Effects of selenium on oxidative damage and antioxidant enzymes of eukaryotic cells: wine Saccharomyces cerevisiae.

AIM: To clarify the effects of selenium (Se), parameters related to oxidative issues, as well as the antioxidant response were investigated on an autochthonous wine yeast strain. METHODS AND RESULTS: Antioxidant enzyme activity, gel electrophoresis, Western blot and MDA level were used to investigate the effects of different concentration of Se in wine yeast. We found that Se is able to affect the enzymatic activities of catalase (CAT), glutathione peroxidase (GPx) and superoxide dismutase (SOD). An increase in lipid peroxidation was observed in a dose-dependent manner of (Se), thus, indicating the occurrence of cell membrane damage. Additionally, Se induced post-translational oxidative modifications of proteins, especially oxidation of thiol groups (both reversible and irreversible) and protein carbonylation (irreversible oxidation). CONCLUSION: These results obtained could further the understanding the effect of different concentration of Se in wine yeast strain with which Se affect the enzymatic activities and induces some post-translational modifications of proteins. SIGNIFICANCE AND IMPACT OF THE STUDY: The understanding of mechanisms regulating the response of wine yeast to Se is important for future work using selenized yeast as enriched Se supplements in human nutrition.

Ovarian masses in pediatric patients: a multicenter study of 98 surgical cases in Tunisia.

Ovarian masses requiring surgical intervention are uncommon in the pediatric population. Our aim is to report results of a multicentric Tunisian study concerning the clinical practice and the management of pediatric ovarian masses and to identify the factors that are associated with ovarian preservation. Between January 2000 and December 2015, 98 pediatric patients (<14 years) were surgically treated for ovarian masses at the five pediatric surgery departments in Tunisia. Ninety-eight patients were included in this study. The mean age of the patients at time of surgery was 8.46 ± 4.87 years. Sixty-three ovarian masses (64.3%) were non-neoplastic lesions, 24 (24.5%) were benign tumors, and 11 (11.2%) were malignant neoplasms. Conservative surgery (ovarian-preserving surgery) was successfully performed in 72.4% of the benign lesions, whereas only three patients (27.3%) with malignant tumors underwent ovary-sparing tumor resection (p < .001). The mean diameter of the tumors in the patients who underwent oophorectomy was significantly larger than that in the patients who underwent conservative surgery (7.8 ± 3.9 cm vs. 5.7 ± 2.9 cm, respectively, p = .001). In our study, the risk factors for oophorectomy were a malignant pathology and large tumor size. In accordance with the Gynecologic Cancer Intergroup consensus, we recommend that surgical management of ovarian masses in children should be based on ovarian-preserving surgery.

[Comparative characterization of skin lesions observed in the three endemic varieties of cutaneous leishmaniasis in Tunisia]. / Caractérisation comparative des trois formes de leishmaniose cutanée endémiques en Tunisie.

BACKGROUND: The recent spread in the geographical distribution of the three forms of cutaneous leishmaniasis (CL) endemic in Tunisia has resulted in the coexistence of more than one species of Leishmania (L.) in some foci, rendering characterization on the basis of geographical criteria alone more difficult. The aim of the study was to establish clinical criteria associated with these noso-geographic forms, namely sporadic CL (SCL) due to L. infantum, zoonotic CL (ZCL) due to L. major and chronic CL (CCL) due to L. tropica. PATIENTS AND METHODS: One hundred and twelve patients with biologically confirmed CL were involved in the study. Leishmania species was systematically identified by iso-enzyme analysis and/or PCR-RFLP. Details of the number, the location, the morphological aspect and the month of outbreak of the lesions were noted for each patient. RESULTS: SCL lesions appeared later than ZCL lesions (53.8% of cases appeared from December onwards vs. 23.6%, P<0.001). ZCL lesions were often multiple (75%) and situated on the limbs (84.7%, P<0.001), whereas SCL lesions were single (92.3%, P<0.001) and located on the face (84.6%, P<0.001). CCL lesions were also single (78.6%) and located on the face (71.4%). The classical ulcerous presentation with scabs was mainly observed in ZCL patients (69.4%) and the erythematous presentation was described more frequently in SCL patients (75%; P<0.001). CONCLUSION: The number, site, morphological aspect and month of outbreak of lesions could be considered as useful criteria that help differentiate between the three noso-geographical forms of CL prevailing in Tunisia. Such characterization is useful for the individual management of patients and for optimizing the combat against the disease.

