Seropositivity and Other Determinants Associated with Toxoplasmosis in Local Buffalo in Iraq

A cross-sectional study was conducted to determine the Seropositivity of Toxoplasma gondii in water buffalo in three Iraqi governorates (Baghdad, Dhi Qar, and Maysan) and to estimate the risk aspects related to infestation throughout the period from January to December 2019. A total of 430 serum samples were inspected with a commercial ELISA (Enzyme linked immunosorbent assay) kit. Indirect multi-species kit. The overall Seropositivity of T. gondii in the examined local buffalo was 7.4%, and the highest rate (9.3%) was in Baghdad Governorate. A multivariate regression analysis revealed that adult buffalo (OR = 7.10;95% CI: 0.87-57.68;P = 0.067) and young herds (OR = 8.42;95% CI: 1.07-66.02;P = 0.043) were more subject to infestation from young buffalo and large herds. Furthermore, the hazard of toxoplasmosis was increased in winter especially among animals in contact with cats. It is therefore requisite to determine risk aspects to evaluate which mitigation, control, prevention and procedures should be carried out to diminish, control and prevent infestation with T. gondii and its propagation.

Current Status of Congenital Toxoplasmosis in Brazzaville, Republic of the Congo

Toxoplasmosis is a parasitic infection caused by Toxoplasma gondii, which is transmitted by contact with animals carrying the parasite, or by eating contaminated food such as undercooked meat or raw fruit and vegetables. Toxoplasmosis is often benign, but can be serious in pregnant women. In order to assess the prevalence of congenital toxoplasmosis in Brazzaville, Republic of Congo, 464 women aged between 16 and 42 were surveyed in 3 health facilities, including one public hospital (Blanche Gomez) and two private medical centers (OCH medical and ultrasound practice and Luiz laboratory). A total of 1868 samples were taken and analyzed using the ELFA method on mini vidas, an enzyme-linked immunosorbent assay for fluorescence detection. The results showed that out of 1392 samples obtained from 464 pregnant women, 693 samples from 231 pregnant women were positive, i.e. a frequency of 49.78%. Analysis of the immunological profile showed 48.70% IgG and 1.07% IgG associated with IgM. The different frequencies varied from one health facility to another: 53.96% at Blanche Gomez Hospital, 53.76% at Luiz Laboratory and 31% at OCH. Seroprevalence by age group showed 57.14% in pregnant women aged 16 to 25, 52.77% in pregnant women aged 26 to 35 and 21.62% in pregnant women aged 36 to 42. A frequency of 52.65% was observed in pregnant women in contact with soil and 49.78% in pregnant women consuming vegetables, while 66.66% of women in contact with cats were positive for toxoplasmosis. IgG avidity assays showed a frequency of 74% for high avidity and 3.75% for low avidity. This study enabled us to diagnose 9 cases of seroconversion, including 6 cases of congenital toxoplasmosis. Among the 6 cases, 4 children showed toxoplasmosis with sub-clinical signs of IgG persistence at one year of age, including one with thrombocytopenia associated with jaundice and 2 others with hepatomegaly associated with hypertransaminase and hyperbilirubinemia. The maternal-fetal transmission rate was 66.66%, with an incidence of congenital toxoplasmosis of 1.29 per 464 births.In conclusion, the results of this study show the impact of toxoplasmosis on public health, and demonstrate the importance of quarterly pregnancy monitoring and compliance with hygienic and dietary measures, which are very important for prevention, early detection and management of contaminated pregnant women during prenatal monitoring, thereby reducing the consequences for newborns.

