1
|
Calero-Bernal R, Gennari SM, Cano S, Salas-Fajardo MY, Ríos A, Álvarez-García G, Ortega-Mora LM. Anti- Toxoplasma gondii Antibodies in European Residents: A Systematic Review and Meta-Analysis of Studies Published between 2000 and 2020. Pathogens 2023; 12:1430. [PMID: 38133313 PMCID: PMC10745778 DOI: 10.3390/pathogens12121430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/24/2023] [Accepted: 12/07/2023] [Indexed: 12/23/2023] Open
Abstract
Toxoplasmosis has a major impact on animal and public health. Information regarding the seroprevalence of human Toxoplasma gondii infections from a European perspective has not yet been compiled to date. Thus, the present review summarized available resident data from the period 2000-2020. The overall seroprevalence of anti-T. gondii IgG was 32.1%, with great variability between countries (n = 30). The subgroup analysis identified different pooled prevalence data depending on the geographic area (p < 0.0001), target population (p = 0.0147), and serological diagnosis assays used (p = 0.0059). A high heterogeneity (I2 = 100%, p < 0.001; Q = 3.5e+05, d.f. = 135, p < 0.001) and degree of publication bias (Egger's test = 6.14, p < 0.001) were observed among the 134 studies considered. The occurrence of anti-T. gondii IgM, which was reported in 64.7% of studies, reached a pooled seroprevalence of 0.6%. In addition, among the eight main risk factors identified, "contact with soil", "consumption of undercooked beef", and "intake of unwashed vegetables" were the most significantly associated with infections. The fact that one-third of the European population has been exposed to T. gondii justifies extra efforts to harmonize surveillance systems and develop additional risk-factor analyses based on detailed source attribution assessment.
Collapse
Affiliation(s)
- Rafael Calero-Bernal
- SALUVET, Animal Health Department, Complutense University of Madrid, 28040 Madrid, Spain; (M.Y.S.-F.); (A.R.); (G.Á.-G.); (L.M.O.-M.)
| | - Solange María Gennari
- PhD Program in One Health, Faculty of Veterinary Medicine, University of Santo Amaro, São Paulo 04829-300, SP, Brazil;
- Faculty of Veterinary Medicine, University of São Paulo, São Paulo 05508-270, SP, Brazil
| | - Santiago Cano
- Computing Services, Research Support Center, Complutense University of Madrid, 28040 Madrid, Spain;
| | - Martha Ynés Salas-Fajardo
- SALUVET, Animal Health Department, Complutense University of Madrid, 28040 Madrid, Spain; (M.Y.S.-F.); (A.R.); (G.Á.-G.); (L.M.O.-M.)
| | - Arantxa Ríos
- SALUVET, Animal Health Department, Complutense University of Madrid, 28040 Madrid, Spain; (M.Y.S.-F.); (A.R.); (G.Á.-G.); (L.M.O.-M.)
| | - Gema Álvarez-García
- SALUVET, Animal Health Department, Complutense University of Madrid, 28040 Madrid, Spain; (M.Y.S.-F.); (A.R.); (G.Á.-G.); (L.M.O.-M.)
| | - Luis Miguel Ortega-Mora
- SALUVET, Animal Health Department, Complutense University of Madrid, 28040 Madrid, Spain; (M.Y.S.-F.); (A.R.); (G.Á.-G.); (L.M.O.-M.)