[Ileocecal ameboma: a case diagnosed by pathology and molecular biology]. / Amoebome iléocaecal: un cas diagnostique par l'anatomie pathologique et la biologie moléculaire.

Colonic ameboma is a rare benign inflammatory tumor due to the infection by Entamoeba histolytica and poses frequently the problem of colon cancer. We report a case of a 52 year-old patient who presented a cecal amoeboma revealed by a painful mass in the right iliac fossa. Radiologic and endoscopic examinations depicted a parietal thickening of the right colon and the cecum. A presumptive diagnosis of colon cancer was firstly discussed. Confirmation of ameboma was made on pathological examination, PCR and serology.

[The intestinal parasites in the food handlers of Tunis area: study of 8502 stool samples (1998-2008)]. / Les parasites intestinaux chez les manipulateurs de denrees alimentaires de la Region de Tunis: etude de 8502 prelevements de selles (1998-2008).

The food handlers control is one of the major measures of the National program against intestinal parasitoses in Tunisia. The collected data allow regular updates of the prevalence and profile of the involved parasitic species and note possible evolutions in time. From 1998 to 2008, 8502 stool samples of food handlers working in Tunis area were examined in the laboratory of Parasitology, Pasteur Institute of Tunis. The mean prevalence of intestinal parasites was 13.5% (1152 positive samples). The protozoa were the most detected parasites (93% of the species observed). Among the pathogenic or potentially pathogenic parasites, Dientamoeba fragilis (15.5%) and Giardia intestinalis (7.6%) were the most frequently encountered. Entamoeba (E.) histolytica/dispar was diagnosed in 41 subjects (a prevalence of 05%). Hymenolepis nana was the most frequent helminth (45% of the whole parasites). Therapeutic failures were noticed in 43.8% of infection by this cestode because of the lack of the appropriate antihelminthic. The identification using PCR of cysts and/or vegetative forms of E. histolytica/dispar revealed the exclusive presence of E. dispar.

[Imported malaria in Tunisia: consequences on the risk of resurgence of the disease]. / Paludisme d'importation en Tunisie: conséquences sur le risque de réintroduction de la maladie.

Although malaria has been eradicated in Tunisia since 1979, the disease is still a health issue due to the persistence of mosquitoes and coexistence with a potential parasite reservoir in the form of imported cases. From 1999 to 2006, 98 cases of imported malaria were diagnosed at the Pasteur Institute in Tunis where nearly 30% of national cases are recorded. Tunisians accounted for 24.5% of these cases versus 75.5% involving foreigners. The occurrence rate has steadily increased in volunteer workers, businessmen, diplomats and athletes who together accounted for 41.7% of cases in 1995 as compared to only 17.4% in 1980 (p<0.01). Most cases (96.5%) were imported from sub-Saharan Africa. The most frequent countries involved in importation were Cote d'Ivoire (23 cases) and Mali (8 cases) that are now linked to Tunisia by regular flights. About one third of patients were asymptomatic at the time of diagnosis. This finding underlines the importance of recommending systematic screening in high-risk groups. Fever (70.6%) and gastro-intestinal manifestations (27.9%) were the most frequent clinical findings in the 69 symptomatic cases. Plasmodium falciparum (71.4%) was the most common species followed by Plasmodium ovale (19.4%). Gametocytes were detected in 9.2% of subjects, thus creating a theoretical source of infection for mosquitoes especially since 60.2% of all cases were recorded between June and October when mosquitoes are active in Tunisia. Due to increasing exchange with endemic malaria areas in Africa that has resulted in a higher incidence of imported cases and a futher risk of introduction of tropical mosquito species as well as to global warming that promotes plasmodium transmission, greater vigilance is necessary to ensure eradication of malaria in Tunisia.

[Antibiotic Susceptibility of Haemophilus influenzae in Sfax: Two Years after the Introduction of the Hib Vaccination in Tunisia]. / Sensibilité aux antibiotiques d'Haemophilus influenzae à Sfax deux ans après l'introduction de la vaccination anti-Hib en Tunisie.

A retrospective study was conducted at the Sfax hospitals between 2013 and 2014 to study the susceptibility to antibiotics of Haemophilus influenzae after the introduction of Hib vaccination in Tunisia. Capsular typing was done by PCR. MICs for ß-lactams were determined by E-test®. The blaTEM, blaROB and ftsI genes were searched using PCR. Among the 259 strains of H. influenzae isolated, 248 (95.7%) were non-invasive. Five strains were encapsulated (3 type b and 2 type c). Resistance rates were 33.4% for ampicillin, 10.4% for amoxicillin-clavulanic acid, 2.3% for cefixime, 1.1% for cefotaxime and 1.9% for fluoroquinolones. Among the strains resistant to ß-lactams, 67 produced ß-lactamase type TEM and 40 had a modification of PLP3. This study shows the change in the epidemiology of H. influenzae induced by vaccination with a dramatic decrease of invasive infections. Replacement with other capsular types or with non-typable strains that may be resistant to antibiotics requires continuous surveillance for H. influenzae infections.

Une étude rétrospective a été menée dans les hôpitaux de Sfax en 2013­2014 pour étudier la sensibilité aux antibiotiques d'Haemophilus influenzae après l'introduction de la vaccination anti-Hib en Tunisie. Le typage capsulaire des souches d'H. influenzae a été fait par PCR. Les concentrations minimales inhibitrices des ß-lactamines ont été mesurées par E-test®. Les gènes bla TEM, bla ROB et ftsI ont été recherchés par PCR. Sur 259 souches d'H. influenzae isolées, 248 (95,7 %) étaient non invasives. Cinq souches étaient capsulées (trois de type b et deux de type c). Les taux de résistance étaient de 33,4 % pour l'ampicilline, de 10,4 % pour l'amoxicilline­acide clavulanique, de 2,3 % pour le céfixime, de 1,1 % pour le céfotaxime et de 1,9 % pour les fluoroquinolones. Parmi les souches résistantes aux ß-lactamines, 67 étaient productrices de ß-lactamases de type TEM et 40 avaient une modification de PLP3. Cette étude atteste du changement de l'épidémiologie d'H. influenzae induit par la vaccination avec la quasi-disparition des infections invasives. Le remplacement de Hib par d'autres types capsulaires ou par des souches non typables éventuellement résistantes aux antibiotiques impose une surveillance continue des infections à H. influenzae.

[Contribution of Real-Time PCR in the Diagnosis of Cutaneous Leishmaniasis: Experience of the Pasteur Institute of Tunis]. / Contribution de la PCR en temps réel dans le diagnostic biologique de la leishmaniose cutanée : expérience de l'institut Pasteur de Tunis.

The aim of this study was to assess the performance of real-time PCR (qPCR) in the diagnosis of cutaneous leishmaniasis (CL). Culture, direct microscopic examination (DE) and qPCR were performed on dermal exudate samples collected from 235 confirmed CL cases. The qPCR was found to be more sensitive than other diagnostic techniques and was able to correct the diagnosis in 49 patients (20.9%) with negative dermal smears. Median parasitic load (PL) of the 49 dermal exudates with negative DE was lower than that of positive ones in microscopy. This suggests that PL likely impact the sensitivity of microscopy. On the other hand, qPCR was performed on DNA extracts of scraped products collected from the 23 out of 49 archived negative Giemsa-stained slides and showed 11 positive. Parasitic loads in the latter smears were lower than those in corresponding exudates. The results highlight qPCR relevance for the diagnosis of CL and recommend its use directly on dermal exudates collected from CL lesions.

L'objectif de ce travail était d'évaluer la place de la PCR en temps réel (qPCR) dans le diagnostic de la leishmaniose cutanée (LC). Des sucs dermiques prélevés chez 235 cas confirmés de LC ont été traités par examen microscopique direct (ED), culture et qPCR, et les résultats analysés. La qPCR s'est révélée plus sensible que les autres techniques diagnostiques permettant de redresser le diagnostic chez 49 patients (20,9 %). Les charges parasitaires (CP) des 49 sucs dermiques correspondants étaient inférieures à celles de prélèvements microscopiquement positifs suggérant que la CP serait un facteur limitant la sensibilité de l'ED. La qPCR a été également pratiquée sur les produits de grattage de 23 des 49 frottis négatifs. Elle a permis d'en détecter 11 positifs avec des CP inférieures à celles dans les sucs dermiques correspondants. Ces résultats recommandent l'utilisation de la qPCR pour le diagnostic de la LC et privilégient sa réalisation directement sur le suc dermique.

A rare case of lumbosacrococcygeal mass in newborn: a human tail.

Caudal cutaneous appendage is a rare condition. According to association with underlying spinal dysraphism, it can be classified into true or pseudotails. Management and prognosis depends closely on spinal anomaly. Fewer than 40 cases of true tail were reported. We describe a rare case of true tail in a newborn explored and operated in our unity.

[Cultures on NNN medium for the diagnosis of leishmaniasis]. / Les cultures sur milieu NNN dans le diagnostic biologique des leishmanioses.

Cutaneous and visceral leishmaniasis (VL, CL) represent the most frequent vector-borne diseases in Tunisia. Their biological confirmation is necessary before the administration of restricting, expensive and toxic specific treatments. Retrospective evaluation of the contribution of Leishmania cultures on NNN medium in leishmaniasis diagnosis have been done using the data of 375 cultures concerning 214 CL cases and 125 VL cases consecutively recruited in Pasteur Institute of Tunisia between 1995 and 2007. The global sensitivity of the culture in the course of CL was of 68.2%. It was significantly higher during zoonotic CL (78.8%) compared to that during sporadic CL (54.9%); p<0.001. This difference is explained by the easier thrust in NNN medium of Leishmania (L.) major, the agent of zoonotic CL than that of L. infantum, particularly its zymodeme MON-24, agent of sporadic CL. In the course of VL, and in spite of the better sensitivity of bone marrow aspirates (BMA) culture (70.8%), the blood buffy-coat, which permit to avoid the trauma induced by BM aspiration gave promising results (58.2%), the difference being not significant. Besides, in the course of both CL and VL, the direct examination of smears is revealed more sensitive, respectively 89.7% and 93.4% (p<0.01 and p<0.01). Although, systematic cultures practise, in parallel with direct examination, is recommended. In fact, in addition of straightening out some diagnosis, 22 cases in our series, the culture provide the isolation and the isoenzymatic identification of the causative species and strains allowing a better comprehend of parasite life cycles and a disposing of important epidemiological data for suitable control measures. As known with all cultures, those of Leishmania are also exposed to the contamination problem, which reached 5.9% in our study. In conformity with previsions, the contamination concerned much more cutaneous samples (8.4%) than blood or BM ones (2.5%; p=0.015).

[Congenital toxoplasmosis: clinical and biological analysis of 11 cases in Tunisia]. / La toxoplasmose congénitale en Tunisie: analyse clinique et biologique de 11 cas.

Early diagnosis of congenital toxoplasmosis (CT) is necessary to prevent serious complications. The CT is diagnosed by the identification of the parasite in amniotic fluid during pregnancy or at birth by detection of antibodies synthesized by the fetus. The aim of this study was to determine the clinical and biological particularities of CT in a cohort of 11 cases observed in Tunisia and to evaluate the performance of the prenatal and neonatal diagnostic techniques that were used. In all patients, the presumed date of maternal contamination was determined based on the mother's serological data. Neonatal serological screening included assays for immunoglobulins (Ig) G and IgM by enzyme-linked-immuno-sorbent assay (ELISA), IgM by immuno-sorbent-agglutination-assay (ISAGA), and comparison of the mother-baby immunological profile by western blot IgG and IgM. Seven out of the 11 cases had been diagnosed prenatally; only 3 (43%) had a positive polymerase chain reaction (PCR) test. Ten newborns out of 11 had serological criteria of fetal infection; western blot results were positive in all of them, ISAGA was positive in 2 and ELISA in none. The newborn who had a negative serology had been treated in utero. The date of positivity of the western blot test varied: 6 cases at birth, 2 at 12 days of life and 2 at 1 month of life. The 2 patients who had positive ISAGA results had been contaminated during the 3rd trimester of gestation.

