Latent Toxoplasmosis in Malignancy J Clin Med Res • 2010;2(3):117-120 Table 2. Relationship Between Toxoplasma Seropositivity and Some Risk Factors Group Seronegative Seropositive History of contact with cat Yes No Yes No Yes No Consumption of undercooked meat Blood transfusion 24 (30.0%) 51 (64.3%) 21 (26.3%) 36 (45.0%) 54 (67.5%) 31 (38.8%) 24 (30.0%) 30 (37.5%) 38 (47.5%) 16 (20.0%) 25 (31.3%) 19 (23.8%) P value > 0.05 < 0.05 < 0.05 < 0.05 < 0.05 < 0.05 to patients living in urban areas (26.6%). There was a sta- tistically significant difference in seropositivity between the two groups of patients (p < 0.05). Among the seropositive patients, non-laborers represent a highest percentage com- pared to laborers and others. However, when multivariate analysis was performed, no significant association between Toxoplasma seroprevalence and the different occupational subgroups (p > 0.05). No statistically significant association between seroposi- tivity and history of contact with cats (p > 0.05). On the other hand, there is a significant association between seropositivity and positive history of consumption of undercooked meat and/or blood transfusion (Table 2). Discussion We found that seroprevalence of latent Toxoplasma among patients complaining of malignant diseases was 50 (40%), which indicates that primary Toxoplasma infection appears to be subclinical and prevalent throughout life. This is a high rate when compared with previous studies in Malaysia [8, 9]. Studies in different parts of the world showed varying seroprevalence, for example, 7.7% in United Kingdom [10], 13.6% in Thailand [11], 58.1% in Egypt [12] and 67% in Bra- zil [13]. The possible explanation for the differences could be due to the geographical variation of the precised study sites, different diagnostic methods employed in each study which have different sensitivities, and the possible risk fac- tors contributing to the acquisition of Toxoplasma infection. It is suggested that any immunocompromised patient should request for testing of Toxoplasma infection, especially those who are at high risk to get infection or are IgM seropositive who requires close observation. In this study, the seroprevalence of Toxoplasma IgM an- tibodies 4 (5.0%) were positive. Of these, only one (1.3%) suggested recent infection (only IgM antibody); an interme- diate stage (IgG and IgM) was found in 3 (3.8%) patients. We followed-up each one of the patients’ medical records throughout their time of hospital admission. No clinically active toxoplasmosis was identified among those patients. It may indicate that either subjects are asymptomatic, despite having a serological status indicating the recent infection, or the clinical signs and symptoms are not reliable in the diagnosis of toxoplasmosis in those patients. Therefore, we support proper guidelines for management of this silent dis- ease to be enforced at any level of health provision, but par- ticularly when dealing with immunocompromised patients in which this infection can be fatal. Toxoplasmosis was considered to be acquired in early life and the prevalence increase with age and decline in later life [14]. From our study, toxoplasmosis was found to be higher in younger population compared to older age group, thus it was in agreement with the above mentioned studies. From this study, the Malays showed higher significant association with Toxoplasma seroprevalence than their counterparts. These data suggest that the Malays are not only the major ethnic population in Malaysia but also that they are more likely to live a life style which makes them more liable to get this infection [14, 15]. Seropositivity rate of Toxoplasma antibody among pa- tients living in rural areas was significantly higher (p < 0.05) Articles © The authors | Journal compilation © J Clin Med Res and Elmer Press™ | www.jocmr.org 119