| |
Collapse
|
2
|
Voyiatzaki C, Orovas C, Trapali M, Chaniotis DI, Kriebardis AG, Beloukas A, Thalassinos ND, Orovou E, Iatrakis G, Antoniou E. The Importance of Use of the On-line Databases as a Source for Systematic Review of Toxoplasmosis Screening During Pregnancy. Acta Inform Med 2021; 29:216-223. [PMID: 34759463 PMCID: PMC8563042 DOI: 10.5455/aim.2021.29.216-223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 09/12/2021] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Infection with the parasite Toxoplasma gondii is a common infection in animals and humans worldwide. This infection can occur after ingestion of water or food contaminated with cat oocytes, ingestion of tissue cysts in mammalian and avian meat and congenitally. The prenatal infection can lead to Congenital Toxoplasmosis with miscarriage or stillbirth. After infection, laboratory tests are positive within 2-3 weeks and remain positive throughout life. However, testing for Toxoplasma infection during pregnancy is necessary in some countries, while in others it is not a mandatory "screening" test. OBJECTIVE The aim of this study was to review systematically the screening of toxoplasmosis in pregnancy in different countries worldwide. METHODS Cohorts, retrospective and cross-sectional studies were incorporated in our review, finally including 11 articles from an initial pool of 1532 related papers. RESULTS The seroprevalence of pregnant women varies from countries with low prevalence to regions with high prevalence and screening policies also differ. Most countries worldwide have control policies, while Germany and Mexico that do not have systematic screening for Toxoplasma during the prenatal period. CONCLUSION Our results show that Congenital Toxoplasmosis is very rare in some countries and it is very difficult to find a balance between potential risk and benefit of a screening program. For this reason, some countries are limited to prenatal counseling to reduce CT. In addition, the reduction of major sources of contamination especially in developing countries is the most important prevention measure.
Collapse
|
3
|
Barakat AMA, Ahmed SO, Zaki MS, El Fadaly HA, Abd El-Razik KA, El-Hariri HM, Johar D. New approach to differentiate primary from latent Toxoplasma gondii abortion through immunoglobulin and DNA interpretation. Microb Pathog 2018; 125:66-71. [PMID: 30189233 DOI: 10.1016/j.micpath.2018.09.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 08/18/2018] [Accepted: 09/01/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND Toxoplasma gondii is an acute or latent zoonotic abortifacient human protozoan. Women may be aborted due to recent or latent infection during pregnancy or order to flare up of the dormant bradyzoites to acute tachyzoites (latent opportunistic relapse). AIMS 1) to validate the interpretation of IgM and IgG immunoglobulins seromonotoring with DNA comparative results in differentiating recent from latent T. gondii abortion. METHOD Blood with the corresponding placental or uterine wash samples were collected from 73 aborted Egyptian women from Cairo and Giza labour wards. Patients aborted in any of the phases (Ph-1, Ph-2, Ph-3 and Ph-4 were corresponding to abortion at the 1st, 2nd and 3rd trimesters plus females who gave birth with congenital anomalies), respectively. All aborted patients were assayed serologically by Enzyme Linked Immunosorbent Assay (ELISA) for IgM and IgG titers and the compatible DNA from placenta and uterine wash tissues by conventional Polymerase Chain Reaction (PCR) specific for T. gondii. RESULTS Sero-positive aborted women were 50.7% by ELISA versus 37% by PCR. Not all T. gondii sero-positive aborted women were having T. gondii DNA or harboring compatible placental T. gondii cysts. This denotes that immunoglobulins alone are insufficient criteria for confirming toxoplasma abortion. CONCLUSION Immunoglobulins with DNA comparative results can possibly differentiate recent from latent T. gondii abortion at higher precision. We recommend the need for routine monitoring of T. gondii i.e. (pre-, during and post-delivery).
Collapse
Affiliation(s)
- Ashraf M A Barakat
- Department of Zoonotic Diseases, National Research Centre, Dokki, 12622, Giza, Egypt.
| | - Sylvia O Ahmed
- Department of Animal Hygiene and Zoonosis, Faculty of Veterinary Medicine, Assiut University, Assiut, Egypt.
| | - Mona S Zaki
- Hydrobiology Department, National Research Centre, Dokki, 12622, Giza, Egypt.
| | - Hassan A El Fadaly
- Department of Zoonotic Diseases, National Research Centre, Dokki, 12622, Giza, Egypt.
| | - Khaled A Abd El-Razik
- Department of Animal Reproduction and Artificial Insemination, National Research Centre, Dokki, Giza, Egypt.
| | - Hazem M El-Hariri
- Department of Community Medicine Research, National Research Centre, Cairo, Egypt.
| | - Dina Johar
- Department of Biochemistry and Nutrition, Faculty of Women for Arts, Sciences and Education, Ain Shams University, Heliopolis, Cairo, Egypt.
