of TOXOPLASMA GONDII

Toxo View from the history, Toxo is a parasite protozoa

single cell cause Toxoplasmosis.
This virus first times found in the rodent in North Africa which is called by Charles gondii Nicolle and Lonis Manceaux in Laboartorium Pasteur Institute in Tunisia in 1908. More life cycle found in the new year 1970 finding that sexual cycle in the cat as hospes keep its, while the mediator is hospes different types of birds and mammals, including humans.

Toxoplasma gondii (in a medical world) wide-spread in nature, both in humans and animals,and is one of the causes of disease infection that most often occurs in humans in the entire surface of the earth. Figures perevalensi Toxoplasmosis in different countries vary, does not distinguish gender men and women.

Toxoplasma gondii is one sel animals called protozoa. This is a parasitic protozoa in the body of animals and humans. Toxoplasmosis considered as zoonosis diseases, the disease can be transmitted from animals to humans.

Similar to butterfly, T. Gondii also have a life cycle with a manifold. Transmission occurs primarily through the form of ookista (such as eggs) and bradizoit form that is usually found in the meat is not cooked thoroughly.

Most of the T. Gondii in three main forms, namely: ookista, tachyzoit and bradizoit. Ookista form only in the definitive gut wet nurse, the nation's cats. Ookista issued through the feces. When consumed by humans or other animals, developed into tachyzoit (tropozoit). This form is a form that can propagate itself quickly.

In the pregnant women, tachyzoit can infeksi fetus. Occupy network Tachyzoit muscle and nerve system such as the brain, and then changed to bradizoit. Bradizoit in meat that is not cooked, if eaten accidentally changed back into tachyzoit and start the cycle again reproduce themselves. For more details

• To more clearly it is this cycle of life and its ways of transmission

Life cycle of Toxoplasma gondii was first raised in 1970 as a wet nurse and definitive (penjamu) is a group including familia Felidae cat - a cat that has been occur domestikasi. Warm-blooded animal, human, and poultry as a mediator iang (Dubey, 1998). Cats that terdomestikasi is a very important group for the occurrence of toksoplasmosis on another animal or human. This parasite is transmitted in three ways, namely in a way that is kongenital through plasenta, consume meat contamination by the cyst and the origin of cat feces containing ookista. In silkus his life on the phylum Amplicomplexa the 3 stages, namely stages takizoit the stadium multiplikasi active tropozoit and usually observed in acute infection. Stadium is most often found on the body organs especially the brain, muscle meat, heart muscle and eye (Sciammarella, 2001; Ghaffar, 2001).

Bradizoit Stadium is a stadium where the cyst is not active and are in the network and are infektif, and third stages ookista stadium is located in cat faeces. In their life cycle by intraselular cells in the medium to wet nurse wet nurse and then perform multiplikasi and parasites have life cycles that are phase obligat with sexual and aseksual. Sexual cycle occurs in the body of a cat and aseksual cycle occur in the different between the wet nurse who is very varied. .

Cats infected by Toxoplasma gondii after ingest food containing cyst in the existing network between body wet nurse (rodensia, birds, etc.) are infected. Parasites will multiplikasi in the small bowel wall and produce ookista. Ookista this will be a ekskresi through feses in large numbers for 2 - 3 weeks, within 5 days ookista will experience sporulasi and to infection another animal or human. Ookista is very resistant to changes in environmental conditions and will survive and who dwells in the land on wet or sandy soil. Intraintestinal infections occur during the cat, will be broken in the cyst lumen and intestinal penetration enterosit in the intestine and through the lamina propia in the body and then bereplikasi quickly and become a stadium takizoit (silkus ekstraselular intestinal) (picture 2). Stadium is a stadium that are associated with acute pathology description. At the stadium this process the body's immune response will be very helpful, this is due to the stadium takizoit will quickly spread and bereplikasi in epitel intestinal cells (entero-epitelial cycle) and overlooks a network body wet nurse. This is the peak of the cycle of sexual reproduction.

There is a cat's immune system, cause the release ookista stopped and detained takizoit development and will result in a formation called bradizoit (replication occurs in slow). Stadium is usually found in the brain and nerve network or heart muscle. Slowly this stadium will change to cyst and cause an infection in the female trader chronicles intermediaries (Dubey, 1999; Smith and Rebuck, 2000; anonymous, 2001b; Sciammarella, 2001).

Sexual cycle occurs only in the group and feline cat swallow begins as the network that contains the cyst or bradizoit. Fertilisasi occur in the intestine and will form ookista.At the time of contact with air, ookista will learn differentiation and form two sporokista, each - each sporokista will contain 4 sporozoit. The entire cycle occurs during the 3 - 10 days from the time tertelannya bradizoit and 18 days after ingesti ookista. The infected cat will produce ookista in the number of thousands (Dubey, 1999; Anonymous, 2001b).