Effects of Integrated Chinese Herbs and Western Medicine on Swine Toxoplasmosis

[ Objective] To evaluate the efficacy of integrated Chinese herbs and western medicine on the treatment of swine toxoplasmosis, in order to increase cure rate and lower recurrence rate. [ Method] Pigs artificially infected by Toxoplasma gondii were treated with compound suffonamide and a self-designed Chinese herbs formula, and the quantities of toxoplasma in ascites were determined. Animal regression experiment was per- formed after mice were inoculated with pathological samples of the pigs infected with toxoplasma. After treatment with integrated Chinese herbs and western medicine, the clinical manifestations of pigs were observed and the level of circulating antigen （CAg） in sera was detected. Curative effect indexes of integrated Chinese herbs and western medicine-treated group were compared with that of Chinese herbs-treated group, western medi- cine-treated group and positive control group. [ Result] All the toxoplasma trophozoites were killed by integrated and westem medicine. Regression expedment results showed that toxoplasma appeared only in one mouse that was inoculated with brain of pig. The treated pigs had nonsignificant clinical symptoms; the peak of serum CAg was lower than that of the positive control group and CAg turned negative faster than that of Chinese herbs-treated group, westem medicine-treated group, and positive control group. [ Conclusion] The integrated Chinese herbs and western medicine has good effect on the treatment of swine toxoplasmosis.

Toxoplasmosis among Saudi Female Students in Al-Ahssa, Kingdom of Saudi Arabia: Awareness and Risk Factors

Background: Toxoplasmosis is a worldwide disease that severely affects the fetuses and immunocompromised patients and results in many critical and life threatening conditions. The present study aimed to evaluate the awareness of toxoplasmosis and its preventive behaviors among female students in King Faisal University in Al-Ahssa. Subjects and methods: A cross sectional study was conducted in April 2014 among female students in KFU. The data were collected by a questionnaire from 88 participants. Results: Results showed that 65.4% were not aware of toxoplasmosis, and only 28.2% were aware of its complications or risk factors. This study showed that some people are at risk to get toxoplasmosis as they do not wash their hands with water and soap before eating (48.8%), do not wash the fruits and vegetables with water and soap (78.2%), drink tank water (51.3%) and cat owners don’t follow the proper measures for their cats. However, some people practice some of the preventive behaviors as they do not raise the cats (93.6%) and do not consume unpasteurized or unboiled milk (100%) or undercooked meat (92.3%). Conclusion: The current study proved the low awareness of toxoplasmosis which emphasized the need to educate the people in Al-Ahssa about the preventive methods, especially the pregnant women to prevent the severe complications of congenital infections.

Congenital Toxoplasmosis or the Tip of an Iceberg. Report of Two Cases

Among the many parasitic diseases observed in the tropics, Toxoplasmosis is a fairly common occurrence. An infected pregnant woman can transmit it, transplacentally, to her foetus. Two cases of congenital toxoplasmosis are discussed in this study. One patient is at 7 days of life, while the other is at 9 days of life. The newborns displayed the typical symptoms of jaundice, hepatosplenomegaly, chorioretinitis, and cranioencephalic abnormalities. However, the uniqueness of these observations is the presence of umbilical haemorrhage, a symptom not described in the literature researched. The evolution of this finding, during treatment is distinguished by the symptoms persisting until six months of age, in addition to growth retardation of saturation-weight, with no retardation of psychomotor development in one patient, and with hydrocephalus accompanied by psychomotor retardation in the other one. Hence, it is recommended that pregnant women are systematically screened for toxoplasmosis, and seronegative women are monitored;in fact, the early and suitable management of congenital toxoplasmosis will significantly control this parasitosis.

Incidence of toxoplasmosis in patients with cirrhosis

AIM:It is known that toxoplasmosis rarely leads to various liver pathologies,most common of which is granulomatose hepatitis in patients having normal immune systems.Patients who have cirrhosis of the liver are subject to a variety of cellular as well as humoral immunity disorders.Therefore,it may be considered that toxoplasmosis can cause more frequent and more severe diseases in patients with cirrhosis and is capable of changing the course of the disease.The aim of this study was to investigate the frequency of toxoplasmosis in patients with cirrhosis. METHODS:Serum samples were taken from 108 patients with cirrhosis under observation in the Hepatology Polyclinic of the Gastroenterology Clinic,and a control group made up of 50 healthy blood donors.IFAT and ELISA methods were used to investigate the IgG and IgM antibodies,which had developed from these sera. RESULTS:Toxoplasma IgG and IgN antibody positivity was found in 74 (68.5%) of the 108 cirrhotic patients and 24 (48%) of the 50 people in the control group.The difference between them was significant (P<0.05). CONCLUSION:In conclusion,it was found that the toxopiasma sero-prevalence in the cirrhotic patients in this study was higher.Cirrhotic patients are likely to form a toxoplasma risk group.More detailed studies are needed on this subject.