| |
Collapse
|
4
|
Liassides M, Christodoulou V, Moschandreas J, Karagiannis C, Mitis G, Koliou M, Antoniou M. Toxoplasmosis in female high school students, pregnant women and ruminants in Cyprus. Trans R Soc Trop Med Hyg 2017; 110:359-66. [PMID: 27358287 DOI: 10.1093/trstmh/trw038] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 05/11/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The protozoan parasite Toxoplasma gondii is important to human and animal health worldwide. This is the first study of prevalence of infection with T. gondii and associated risk factors in human populations and small ruminants in Cyprus. METHODS A random sample of 18 schools out of 46 participated: 1056 girls aged 16 to 18 years completed a questionnaire and were serologically tested for Toxoplasma between 2008 and 2011 (response rate 30%). In addition, infection with T. gondii laboratory results of 23 076 pregnant women tested between 2009 and 2014 were obtained from hospital records. Finally, 163 (out of 3123) farms were randomly sampled and blood samples from 515 sheep and 581 goats were obtained. RESULTS Estimated seropositivity prevalence in female students was 6.5% (95% CI 4.3 to 8.7%) and 18% (95% CI 17 to 19%) in pregnant women. Overall, 40.1% of the ruminants tested were seropositive (95% CI 37.2% to 43.0%). Seropositivity differed according to geographical region in all three groups. CONCLUSIONS Further studies are needed to investigate the differences between regions that lead to differing prevalence levels and patterns between ruminants and humans so that health education policies can be developed to help prevent infection and reduce environmental contamination.
Collapse
Affiliation(s)
- Marios Liassides
- Laboratory of Clinical Bacteriology, Parasitology, Zoonoses and Geographical Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece
| | | | - Joanna Moschandreas
- Biostatistics Laboratory, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece
| | | | - George Mitis
- Immunology Department, Nicosia General Hospital, Nicosia, Cyprus
| | - Maria Koliou
- Department of Pediatrics, Infectious Diseases and Immunology Unit, Archbishop Makarios Hospital, Nicosia, Cyprus Control of Communicable Disease, Medical and Public Health Services, Ministry of Health, Cyprus
| | - Maria Antoniou
- Laboratory of Clinical Bacteriology, Parasitology, Zoonoses and Geographical Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece
| |
Collapse
|
5
|
Billi P, Della Strada M, Pierro A, Semprini S, Tommasini N, Sambri V. Three-year retrospective analysis of the incidence of Toxoplasma gondii infection in pregnant women living in the Greater Romagna Area (northeastern Italy). Clin Microbiol Infect 2016; 22:572.e1-3. [DOI: 10.1016/j.cmi.2016.02.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 02/22/2016] [Accepted: 02/24/2016] [Indexed: 10/22/2022]
|
6
|
Flegr J, Dama M. Does the prevalence of latent toxoplasmosis and frequency of Rhesus-negative subjects correlate with the nationwide rate of traffic accidents? Folia Parasitol (Praha) 2014. [DOI: 10.14411/fp.2014.061] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
|
7
|
Flegr J, Prandota J, Sovičková M, Israili ZH. Toxoplasmosis--a global threat. Correlation of latent toxoplasmosis with specific disease burden in a set of 88 countries. PLoS One 2014; 9:e90203. [PMID: 24662942 PMCID: PMC3963851 DOI: 10.1371/journal.pone.0090203] [Citation(s) in RCA: 371] [Impact Index Per Article: 37.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2013] [Accepted: 01/22/2014] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Toxoplasmosis is becoming a global health hazard as it infects 30-50% of the world human population. Clinically, the life-long presence of the parasite in tissues of a majority of infected individuals is usually considered asymptomatic. However, a number of studies show that this 'asymptomatic infection' may also lead to development of other human pathologies. AIMS OF THE STUDY The purpose of the study was to collect available geoepidemiological data on seroprevalence of toxoplasmosis and search for its relationship with mortality and disability rates in different countries. METHODS AND FINDINGS Prevalence data published between 1995-2008 for women in child-bearing age were collected for 88 countries (29 European). The association between prevalence of toxoplasmosis and specific disease burden estimated with age-standardized Disability Adjusted Life Year (DALY) or with mortality, was calculated using General Linear Method with Gross Domestic Product per capita (GDP), geolatitude and humidity as covariates, and also using nonparametric partial Kendall correlation test with GDP as a covariate. The prevalence of toxoplasmosis correlated with specific disease burden in particular countries explaining 23% of variability in disease burden in Europe. The analyses revealed that for example, DALY of 23 of 128 analyzed diseases and disease categories on the WHO list showed correlations (18 positive, 5 negative) with prevalence of toxoplasmosis and another 12 diseases showed positive trends (p<0.1). For several obtained significant correlations between the seroprevalence of toxoplasmosis and specific diseases/clinical entities, possible pathophysiological, biochemical and molecular explanations are presented. CONCLUSIONS The seroprevalence of toxoplasmosis correlated with various disease burden. Statistical associations does not necessarily mean causality. The precautionary principle suggests however that possible role of toxoplasmosis as a triggering factor responsible for development of several clinical entities deserves much more attention and financial support both in everyday medical practice and future clinical research.
