Trabzon’da 20 Yaş ve Üzeri BireylerdeToksoplazmoz Seroprevalansı

Toxoplasma gondii, dünya çapında en yaygın zoonotik parazitlerden biridir. Bağışıklık sistemi sağlambireylerde enfeksiyonun büyük oranda asemptomatik geçirilmesi, hastalığın farkında olmadan geçiril mesine ve göz ardı edilmesine sebep olmaktadır. Bu çalışmada, 20 yaş ve üzeri bireylerde toksoplazmozseroprevalansının ve seroprevalans ile ilişkili faktörlerin tespit edilmesi amaçlanmıştır. Kesitsel tipteki buçalışma, 20 yaş ve üstü bireylerin katılımıyla Türkiye’nin yüksek nüfuslu bir kenti olan Trabzon’da gerçek leştirilmiştir. Hesaplanan örneklem büyüklüğü %50 bilinmeyen prevalans, %3 sapma, bir desen etkisi ile1066 kişidir. Çalışmada kırsal-kentsel, cinsiyet ve yaşa göre tabakalandırma yapıldığı için %40 fire olmaolasılığı eklenerek 1500 kişiye ulaşılması hedeflenmiş, toplamda 1502 kişiye ulaşılmıştır. Saha çalışması ikiaşamada gerçekleştirilmiştir. İlk aşamada hane ziyaretleri gerçekleştirilmiş, yüz yüze anket uygulanmıştır.İkinci aşamasında ise anti-Toxoplasma antikorlarını saptayabilmek amacıyla kan alımı işlemi gerçekleştiril miştir. Serum örneklerinde elektrokemilüminesans immunoassay (ECLIA) yöntemi ile anti-Toxoplasma IgGve IgM antikorlarının varlığı ve düzeyi araştırılmıştır. Araştırma kapsamında katılımcıların 767 (%51.1)’si kadın, 735 (%48.9)’i erkek olup, yaş ortalamaları 45.7 ± 16.9 yıldır. Katılımcıların %58.8’inde anti-Toxop lasma gondii IgG, %2.3’ünde anti-Toxoplasma gondii IgM seropozitifliği saptanmıştır. Yaş ve vücut kitleindeksi arttıkça toksoplazmoz seroprevalansının arttığı, gelir arttıkça ise seroprevalansın düştüğü göz lenmiştir. Bahçe ve tarla işleri ile uğraşanlarda, hayvancılık yapanlarda, kırsal ilçelerde ikamet edenlerde,medeni durumu evli olanlarda, eğitim düzeyi ilkokul ve altı olanlarda, riskli meslek sahiplerinde, diyabethastalığı olanlarda ve psikiyatrik rahatsızlığı olanlarda seropozitiflik istatistiksel olarak önemli düzeydeyüksek bulunmuştur. Çiğ et ve süt, yıkanmamış sebze ve meyve tüketimi olanlarda, kedi besleyenlerdeve işlenmemiş su kullananlarda seropozitiflik açısından önemli bir fark saptanmamıştır. Lojistik regresyonmodelinde yaş (OR= 1.05; %95 GA= 1.04-1.06) ve bahçe ve tarla işleriyle uğraşmanın (OR= 1.31; %95GA= 1.03-1.67) bağımsız risk faktörü olduğu, eğitim durumunun ilkokul ve altı olmasının (OR= 1.41;%95 GA= 1.07-1.86) riski artırıcı faktör olduğu tespit edilmiştir. Çalışmamızda, anti-Toxoplasma gondii seropozitifliği dünyada ve Türkiye’de yapılan çalışmalara göre görece yüksek bulunmuştur. Bahçe ve tarlaişleriyle uğraşan insanlar toksoplazmoz konusunda bilinçlendirilmelidir. Diyabetik ve psikiyatrik hastalığıolanlarda toksoplazmozun daha sık görülebildiği klinisyenlerce dikkate alınmalıdır.

Anahtar Kelime:

Seroprevalence of Toxoplasmosis among 20 Years and Older Individuals in Trabzon, Turkey

Öz:

Toxoplasma gondii is one of the most prevalent zoonotic parasites. The fact that the infection is mostlyasymptomatic in immunocompromised individuals causes the disease to be recovered without realisingand ignored. The aim of this study was to determine the seroprevalence of toxoplasmosis and the factorsassociated with seroprevalence in individuals aged 20 and over. This cross-sectional study was conductedin Trabzon which is a high populated city of Turkey with the participation of individuals aged 20 and over.The calculated sample size including 50% unknown prevalence, 3% deviation and one pattern effect was1066 people. Since the rural-urban, gender and age stratification was performed in the study, the goalwas to reach 1500 people by adding the possibility of 40% loss and finally a total of 1502 people were re ached. Field research was carried out in two stages. First, household visits were conducted and face-to-faceinterviews were performed. Then, blood samples were collected to determine anti-Toxoplasma antibodies.The presence and the level of anti-Toxoplasma IgG and IgM antibodies were detected in serum samples by using the electrochemiluminescence immunoassay (ECLIA) method. In the scope of the research, 767(51.1%) of the participants were women and 735 (48.9%) of them were men and their average age was45.7 ± 16.9 years. Anti-Toxoplasma gondii IgG and IgM seropositivity among the participants were 58.8%and 2.3%, respectively. It was observed that seroprevalence of toxoplasmosis increased as age and bodymass index increased and as the income increased seroprevalence decreased. Seropositivity was foundto be statistically significantly higher in those who were working in gardening and field work, those whowere working in animal husbandry, those who resided in rural districts, those whose marital status wasmarried, those whose education level was primary school or below, those who had high-risk professions,those with diabetes and those with psychiatric disorders. There was no significant difference in seropositi vity among those who ate raw meat and milk, unwashed fruit and vegetables, cat owners and used unpro cessed water. In the logistic regression model, it was determined that age (OR= 1.05; 95% CI= 1.04-1.06)and working in gardening and field work (OR= 1.31; 95% CI= 1.03-1.67) were independent risk factorsand education status of primary school and below (OR= 1.41; 95% CI: 1.07-1.86) was a risk-increasingfactor. In our study, anti-Toxoplasma gondii seropositivity was found to be relatively higher compared tothe other studies conducted in the world and Turkey. Awareness of individuals working in gardening and field work about toxoplasmosis must be enhanced. Clinicians must consider the fact that toxoplasmosiscan be more frequently observed in individuals with diabetes and psychiatricdisorders.

Anahtar Kelime:

Belge Türü: Makale Makale Türü: Diğer Erişim Türü: Bibliyografik

1. Montoya JG, Boothroyd JC, Kovacs JA. Toxoplasma gondii. In: Bennett JE, Dolin R, Blaser MJ, editors. Mandell, Douglas, and Bennett’s Principles and Practice of Infectious Disease 8th ed. Philadelphia 2015; 3122-53.
2. Frenkel JK, Dubey JP, Miller NL. Toxoplasma gondii in cats: fecal stages identified as Coccidian Oocysts. Science 1970; 167(3919): 893-6.
3. Dubey JP. Toxoplasmosis - a waterborne zoonosis. Vet Parasitol 2004; 126(1-2): 57-72.
4. Frenkel JK. Pursuing Toxoplasma. J Infect Dis 1970; 122(6): 553-9.
5. Liu Q, Wang Z-D, Huang S-Y, Zhu X-Q. Diagnosis of toxoplasmosis and typing of Toxoplasma gondii. Parasit Vectors 2015; 8(1): 292.
6. Weiss LM, Dubey JP. Toxoplasmosis: a history of clinical observations. Int J Parasitol 2009; 39(8): 895-901.
7. Molan A, Nosaka K, Hunter M, Wang W. Global status of Toxoplasma gondii infection: systematic review and prevalence snapshots. Trop Biomed 2019: 36(4): 898-925.
8. Bigna JJ, Tochie JN, Tounouga DN, Bekolo AO, Ymele NS, Youda EL, et al. Global, regional, and country seroprevalence of Toxoplasma gondii in pregnant women: a systematic review, modelling and meta-analysis. Scientific Rep 2020; 10(1): 1-10.
9. Koloren Z, Dubey JP. A review of toxoplasmosis in humans and animals in Turkey. Parasitol 2020; 147(1): 12-28.
10. Yolasigmaz A, Sakru N, Yazar S, Akisu C, Guruz AY, Kuman HA, et al. Investigation of anti-Toxoplasma Antibodies in residence of urban and rural areas. Acta Parasitol Turcica 2003; 27(2): 81-4.
11. Liesenfeld O, Press C, Montoya JG, Gill R, Isaac-Renton JL, Hedman K, et al. False-positive results in immunoglobulin M (IgM) Toxoplasma antibody tests and importance of confirmatory testing: the platelia toxo IgM test. J Clin Microbiol 1997; 35(1): 174-8.
12. Olariu TR, Petrescu C, Darabus G, Lighezan R, Mazilu O. Seroprevalence of Toxoplasma gondii in Western Romania. Infect Dis (Lond) 2015; 47(8): 580-3.
13. Wilking H, Thamm M, Stark K, Aebischer T, Seeber F. Prevalence, incidence estimations, and risk factors of Toxoplasma gondii infection in Germany: a representative, cross-sectional, serological study. Sci Rep 2016;
6: 22551. 14. Birgisdottir A, Asbjornsdottir H, Cook E, Gislason D, Jansson C, Olafsson I, et al. Seroprevalence of Toxoplasma gondii in Sweden, Estonia and Iceland. Scand J Infect Dis 2006; 38(8): 625-31.
15. Shuralev EA, Shamaev ND, Mukminov MN, Nagamune K, Taniguchi Y, Saito T, et al. Toxoplasma gondii seroprevalence in goats, cats and humans in Russia. Parasitol Int 2018; 67(2): 112-4.
16. Studeničová C, Benčaiová G, Holková R. Seroprevalence of Toxoplasma gondii antibodies in a healthy population from Slovakia. Eur J Int Med 2006; 17(7): 470-3.
17. Abu EK, Boampong JN, Ayi I, Ghartey-Kwansah G, Afoakwah R, Nsiah P, et al. Infection risk factors associated with seropositivity for Toxoplasma gondii in a population-based study in the Central Region, Ghana. Epidemiol Infect 2015; 143(9): 1904-12.
18. Tilahun B, Hailu Y, Tilahun G, Ashenafi H, Vitale M, Di Marco V, et al. Seroprevalence and risk factors of Toxoplasma gondii infection in humans in East Hararghe Zone, Ethiopia. Epidemiol Infect 2016; 144(1): 64-71.
19. Li HL, Dong L, Li Q, Zhang L, Chen J, Zou FC, et al. Seroepidemiology of Toxoplasma gondii infection in Bai and Han ethnic groups in southwestern China. Epidemiol Infect 2015; 143(4): 881-6.
20. Lim H, Lee S-E, Jung B-K, Kim M-K, Lee MY, Nam H-W, et al. Serologic survey of Toxoplasmosis in Seoul and Jeju-do, and a brief review of its seroprevalence in Korea. The Korean J Parasitol 2012; 50(4): 287-93.
21. Minbaeva G, Schweiger A, Bodosheva A, Kuttubaev O, Hehl AB, Tanner I, et al. Toxoplasma gondii infection in Kyrgyzstan: seroprevalence, risk factor analysis, and estimate of congenital and AIDS-related toxoplasmosis. PLoS Negl Trop Dis 2013; 7(2): e2043.
22. Khan MU, Rashid I, Akbar H, Islam S, Riaz F, Nabi H, et al. Seroprevalence of Toxoplasma gondii in South Asian countries. Rev Sci Tech-Off Int Des Epizoot 2017; 36(3): 981-96.
23. Jones JL, Kruszon-Moran D, Rivera HN, Price C, Wilkins PP. Toxoplasma gondii seroprevalence in the United States 2009–2010 and comparison with the past two decades. Am J Trop Med Hyg 2014; 90(6): 1135-9.
24. Almasian R, Almasian M, Zibaei M. Sero-Epidemiology of toxoplasmosis among the people of Khorram Abad, Iran. J Infect Dis Ther 2014; 2(5): 1-3.
25. De Almeida Aloise D, Coura-Vital W, Carneiro M, Venâncio Rodrigues M, Acásia da Silva Toscano G, Bernardino da Silva R, et al. Seroprevalence and risk factors for human toxoplasmosis in Northeastern Brazil. Rev Patol Trop 2017; 46(4): 307.
26. Acici M, Babur C, Kilic S, Hokelek M, Kurt M. Prevalence of antibodies to Toxoplasma gondii infection in humans and domestic animals in Samsun Province, Turkey. Trop Anim Health Prod 2008; 40(5): 311-5.
27. Hamidi M, Khulojini M, Azizian R, Bashiri H, Ahanchian A, Babanejad M, et al. Seroprevalence of toxoplasmosis among women referring to Shahid Beheshti Hospital, Hamadan, Iran. Novel Biomed 2015; 3(1): 1-5.
28. Cook AJC, Holliman R, Gilbert RE, Buffolano W, Zufferey J, Petersen E, et al. Sources of Toxoplasma infection in pregnant women: European Multicentre Case-Control Study. European Research Network on Congenital Toxoplasmosis. BMJ 2000; 321(7254): 142.
29. Daryani A, Sarvi S, Aarabi M, Mizani A, Ahmadpour E, Shokri A, et al. Seroprevalence of Toxoplasma gondii in the Iranian general population: a systematic review and meta-analysis. Acta Trop 2014; 137: 185-94.
30. Mahmoudvand H, Saedi Dezaki E, Soleimani S, Baneshi MR, Kheirandish F, Ezatpour B, et al. Seroprevalence and risk factors of Toxoplasma gondii infection among healthy blood donors in South-East of Iran. Parasite Immunol 2015; 37(7): 362-7.
31. Alvarado-Esquivel C, Mercado-Suarez MF, Rodriguez-Briones A, Fallad-Torres L, Ayala-Ayala JO, NevarezPiedra LJ, et al. Seroepidemiology of Infection with Toxoplasma gondii in Healthy Blood Donors of Durango, Mexico. BMC Infect Dis 2007; 13(7): 75.
32. Sakikawa M, Noda S, Hanaoka M, Nakayama H, Hojo S, Kakinoki S, et al. Anti-Toxoplasma antibody prevalence, primary infection rate, and risk factors in a study of toxoplasmosis in 4,466 pregnant women in Japan. Clin Vaccine Immunol CVI 2012; 19(3): 365-7.
33. Majidiani H, Dalvand S, Daryani A, Galvan-Ramirez ML, Foroutan-Rad M. Is chronic toxoplasmosis a risk factor for diabetes mellitus? A systematic review and meta-analysis of case-control studies. Braz J Infect Dis 2016; 20(6): 605-9.
34. Shin DW, Cha DY, Hua QJ, Cha GH, Lee YH. Seroprevalence of Toxoplasma gondii infection and characteristics of seropositive patients in general hospitals in Daejeon, Korea. Korean J Parasitol 2009; 47(2): 125-30.
35. Molan A, Nosaka K, Hunter M, Wang W. The role of Toxoplasma gondii as a possible inflammatory agent in the pathogenesis of type 2 diabetes mellitus in humans. Fam Med Commun Health 2016; 4(4): 44-62.
36. Hinze-Selch D, Däubener W, Erdag S, Wilms S. The diagnosis of a personality disorder increases the likelihood for seropositivity to Toxoplasma gondii in psychiatric patients. Folia parasitologica 2010; 57(2): 129-35.
37. Sutterland AL, Fond G, Kuin A, Koeter MW, Lutter R, van Gool T, et al. Beyond the association. Toxoplasma gondii in schizophrenia, bipolar disorder, and addiction: systematic review and meta-analysis. Acta Psychiatr Scand 2015; 132(3): 161-79.