Toxoplasmosis among pregnant women:High seroprevalence and risk factors in Kinshasa,Democratic Republic of Congo

Objective:To determine the seroprevalence of toxoplasmosis in pregnant women,as well as the proportion of acutely infected and risk factors in the Democratic Republic of Congo.Methods:Thirty maternities in Kinshasa were randomly selected and women attending antenatal consultation were invited to participate.They were interviewed with a structured questionnaire about known risk factors(age,meat consumption,contact with soil,and presence of cat)and a venous blood sample was taken.Sera were analysed for total immunoglobulins(Ig)by VIDAS Toxo Competition using Enzyme Linked Fluorescent Assay.IgM was determined by VIDIA Toxo IgM and IgG avidity by VIDAS Toxo IgG avidity.Results:A total of 781 women were included.Median age was 28 years old(IQR:8.S).And 627women(80.3%;95%CI:77.5-83.1)were found to be positive to total Ig and 17 out of 387(4.4%;95%CI:2.3-6.4)were positive to IgM.IgC avidity was low for 2(11.8%)women,intermediate for 2(11.8%)and high for 13 women(76.4%).There was no statistically significant association between Toxoplasma gondii infection and any risk factors assessed.Conclusion:In Kinshasa,toxoplasmosis endemicity is highly prevalent.One woman out of twenty five had a recent toxoplasmosis infection and 20%were not protected against primoinfection,indicating a need for measures to prevent and control toxoplasmosis during pregnancy.

Recurrent headaches may be caused by cerebral toxoplasmosis

AIM: To establish seroprevalence and provide characteristics of Toxoplasma gondii(TG) infection in children with recurrent headaches. METHODS: The study was performed in 178 children aged 7-17 years admitted consecutively to the Department of Pediatric Neurology from November 2009 to July 2011. The children were surveyed with a questionnaire with the help and assistance of their parents and blood samples taken on admission were studied for the presence of specific anti-TG Ig M, Ig G antibodies and Ig G avidity using enzyme immunoassay Platelia Toxo Ig M, Ig G. RESULTS: The study showed that 19 children(8 boys, 11 girls; 8-17 years old, mean age 14.36 years) hadhigh serum anti-TG Ig G antibody levels(range: 32.2 > 240 UI/m L, mean 120.18 UI/m L; positive value for Ig G was ≥ 9 UI/m L). The avidity index(AI) ranged from 0.202 to 0.925(scale: ≥ 0.5 high AI). The results for Ig M antibodies were all negative and the obtained results ranged from 0.113 to 0.25 U/m L(mean = 0.191 IU/m L) and all values below 0.8 IU/m L were considered negative. The most frequent complaints found in the seropositive patients were headaches that affected the frontal(13 children), occipital(4) and parietal areas(5). Headaches usually had a pulsating(in 7 patients) and squeezing(6) character and rarely were piercing, dull or expanding. Interestingly, 8 children did not feel discomfort during the headaches, probably because they did not have sufficiently increased intracranial pressure yet. The headaches usually appeared 1-2 times/mo, lasted for 2-6 h, and had a mean intensity of 5.5 points in a 10 point subjective scale. The comorbidities included epilepsy(5 patients), various infections in 3 children(chronic eustachitis, chronic rhinitis, chronic purulent tonsillitis, streptococcal pharyngitis, meningitis, allergic diseases), disturbances of behavior, deficits of attention, and ocular and motor concentration disorders in 1 child. The electroencephalographic and neuroimaging studies performed in our patients had a very limited value in establishing cerebral toxoplasmosis.CONCLUSION: Ten point six seven percent of the studied children had markedly increased serum anti-TG Ig G antibodies and high AI indicated chronic infestation. It is suggested that tests for TG infection should be introduced to routine diagnostics in patients with recurrent headaches.