Collapse
Affiliation(s)
- Jaroslav Flegr
- Department of Biology, Faculty of Science, Charles University in Prague, Prague, Czech Republic
| | - Joseph Prandota
- Department of Social Pediatrics, Faculty of Health Sciences, Wroclaw Medical University, Wroclaw, Poland
| | - Michaela Sovičková
- Department of Biology, Faculty of Science, Charles University in Prague, Prague, Czech Republic
| | - Zafar H. Israili
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, United States of America
| |
Collapse
|
8
|
Capobiango JD, Breganó RM, Navarro IT, Rezende Neto CP, Casella AMB, Mori FMRL, Pagliari S, Inoue IT, Reiche EMV. Congenital toxoplasmosis in a reference center of Paraná, Southern Brazil. Braz J Infect Dis 2014; 18:364-71. [PMID: 24662141 PMCID: PMC9427446 DOI: 10.1016/j.bjid.2013.11.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2013] [Revised: 10/16/2013] [Accepted: 11/07/2013] [Indexed: 11/15/2022] Open
Abstract
This study describes the characteristics of 31 children with congenital toxoplasmosis children admitted to the University Hospital of Londrina, Southern Brazil, from 2000 to 2010. In total, 23 (85.2%) of the mothers received prenatal care but only four (13.0%) were treated for toxoplasmosis. Birth weight was <2500 g in 37.9% of the infants. During the first month of life, physical examination was normal in 34.5%, and for those with clinical signs and symptoms, the main manifestations were hepatomegaly and/or splenomegaly (62.1%), jaundice (13.8%), and microcephaly (6.9%). During ophthalmic examination, 74.2% of the children exhibited injuries, 58.1% chorioretinitis, 32.3% strabismus, 19.4% microphthalmia, and 16.2% vitreitis. Anti-Toxoplasma gondii IgM antibodies were detected in 48.3% of the children. Imaging brain evaluation was normal in 44.8%; brain calcifications, hydrocephaly, or both conditions were observed in 27.6%, 10.3%, and 17.2%, respectively, of the patients. Patients with cerebrospinal fluid protein ≥ 200 mg/dL presented more brain calcifications (p = 0.0325). Other sequelae were visual impairment (55.2% of the cases), developmental delay (31.0%), motor deficit (13.8%), convulsion (27.5%), and attention deficit (10.3%). All patients were treated with sulfadiazine, pyrimethamine, and folinic acid, and 55.2% of them exhibited adverse effects. The results demonstrate the significance of the early diagnosis and treatment of toxoplasmosis during pregnancy to reduce congenital toxoplasmosis and its consequences.
Collapse
Affiliation(s)
- Jaqueline Dario Capobiango
- Department of Clinical Medicine, Health Sciences Center, Universidade Estadual de Londrina (UEL), Londrina, PR, Brazil.
| | - Regina Mitsuka Breganó
- Department of Pathological Sciences, Biological Sciences Center, Universidade Estadual de Londrina (UEL), Londrina, PR, Brazil
| | - Italmar Teodorico Navarro
- Department of Veterinary, Agricultural Sciences Center, Universidade Estadual de Londrina (UEL), Londrina, PR, Brazil
| | | | | | | | - Sthefany Pagliari
- Graduate Program in Veterinary Medicine, Agricultural Sciences Center, Universidade Estadual de Londrina (UEL), Londrina, PR, Brazil
| | - Inácio Teruo Inoue
- Department of Gynecology and Obstetrics, Health Sciences Center, Universidade Estadual de Londrina (UEL), