antibody prevalence among HFMD patients was 12.46 %, which was significantly higher than that in clinically healthy children (1.80 %). The highest T. gondii seroprevalence was detected in critical cases (22.58 %), followed by severe cases (11.50 %), and the lowest was detected in mild cases (8.33 %)., Conclusion: The present study is the first survey of T. gondii seroprevalence among HFMD patients in China; 12.46 % were defined as seropositive. It is imperative that improved integrated measures are taken to prevent and control T. gondii infection among HFMD patients.

Objective: To investigate the prevalence and risk factors of Toxoplasma gondii infection among pregnant women in Wuxi City of Jiangsu Province, so as to provide the evidence for developing the preventive and control interventions of T. gondii infection., Methods: The anti-Toxoplasma IgM and IgG antibodies were detected by using ELISA in the sera sampled from 3 014 pregnant women from 2011 to 2014, and the pregnant outcomes were followed up. The risk factors of T. gondii infection were identified with questionnaires., Results: Among the 3 014 pregnant women, 215 cases were found positive to anti-Toxoplasma antibody (7.13%), including 49 cases positive to IgM antibody (49/215, 22.79%), and 166 cases positive to IgG antibody (166/215, 77.21%). The follow-up revealed that 46 T. gondii-infected pregnant women developed adverse pregnant outcomes (46/215, 21.40%), including 35 cases positive to IgM antibody (35/46, 76.09%) and 11 cases positive to IgG antibody (11/ 46, 23.9.1%). Of the 275 pregnant women without T. gondii infection, 7 cases were found to have adverse pregnant outcomes (2.55%) , which was significantly lower than that in T. gondii-infected pregnant women (P < 0.01). The univariate analysis showed that the close contact with animals, liking eating raw meat, liking eating hot pot or barbecue, and tasting raw meat stuffing were important risk factors of T. gondii infection in pregnant women, compared with the uninfected group (all P values < 0.01)., Conclusions: T. gondii infection may lead to adverse pregnant outcomes among pregnant women. Reduction of close contact with animals, development of good diet and hygiene habits and monitoring of T. gondii infection during pregnancy are effective approaches to avoid the development of adverse pregnant outcomes.

Background: Toxoplasmosis is typically diagnosed by serologic testing. External quality assessment (EQA) of clinical laboratories could ensure the accuracy and reliability of serological tests. We assessed the quality of toxoplasma serological assays in Chinese clinical laboratories by an EQA performed between 2004 and 2013 by the National Center for Clinical Laboratories., Methodology and Findings: EQA panels were prepared and shipped at room temperature to participating laboratories that employed toxoplasma IgG and IgM serological detection. By 2013, 5,384 EQA test reports for toxoplasma-specific IgM and 2,666 reports for toxoplasma-specific IgG were collected. Enzyme-linked immunosorbent (ELISA) and chemical immunofluorescent assays were the most commonly used detection methods. The overall coincidence rates of negative samples were better than those of positive samples. The overall EQA score for toxoplasma-specific IgM detection ranged between 84.3% and 99.6%. The ratio of laboratories that achieved correct IgG detection ranged from 61.1% to 99.3%. However, the inter- and intra-assay variabilities were found to be considerable. The most common problem was failure to detect low titers of antibody., Conclusion: The EQA scheme showed an improvement in toxoplasma serological testing in China. However, further optimization of assay sensitivity to detect challenging samples remains a future challenge.

Background: Toxoplasmosis is one of the most common parasitic zoonoses. The seroprevalence of Toxoplasma gondii infection in humans varies widely worldwide. Detection of Toxoplasma-specific antibodies has been a gold standard method for both epidemiological investigation and clinical diagnosis. Genetic investigation indicated that there is a wide distribution of different genome types or variants of the parasite prevalent in different areas. Thus the reliability of using antigens from parasites of a single genome type for diagnosis and epidemiology purposes needs to be extensively evaluated., Methods: In this study, the prevalence of T. gondii infection among 880 clinically healthy individuals in China was systematically tested using crude soluble native antigens and purified recombinant antigens of type I and II T. gondii. The T. gondii-specific IgG and IgM in the sera was further confirmed using commercial Toxoplasmosis Diagnosis Kits and Western blot assays., Results: The sero-prevalence of T. gondii-specific IgG detected with crude native Type I and type II antigens was 12.2% and 11.3% respectively. Whereas the overall prevalence was more than 20% when combined with the results obtained with recombinant tachyzoite and bradyzoite antigens. There was an obvious variation in immune-recognition of parasite antigens among the individuals studied., Conclusions: The general prevalence of anti-T. gondii IgG in the study population was likely much higher than previously reported. The data also suggested that there is more genetic diversity among the T. gondii isolates in China. Further, combination of recombinant antigens with clear immuno-recognition will be able to generate more sensitive diagnostic results than those obtained with crude antigens of T. gondii tachyzoites.

Hemophagocytic syndrome is a rare disease that is often fatal, despite treatment. An immunocompetent patient was presented with fever, hepatosplenomegaly, cytopenias, hypertriglyceridemia, hypofibrinogenemia, and hyperferritinemia, which conformed to a hemophagocytic syndrome diagnosis. Despite broad antibiotic treatment, the patient's clinical condition rapidly deteriorated and he died within 8 days of admission. Blood cultures and a serology test were negative; however, based on morphological characteristics, tissue cysts Toxoplasma gondii were found in the bone marrow. Based on polymerase chain reaction analysis, identity of the parasite was confirmed. Although very rare, T. gondii-associated hemophagocytic syndrome should be suspected in the case of cytopenia or multiorgan failure symptoms. To our knowledge, this is the first fatal toxoplasmosis case reported from China.

A total of 205 dialysis patients with renal insufficiency were selected as an experiment group, and 360 healthy people were selected as a control group. The specific IgG antibodies of Toxoplasma gondii of the objects in the 2 groups were detected by ELISA. The positive rates of the experiment and control groups were 27. 3% and 3. 6% ,respectively, with a significant difference between them (P < 0.05). Among the dialysis patients with renal insufficiency, the positive rates of the patients with or without a history of blood transfusion were 31.2% and 19.2% , respectively, and there was a significant difference between them (P < 0.05). In conclusion, the infection rate of T. gondii in dialysis patients with renal insufficiency is higher than that of common people, and dialysis and/or blood transfusion may be potential risk(s) for Toxoplasma gondii infection.

The goal of the present study is to develop an enzyme-linked immunosorbent assay (ELISA) using a truncated surface antigen 1 (SAG1) gene of Toxoplasma gondii for the diagnosis of human toxoplasmosis. The truncated SAG1 gene was highly expressed in Escherichia coli. An ELISA kit based on the purified recombinant truncated SAG1 (rtSAG1) was developed, which was used to detect antibodies against T. gondii in human sera. The results showed that the infection of T. gondii could be detected sensitively and specifically by this serologic method. The positive concordance between rtSAG1-ELISA and Western blot, the gold standard, was 93.9% (31/33). However, the positive concordance between the commercial available ELISA Kit 1 (Haitai, Zhuhai, China) and ELISA Kit 2 (DiaSorin ETI-TOXOK-M reverse Plus, Italy) with Western blot was 79.5% (31/39) and 91.2% (31/34), respectively. Comparatively, the positive concordance of ELISA Kit 1 and 2 with Western blot was lower than rtSAG1-ELISA, in particular, the ELISA Kit 1 (P < 0.01), which indicated that the rtSAG1 protein could be used as the diagnostic antigen for human toxoplasmosis.

The indirect fluorescence antibody technique has been employed to study the prevalence of toxoplasma antibodies in Singapore. 42.5% of clinically suspected cases of toxoplasmosis showed antibody titres. Of these, 17.5% had titres greater than or equal to 1.64. Malays and Indians have higher positive rates compared to the main ethnic group, the Chinese. Antibody titres are found in both males and females and span through the various age groups. The possible mode of transmission is discussed and the importance of congenital toxoplasmosis is indicated.