Molecular differentiation of Entamoeba histolytica and Entamoeba dispar from Tunisian food handlers with amoeba infection initially diagnosed by microscopy.

The purpose of the study was to obtain more reliable epidemiological data concerning Entamoeba (E.) histolytica infection in Tunisian food handlers using established molecular tools able to differentiate E. histolytica from E. dispar. From 2002 to 2005, 4,266 fresh stools specimens received in the setting of the National program of food handlers' control were analysed by optical microscopy. Twelve (2.8 per thousand) were positive for the presence of four nuclei cysts identified as E. histolytica/E. dispar. Extraction of DNA from the 12 samples, followed by specific amplifications of E. histolytica and E. dispar SSU rDNA, showed that 11 samples (92%) were positive for E. dispar and negative for E. histolytica. Sequencing analysis of 8 PCR products permitted to verify the results obtained with conventional PCR. The remaining sample was negative by PCR amplifying E. histolytica DNA or E. dispar DNA specifically, although it did not show any inhibition. It probably contains protozoan cysts genetically distinct from these two species but morphological similar. Estimation of relative proportions between E. histolytica and E. dispar in cyst carriers showed that all explored individuals harboured the non pathogenic E. dispar strains. This result highlights the need of use in this population of complementary tests that allow specific diagnosis and obviate unnecessary chemotherapy.

[Management of Toxoplasmic Seroconversion in the Third Trimester of Pregnancy in Tunisia]. / Particularités de la prise en charge en Tunisie des séroconversions toxoplasmiques du troisième trimestre de grossesse.

The purpose of our study was to report the particularities of the management of toxoplasmosis seroconversion cases occurred during the third trimester of pregnancy and diagnosed in the Institute Pasteur of Tunis. The study was conducted in the Laboratory of Parasitology-Mycology of the Institute Pasteur of Tunis between January 2005 and December 2017. A total of 27 cases of toxoplasmosis seroconversion during the third trimester were included. Prenatal diagnosis was performed in five cases. PCR was positive in one case. Pyrimethamine-sulfadoxine was prescribed in one case with positive PCR and in another case as soon as maternal infection was confirmed. Spiramycine was prescribed in 24 cases for the duration of the pregnancy. One woman did not take any treatment because seroconversion was diagnosed just before delivery. Twenty newborns had congenital toxoplasmosis: 19 cases were diagnosed by serology and one case was diagnosed after amniocentesis. Two newborns (10%) were symptomatic at birth. All the newborns had neither clinical nor radiological signs during the follow-up.

L'objectif de notre travail était de rapporter les particularités de la prise en charge d'une série de cas de séroconversion toxoplasmique du troisième trimestre de grossesse diagnostiquée à l'institut Pasteur de Tunis. Il s'agit d'une étude rétrospective colligée au laboratoire de parasitologie-mycologie de l'institut Pasteur de Tunis entre janvier 2005 et décembre 2017, incluant 27 femmes enceintes ayant présenté une séroconversion toxoplasmique au cours du troisième trimestre de la grossesse diagnostiquée au cours de leurs suivis sérologiques. Cinq femmes ont bénéficié d'un diagnostic anténatal. La PCR (polymerase chain reaction) s'est révélée positive dans un seul cas. Deux femmes ont été mises sous pyriméthamine-sulfadoxine dont une avait une PCR positive. La spiramycine a été instituée chez 24 femmes jusqu'à l'accouchement. Une femme n'a reçu aucun traitement, la séroconversion ayant été diagnostiquée la veille de l'accouchement. Le diagnostic de la toxoplasmose congénitale a été retenu chez 20 nouveau-nés (74 %) dont un en anténatal et 19 à la naissance. Deux étaient symptomatiques (10 %) à la naissance. Aucune manifestation clinique ou radiologique n'a été observée au cours de leurs suivis.

[Recurrent chromomycosis of the face and extremities: first case report from Iibya]. / Chromomycose récidivante du visage et des membres: a propos du 1er cas libyen.