Diagnosis and Treatment of Swine Toxoplasmosis

Toxoplasmosis is a zoonotic parasitic disease caused by Toxoplasma gondii, which mainly affects pigs, cattle, sheep, rabbits and other animals. In addition, human beings are also susceptible to Toxoplasma gondii. Because Toxoplasma gondii infections are widely prevalent in human beings and other animals, we should pay more attention to prevention and control of the disease in order to promote the healthy development of breeding industry and the protection of people＇s health. In the present article, the pathogen of swine toxoplasmosis, life history, clinical features and treatment are elaborated.

Great efficacy of sulfachloropyrazine-sodium against acute murine toxoplasmosis

Objective:To identify more effective and less toxic drugs to treat animal toxoplasmosis.Methods:Efficucy of seven kinds of sulfonamides against Toxoplasma gondii(T.gondii)in an acute murine model was evaluated.The mice used throughout the study were randomly assigned to many groups(10 mice each),which either remained uninfected or were infected intraperitoneally with lachyzoites of T.gondii(strains RH and CN).All groups were then treated with different sulfonamides and the optimal treatment protocol was determined candidates.Sulfadiazine-sodium(SD)was used for comparison.Results:The oplimal therapy involved gavaging mice twice per day with 250 mg/kg bw of sulfachloropyrazine-sodium(SPZ)for five days.Using this protocol,the average survival time and the time-point of 50%fatalities were prolonged significantly compared with SD treatment.Treatment with SFZ protected 40%of mice from death,and the heart and kidney tissue of these animals was parasite-free,as determined by nestedPCK.SPZ showed excellent therapeutic effects in the treatment of T.gondii in an acute murine model and is therefore a promising drug candidate for the treatment and prevention of T.gondii in animals.Conclusions:It can be concluded that the effective drug sulfachloropyrazine may be the new therapeutic options against animal toxoplasmosis.

Novel Synergistic Protective Efficacy of Atovaquone and Diclazuril on Fetal-Maternal Toxoplasmosis

Over 1 billion people globally are estimated to be infected with Toxoplasma gondii with severe or unknown consequences and no safe and effective therapies are available against congenital or persistent chronic infection. We propose that atovaquone and diclazuril synergistically protect against fetal-maternal toxoplasmosis. Methods: Programmed pregnant mice were treated with atovaquone and diclazuril monotherapy, or combined (atovaquone + diclazuril) therapy and infected with tachyzoites (0, 300, 600) and the course of infection was studied. Results: Infected dams with low dose (300) developed moderate toxoplasmosis complications and treatments were similarly effective with minor differences between monotherapies. In contrast, major differences were observed amongst varied treatments during high-dose (600) infection and severe related-toxoplasmosis complications as follows. Dams developed hydrothorax, ascities and excess weight gain. Combined therapy (&#80 < 0.01) and to a lesser extent diclazuril monotherapy (&#80 0.05) protected dams from excess weight, hydrothorax, and ascities. Infected dams exhibited splenomegaly, hepatomegaly and severe hepatitis. Combined therapy synergistically normalized pathology (&#80 < 0.001) and to a lesser degree monotherapy (diclazuril &#80 0.01, and atovaquone &#80 0.05) protected dams from hepatitis and splemomegaly. Additionally, behavioral response to pain stimuli and fetal weight and fetal numbers were significantly preserved in treated dams. Conclusions: This is the first report describing combined atovaquone and diclazuril therapy a) to be safe in pregnancy, b) to exert novel synergistic effects, and c) to protect dams and their nested fetuses against adverse effects of severe toxoplasmosis.

