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1.
Parasit Vectors ; 17(1): 281, 2024 Jul 01.
Article in English | MEDLINE | ID: mdl-38951858

ABSTRACT

BACKGROUND: Abiotic factors play a significant role in the evolution of Leishmania infantum infection due to its vectorial nature. This study aims to assess the evolution in the detection of new L. infantum infection cases in Valdeorras (Ourense, Northwestern Spain) over a 20-year period and how different climatic variables and preventive measures may have affected it. METHODS: Indirect immunofluorescence antibody tests (IFAT) were performed on serum samples collected from dogs attending the 'Servicios Veterinarios de Sil' veterinary clinic (Valdeorras, Northwestern Spain) between May 2003 and April 2023 to detect L. infantum exposure. The percentage of new cases of L. infantum infection was calculated from May of one year to April of the following year. Climatic conditions in the region, global sales of ectoparasiticides and the number of vaccines against L. infantum delivered in the veterinary clinic from 2003 to 2022 were recorded. Statistical analyses were conducted to determine the associations between these factors and the percentage of new cases of L. infantum infection. RESULTS: A total of 2909 dogs were assessed, and 3785 IFAT tests were performed between May 2003 and April 2023. The mean percentage of new seropositive cases over the 20-year period studied was 21.65 ± 10.8%, with a decline from the beginning to the end of the period studied. The percentage was significantly higher between May 2003 and April 2008 compared with the other periods (May 2008 to April 2013, May 2013 to April 2018 and May 2018 to April 2023). There was a positive correlation between the percentage of new cases of L. infantum infection and the maximum relative humidity in winter. Conversely, there was a negative correlation between the percentage of new cases and sales of ectoparasiticides and vaccination against L. infantum. CONCLUSIONS: This study is one of the longest evaluations of the evolution of L. infantum infection in a fixed location and its association with external factors including climatic conditions and preventive measures. The results confirm that Valdeorras is a high-risk area for L. infantum infection. The use of ectoparasiticides and vaccines against L. infantum has been shown to play a significant role in preventing L. infantum infection, highlighting the crucial role of veterinarians in the fight against this disease.


Subject(s)
Climate , Dog Diseases , Leishmania infantum , Leishmaniasis, Visceral , Dogs , Animals , Spain/epidemiology , Dog Diseases/parasitology , Dog Diseases/epidemiology , Dog Diseases/prevention & control , Leishmania infantum/immunology , Leishmania infantum/isolation & purification , Leishmaniasis, Visceral/veterinary , Leishmaniasis, Visceral/epidemiology , Leishmaniasis, Visceral/prevention & control , Leishmaniasis, Visceral/parasitology , Antibodies, Protozoan/blood , Male , Fluorescent Antibody Technique, Indirect , Female
2.
Infect Dis Poverty ; 13(1): 53, 2024 Jul 08.
Article in English | MEDLINE | ID: mdl-38978124

ABSTRACT

BACKGROUND: Serological screening tests play a crucial role to diagnose gambiense human African trypanosomiasis (gHAT). Presently, they preselect individuals for microscopic confirmation, but in future "screen and treat" strategies they will identify individuals for treatment. Variability in reported specificities, the development of new rapid diagnostic tests (RDT) and the hypothesis that malaria infection may decrease RDT specificity led us to evaluate the specificity of 5 gHAT screening tests. METHODS: During active screening, venous blood samples from 1095 individuals from Côte d'Ivoire and Guinea were tested consecutively with commercial (CATT, HAT Sero-K-SeT, Abbott Bioline HAT 2.0) and prototype (DCN HAT RDT, HAT Sero-K-SeT 2.0) gHAT screening tests and with a malaria RDT. Individuals with ≥ 1 positive gHAT screening test underwent microscopy and further immunological (trypanolysis with T.b. gambiense LiTat 1.3, 1.5 and 1.6; indirect ELISA/T.b. gambiense; T.b. gambiense inhibition ELISA with T.b. gambiense LiTat 1.3 and 1.5 VSG) and molecular reference laboratory tests (PCR TBRN3, 18S and TgsGP; SHERLOCK 18S Tids, 7SL Zoon, and TgsGP; Trypanozoon S2-RT-qPCR 18S2, 177T, GPI-PLC and TgsGP in multiplex; RT-qPCR DT8, DT9 and TgsGP in multiplex). Microscopic trypanosome detection confirmed gHAT, while other individuals were considered gHAT free. Differences in fractions between groups were assessed by Chi square and differences in specificity between 2 tests on the same individuals by McNemar. RESULTS: One gHAT case was diagnosed. Overall test specificities (n = 1094) were: CATT 98.9% (95% CI: 98.1-99.4%); HAT Sero-K-SeT 86.7% (95% CI: 84.5-88.5%); Bioline HAT 2.0 82.1% (95% CI: 79.7-84.2%); DCN HAT RDT 78.2% (95% CI: 75.7-80.6%); and HAT Sero-K-SeT 2.0 78.4% (95% CI: 75.9-80.8%). In malaria positives, gHAT screening tests appeared less specific, but the difference was significant only in Guinea for Abbott Bioline HAT 2.0 (P = 0.03) and HAT Sero-K-Set 2.0 (P = 0.0006). The specificities of immunological and molecular laboratory tests in gHAT seropositives were 98.7-100% (n = 399) and 93.0-100% (n = 302), respectively. Among 44 reference laboratory test positives, only the confirmed gHAT patient and one screening test seropositive combined immunological and molecular reference laboratory test positivity. CONCLUSIONS: Although a minor effect of malaria cannot be excluded, gHAT RDT specificities are far below the 95% minimal specificity stipulated by the WHO target product profile for a simple diagnostic tool to identify individuals eligible for treatment. Unless specificity is improved, an RDT-based "screen and treat" strategy would result in massive overtreatment. In view of their inconsistent results, additional comparative evaluations of the diagnostic performance of reference laboratory tests are indicated for better identifying, among screening test positives, those at increased suspicion for gHAT. TRIAL REGISTRATION: The trial was retrospectively registered under NCT05466630 in clinicaltrials.gov on July 15 2022.


