Serological and Hematological Study of Toxoplasmosis in Blood of Newly Born Babies

Serological identification and blood pictures were done for specific IgM and IgG.10% of cases were positive IgM of Toxoplasmosis because have 10 IU/ml (mean) in comparison with control group were 0.11 IU/ml (mean). On other hand 20% of diagnosed cases were positive IgG of Toxoplasmosis because have 11 IU/ml .Two cases were followed for their history one from group IgM and other IgG , first one suffered from three abortion and now have five child three of them healthy while two have congenital defects. Second case (IgG positive ) have four abortion and now have three child , two healthy and one have congenital defect. Blood picture reveal 40% suffered from Normocytic anemia , these cases classified to three groups , first Toxoplasma group 30% (positive in ELISA test). Second group (Unknown causes), these cases not only normocytic anemia also have high total leukocytes 17 x10 (mean) and high MCV (103 ft). Third group have low MCV 78ft.


INTRODUCTION
Congenital Toxoplasmosis occur when Toxoplasma gondii crosses the placenta barrier from the mothers blood. Most neonatal infection are asymptomatic but some causes death or disability to newborns ( Duby, J.  Guerina , N. et al (1994) published data on neonatal serologic screening and early treatment for congenital toxoplasmosis in new England region. In Norway Jenum ,P (1998

MATERIALS AND METHODS
Hundred pregnant women attended to the maternity and children hospital of Hilla on January 2017, Blood sample were collected from umbilical cord of newly born babies, these samples were hundred divided in two tubes , one with anticoagulant for study blood pictures, while other tube without anticoagulant for isolation serum to identify Toxoplasmosis by direct method of ELISA , the assays for toxoplasma IgM and IgG, briefly a 6mm ,and specimen was tested by an IgM specific enzyme linked immunosorbent ássay with a reported a sensitivity , therefore control group rang 0.1-0.9 IU/ml (negative) , While over 5 IU/ml (positive ) for toxoplasmosis , in between these (suspicion), (Schmidt, S. et al.,2012).
Blood pictures were done in hematology laboratory of hospital by using blood analyzer. The results of these tests included complete blood picture of each sample.
Serological test confirmed the presence of toxoplasma IgM or IgG and accompanied with history of mother must be treated immediately.

RESULT
Results of blood analysis for umbilical cord blood divided to three groups depend on picture. Normocytic (1) group, Normocytic (2) group, Toxoplasmosis group.
Toxoplasmosis: These group of cases where identified serologically direct method of ELISA , 10% of cases where positive to ELISA test for T. gondii because have 10 IU/ml (mean) of IgM, in comparison with control were 0.11 IU/ml ,therefore these cases consider acute cases.
On other hand 20% of dignosed cases were positive for toxoplasmosis because IgG which is specific for T. gondii was 11 IU/ml (mean), therefore these cases are chronic cases. The most prominent result of blood picture of Toxoplasmosis cases showed increase in total number of leukocytes 15.2-24.1×1000 ( rang) table (1) Fig. 1.
Two cases of toxoplasmosis were followed for their history, case number (2) who have IgM 10 IU/ml, history of these was suffered from three abortion in previous time and now have five children, three of them were healthy while other two have congenital defects. Case number (4) has IgG 11 IU/ml suffered from four abortions and now has three children, two healthy and one have congenital defect.

Normocytic 1:
Blood analysis revealed this group of cases was suffer from normocytic anemia with unknown cases with increase in total number of leukocytes 14.5-21.9 x1000 (mean)  Fig 3 demonstrated the mean corpuscular volume (MCV) increased 101 -107 fil (rang), 103 ftL mean while the control 81-96 fL. These cases also showed increased in (MCHC) mean corpuscular hemoglobin concentration, the range was 34.1-37.6 with a mean 35.9 in comparison with control 31.8 -35.4, Fig. (2). As well as hemoglobin quantity was in between 14.1-21.9 gm with a mean

DISCUSSION
Many researchers work on toxoplasmosis and especially on congenital toxoplasmosis but from different aspects . Murwa, J. (2010) worked on toxoplasmosis serologically , 30% worked on toxoplasmosis serologically , 30% of IgG were positive by ELISA test , these results similar of these research but not IgM not recorded in comparison with present 10%, this variation depend several factors such as hosts, intermediate and final hosts and its distribution , susceptibility of women , or ingestion of undercooked meat (conimon in IRAQ) during pregnancy , as well as contact with cats or its fecal materials in gardens.
This research proved IgM production and this mean acute infection is present because it is produced during fitst month of infection .As well as several abortions from the same mother this represent reinfection and chronic disease can be reactivated to acute stage. 6-10 % of women were normal healthy depend on blood picture.

Congenital
Toxoplasmosis serious problem, therefore prevention and control needed as soon as possible as follows: 1-Primary prevention is characterized by educational programs and public health to avoid infection because two cases were followed randomly, these women were uneducated.
2-Secondary prevention consists of serological screening during prenatal care to detect and treat acute infections by T. gondii , thus reducing the squeal caused by congenital toxoplasmosis.
3-Tertiary prevention is focused on the newborn , in which newborns with subclinical congenital Toxoplasmosis are treated in order to prevent further complications, especially ocular and risk of reactivation.