1. A FIVE-YEAR INVESTIGATION OF THE SEROPOSITIVITY OF TOXOPLASMA GONDİİ IN KARS STATE HOSPITAL (KARS, TURKEY) Neriman Mor¹Atila Akça² Kafkas University Kars School of Health, 36100, Kars-Turkey Kafkas University Faculty of Veterinary Medicine, Department of Parasitology, 36100, Kars- Turkey Tel: +90-474-225-1150, E-mail: nery.man@hotmail.comnery.man@hotmail.com

2. Toxoplasmosis is one of the zoonotic diseases. Etiologic agent = Toxoplasma gondii. Toxoplasma gondii is an obligate intracellular parasite Definitive host=Mainly domestic and wild cats. Intermediate host= Human, birds, pigs, rodents, cattle and sheep

3. Tissue phase (intermediate hosts). Intermediate host gets infected by ingesting sporulated oocysts. The oocyte is excreted in the feces of the cat. Oocytes do not become infectious until they sporulate in the environment, sporulation occurs within 1 to 5 days. Intermediate host Human, cattle, birds, rodents, pigs, and sheep.

4. Sources of infection : _ Contaminated water or food by oocysts _ Undercooked meat. _ Mother to fetus. _ Organ transplant (rare). _ Blood transfusion (rare). DEFINITIVE HOST INTERMEDIATE HOST TOXOPLASMA TRANSMISSION Ingestion of tachyzoites and bradyzoites (cysts) in flesh of infected host.

5. Symptoms Infection is usually asymyomatic in healthy individuals.  In acute infection: Lymphadenitis is the most common in humans. Flu-like symptoms (Headache, fever, muscle pain) the infection is generally self limited & symptom usually resolve in a few months. Causes Encephalitis, hiptitis in the immunosuppressed patients and people infected with HIV. Congenital neurological defects in infants. Abortion.  In chronic infections: visual problems or blindness may occur over time.

6. Diagnosis Biopsy of humans. (SFDT) Sabin-Feldman Dye Test. (ELISA) Enzyme-Linked Immuno sorbent Assays. (IFAT) Indirect Fluorescent Antibody tests. Treatment  Usually not required.  Sulfadiazine and pyrimethamine are two drugs widely used to treat toxoplasmosis in humans.  Patients allergic to sulfa drugs may take Clindamycin, Clarithromycin, Azithromycin

7. Prevention & Control Hands should be washed after contact with raw meat or in contact with soil. Vegetables should be washed well. Avoid undercooked meats. If you have a cat – Keep it inside if possible. – Don’t feed it with raw meat. –Avoid contact with cat if you are pregnant.

8. The aim of this study There is no such data as to the seroprevalence of toxoplasmosis in humans in our region including Kars province and its districts. Thus, the purpose of this study is to investigate the prevalence and age group distribution of Toxoplasma antibodies, in serum samples which were taken from patients who applied to gynecology polyclinic in State Hospital in the 5- year-period between 2008 and 2012, within the scope of routine screenings.

9. MATERIAL and METHOD The blood samples taken from 7827 female patients, who applied to microbiology laboratory in Kars Maternity and Children Hospital between January 2008 and December 2012, were examined retrospectively in terms of Toxoplasma gondii IgG and IgM antibodies. Abbott ARCHITECT Toxo- IgG and IgM commercial kits were used in this study. IgG test were considered as; if the result is less then 1.60: negative Values between 1.60 and 3.00: suspicious Values more then 3.10: positive For the IgM test: The values less then 0.50: negative Values between 0.50 and 0.60 : suspicious Values more then 0.60: positive

10. FINDINGS Table 1. Seroprevalence of Anti-Toxoplasma gondii IgM and IgG by Years Years Anti-Toxoplasma IgMAnti-Toxoplasma IgG Total nPositivesuspiciousnpositivesuspicious 2008100737 (3.6%)11 (1.1%)968380 (39.3%)0 (0.0%)1975 200998125 (2.5%)23 (2.3%)1117428 (38.3%)28 (2.5%)2098 201063312 (1.9%)1 (0.2%)428156 (36.5%)18 (4.2%)1061 201177316 (2.1%)5 (0.6%)420147 (35.0%)12 (2.9%)1193 201281812 (1.5%)5 (0.6%)682220 (32.3%)20 (2.9%)1500 Total4212102 (2.5%)45 (1.1%)36151331(36.8%)78 (2.2%)7827

11. Table 2. Seroprevalence of Anti-Toxoplasma gondii IgM and IgG by Ages Ages Anti-Toxoplasma IgMAnti-Toxoplasma IgG Total nPositivesuspiciousnpositivesuspicious 15-24159248 (3.0%)18 (1.1%)1314405 (30.8%)19 (1.4%)2906 25-341883 41 (2.2%)18 (0.9%) 1643577 (35.1%)40 (2.4%)3526 35-44509 8 (1.6%) 445211 (47.4%)17 (3.8%)954 45 ve üstü 2285 (2.2%)1 (0.4%) 213138 (64.8%)2 (0.9%)441 Total4212102 (2.5%)45 (1.0%)36151331(36.8%)78 (2.2%)7827

12. CONCLUSION In conclusion; toxoplasmosis is a zoonosis which has a high seroprevalence in almost every region of our country as well as all over the world. In Kars, toxoplasmosis was diagnosed at 51.4-95.7% in sheep, 49.6-93.5% in cattles, 20.6% in horses and 83.8-96.1% in dogs. Our findings are remarkable since they serve as the first preliminary study in regard to the seroprevalence of toxoplasmosis in human beings in Kars province. Study results show that toxoplasmosis has a high prevalence rate in animals and humans in the region, and this situation should not be ignored. Besides, necessary steps should be taken in order to inform and take necessary precautions by women under risk of infection.

13. nery.man@hotmail.com