Subject(s)
Sensitivity and Specificity , Trypanosoma brucei gambiense , Trypanosomiasis, African , Humans , Trypanosomiasis, African/diagnosis , Trypanosomiasis, African/blood , Cote d'Ivoire , Trypanosoma brucei gambiense/immunology , Trypanosoma brucei gambiense/isolation & purification , Adult , Guinea , Prospective Studies , Male , Adolescent , Female , Young Adult , Middle Aged , Serologic Tests/methods , Child , Enzyme-Linked Immunosorbent Assay/methods , Aged , Child, Preschool , Antibodies, Protozoan/blood
3.
BMJ Open ; 14(6): e084582, 2024 Jul 01.
Article in English | MEDLINE | ID: mdl-38950992

ABSTRACT

BACKGROUND: Toxoplasmosis is a zoonotic parasitic disease caused by Toxoplasma gondii (T. gondii). It has a wide host range and is capable of vertical transmission in pregnant women, which may lead to undesirable pregnancy outcomes such as congenital malformations, miscarriage, premature birth and stillbirth. This study investigated the seroprevalence of T. gondii infection among pregnant women attending the antenatal clinic at Namwala District Hospital in Southern Zambia. METHODS: This was a cross-sectional study where blood was collected, and the serum was tested for Toxoplasma IgG and IgM. A questionnaire was administered to participants on demographic characteristics and risk factors. Data were entered in Microsoft Excel and exported to STATA version 14 for analysis. RESULTS: A total of 401 women were enrolled in the study from 3 March to 5 August 2021. The seroprevalence of Toxoplasma IgG was 4.2% (n=17), while the seroprevalence of Toxoplasma IgM was 0.7% (n=3). The median age was 27 (IQR: 24-30) years, and a larger proportion had primary-level education (n=223, 55.6%). The majority (81.6%) of the women were married. None of the risk factors investigated in this study were significant for T. gondii infection. CONCLUSION: There was a low seroprevalence of T. gondii infection among pregnant women in the Namwala district of Southern Province, Zambia, and regular screening may not be warranted in this population. Continued research on toxoplasmosis is recommended to understand its epidemiology across Zambia.


Subject(s)
Antibodies, Protozoan , Immunoglobulin M , Pregnancy Complications, Parasitic , Toxoplasma , Toxoplasmosis , Humans , Female , Zambia/epidemiology , Cross-Sectional Studies , Seroepidemiologic Studies , Adult , Pregnancy , Toxoplasmosis/epidemiology , Toxoplasmosis/blood , Risk Factors , Toxoplasma/immunology , Young Adult , Immunoglobulin M/blood , Antibodies, Protozoan/blood , Pregnancy Complications, Parasitic/epidemiology , Pregnancy Complications, Parasitic/blood , Immunoglobulin G/blood , Prenatal Care
4.
Rev Bras Parasitol Vet ; 33(2): e006024, 2024.
Article in English | MEDLINE | ID: mdl-38985053

ABSTRACT

Neospora caninum is a major cause of reproductive loss in cattle worldwide as it leads to abortion and animal repositioning. Although Toxoplasma gondii does not cause a reproductive problem in cattle, consuming raw or uncooked beef poses the risk of transmission. This study aimed to evaluate the occurrence of anti-N. caninum and anti-T. gondii antibodies in dairy cattle in the West and Northwest regions of São Paulo State, Brazil. A total of 653 serum samples from dairy cows were analyzed using an indirect immunofluorescence assay (IFA). Epidemiological data from the farms were associated with the serological results of the animals by logistic regression based on the presence of antibodies. The frequencies of the antibodies against N. caninum and T. gondii were 41.6% (272/653) and 11.5% (75/653), respectively. A statistically significant association was observed between: the serum anti-N. caninum antibodies and breed, history of food supplementation for calves, introduction of outside animals that later presented reproductive problems, and history of reproductive problems by the trimester of gestation. The present study highlights the importance of neosporosis in dairy cattle in the study regions and that the inclusion of this parasite in the investigation of animals with reproductive disorders is important.


Subject(s)
Antibodies, Protozoan , Cattle Diseases , Coccidiosis , Neospora , Toxoplasma , Toxoplasmosis, Animal , Animals , Cattle , Neospora/immunology , Brazil/epidemiology , Coccidiosis/veterinary , Coccidiosis/epidemiology , Cattle Diseases/epidemiology , Cattle Diseases/parasitology , Toxoplasmosis, Animal/epidemiology , Toxoplasmosis, Animal/diagnosis , Risk Factors , Seroepidemiologic Studies , Toxoplasma/immunology , Female , Antibodies, Protozoan/blood , Dairying , Fluorescent Antibody Technique, Indirect/veterinary
5.
Parasite ; 31: 38, 2024.
Article in English | MEDLINE | ID: mdl-38995111

ABSTRACT

In total, 901 dairy cow sera and data were collected from 51 farms in Nakhon Pathom, Ratchaburi and Kanchanaburi provinces (Western Region of Thailand). Serum samples were processed via the multispecies ELISA method to detect IgG antibodies against Toxoplasma gondii infection. The results demonstrated that the calculated true prevalence was 1.48% (95% CI, 0.64-2.75%) for the individual-level and 29.41% (95% CI, 18.71-43%) for the farm-level. The univariate risk factor analysis showed that the number of total owned cats, the presence of stray cats, and the frequency of cleaning per day were significant factors (p < 0.2). These three factors were subjected to logistic regression analysis, and the results revealed that the frequency of cleaning farms per day was a potential risk factor for T. gondii-seropositive farms (OR = 2.745, 95% CI, 1.15-8.69, p = 0.02). The frequency of cleaning might increase the T. gondii oocyst distribution within the barn area, thus increasing the possibility of infection. Our findings show that T. gondii continues to circulate in the dairy cow population in the western part of Thailand. The presence of cats on farms was not found to be associated with T. gondii infection, but the high frequency of cleaning the floor was, and contributed to the potential risk of infection.