Preliminary study on association between toxoplasmosis and breast cancer in Iran

Objective:To investigate the possible association between Toxoplasma gondii(T.gondii)infection and breast cancer by examining the seropositivity and serointensity rate of anti-T gondii antibodies in breast cancer patients and healthy volunteers.Methods:This study was carried out on 66 women with breast cancer which consists of 29 newly diagnosed patients(Group 1) and 37 cases undergoing treatment and regular checkups(Group 2).Also,60 healthy women(Group 3) with no history of cancer confirmed by clinical examination and imaging participated in this study.The participants were tested for T.gondii immunoglobulin G(IgG) and immunoglobulin M(IgM) antibodies by enzyme-linked immunoassays.Results:The mean age of Groups 1.2 and 3 were 43.3±6.8,41.8±5.5 and 42.3±4.9.respectively(P=0.72).Overall.104(82.5%) and 8(6.3%) out of 126 women were positive for anti-T gondii IgG and IgM antibodies,respectively.Higher seropositivity rate of anti-T.gondii antibodies(IgG) was seen in breast cancer patients(86.4%) compared with control group(78.3%)(P=0.24).IgG antibodies were detected in 89.2%of cancer patients under treatment.82.7%of newly diagnosed patients(P=0.18).IgM antibodies were found in 3(10.3%),2(5.4%)and 3(5%) in Groups 1.2 and 3.No significant difference was found between the mean titers of T.gondii IgG antibody among these groups(P=0.87).Conclusions:This study did not find any significant association between toxoplasmosis and breast cancer besides higher rates of seropositivity and serointensity in patients compared with healthy volunteers.

Ocular toxoplasmosis in Iran:40 cases analysis

·AIM:To report ocular symptoms,funduscopic findings and demographic distribution of ocular toxoplasmosis in Iran·METHODS:In this cross-sectional study,a total of 40 patients with ocular toxoplasmosis (24 female,16 male) were enrolled.The distribution of symptoms and funduscopic findings were studied.·RESULTS:The patients’ age was in the range of 13-52 with the most common age of 19 years old.Twenty-four patients were female (60.0%).The most common presenting sign was visual loss.There was anterior chamber (AC) inflammation in 23 patients (57.5%).Vitritis was presented in 36 patients (90.0%).In 35 patients (87.5%),the retinal lesion was central.In patients with peripheral lesion,3 patients (60.0%) had flashing vs 12.5% chance of flashing in all patients.Older patients had larger lesion (P =0.04).·CONCLUSION:Ocular toxoplasmosis substantially varies among patients with different age,gender,status of immunity,site of lesion and other undetermined factors.One of ocular symptoms,flashing,may necessitate a more precise peripheral fundus examination.·

Cytokine profile in murine toxoplasmosis

Objective:To investigate which cytokines are produced after acute infection of mice with Toxoplasma gondii(T.Gondii) RH strain.Methods:Mus domesticus domesticus mice in infected group were inoculated with with highly virulent T.Gondii RH strain by intraperitoneally.Serum samples were obtained from infected and non-infected mice for cytokine levels for ELISA assay.Results:The concentrations of tumor necrosis factor-α,interferon-γ,interleukin(IL)- 10 and IL-12 in the cardiac blood sample of the infected mice were significantly higher than those in uninfected controls(P【0.05).The levels of transforming growth factor-1βdecreased in mice infected with T.gondii compared to those of the controls,the decrease was statistically significant(P【0.05).No significant difference was observed in levels of IL-4 between infected and healty control groups(P】0.05).Conclusions:According to our findings,immune response into T helper type 1 was predominant during acute T.gondii infection.Further characterization and purification of Toxoplasma molecule(s) implicated in the regulation of cytokines could lead to the development of new drug prospects to control Toxoplasma infection.

