Sains Malaysiana 46(4)(2017): 583–588

http://dx.doi.org/10.17576/jsm-2017-4604-10

Kajian Serologi Toksoplasmosis dalam Kalangan Penerima Transplan Renal di Hospital Kuala Lumpur

(Serological Study of Toxoplasmosis among Renal Transplant Recipients in Kuala Lumpur Hospital)

HARTINI YUSOF¹ & MOHAMED KAMEL ABD GHANI²*

¹Jabatan Teknologi Makmal Perubatan, Fakulti Sains Kesihatan, Universiti Teknologi MARA

Kampus Puncak Alam, 42300 Puncak Alam, Selangor Darul Ehsan, Malaysia

²Jabatan Sains Bioperubatan, Fakulti Sains Kesihatan Bersekutu, Universiti Kebangsaan Malaysia

50300 Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Wilayah Persekutuan, Malaysia

Diserahkan: 16 Jun 2016/Diterima: 10 Oktober 2016

ABSTRAK

Toksoplasmosis adalah penyakit akibat daripada jangkitan Toxoplasma gondii kerana protozoa ini merupakan patogen oportunistik yang penting dalam kalangan penerima organ. Jangkitan biasanya adalah tanpa gejala tetapi ia boleh menjadi serius sehingga mengancam nyawa terutama bagi pesakit terimunokompromi. Oleh itu, suatu kajian irisan lintang dengan pensampelan purposif telah dijalankan untuk mengesan kadar prevalens jangkitan T. gondii dalam kalangan 171 orang pesakit renal kronik di Hospital Kuala Lumpur (HKL). Subjek kajian dibahagi kepada 2 kumpulan iaitu kumpulan penerima transplan renal yang terdiri daripada 138 orang pesakit renal kronik dan kumpulan kawalan yang merupakan 33 orang pesakit renal kronik yang belum menjalani transplantasi renal. Kaedah serologi iaitu ‘Indirect Immunofluorescent Antibody’ (IFA) digunakan untuk mengesan IgG anti-Toksoplasma di dalam serum kedua-dua kumpulan pesakit. Selain itu, kadar seropositif dan min titer IgG ditentukan berdasarkan tempoh pascatransplantasi. Sebanyak 39.4% pesakit daripada kumpulan kawalan dikesan mempunyai antibodi IgG terhadap T. gondii manakala kadar seropositif dalam kalangan pesakit pascatransplan adalah 30.4%. Hasil kajian turut menunjukkan tempoh pascatransplantasi tidak mempengaruhi corak jangkitan T. gondii walaupun terdapat peningkatan kadar seropositif jangkitan selepas 6 bulan transplantasi renal dijalankan. Di samping itu, wujudnya korelasi antara min titer IgG dan tempoh pascatransplantasi dengan titer meningkat secara signifikan daripada 2.68 kepada 7.14 sejajar dengan pertambahan tempoh pascatransplantasi renal. Kadar kes toksoplasmosis dalam kalangan pesakit pascatransplan boleh dikurangkan sekiranya ujian saringan awal terhadap jangkitan T. gondii dijalankan. Profilaksis dan pemeriksaan susulan juga perlu dilakukan ke atas pesakit renal kronik untuk mengelak daripada berlakunya sebarang kerumitan yang teruk.

Kata kunci: Renal; serologi; transplantasi; toksoplasmosis

ABSTRACT

Toxoplasmosis is a parasitic disease caused by an important opportunistic pathogen, Toxoplasma gondii. Infection with T. gondii is often asymptomatic but it can be lethal in immunocompromised patients. Therefore, a cross-sectional study with purposive sampling had been conducted in order to determine the prevalence of T. gondii infection in 171 patients with chronic renal diseases. The patients were divided into 2 groups: 138 of chronic renal patients who received renal transplants were categorized in renal transplant recipient group and 33 patients of chronic renal disorders who have not yet received renal transplants were selected as a control group. The serological Indirect Fluorescent Antibody Test (IFAT) was used to detect the presence of IgG anti-Toxoplasma in sera from both groups. This study showed that the prevalence of T. gondii infection in control and renal transplant patients were 39.4% and 30.4%, respectively. Furthermore, there was no significant association between post-transplantation period and pattern in prevalence of T. gondii infection, however, it was noted that the prevalence rates of T. gondii had increased after 6 months post transplantation. In addition to that, the significant correlation occurring between mean titer of IgG where the values increased from 2.68 to 7.14 with the duration of renal postransplantation. Therefore, the prevalence of infection among renal transplant patients may reduce if screening tests are not being neglected. Patients with chronic renal disease should also be administered with prophylaxis and followed up for toxoplasmosis to prevent severe complications after transplantation procedure.

Keywords: Renal; serology; toxoplasmosis; transplantation

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*Pengarang untuk surat-menyurat; email: profkamel@ukm.edu.my