Chromomycosis is a chronic cutaneous fungal infection most prevalent in tropical and subtropical countries. It mainly affects adults working in rural areas. This purpose of this report is to describe the first cases in Libya in a 16-year-old girl. This case is also remarkable with regard to location on the face and members, lack of association with trauma and long delay for recurrence, i.e., 6 years after first occurrence.

[Contribution of the real time PCR in antenatal diagnosis of congenital toxoplasmosis]. / Apport de la pcr en temps réel dans le diagnostic anténatal de la toxoplasmose congénitale.

BACKGROUND: The antenatal diagnosis of congenital toxoplasmosis rests in Tunisia on ultrasonography coupled with biological explorations. Among these explorations the search of Toxoplasma gondii by means of real time PCR in amniotic fluid is the examination of choice. AIM: We report the results of 33 parturients for which the biological examinations allowed to retain the notion of perigravidic or pergravidic toxoplasmic infection. METHODS: They were 13 patients having a seroconversion during the pregnancy, 19 having anti-toxoplasmic IgM with a low or intermediate index of avidity and a patient having presented a symptomatic anteconceptional primary infection. The ADN was extracted by means of the Kit (Qiagen). Genic amplification by PCR TaqMan targeted a portion of 71 pairs of bases of the B 1 gene. RESULTS: The PCR was positive among 9 patients (27.3%). They were a patient having presented a symptomatic toxoplasmosis during the pregnancy, 4 patients having consulted only in the 2nd quarter and for which the index of avidity was intermediate and 4 patients having presented seoconversions of 1st (n=1) of 2nd (n=2) or 3rd trimester. Among these patients, 2 had a medical interruption of pregnancy. The 7 others were put under pyrimethamine sulfadiazine. The neonatal assessment practised at 5 new-born babies was negative in all the cases. The PCR was negative for 24 patients. 18 pregnancies were followed. The neonatal serology was negative. The follow-up of 13 newborn child showed the disappearance of the antitoxoplasmic IgG between the 6th and 12th month.

[Epidemiological, clinical and parasitological data concerning intestinal amebiasis in northern Tunisia]. / Données épidémiologiques, cliniques et parasitologiques concernant l'amibiase intestinale dans le nord de la Tunisie.

In order to evaluate the principal characteristics of the intestinal amoebiasis in the north of Tunisia, one retrospective study review all cases diagnosed in principal gastroenterologic sections of the hospitals of Tunis. Twenty height cases of intestinal amoebiasis, 10 of which have an inflammatory bowel disease associated were included. Watery stools containing blood and mucus were the most important symptoms (25 cases). The endoscopic exam showed for all the cases non specific lesions. The diagnosis was based on histologic exam in 21 cases, on the positivity of serologic tests in 3 cases and on the presence of E. histolytica/dispar cysts in stools in 6 cases. In two cases, the diagnosis was made by therapeutic test.

[Toxoplasmic infections in pregnancy: about 94 cases diagnosed at the Pasteur Institute of Tunis]. / Infections toxoplasmiques au cours de la grossesse: à propos de 94 cas diagnostiqués à l'institut Pasteur de Tunis.

OBJECTIVES: The objectives of this study were to estimate the risk of maternal-fetal transmission of toxoplasmosis and its consequences on the fetus and to emphasize the importance of follow-up of newborns in Tunisia. PATIENTS AND METHODS: It was a retrospective study of 94 cases of pergravidic toxoplasmic seroconversion who were diagnosed and followed in the Laboratory of Parasitology of Pasteur Institute of Tunis between 2005 and 2010. RESULTS: In our series, amniocentesis was performed for 60 parturients. Among the amniotic fluid tested, research of toxoplasmosis DNA by PCR was positive in 12 cases (12/60, 20 %). Twenty-six cases of congenital toxoplasmosis were diagnosed with 14 postnatal cases. The rate of maternal-fetal transmission of Toxoplasma gondii was 27.6 % (26/94). This risk increases with gestational age, from 19 % at seroconversion of the 1st quarter to 29.4 % in the 2nd quarter and 44.4 % in the 3rd trimester. Monitoring of newborns with congenital toxoplasmosis showed that only 3 children were symptomatic. There were 2 cases of toxoplasmic chorioretinitis and a case of brain damage. Under serological monitoring of newborns, 21 cases were lost to follow-up and monitoring was stopped for 29 after decrease of anti-toxoplasmic IgG. DISCUSSION AND CONCLUSION: The prenatal diagnosis allowed to decrease the severe forms of congenital toxoplasmosis in Tunisia. Nevertheless, it is always necessary to raise the problem of the significant number of newborn children whose follow-up is incomplete.