Title: Prévalence et facteurs de risque de l'infection à Toxoplasma gondii chez les bovins laitiers de la région occidentale de la Thaïlande. Abstract: Au total, 901 sérums de vaches laitières et des données ont été collectés dans 51 fermes des provinces de Nakhon Pathom, Ratchaburi et Kanchanaburi (région occidentale de la Thaïlande). Les échantillons de sérum ont été traités via la méthode ELISA multi-espèces pour détecter les anticorps IgG contre l'infection à Toxoplasma gondii. Les résultats ont démontré que la prévalence réelle calculée était de 1,48 % (IC à 95 %, 0,64­2,75 %) au niveau individuel et de 29,41 % (IC à 95 %, 18,71­43 %) au niveau des exploitations. L'analyse factorielle a montré que le nombre total de chats possédés, la présence de chats errants et la fréquence quotidienne de nettoyage étaient des facteurs significatifs (p < 0,2). Ces trois facteurs ont été soumis à une analyse de régression logistique et les résultats ont révélé que la fréquence quotidienne de nettoyage des exploitations était un facteur de risque potentiel pour les exploitations séropositives à T. gondii (OR = 2,745, IC à 95 % = 1,15­8,69, p = 0,02). La fréquence du nettoyage pourrait favoriser la répartition des oocystes de T. gondii dans les étables, augmentant ainsi le risque d'infection. Nos résultats indiquent que T. gondii continue de circuler dans la population de vaches laitières de l'ouest de la Thaïlande. La présence de chats dans les fermes n'a pas été associée à l'infection à T. gondii, mais la fréquence élevée du nettoyage du sol l'était et contribuait au risque potentiel d'infection.


Subject(s)
Antibodies, Protozoan , Cattle Diseases , Enzyme-Linked Immunosorbent Assay , Immunoglobulin G , Toxoplasma , Toxoplasmosis, Animal , Animals , Cattle , Thailand/epidemiology , Toxoplasmosis, Animal/epidemiology , Risk Factors , Cattle Diseases/epidemiology , Cattle Diseases/parasitology , Toxoplasma/immunology , Antibodies, Protozoan/blood , Female , Cats , Seroepidemiologic Studies , Immunoglobulin G/blood , Enzyme-Linked Immunosorbent Assay/veterinary , Dairying , Prevalence , Cat Diseases/epidemiology , Cat Diseases/parasitology , Logistic Models
6.
PLoS Negl Trop Dis ; 18(7): e0012294, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38950072

ABSTRACT

The scarcity of reliable devices for diagnosis of Animal African trypanosomiasis (AAT) presents a limitation to control of the disease. Existing high-sensitivity technologies such as PCR are costly, laborious, time-consuming, complex, and require skilled personnel. Hence, utilisation of most diagnostics for AAT is impracticable in rural areas, where the disease occurs. A more accessible point-of-care test (POCT) capable of detecting cryptic active infection, without relying on expensive equipment, would facilitate AAT detection. In turn, early management, would reduce disease incidence and severity. Today, several ongoing research projects aim at modifying complex immunoassays into POCTs. In this context, we report the development of an antigen (Ag) detection sandwich ELISA prototype for diagnosis of T. congolense infections, which is comprised of nanobody (Nb) and monoclonal antibody (mAb) reagents. The Nb474H used here, originated from a past study. Briefly, the Nb was engineered starting from mRNA of peripheral blood lymphocytes of an alpaca immunized with soluble lysate of Trypanosoma congolense (TC13). T. congolense glycosomal fructose-1,6-bisphosphate aldolase (TcoALD) was discovered as the cognate Ag of Nb474H. In this study, splenocytes were harvested from a mouse immunized with recombinant TcoALD and fused with NS01 cells to generate a hybridoma library. Random screening of the library on TcoALD retrieved a lone binder, designated IgM8A2. Using Nb474H as Ag-capture reagent in combination with the IgM8A2 monoclonal antibody Ag-detection reagent resulted in a tool that effectively detects native TcoALD released during infection by T. congolense parasites. Hitherto, development of POCT for detection of active trypanosome infection is elusive. The Nanobody/Monoclonal Antibody (Nb/mAb) "hybrid" sandwich technology offers prospects for exploration, using the unique specificity of Nb as a key determinant in Ag capturing, while using the versatility of monoclonal Ab to adapt to various detection conditions.


Subject(s)
Antibodies, Monoclonal , Antibodies, Protozoan , Enzyme-Linked Immunosorbent Assay , Trypanosoma congolense , Trypanosomiasis, African , Trypanosomiasis, African/diagnosis , Trypanosomiasis, African/immunology , Animals , Trypanosoma congolense/immunology , Antibodies, Monoclonal/immunology , Antibodies, Protozoan/blood , Antibodies, Protozoan/immunology , Enzyme-Linked Immunosorbent Assay/methods , Mice , Single-Domain Antibodies/immunology , Antigens, Protozoan/immunology , Sensitivity and Specificity
7.
PeerJ ; 12: e17632, 2024.
Article in English | MEDLINE | ID: mdl-38948214

ABSTRACT

Background: The integration of diagnostic methods holds promise for advancing the surveillance of malaria transmission in both endemic and non-endemic regions. Serological assays emerge as valuable tools to identify and delimit malaria transmission, serving as a complementary method to rapid diagnostic tests (RDT) and thick smear microscopy. Here, we evaluate the potential of antibodies directed against peptides encompassing the entire amino acid sequence of the PvMSP-1 Sal-I strain as viable serological biomarkers for P. vivax exposure. Methods: We screened peptides encompassing the complete amino acid sequence of the Plasmodium vivax Merozoite Surface Protein 1 (PvMSP-1) Sal-I strain as potential biomarkers for P. vivax exposure. Here, immunodominant peptides specifically recognized by antibodies from individuals infected with P. vivax were identified using the SPOT-synthesis technique followed by immunoblotting. Two 15-mer peptides were selected based on their higher and specific reactivity in immunoblotting assays. Subsequently, peptides p70 and p314 were synthesized in soluble form using SPPS (Solid Phase Peptide Synthesis) and tested by ELISA (IgG, and subclasses). Results: This study unveils the presence of IgG antibodies against the peptide p314 in most P. vivax-infected individuals from the Brazilian Amazon region. In silico B-cell epitope prediction further supports the utilization of p314 as a potential biomarker for evaluating malaria transmission, strengthened by its amino acid sequence being part of a conserved block of PvMSP-1. Indeed, compared to patients infected with P. falciparum and uninfected individuals never exposed to malaria, P. vivax-infected patients have a notably higher recognition of p314 by IgG1 and IgG3.


Subject(s)
Antibodies, Protozoan , Biomarkers , Malaria, Vivax , Merozoite Surface Protein 1 , Plasmodium vivax , Humans , Malaria, Vivax/immunology , Malaria, Vivax/blood , Malaria, Vivax/parasitology , Malaria, Vivax/transmission , Malaria, Vivax/diagnosis , Merozoite Surface Protein 1/immunology , Plasmodium vivax/immunology , Biomarkers/blood , Antibodies, Protozoan/immunology , Antibodies, Protozoan/blood , Immunoglobulin G/immunology , Immunoglobulin G/blood , Adult , Female , Male , Middle Aged , Peptides/immunology , Enzyme-Linked Immunosorbent Assay/methods , Young Adult , Adolescent , Amino Acid Sequence
8.
Parasit Vectors ; 17(1): 305, 2024 Jul 15.
Article in English | MEDLINE | ID: mdl-39010122

ABSTRACT

BACKGROUND: Chagas disease (CD), a neglected parasitic disease caused by Trypanosoma cruzi, poses a significant health threat in Latin America and has emerged globally because of human migration. Trypanosoma cruzi infects humans and over 100 other mammalian species, including dogs, which are important sentinels for assessing the risk of human infection. Nonetheless, the serodiagnosis of T. cruzi in dogs is still impaired by the absence of commercial tests. In this study, we investigated the diagnostic accuracy of four chimeric recombinant T. cruzi IBMP antigens (IBMP-8.1, IBMP-8.2, IBMP-8.3, and IBMP-8.4) for detecting anti-T. cruzi antibodies in dogs, using latent class analysis (LCA). METHODS: We examined 663 canine serum samples, employing indirect ELISA with the chimeric antigens. LCA was utilized to establish a latent variable as a gold standard for T. cruzi infection, revealing distinct response patterns for each antigen. RESULTS: The IBMP (Portuguese acronym for the Molecular Biology Institute of Paraná) antigens achieved area under the ROC curve (AUC) values ranging from 90.9% to 97.3%. The highest sensitivity was attributed to IBMP-8.2 (89.8%), while IBMP-8.1, IBMP-8.3, and IBMP-8.4 achieved 73.5%, 79.6%, and 85.7%, respectively. The highest specificity was observed for IBMP-8.4 (98.6%), followed by IBMP-8.2, IBMP-8.3, and IBMP-8.1 with specificities of 98.3%, 94.4%, and 92.7%, respectively. Predictive values varied according to prevalence, indicating higher effectiveness in endemic settings. CONCLUSIONS: Our findings underscore the remarkable diagnostic performance of IBMP-8.2 and IBMP-8.4 for the serodiagnosis of Trypanosoma cruzi in dogs, representing a promising tool for the diagnosis of CD in dogs. These chimeric recombinant antigens may not only enhance CD surveillance strategies but also hold broader implications for public health, contributing to the global fight against this neglected tropical disease.


Subject(s)
Antibodies, Protozoan , Antigens, Protozoan , Chagas Disease , Dog Diseases , Enzyme-Linked Immunosorbent Assay , Sensitivity and Specificity , Serologic Tests , Trypanosoma cruzi , Animals , Dogs , Chagas Disease/diagnosis , Chagas Disease/veterinary , Chagas Disease/parasitology , Trypanosoma cruzi/immunology , Trypanosoma cruzi/genetics , Dog Diseases/diagnosis , Dog Diseases/parasitology , Antigens, Protozoan/immunology , Antigens, Protozoan/genetics , Serologic Tests/methods , Serologic Tests/veterinary , Enzyme-Linked Immunosorbent Assay/methods , Enzyme-Linked Immunosorbent Assay/veterinary , Antibodies, Protozoan/blood , Recombinant Proteins/immunology , Recombinant Proteins/genetics
9.
PLoS One ; 19(6): e0304268, 2024.
Article in English | MEDLINE | ID: mdl-38838004

ABSTRACT

American tegumentary leishmaniasis (ATL) diagnosis is an open question, and the search for a solution is urgent. The available tests that detect the etiological agent of the infection are specific for ATL diagnosis. However, they present disadvantages, such as low sensitivity and the need for invasive procedures to obtain the samples. Immunological methods (leishmanin skin test and search for anti-Leishmania antibodies) are good alternatives to the etiological diagnosis of ATL. Presently, we face problems with disease confirmation due to the discontinuity in the production of leishmanin skin test antigen, particularly in resource-poor settings. Aiming to diagnose ATL, we validated rLb6H-ELISA for IgG antibodies using 1,091 samples from leishmaniasis patients and healthy controls, divided into four panels, living in 19 Brazilian endemic and non-endemic states. The rLb6H-ELISA showed a sensitivity of 98.6% and a specificity of 100.0%, with the reference panel comprising 70 ATL patient samples and 70 healthy controls. The reproducibility evaluation showed a coefficient of variation of positive samples ≤ 8.20% for repeatability, ≤ 17,97% for reproducibility, and ≤ 8.12% for homogeneity. The plates sensitized with rLb6H were stable at 4°C and -20°C for 180 days and 37°C for seven days, indicating 12 months of validity. In samples of ATL patients from five research and healthcare centers in endemic and non-endemic areas, rLb6H-ELISA showed a sensitivity of 84.0%; no significant statistical difference was observed among the five centers (chi-square test, p = 0.13). In samples of healthy controls from four areas with different endemicity, a specificity of 92.4% was obtained; lower specificity was obtained in a visceral leishmaniasis high endemicity locality (chi-square test, p<0.001). Cross-reactivity was assessed in 166 other disease samples with a positivity of 13.9%. Based on the good diagnostic performance and the reproducibility and stability of the antigen, we suggest using ELISA-rLb6H to diagnose ATL.


Subject(s)
Antigens, Protozoan , Enzyme-Linked Immunosorbent Assay , Leishmaniasis, Cutaneous , Humans , Leishmaniasis, Cutaneous/diagnosis , Leishmaniasis, Cutaneous/immunology , Leishmaniasis, Cutaneous/parasitology , Leishmaniasis, Cutaneous/epidemiology , Enzyme-Linked Immunosorbent Assay/methods , Antigens, Protozoan/immunology , Female , Male , Adult , Middle Aged , Sensitivity and Specificity , Adolescent , Reproducibility of Results , Recombinant Proteins/immunology , Young Adult , Immunoglobulin G/blood , Immunoglobulin G/immunology , Antibodies, Protozoan/blood , Antibodies, Protozoan/immunology , Aged , Child , Case-Control Studies , Brazil/epidemiology
10.
Infect Dis Obstet Gynecol ; 2024: 8844325, 2024.
Article in English | MEDLINE | ID: mdl-38883209