Bradizoit can be found 5 to 6 days after infection and the form of a cyst found on various networks, especially brain and nerve network. The number of cyst will increase and reach its peak in 2 - 12 weeks after infection, and will slowly decline due to periodic ruptur cyst. Bradizoit were released from the cyst and will be signed in to encircle the cell and then form a new cyst,

and usually will circumnavigate the cyst ruptur or bradizoit this will change to takizoit. There bradizoit and takizoit that can be infected toksoplasmosis which chronicles(Dubey, 1999; Anonymous, 2001c; Rebuck and Smith, 2000).

According to Wu in 2001, this parasite transmission to humans because:

• swallow food contamination ookista the sporulasi.

• Swallow the meat or the brain that contain bradizoit.

• Kongenital a result of infection transmitted through plasenta of pregnant women to the fetus in the womb.

Cats are the definitive wet nurse as a wet nurse and ookista in addition will produce an bradizoit it will be in ekskresi through feses.Feses then this water will be mixed, land and cattle feed that is open (Lawrence, 1995; Weigel etal, 1999; Dubey, 1998), so it can spread to humans. Reported that in cat feces that enter the human in the water, land and feed pigs in swine farms in Illinois in which many of them also find a cat, a point that found in ookista in feses and cat fur, land, water and feed the pigs a in the livestock environment. In addition to the ookista found in it have also found positive results toksoplasmosis on blood samples from people - people who handle the processing of pork (92%), handling of feed pigs and cats 74% of the 174 workers (Weigel et al, 1999). According to the European multicentre case control study, comparison between the transmission through the cyst is in the meat and ookista from feses cat to human 5-10 times higher risk on its people to the consumption of meat (Anonymous, 2001).

Meat is the route of transmission of many reported in the year - last year. Pigs, goats, sheep and cattle are very important as a source of transmission of Toxoplasma gondii. In addition to livestock is also on the cattle, poultry and animal prey (Dubey, 2000, Figueiredo, 2001). Estimated that 50% of people infected with Toxoplasma gondii in the United States due to consumption of poultry meat(Roghmann, 1999), so that the attention of higher compare Foodborne pathogenic in others, because a decrease in productivity and increased health care costs (Frenkel and Robert, 1990 ). According to Dubey in Figueiredo, 2001 that the infected goats by Toxoplasma gondii in the vaginal mucosa, saliva, nasal sekresi, urine and milk of water diekskresi contain takizoit. Swallow occurred because of the cyst on the brain, flesh, heart or other organ of origin of cattle, which made its process pemasakka less perfect or less the evaporation process. From the results of the research serologi on 1000 pregnant women in Europe indicate that between 30 - 63 percent of infected toksoplasma consume meat because of its less penangannan in perfect concoction or evaporation (Gilbert, 2000) and 17% because of contact with the contagious ookista in the land. Risk of contracting by Toxoplasma also came from women who prepare raw meat for cooking, drinking milk that is not specific to its pasteurisasi goat milk, raw eggs, or the person who is always in contact with animals, eating vegetables or fruit that is not washed. Seroprevalensi against toxoplasma found high on people - people of Nepal have kebiasan eat raw meat and keep the cat inside the house. In this study a cross-appeal in the district, and districts that have a habit consume raw meat, which is seroprevalen high point in the appeal the district does not consume (Rai et al, 1999, Anonymous, 2001â). According Roghmann et al 1999, that the Adventist people in Maryland who do not normally eat, and meat or fish products to its appeal is in control with the person who always consume the meat products point is a significant result.According to research from consuming the meat habit, the age, race, body immunity is also a role in transmission toksoplasmosis (Dubey, 1998; Roghmann, 1999; Weigel, 1999). Seroprevalensi incident toksoplasmosis the world vary widely dijepang namely 12%, 21-36% in the UK and the United States, while in France and El Salvador are very high, namely 84 - 90% (Smith and Rebuck, 2000).

According to Gilbert in 2001, that pregnant women who suffer toksoplasmosis 25% will

send it to fetus. Toksoplasmosis kongenital transmission occurs when infection at the time gestasi and the abortus in the first trimester of pregnancy (Dubey, 1999; Smith and Rebuck, 2000), in addition can also occur causing its early birth, disruption in infants born in the right form, with the birth weight the abnormal body, blindness, hearing loss, mental disturbance development (Frenkel, 1990; Weigel, 1999), when pregnant women are infected in one second or third trimester of pregnancy the baby is going to reveal the scale of pem (hidrochepalus) (picture 3 ), or retina eye lesi on the special (picture 4) and brain (Lawrence, 1995; Dubey, 1999; Sciammarella, 2001).

• This is his PATHOGENESA

Toxoplasma gondii is a prasit intraselular pitch and so on reproduction in cells. Most cases in humans in toksoplasmosis can consume the network that contains the cyst is in the process of meathis concoction less perfect or raw meat. In addition, direct contact with soil or water contamination by coal tar containing feses cat ookista that are not directly in contact with food or drink. Other form of transmission is through plasenta pregnant women who suffer toksoplasmosis (Dubey, 1999; Anonymous, 2001â). Bradizoit existing in the network or the tropozoit separated from ookista will do epitel penetration to the intestinal cells and multiplikasi. Toxoplasma will spread locally on limfoglandula mesenterika through the intestine and blood vessel limfe and will spread to all organs. Before other organs become damaged, nekrosis will occur first in the intestine and limfoglandula mesenterika, then going focal necrosis occurred in other organs.