APA	KARAKULLUKÇU S, Beyhun N, KAKLIKKAYA N, Koksal I, Topbas M, BURUK C, Çan G, YILMAZ M, HAMZAOĞLU K, Sayin E, KOLAYLI C (2021). Trabzon’da 20 Yaş ve Üzeri BireylerdeToksoplazmoz Seroprevalansı. , 233 - 247. 10.5578/mb.20219909
Chicago	KARAKULLUKÇU SERDAR,Beyhun Nazim Ercument,KAKLIKKAYA NESE,Koksal Iftihar,Topbas Murat,BURUK Celal Kurtuluş,Çan Gamze,YILMAZ Mustafa,HAMZAOĞLU KÖKSAL,Sayin Esin,KOLAYLI Cevriye Ceyda Trabzon’da 20 Yaş ve Üzeri BireylerdeToksoplazmoz Seroprevalansı. (2021): 233 - 247. 10.5578/mb.20219909
MLA	KARAKULLUKÇU SERDAR,Beyhun Nazim Ercument,KAKLIKKAYA NESE,Koksal Iftihar,Topbas Murat,BURUK Celal Kurtuluş,Çan Gamze,YILMAZ Mustafa,HAMZAOĞLU KÖKSAL,Sayin Esin,KOLAYLI Cevriye Ceyda Trabzon’da 20 Yaş ve Üzeri BireylerdeToksoplazmoz Seroprevalansı. , 2021, ss.233 - 247. 10.5578/mb.20219909
AMA	KARAKULLUKÇU S,Beyhun N,KAKLIKKAYA N,Koksal I,Topbas M,BURUK C,Çan G,YILMAZ M,HAMZAOĞLU K,Sayin E,KOLAYLI C Trabzon’da 20 Yaş ve Üzeri BireylerdeToksoplazmoz Seroprevalansı. . 2021; 233 - 247. 10.5578/mb.20219909
Vancouver	KARAKULLUKÇU S,Beyhun N,KAKLIKKAYA N,Koksal I,Topbas M,BURUK C,Çan G,YILMAZ M,HAMZAOĞLU K,Sayin E,KOLAYLI C Trabzon’da 20 Yaş ve Üzeri BireylerdeToksoplazmoz Seroprevalansı. . 2021; 233 - 247. 10.5578/mb.20219909
IEEE	KARAKULLUKÇU S,Beyhun N,KAKLIKKAYA N,Koksal I,Topbas M,BURUK C,Çan G,YILMAZ M,HAMZAOĞLU K,Sayin E,KOLAYLI C "Trabzon’da 20 Yaş ve Üzeri BireylerdeToksoplazmoz Seroprevalansı." , ss.233 - 247, 2021. 10.5578/mb.20219909
ISNAD	KARAKULLUKÇU, SERDAR vd. "Trabzon’da 20 Yaş ve Üzeri BireylerdeToksoplazmoz Seroprevalansı". (2021), 233-247. https://doi.org/10.5578/mb.20219909