Diclazuril Protects against Maternal Gastrointestinal Syndrome and Congenital Toxoplasmosis

Background: Toxoplasmosis is a common cause of foodborne, gastrointestinal and congenital syndrome with particularly severe or unknown health consequences. There is no safe and effective preventive or therapeutic modality against congenital toxoplasmosis or to eliminate the persistent chronic infection. Hypothesis: Diclazuril to be safe in pregnancy and effective against gastrointestinal toxoplasmosis. Methods: CD1 programmed pregnant mice were divided into groups and administered a diet containing diclazuril, or sham control. Treatments were initiated on Day 5 of pregnancy and continued until Day 16 when dams were euthanatized. On Day 8 of pregnancy dams were infected intraperitoneally with escalating doses of tachyzoites (0, 100, 300, 600) from Type II strain. Dams were monitored daily for distress, pain, and abortion and samples collected at the end of the experiments. Results: Infected dams developed moderate to severe Toxoplasma related complications in tachyzoites dose dependent manner. Animals became anemic and showed hydrothorax, and ascities. Diclazuril effectively protected dams from ascities and anemia (p < 0.05). Infected dams showed splenomegaly, with massive infiltration of epithelioid cells compared with the protective effect of diclazuril in treated animals. Infected dams exhibited severe hepatitis (score 0 to 4 scale = 3.5 ± 0.01) with influx of inflammatory and plasma cells, dysplastic hepatocytes, multinucleated giant cell transformation and hepatic cells necrosis. Diclazuril treatment significantly protected dams from hepatitis, also in tachyzoites dose (100, 300, 600) dependent manner (respectively infected-treated versus infected controls, p < 0.001, p < 0.01 and p with infiltration of lymphocytes, and macrophages and microabscess formations in the cryptic structures, with significant improvement in diclazuril treated animals. Additionally, the number of fetuses, fetal length and fetal weight were preserved in diclazuril treated dams. Conclusions: This is the first report describing of diclazuril safety in pregnancy as well as efficacy against mild to moderate hepato-gastrointestinal syndrome in dams and fetal toxoplasmosis (Special issue, “Treatment of Liver Diseases”).

Observational study to assess pregnant women's knowledge and behaviour related to toxoplasmosis in Essaouira province, Morocco

Objective: To assess knowledge and behaviour related to toxoplasmosis which remains a neglected disease in Morocco.Methods: Observational investigations were conducted among 600 pregnant women from Essaouira Province.The interview items covered respondents' knowledge of the disease, its preventive practices and risk behaviours.Results: A total of 22/600 women had already carried out the anti-toxoplasmosis test, while, 96% have never done any screening of anti-Toxoplasma antibodies.Only 16/600 women have good information about the disease, its mode of transmission and its complications in both the fetus and his mother.Although most women adopt a healthy diet, the consumption of raw or undercooked meat is far to be considered as a risk factor, along with other potential factors that may foster the acquisition of the disease, such as possessing a domestic cat, educational status and knowledge of the disease.However, in this study, contact with soil was revealed the most important risk factor(P = 0.045), followed by the hygiene conditions after handling raw meat(P = 0.048).Conclusion: The underestimation of the Toxoplasma gondii sero-prevalence in Essaouira Province can be explained by the absence of toxoplasmosis serology in health institutions, as well as the gap of knowledge about the disease by local population.

Comparison of histopathology and PCR based assay for detection of experimentally induced toxoplasmosis in murine model

Objective:To compare histopathology and PCR based detection in diagnosis of experimentally induced toxoplasmosis of RH human strain of the parasite in murine models.Methods:A comparison of histopathology and PCR based detection was done to diagnose experimentally induced toxoplasmosis in ten inbred swiss albino mice after intraperitoneal inoculation of 100 tachyzoites of laboratory mantained human RH strain of the parasite.Tissue samples from lung,liver,spleen,brain,heart and kidney were taken and processed for histopathological examination while all the samples also were subjected to PCR,using primers directed to the multicopy of SAG 3 gene,in dublicates.Results:Histopathology revealed presence of tachyzoites only in liver while along with lung,liver,spleen and brain tissue yielded desired positive PCR amplicons.Conclusions:The SAG 3 based PCR is able to diagnose toxoplasmosis in those tissues which are declared negative by histopathological assay.