ABSTRACT

Introduction: Transplacental infections are frequent, especially in developing countries, where limited screening is performed to find infectious agents in the pregnant population. We aim to determine the clinical and epidemiological characteristics and seroinfection of antibodies against Toxoplasma, parvovirus B19, T. pallidum, and HIV in pregnant women who attended the Motupe Health Center in Lambayeque, Peru during July-August 2018. Methods: A descriptive cross-sectional study was conducted in 179 pregnant women interviewed with a standardized questionnaire. ELISA was used to determine antibodies to Toxoplasma and parvovirus B19. The detection of syphilis and HIV was conducted using immunochromatography, while the detection of hepatitis B was conducted using FTA-ABS and immunofluorescence, respectively. Results: Of 179 pregnant women, syphilis and HIV infections routinely included in the screening of pregnant women presented a seroinfection of 2.2 and 0.6%, respectively. Toxoplasmosis seroinfection was 25.1%, while IgM antiparvovirus B19 was 40.8%, revealing that pregnant women had an active infection at the time of study. Conclusion: The level of seroinfection of toxoplasmosis reveals the risk to which pregnant women who participated in the study are exposed. The high seroinfection of parvovirus B19 could explain the cases of spontaneous abortion and levels of anemia in newborn that have been reported in Motupe, Lambayeque, Peru. However, future causality studies are necessary to determine the significance of these findings.


Subject(s)
HIV Infections , Parvovirus B19, Human , Pregnancy Complications, Infectious , Syphilis , Toxoplasma , Toxoplasmosis , Treponema pallidum , Humans , Female , Pregnancy , Peru/epidemiology , Treponema pallidum/immunology , Adult , Cross-Sectional Studies , Syphilis/epidemiology , Pregnancy Complications, Infectious/epidemiology , Pregnancy Complications, Infectious/virology , Toxoplasmosis/epidemiology , Toxoplasmosis/immunology , HIV Infections/epidemiology , Toxoplasma/immunology , Young Adult , Parvovirus B19, Human/immunology , Antibodies, Protozoan/blood , Antibodies, Viral/blood , Adolescent , Seroepidemiologic Studies
11.
Vet Parasitol Reg Stud Reports ; 52: 101054, 2024 Jul.
Article in English | MEDLINE | ID: mdl-38880562

ABSTRACT

Canine visceral leishmaniasis (CVL) has long been considered an endemic disease in the northern and northeastern regions of Brazil, while the southern region remains non-endemic. However, in recent years, several cases of CVL have been reported in southern states. The objective of this work was to determine the seroprevalence of CVL in dogs in the state of Santa Catarina, Brazil, through immunochromatographic tests (DPP®) and ELISA (Enzyme-Linked Immunosorbent Assay) and its correlation with environmental characteristics through georeferencing. Blood samples from dogs (n = 1227) were collected in six mesoregions of the state and evaluated by the rapid test (DPP®). Positive samples were sent to Lacen (Central Public Health Laboratory) in Santa Catarina to be tested using ELISA. Information obtained from the epidemiological questionnaire was subjected to statistical analysis (Chi-square and Student's t-test; P < 0.05) to verify the correlation between serology and the analyzed variables. The locations (GPS) of the samples were used for georeferencing and creating heatmaps (Kernel Method). Four animals that died from CVL were necropsied and organ samples were collected for molecular analysis (PCR), immunohistochemistry, and histopathology (HE). Of the 1227 dogs analyzed, 22 (1.8%) were reactive in the DPP® and of these, 7 (0.6%) were also positive in the ELISA. A correlation (P < 0.01) was observed between positive serology and region, environment, access to the street, and clinical signs. The positive cases were concentrated in the eastern region of the state, in low-altitude areas with average rainfall and higher average temperatures, and in more populated areas close to forest fragments. PCR, HE, and immunohistochemistry, along with serology, have proven to be efficient for characterizing positive cases.


Subject(s)
Dog Diseases , Enzyme-Linked Immunosorbent Assay , Leishmaniasis, Visceral , Dogs , Animals , Brazil/epidemiology , Leishmaniasis, Visceral/veterinary , Leishmaniasis, Visceral/epidemiology , Dog Diseases/epidemiology , Dog Diseases/parasitology , Seroepidemiologic Studies , Enzyme-Linked Immunosorbent Assay/veterinary , Male , Female , Antibodies, Protozoan/blood , Chromatography, Affinity/veterinary , Geographic Information Systems
12.
PLoS Comput Biol ; 20(6): e1012131, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38848436

ABSTRACT

Immunization through repeated direct venous inoculation of Plasmodium falciparum (Pf) sporozoites (PfSPZ) under chloroquine chemoprophylaxis, using the PfSPZ Chemoprophylaxis Vaccine (PfSPZ-CVac), induces high-level protection against controlled human malaria infection (CHMI). Humoral and cellular immunity contribute to vaccine efficacy but only limited information about the implicated Pf-specific antigens is available. Here, we examined Pf-specific antibody profiles, measured by protein arrays representing the full Pf proteome, of 40 placebo- and PfSPZ-immunized malaria-naïve volunteers from an earlier published PfSPZ-CVac dose-escalation trial. For this purpose, we both utilized and adapted supervised machine learning methods to identify predictive antibody profiles at two different time points: after immunization and before CHMI. We developed an adapted multitask support vector machine (SVM) approach and compared it to standard methods, i.e. single-task SVM, regularized logistic regression and random forests. Our results show, that the multitask SVM approach improved the classification performance to discriminate the protection status based on the underlying antibody-profiles while combining time- and dose-dependent data in the prediction model. Additionally, we developed the new fEature diStance exPlainabilitY (ESPY) method to quantify the impact of single antigens on the non-linear multitask SVM model and make it more interpretable. In conclusion, our multitask SVM model outperforms the studied standard approaches in regard of classification performance. Moreover, with our new explanation method ESPY, we were able to interpret the impact of Pf-specific antigen antibody responses that predict sterile protective immunity against CHMI after immunization. The identified Pf-specific antigens may contribute to a better understanding of immunity against human malaria and may foster vaccine development.