APA	KARAKULLUKÇU S, Beyhun N, KAKLIKKAYA N, Koksal I, Topbas M, BURUK C, Çan G, YILMAZ M, HAMZAOĞLU K, Sayin E, KOLAYLI C (2021). Trabzon’da 20 Yaş ve Üzeri BireylerdeToksoplazmoz Seroprevalansı. Mikrobiyoloji Bülteni, 55(2), 233 - 247. 10.5578/mb.20219909
Chicago	KARAKULLUKÇU SERDAR,Beyhun Nazim Ercument,KAKLIKKAYA NESE,Koksal Iftihar,Topbas Murat,BURUK Celal Kurtuluş,Çan Gamze,YILMAZ Mustafa,HAMZAOĞLU KÖKSAL,Sayin Esin,KOLAYLI Cevriye Ceyda Trabzon’da 20 Yaş ve Üzeri BireylerdeToksoplazmoz Seroprevalansı. Mikrobiyoloji Bülteni 55, no.2 (2021): 233 - 247. 10.5578/mb.20219909
MLA	KARAKULLUKÇU SERDAR,Beyhun Nazim Ercument,KAKLIKKAYA NESE,Koksal Iftihar,Topbas Murat,BURUK Celal Kurtuluş,Çan Gamze,YILMAZ Mustafa,HAMZAOĞLU KÖKSAL,Sayin Esin,KOLAYLI Cevriye Ceyda Trabzon’da 20 Yaş ve Üzeri BireylerdeToksoplazmoz Seroprevalansı. Mikrobiyoloji Bülteni, vol.55, no.2, 2021, ss.233 - 247. 10.5578/mb.20219909
AMA	KARAKULLUKÇU S,Beyhun N,KAKLIKKAYA N,Koksal I,Topbas M,BURUK C,Çan G,YILMAZ M,HAMZAOĞLU K,Sayin E,KOLAYLI C Trabzon’da 20 Yaş ve Üzeri BireylerdeToksoplazmoz Seroprevalansı. Mikrobiyoloji Bülteni. 2021; 55(2): 233 - 247. 10.5578/mb.20219909
Vancouver	KARAKULLUKÇU S,Beyhun N,KAKLIKKAYA N,Koksal I,Topbas M,BURUK C,Çan G,YILMAZ M,HAMZAOĞLU K,Sayin E,KOLAYLI C Trabzon’da 20 Yaş ve Üzeri BireylerdeToksoplazmoz Seroprevalansı. Mikrobiyoloji Bülteni. 2021; 55(2): 233 - 247. 10.5578/mb.20219909
IEEE	KARAKULLUKÇU S,Beyhun N,KAKLIKKAYA N,Koksal I,Topbas M,BURUK C,Çan G,YILMAZ M,HAMZAOĞLU K,Sayin E,KOLAYLI C "Trabzon’da 20 Yaş ve Üzeri BireylerdeToksoplazmoz Seroprevalansı." Mikrobiyoloji Bülteni, 55, ss.233 - 247, 2021. 10.5578/mb.20219909
ISNAD	KARAKULLUKÇU, SERDAR vd. "Trabzon’da 20 Yaş ve Üzeri BireylerdeToksoplazmoz Seroprevalansı". Mikrobiyoloji Bülteni 55/2 (2021), 233-247. https://doi.org/10.5578/mb.20219909