Tuberculosis/toxoplasmosis co-infection in Egyptian patients:A reciprocal impact

Objective:To assess the concurrent toxoplasmosis infection in Egyptian TB patients and the impact of each infection on the other in terms of increased severity of TB or reactivation of latent Toxoplasma infection.Methods:Three hundred suspected pulmonary TB cases were initially screened for TB using direct Ziehl Neelsen staining and Lowenstein Jensen culture of their sputa.Rifampicin resistance was detected by Xpert MTB/RIF assay.Control group of 30 age and sex-matched healthy individuals negative for TB was included for comparison.All subjects were further assessed for serum levels of anti-Toxoplasma Ig G antibodies and malondialdehyde(MDA).Results:Forty three confirmed TB-infected patients including 10(23.3%)rifampicin-resistant patients were detected.Associated toxoplasmosis was found to be significantly higher among TB patients(OR=2.709;95%CI:1.034-7.099;P<0.05)and among rifampicin sensitive than rifampicin resistant TB patients(OR=0.213;95%CI:0.048-0.951);P<0.05).Serum levels of anti-Toxoplasma IgG antibodies and MDA were significantly higher among TB patients than the control group.Furthermore,serum level of MDA was significantly higher among TB/Toxoplasma co-infected patients as compared to toxoplasmosis free-TB patients.Strong positive correlation was detected between serum levels of anti-Toxoplasma Ig G and MDA in TB patients(r=0.75,P=0.001).Conclusions:Among pulmonary TB Egyptian patients,there is a considerable prevalence of toxoplasmosis.Severity of pulmonary tuberculosis could be increased by Toxoplasma co-infection.

Clinical feature and treatment outcome of active ocular toxoplasmosis in immunocompetent patients

Objective:To investigate clinical features,ocular findings,management and follow-up data in a series of immunocompetent patients with active ocular toxoplasmosis.Methods:A prospective study of 25 immunocompetent patients with first attack of active ocular toxoplasmosis. Age,gender,clinical presentation and ophthalmic examination finding were recorded.The diagnosis was based on typical finding in ophthalmic examination.Systemic antimicrobials and corticosteroids were given to all patients.The treatment outcome and side-effects of drugs were observed.Results:Thirteen(52%) patients were male and 12(48%) were female.The mean±SD age at presentation was(26.8±11.1) years.Eye involvement was unilateral in 92% of patients and bilateral only in 8%.Lesions were located at the peripheral retina in 48%,at the macula retina in 28%,and at the macula and peripheral retina in 24%of the patients.The most common presenting symptom was blurred vision(96%),followed by eye pain(28%).All patients received antimicrobials treatment.Systemic corticosteroids were used in 48%of the patients. Clinical response were observed in 44%2 weeks before and in 56%2 weeks after.Vision was improved with treatment except in two cases.No recurrences occurred during one year follow up.Conclusions:Our study shows that active ocular toxoplasmosis has no gender predilection and affects young individuals.Unilateral involvement is more common in our study.Response to treatment is good in patients and no recurrences occur during one year follow-up.It may have implications in favor of treatment of active ocular toxoplasmosis.

Toxoplasmosis and anti-Toxoplasma effects of medicinal plant extracts-A mini-review

Toxoplasmosis is a globally diwstributed parasitic protozoan disease,caused by Toxoplasma gondii.The infection can result in more severe symptoms with potentially life-threatening in case of immunocompromised individuals.Sulfadiazine and pyrimethamine are the two drugs used as a part of standard therapy for toxoplasmosis.Researchers have demonstrated the therapeutic effects of medicinal plants for toxoplasmosis,which can be used as an alternative to standard drug therapy with reduced side effects.Traditional herbal plants are used by people to cure a large number of parasitic disorders.This review provides new insights into various medicinal plants that are used traditionally for the treatment of toxoplasmosis and other parasitic infections,which can be useful as an alternative treatment option for Toxoplasma gondii infections.