Subject(s)
Antibodies, Protozoan , Machine Learning , Malaria Vaccines , Malaria, Falciparum , Plasmodium falciparum , Malaria Vaccines/immunology , Humans , Plasmodium falciparum/immunology , Malaria, Falciparum/prevention & control , Malaria, Falciparum/immunology , Malaria, Falciparum/parasitology , Antibodies, Protozoan/immunology , Antibodies, Protozoan/blood , Vaccine Efficacy , Support Vector Machine , Computational Biology/methods
13.
Nat Commun ; 15(1): 5194, 2024 Jun 18.
Article in English | MEDLINE | ID: mdl-38890271

ABSTRACT

Resistance to clinical malaria takes years to develop even in hyperendemic regions and sterilizing immunity has rarely been observed. To evaluate the maturation of the host response against controlled repeat exposures to P. falciparum (Pf) NF54 strain-infected mosquitoes, we systematically monitored malaria-naïve participants through an initial exposure to uninfected mosquitoes and 4 subsequent homologous exposures to Pf-infected mosquitoes over 21 months (n = 8 males) (ClinicalTrials.gov# NCT03014258). The primary outcome was to determine whether protective immunity against parasite infection develops following repeat CHMI and the secondary outcomes were to track the clinical signs and symptoms of malaria and anti-Pf antibody development following repeat CHMI. After two exposures, time to blood stage patency increases significantly and the number of reported symptoms decreases indicating the development of clinical tolerance. The time to patency correlates positively with both anti-Pf circumsporozoite protein (CSP) IgG and CD8 + CD69+ effector memory T cell levels consistent with partial pre-erythrocytic immunity. IFNγ levels decrease significantly during the participants' second exposure to high blood stage parasitemia and could contribute to the decrease in symptoms. In contrast, CD4-CD8 + T cells expressing CXCR5 and the inhibitory receptor, PD-1, increase significantly after subsequent Pf exposures, possibly dampening the memory response and interfering with the generation of robust sterilizing immunity.


Subject(s)
Malaria, Falciparum , Plasmodium falciparum , Protozoan Proteins , Humans , Malaria, Falciparum/immunology , Malaria, Falciparum/parasitology , Malaria, Falciparum/blood , Plasmodium falciparum/immunology , Male , Protozoan Proteins/immunology , Animals , Adult , Antibodies, Protozoan/immunology , Antibodies, Protozoan/blood , Interferon-gamma/metabolism , Interferon-gamma/immunology , Female , Immunoglobulin G/blood , Immunoglobulin G/immunology , Young Adult , CD8-Positive T-Lymphocytes/immunology , Mosquito Vectors/parasitology , Mosquito Vectors/immunology , Anopheles/parasitology
14.
Infect Immun ; 92(7): e0001524, 2024 Jul 11.
Article in English | MEDLINE | ID: mdl-38842304

ABSTRACT

Strain-transcending antibodies against virulence-associated subsets of P. falciparum-infected erythrocyte surface antigens could protect children from severe malaria. However, the evidence supporting the existence of such antibodies is incomplete and inconsistent. One subset of surface antigens associated with severe malaria, rosette-mediating Plasmodium falciparum Erythrocyte Membrane Protein one (PfEMP1) variants, cause infected erythrocytes to bind to uninfected erythrocytes to form clusters of cells (rosettes) that contribute to microvascular obstruction and pathology. Here, we tested plasma from 80 individuals living in malaria-endemic regions for IgG recognition of the surface of four P. falciparum rosetting strains using flow cytometry. Broadly reactive plasma samples were then used in antibody elution experiments in which intact IgG was eluted from the surface of infected erythrocytes and transferred to heterologous rosetting strains to look for strain-transcending antibodies. We found that seroprevalence (percentage of positive plasma samples) against allopatric rosetting strains was high in adults (63%-93%) but lower in children (13%-48%). Strain-transcending antibodies were present in nine out of eleven eluted antibody experiments, with six of these recognizing multiple heterologous rosetting parasite strains. One eluate had rosette-disrupting activity against heterologous strains, suggesting PfEMP1 as the likely target of the strain-transcending antibodies. Naturally acquired strain-transcending antibodies to rosetting P. falciparum strains in humans have not been directly demonstrated previously. Their existence suggests that such antibodies could play a role in clinical protection and raises the possibility that conserved epitopes recognized by strain-transcending antibodies could be targeted therapeutically by monoclonal antibodies or vaccines.


Subject(s)
Antibodies, Protozoan , Immunoglobulin G , Malaria, Falciparum , Plasmodium falciparum , Humans , Plasmodium falciparum/immunology , Antibodies, Protozoan/immunology , Antibodies, Protozoan/blood , Malaria, Falciparum/immunology , Malaria, Falciparum/parasitology , Child , Adult , Immunoglobulin G/immunology , Immunoglobulin G/blood , Child, Preschool , Adolescent , Protozoan Proteins/immunology , Erythrocytes/parasitology , Erythrocytes/immunology , Antigens, Protozoan/immunology , Female , Male , Young Adult , Middle Aged , Seroepidemiologic Studies , Rosette Formation , Flow Cytometry
15.
Infect Immun ; 92(7): e0021524, 2024 Jul 11.
Article in English | MEDLINE | ID: mdl-38884473

ABSTRACT

Human babesiosis is a malaria-like illness caused by protozoan parasites of the genus Babesia. Babesia microti is responsible for most cases of human babesiosis in the United States, particularly in the Northeast and the Upper Midwest. Babesia microti is primarily transmitted to humans through the bite of infected deer ticks but also through the transfusion of blood components, particularly red blood cells. There is a high risk of severe and even fatal disease in immunocompromised patients. To date, serology testing relies on an indirect immunofluorescence assay that uses the whole Babesia microti antigen. Here, we report the construction of phage display cDNA libraries from Babesia microti-infected erythrocytes as well as human reticulocytes obtained from donors with hereditary hemochromatosis. Plasma samples were obtained from patients who were or had been infected with Babesia microti. The non-specific antibody reactivity of these plasma samples was minimized by pre-exposure to the human reticulocyte library. Using this novel experimental strategy, immunoreactive segments were identified in three Babesia microti antigens termed BmSA1 (also called BMN1-9; BmGPI12), BMN1-20 (BMN1-17; Bm32), and BM4.12 (N1-15). Moreover, our findings indicate that the major immunoreactive segment of BmSA1 does not overlap with the segment that mediates BmSA1 binding to mature erythrocytes. When used in combination, the three immunoreactive segments form the basis of a sensitive and comprehensive diagnostic immunoassay for human babesiosis, with implications for vaccine development.