Clinical picture will appear soon after some time the network damage occurred organ especially the eyes, heart, and adrenal gland. Gen. nekrosis on the organ - the organ caused by the multiplikasi intraselular from takizoit (Dubey, 1999; Dubey, 1999). Fifteen to 85% population of children - children of the world by chronic toxoplasma infection is influenced by geographic conditions (Dubey in Fuentes, 2001) temperature or humidity (Anonymous, 2001â). With the factors of temperature and humidity according ookista will be able to survive several months to more than one year. Fly, worm, cockroach and other insects may be regarded as agents in the mechanical spread of this parasite. The other factor is the effect age, according to research conducted by Martin Lawrence in 1995, that the effect of age on serologi people who consume the meat of pigs that his concoction not perfect and the people who always handle raw meat.

Levels of mortality and morbiditas of this parasite is high enough on the patient imunocompromise (AIDS, cancer, transplant) and on the children - children who are contagious through his mother (Dubey, 1999; Smith and Rebuck, 2000). Conditions that usually appear on people imunocompromise membrane form of brain inflammation or abses that can happen is two-fold.

• clinical symptoms of this toksoplasmosis kongenital

Estimated that more than 3000 people who suffered toksoplasmosis kongenital in the United States each year do not show symptoms. Symptoms will appear and is the individual. Serious symptoms appear on the baby who was born and born early abortus (1: 10 infants were infected) (Anonymous, 2001â) found with symptoms of eye infections, liver and spleen enlargement, in the eyes and yellow skin and pneumonia, and ensepalopati followed by death. While the baby is born normal, symptoms appear after a few weeks, months or years after birth. This found many symptoms after the age of pubertas such as the interference in the eyes until blindness occurs, a failure on the nerve system, interference hearing (deaf-mute), Demand, yellow due to heart trouble, erupsi skin, respiratory disturbances (Anonymous, 2001b). In the form of a latent form of damage usually psikomotor, konvulsi and head enlargement (hidrosepalus). At 69% of cases associated with korioretinitis with the increase in brain volume (Chandra, 2001). On imunocompromise people, namely people with AIDS, cancer or organ transplants will be quickly visible symptoms of the nerve system interference, encepalitis, limfoglandula enlargement, eye disturbances, hearing, respiratory disturbances and heart disturbances and mortality in patients over the high (Anonymous, 2001b; rebuck and Smith, 2000; Theobald 2001).

• Diagnosis

To do diagnosis against disease toksoplasmosis can be done several ways that can use serologi or histopatologi examination. With only see the symptoms of clinical diagnosis can be less in a portrait because symptoms do not appear specific (Dubey, 1999). Examination can be done directly with the notice a dark spot on the retina, making the examination of blood to see if the parasite is spread through the blood to see the changes that occur in the blood picture, and can use the CT scan, MRI to find the parasite is due lesi. Examination can also be done with the biopsy and the biopsy sample from the test can be done by using PCR (Theobald, 2001; Fuentes, 2001), isolation on animal experiments or making preparation histopatologi (Dubey, 1999).

Diagnostic method that is often used with the Indirect haemaglutination (IHA), Immunoflourescence (IFAT) or with Enzym Immunoassay (Elisa) (Figueiredo et al, 2001).

treatment of toksoplasmosis. For prevention against toksoplasmosis with, among others (Dubey, 1999; Anonymous, 2001â, Gilbert, 2000; Anonymous, 2001b)

• Minimize exposure to the parasite with a way to cook beef, pork, goat and others with internal heating 70oC (158oF) at least 15 - 30 minutes. By doing thawinig freezing,going collection of salt, smoking or curing, cyst can not be destroyed. Avoid consuming dairy goat that is not or raw eggs

• Avoid direct contact with the land as a potential place ookista, because ookista will be able to survive in the soil in a very long time and is not affected by poor environmental conditions or to use gloves during contact with the ground to wash hands with soap and water

• Avoid cross-contamination between raw material with material that has been cooked meals

• Sink to wash vegetables and fruits that will be consumed

• Clean your hands with soap and water after preparing raw meat to be cooked
  

• Remove the cat from the cage feses cat every day to prevent ookista sporulasi

• Do infections in the cat using Cage washing with boiling water or the sterilization 55oC, infection in the chemicals do not destroy ookista

• Does not provide raw meat to the cat and let a cat stay at home not to hunt wild birds or rodensia

• Pregnant women to avoid consuming the meat in a less perfect concoction (smoked meat, salami, etc.) and milk or products that are not pasteurisasi.

• Giving antibiotics is one way to toksoplasmosis for treatment. Antibiotics that are frequently in use is a combination of pyrimethamine and sulfonamide, and this effective combination for acute infections (Sciammarella, 2001). According to Wu in 2000, other drugs that can be used in the preparation azitromycin, clindammycin and atovaquone. Vaccination at the time of this new development.

I hope all of us can avoid, and can live healthy and grateful to god