Submitted by Automa??o e Estat?stica (sst@bczm.ufrn.br) on 2017-02-13T20:11:14Z No. of bitstreams: 1 ThatianyAraujoDeMedeiros_DISSERT.pdf: 1620239 bytes, checksum: e75f59b47b08a1483c79c95ce336be37 (MD5) / Approved for entry into archive by Arlan Eloi Leite Silva (eloihistoriador@yahoo.com.br) on 2017-02-16T00:30:20Z (GMT) No. of bitstreams: 1 ThatianyAraujoDeMedeiros_DISSERT.pdf: 1620239 bytes, checksum: e75f59b47b08a1483c79c95ce336be37 (MD5) / Made available in DSpace on 2017-02-16T00:30:21Z (GMT). No. of bitstreams: 1 ThatianyAraujoDeMedeiros_DISSERT.pdf: 1620239 bytes, checksum: e75f59b47b08a1483c79c95ce336be37 (MD5) Previous issue date: 2016-04-08 / Coordena??o de Aperfei?oamento de Pessoal de N?vel Superior (CAPES) / A toxoplasmose tem como agente etiol?gico o protozo?rio Toxoplasma gondii e geralmente causa infec??o assintom?tica em indiv?duos imunocompetentes. Entretanto, na transmiss?o cong?nita pode gerar quadros graves e morte, representando um s?rio problema de sa?de p?blica. Em pacientes gr?vidas reativas para IgM anti-T. gondii recomenda-se diagn?stico molecular do l?quido amni?tico utilizando a metodologia de PCR qualitativa com o iniciador B1. Por?m, seu diagn?stico utilizando esta metodologia pode ser ineficiente principalmente na detec??o de cepas h?bridas encontradas na Am?rica Latina. Nesse contexto, o objetivo deste trabalho foi avaliar a efici?ncia dos m?todos sorol?gicos e da t?cnica de Nested-PCR utilizando o iniciador GRA7 na detec??o do Toxoplasma gondii na transmiss?o cong?nita. O estudo foi realizado em 71 gestantes, atendidas no Centro de Sa?de Anita Garibaldi (CSAG), Maca?ba-RN no per?odo de 2011 a 2015, com idades gestacionais vari?veis e faixa et?ria entre 15-49 anos, submetidas a procedimentos de rotina durante o exame pr?-natal tratando-se, portanto, de um estudo de delineamento observacional transversal de acur?cia. Foram coletadas amostras de sangue perif?rico e l?quido amni?tico. Inicialmente foi realizado o diagn?stico sorol?gico para toxoplasmose com o aux?lio das t?cnicas de ELISA e Imunofluoresc?ncia indireta (IFI) para a detec??o de IgG e IgM anti-T. gondii. Posteriormente, as gestantes que apresentaram testes sorol?gicos reativos para IgM foram selecionadas para a realiza??o da t?cnica de Nested-PCR utilizando os iniciadores RE e GRA7. A sororeatividade detectada pela presen?a de IgG e IgM anti-.T gondii pelas t?cnicas de ELISA e IFI foram, respectivamente, 91,55% e 14,08%, 76,06% e 5,63%. A positividade total para IgM quando associado as t?cnicas de ELISA e IFI foi de 15,49% (11/71). Entretanto, a an?lise da positividade com a utiliza??o da Nested-PCR foi de 0% (0/11), 9,09% (1/11) e 54,5% (6/11) utilizando os iniciadores RE, B1 e GRA7 respectivamente. Os resultados indicam que o iniciador GRA7 proposto ? mais eficiente na detec??o do T. gondii no l?quido amni?tico que o iniciador B1 e RE, quando utilizada a t?cnica de Nested-PCR. / Toxoplasmosis is the etiologic agent protozoan Toxoplasma gondii and usually cause asymptomatic infection in immunocompetent individuals. However, congenital transmission can lead to serious and death, representing a serious public health problem. In pregnant patients reactive to IgM anti-T. gondii is recommended molecular diagnosis using amniotic fluid qualitative PCR method with the primer B1. However, the diagnosis using this approach can be inefficient mainly for detection of hybrid strains found in Latin America. In this context, the objective of this study was to evaluate the effectiveness of serological methods and nested PCR technique using the primer GRA7 the detection of Toxoplasma gondii congenital transmission. The study was performed in 71 pregnant women seen at the Anita Garibaldi Health Center (CSAG), Maca?ba-RN in the period 2011 to 2015, aged gestational variables and age group 15-49 years, subjected to routine procedures during the examination prenatal the case, therefore, a study of cross-sectional observational design accuracy. Samples of peripheral blood and amniotic fluid was collected. Initially it performed the serological diagnosis of toxoplasmosis with the help of ELISA and indirect immunofluorescence (IIF) for the detection of IgG and IgM anti-T. gondii. Subsequently, patients showed reactive serologic tests for IgM were selected to perform the nested PCR technique using the RE and GRA7 initiators. The seroreactivity detected by the presence of anti-IgG and IgM. T. gondii by the ELISA and IFA techniques were respectively 91.55% and 14.08%, 76.06% and 5.63%. Total positivity for IgM when combined the techniques of ELISA and IFA was 15.49% (11/71). However, analysis of positive using the nested PCR was 0% (0/11), 9,09% (1/11) and 54.5% (6/11) using the primers RE, B1 and GRA7 respectively. The results indicate that the proposed GRA7 initiator is more efficient in the detection of T. gondii in amniotic fluid B1 and RE primer, when using the nested PCR technique.