Subject(s)
Antigens, Protozoan , Babesia microti , Babesiosis , Gene Library , Babesia microti/immunology , Babesia microti/genetics , Humans , Antigens, Protozoan/immunology , Antigens, Protozoan/genetics , Babesiosis/immunology , Babesiosis/parasitology , Antibodies, Protozoan/immunology , Antibodies, Protozoan/blood , Erythrocytes/parasitology , Erythrocytes/immunology , Cell Surface Display Techniques , Animals
16.
Parasit Vectors ; 17(1): 277, 2024 Jun 28.
Article in English | MEDLINE | ID: mdl-38943202

ABSTRACT

BACKGROUND: Chicken coccidiosis is a protozoan disease that leads to considerable economic losses in the poultry industry. Live oocyst vaccination is currently the most effective measure for the prevention of coccidiosis. However, it provides limited protection with several drawbacks, such as poor immunological protection and potential reversion to virulence. Therefore, the development of effective and safe vaccines against chicken coccidiosis is still urgently needed. METHODS: In this study, a novel oral vaccine against Eimeria tenella was developed by constructing a recombinant Lactobacillus plantarum (NC8) strain expressing the E. tenella RON2 protein. We administered recombinant L. plantarum orally at 3, 4 and 5 days of age and again at 17, 18 and 19 days of age. Meanwhile, each chick in the commercial vaccine group was immunized with 3 × 102 live oocysts of coccidia. A total of 5 × 104 sporulated oocysts of E. tenella were inoculated in each chicken at 30 days. Then, the immunoprotection effect was evaluated after E. tenella infection. RESULTS: The results showed that the proportion of CD4+ and CD8+ T cells, the proliferative ability of spleen lymphocytes, inflammatory cytokine levels and specific antibody titers of chicks immunized with recombinant L. plantarum were significantly increased (P < 0.05). The relative body weight gains were increased and the number of oocysts per gram (OPG) was decreased after E. tenella challenge. Moreover, the lesion scores and histopathological cecum sections showed that recombinant L. plantarum can significantly relieve pathological damage in the cecum. The ACI was 170.89 in the recombinant L. plantarum group, which was higher than the 150.14 in the commercial vaccine group. CONCLUSIONS: These above results indicate that L. plantarum expressing RON2 improved humoral and cellular immunity and enhanced immunoprotection against E. tenella. The protective efficacy was superior to that of vaccination with the commercial live oocyst vaccine. This study suggests that recombinant L. plantarum expressing the RON2 protein provides a promising strategy for vaccine development against coccidiosis.


Subject(s)
Chickens , Coccidiosis , Eimeria tenella , Lactobacillus plantarum , Poultry Diseases , Protozoan Proteins , Protozoan Vaccines , Vaccination , Animals , Eimeria tenella/immunology , Eimeria tenella/genetics , Coccidiosis/prevention & control , Coccidiosis/veterinary , Coccidiosis/immunology , Poultry Diseases/prevention & control , Poultry Diseases/parasitology , Protozoan Vaccines/immunology , Protozoan Vaccines/genetics , Protozoan Vaccines/administration & dosage , Lactobacillus plantarum/genetics , Lactobacillus plantarum/immunology , Administration, Oral , Protozoan Proteins/immunology , Protozoan Proteins/genetics , Vaccination/veterinary , Antibodies, Protozoan/blood , Vaccines, Synthetic/immunology , Vaccines, Synthetic/administration & dosage , Vaccines, Synthetic/genetics
17.
J Vector Borne Dis ; 61(2): 203-210, 2024 Apr 01.
Article in English | MEDLINE | ID: mdl-38922654

ABSTRACT

BACKGROUND OBJECTIVES: Plasmodium knowlesi, a simian malaria species, is now known to infect humans. Due to disadvantages in the current diagnosis methods, many efforts have been placed into developing new methods to diagnose the disease. This study assessed the ability of the PkRAP-1 sandwich enzyme-linked immunosorbent (ELISA) to detect P knowlesi antigens in whole blood specimens. METHODS: Western blot assay was conducted to evaluate the ability of raised mouse and rabbit anti-PkRAP-1 polyclonal antibodies to bind to the native proteins in P. knowlesi lysate. The polyclonal antibodies were then used in sandwich ELISA to detect P. knowlesi. In the sandwich ELISA, mouse and rabbit polyclonal antibodies were used as the capture and detection antibodies, respectively. The limit of detection (LOD) of the assay was determined using P. knowlesi A1H1 culture and purified recombinant PkRAP-1. RESULTS: Western blot results showed positive reactions towards the proteins in P. knowlesi lysate. The LOD of the assay from three technical replicates was 0.068% parasitaemia. The assay performance in detecting P. knowlesi was 83% sensitivity and 70% specificity with positive and negative predictive values of 74% and 80%, respectively. The anti-PkRAP-1 polyclonal antibodies did not cross-react with P. falciparum and healthy samples, but P. vivax by detecting all 12 samples. INTERPRETATION CONCLUSION: PkRAP-1 has the potential as a biomarker for the development of a new diagnostic tool for P. knowlesi detection. Further studies need to be conducted to establish the full potential of the usage of anti-PkRAP-1 antibodies for P. knowlesi detection.


Subject(s)
Antibodies, Protozoan , Antigens, Protozoan , Enzyme-Linked Immunosorbent Assay , Malaria , Plasmodium knowlesi , Protozoan Proteins , Sensitivity and Specificity , Plasmodium knowlesi/immunology , Enzyme-Linked Immunosorbent Assay/methods , Animals , Malaria/diagnosis , Malaria/blood , Antibodies, Protozoan/blood , Rabbits , Mice , Protozoan Proteins/immunology , Humans , Antigens, Protozoan/immunology , Antigens, Protozoan/blood , Blotting, Western/methods , Limit of Detection
18.
Parasites Hosts Dis ; 62(2): 193-204, 2024 May.
Article in English | MEDLINE | ID: mdl-38835260

ABSTRACT

Malaria is a global disease affecting a large portion of the world's population. Although vaccines have recently become available, their efficacies are suboptimal. We generated virus-like particles (VLPs) that expressed either apical membrane antigen 1 (AMA1) or microneme-associated antigen (MIC) of Plasmodium berghei and compared their efficacy in BALB/c mice. We found that immune sera acquired from AMA1 VLP- or MIC VLP-immunized mice specifically interacted with the antigen of choice and the whole P. berghei lysate antigen, indicating that the antibodies were highly parasite-specific. Both VLP vaccines significantly enhanced germinal center B cell frequencies in the inguinal lymph nodes of mice compared with the control, but only the mice that received MIC VLPs showed significantly enhanced CD4+ T cell responses in the blood following P. berghei challenge infection. AMA1 and MIC VLPs significantly suppressed TNF-α and interleukin-10 production but had a negligible effect on interferon-γ. Both VLPs prevented excessive parasitemia buildup in immunized mice, although parasite burden reduction induced by MIC VLPs was slightly more effective than that induced by AMA1. Both VLPs were equally effective at preventing body weight loss. Our findings demonstrated that the MIC VLP was an effective inducer of protection against murine experimental malaria and should be the focus of further development.