[Toxoplasmosis mother-to-child screening: study of cases followed in the Pasteur Institute of Tunis (2007-2010)]. / Dépistage de la toxoplasmose materno-foetale : étude des cas suivis à l'Institut Pasteur de Tunis (2007-2010).

Toxoplasmosis when occurring during pregnancy can be transmitted to the fetus and lead to congenital toxoplasmosis (CT). Therefore, pregnant women are a risk group, for which it is necessary to determine the serologic profile. The objective of this study is to determine the serologic profile of toxoplasmosis in pregnant women followed at the Parasitology Laboratory of the Pasteur Institute in Tunis, to establish the prevalence of toxoplasmic infections during pregnancy and the incidence of the CT, noting the difficulties faced in the interpretation of serological results. This is a retrospective study concerning 2833 toxoplasmic serologies practiced on 2070 pregnant women, followed at the Parasitology-Mycology Laboratory of the Pasteur Institute of Tunis, between 2007 and 2010. Serological diagnosis of toxoplasmosis was done by ELISA (Enzyme Linked Immunosorbent Assay) for the detection of Immunoglobulin (Ig) G and M and the study of toxoplasmosis IgG avidity. Prenatal diagnosis was performed for 58 women by amniotic fluid sampling. Toxoplasma gondii was detected by Polymerase Chain Reaction (PCR). At birth, the diagnosis of congenital toxoplasmosis was established based on serology. The toxoplasmic serologies carried out have shown that 45.6% of the pregnant women were formerly immunized while 49.6% had a negative serology. A toxoplasmosis primary infection acquired during pregnancy was detected in 79 cases (3.8%). Among them, 33% had a true seroconversion while 67% had a recent toxoplasmosis infection in view of the positivity of IgG and IgM on the first sample with a low index of avidity (IA). For 21 parturients whose serology showed the presence of IgG, IgM and an intermediate or high IA. Among the 58 parturients in whom prenatal diagnosis was performed, PCR was positive in four cases. After birth, six cases of congenital toxoplasmosis were detected by serology.

[Evaluation and contribution of OptiMAL-IT® test for the diagnosis of imported malaria in Tunisia]. / Évaluation et apport du test OptiMAL-IT® dans le diagnostic du paludisme d'importation en Tunisie.

The rapid test OptiMAL-IT® was evaluated in the diagnosis and the screening of imported malaria in Tunisia in comparison with microscopic techniques. This prospective study focused on 500 individuals recruited from September 2010 to September 2012 in laboratory of Parasitology of Pasteur Institute of Tunis. They include 192 patients with clinical manifestations suggestive of malaria and 308 students originating from endemic areas. Microscopy of thick-and-thin blood smears and OptiMAL-IT® test were systematically performed on blood samples of all participants. Sixty individuals revealed infected by Plasmodium (12%). Positivity rates were respectively 20.3% in patients (44 cases) and 5.2% among asymptomatic students (16 cases) (p<0.01). The sensitivity and specificity of the OptiMAL-IT® test were respectively 88.6% and 100%. The concordance kappa was 0.92. The sensitivity and specificity during the screening of asymptomatic subjects were respectively 68.8% and 98.3% with a concordance of 0.67.

[Congenital toxoplasmosis following infection occurring late in pregnancy]. / Toxoplasmose congénitale faisant suite à une primo-infection maternelle en fin de grossesse.

Monthly serological screening of non immune pregnant women is recommended for prevention of congenital toxoplasmosis. However, this screening is often interrupted before delivery. We report a case of congenital toxoplasmosis following infection occurring late in pregnancy. This documented case highlights the need for a final routine serological test, 2-3 weeks post-partum for all seronegative pregnant women. In fact, the screening of congenital toxoplasmosis cases allows the early administration of specific treatment that avoids later severe complications such as chorioretinitis.