Original Article Elmer Press J Clin Med Res • 2010;2(3):117-120 Latent Toxoplasmosis in Patients With Different Malignancy: A Hospital Based Study Amal Nimira, c, Amizah Othmanb, Soon Eeb, Zohdy Musab, Iffah Abd Majidb, Zalikha Kamarudinb, Chee Xianb, Noor Hayati Isab Abstract Background: Seroprevalence of toxoplasmosis in different popula- tions may vary according to different environments, social customs and habits. This study was designed to measure the seroprevalence of toxoplasmosis among patients with different malignancies and to ascertain the association between common risk factors and disease transmission. Methods: This Cross-sectional study was from January to April of 2009. Four Oncology wards in Hospital Universiti Kebangsaan Ma- laysia (HUKM) were selected as the site for undertaking the present study. The survey involved 129 patients with different malignan- cies. Information was gathered by using study subject information sheet and a standardized structured questionnaire. Toxoplasma was screened by a standerd ELISA commercial kit in accordance with the manufacturer’s instructions and performed at the Department of Microbiology, HUKM Kuala Lumpur. A result of > 51 IU/ml of anti-Toxoplasma (IgG) antibody was regarded as positive, indicat- ing latent or pre-existing Toxoplasma infection. A result of > 51 IU/ ml of anti-Toxoplasma (IgM) antibody was regarded as positive, indicating recently acquired Toxoplasma infection. Results: Total number of seropositive patients was 54 (67.6%), the mean age was 51 years (range15 - 88 years). Toxoplasma IgG positivity was highest among Malaysian (32%). Male to female ra- tio was almost equal. There was a statistically significant difference in seropositivity between patients living in rural areas compared to those living in urban areas, positive history of consumption of undercooked meat and/or blood transfusion (p < 0.05). Manuscript accepted for publication May 26, 2010 aDepartment of Pathology, Cyberjaya University College of Medical Sciences, Malaysia bDepartment of Parasitology, Universiti Kebangsaan Malaysia, Malaysia cCorresponding author, Email: aralmadi@yahoo.com doi:10.4021/jocmr2010.06.375w Conclusions: These findings give some support to Toxoplasma screening program and health education, including promotion of a healthy lifestyle exclusively in seronegative patients in order to prevent seroconversion and the incidence of clinically evident op- portunistic infection. Keywords: Toxoplasma gondii; Risk factors; Immunocompro- mised; seroconversion; Seroprevalence Introduction Toxoplasma gondii (T. gondii) is a protozoan parasite that is endemic worldwide and is a major opportunistic pathogen in immunocompromised hosts. Infection is mainly acquired by ingestion of food, water or soil that is contaminated with oocysts shed by cats, or by eating undercooked or raw meat containing tissue cysts [1]. Primary infection is usually subclinical, but in severely immunocompromised patients it may be life-threatening. Most primary infections subsequently phase into chronic in- fections in which the parasite persist in tissue cysts, mainly in the brain, retina, skeletal and cardiac muscles [2]. These chronic infections probably persist indefinitely throughout the life and may remain undiagnosed until or unless it is re- activated as a result of severe immune suppression [3]. For the diagnosis of T. gondii infection, detection of the organism itself is confirmative but very difficult. Thus, most clinical laboratories use serological tests to detect antibodies against T. gondii such as the latex agglutination (LA) test, ELISA and indirect fluorescent antibody test because of its high specificity and sensitivity [4]. Seroprevalence in different populations may vary ac- cording to different environments, social customs and habits [5, 6]. Analysis of worldwide reports indicated that about 38.5% humans, 32.9% cats and 24.2% goats were seroposi- tive for toxoplasmosis [7]. This study was designed to measure the seroprevalence of toxoplasmosis among patients with different malignancies and to ascertain the association between common risk factors Articles © The authors | Journal compilation © J Clin Med Res and Elmer Press™ | www.jocmr.org 117