Subject(s)
Antigens, Protozoan , Malaria Vaccines , Membrane Proteins , Plasmodium berghei , Protozoan Proteins , Vaccines, Virus-Like Particle , Animals , Female , Mice , Antibodies, Protozoan/immunology , Antibodies, Protozoan/blood , Antigens, Protozoan/immunology , B-Lymphocytes/immunology , B-Lymphocytes/metabolism , CD4-Positive T-Lymphocytes/immunology , Malaria/prevention & control , Malaria/immunology , Malaria Vaccines/immunology , Malaria Vaccines/administration & dosage , Membrane Proteins/immunology , Mice, Inbred BALB C , Parasitemia/immunology , Parasitemia/prevention & control , Plasmodium berghei/immunology , Protozoan Proteins/immunology , Protozoan Proteins/genetics , Vaccines, Virus-Like Particle/immunology , Vaccines, Virus-Like Particle/administration & dosage
19.
PLoS Negl Trop Dis ; 18(6): e0012020, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38924064

ABSTRACT

Bovine trypanosomosis, caused by Trypanosoma vivax, currently affects cattle and has a significant economic impact in sub-Saharan Africa and South America. The development of new diagnostic antigens is essential to improve and refine existing methods. Our study evaluated the efficacy of two recombinant antigens in detecting specific antibodies in cattle. These antigens are derivatives of an invariant surface glycoprotein (ISG) from T. vivax. A fraction of a previously described antigen (TvY486_0045500), designated TvISGAf, from an African strain was evaluated, and a new ISG antigen from an American isolate, TvISGAm, was identified. The two antigens were expressed as fusion proteins in Escherichia coli: TvISGAf was fused to the MBP-His-tag, and TvISGAm was obtained as a His-tag fused protein. An ELISA evaluation was conducted using these antigens on 149 positive and 63 negative bovine samples. The diagnostic performance was enhanced by the use of a combination of both antigens (referred to as TvISG-based ELISA), achieving a sensitivity of 89.6% and specificity of 93.8%. Following the validation of the TvISG-based ELISA, the seroprevalence of T. vivax infection in 892 field samples from cattle in the central region of Argentina was determined. The mean seroprevalence of T. vivax was 53%, with variation ranging from 21% to 69% among the six departments studied. These results support the use of the TvISG ELISA as a valuable serological tool for the detection and monitoring of T. vivax infection in cattle. Furthermore, we report for the first time the seroprevalence of T. vivax in Argentina, which highlights the widespread endemic nature of the disease in the region. In order to effectively manage the increasing spread of T. vivax in the vast livestock production areas of South America, it is essential to implement consistent surveillance programs and to adopt preventive strategies.


Subject(s)
Antigens, Protozoan , Cattle Diseases , Enzyme-Linked Immunosorbent Assay , Serologic Tests , Trypanosoma vivax , Animals , Cattle , Argentina/epidemiology , Trypanosoma vivax/immunology , Trypanosoma vivax/genetics , Trypanosoma vivax/isolation & purification , Serologic Tests/methods , Serologic Tests/veterinary , Cattle Diseases/diagnosis , Cattle Diseases/epidemiology , Cattle Diseases/parasitology , Antigens, Protozoan/immunology , Antigens, Protozoan/genetics , Enzyme-Linked Immunosorbent Assay/methods , Enzyme-Linked Immunosorbent Assay/veterinary , Antibodies, Protozoan/blood , Sensitivity and Specificity , Trypanosomiasis, African/diagnosis , Trypanosomiasis, African/veterinary , Trypanosomiasis, African/epidemiology , Livestock/parasitology
20.
J Affect Disord ; 361: 82-90, 2024 Sep 15.
Article in English | MEDLINE | ID: mdl-38844171

ABSTRACT

BACKGROUND AND AIM: Immunity alterations have been observed in bipolar disorder (BD). However, whether serum positivity of antibodies to Toxoplasma gondii (T gondii), rubella, and cytomegalovirus (CMV) shared clinical relevance with BD, remains controversial. This study aimed to investigate this association. METHODS: Antibody seropositivity of IgM and IgG to T gondii, rubella virus, and CMV of females with BD and controls was extracted based on medical records from January 2018 to January 2023. Family history, type of BD, onset age, and psychotic symptom history were also collected. RESULTS: 585 individuals with BD and 800 healthy controls were involved. Individuals with BD revealed a lower positive rate of T gondii IgG in the 10-20 aged group (OR = 0.10), and a higher positive rate of rubella IgG in the 10-20 (OR = 5.44) and 20-30 aged group (OR = 3.15). BD with family history preferred a higher positive rate of T gondii IgG (OR = 24.00). Type-I BD owned a decreased positive rate of rubella IgG (OR = 0.37) and an elevated positive rate of CMV IgG (OR = 2.12) compared to type-II BD, while BD with early onset showed contrast results compared to BD without early onset (Rubella IgG, OR = 2.54; CMV IgG, OR = 0.26). BD with psychotic symptom history displayed a lower positive rate of rubella IgG (OR = 0.50). LIMITATIONS: Absence of male evidence and control of socioeconomic status and environmental exposure. CONCLUSIONS: Differential antibody seropositive rates of T gondii, rubella, and cytomegalovirus in BD were observed.


Subject(s)
Antibodies, Protozoan , Antibodies, Viral , Bipolar Disorder , Cytomegalovirus , Immunoglobulin G , Immunoglobulin M , Rubella virus , Toxoplasma , Humans , Bipolar Disorder/immunology , Bipolar Disorder/blood , Female , Toxoplasma/immunology , Adult , Rubella virus/immunology , Cytomegalovirus/immunology , Cross-Sectional Studies , Antibodies, Viral/blood , Young Adult , Immunoglobulin G/blood , Antibodies, Protozoan/blood , Adolescent , Middle Aged , Immunoglobulin M/blood , Child , Toxoplasmosis/immunology , Toxoplasmosis/blood , Rubella/immunology , Cytomegalovirus Infections/immunology
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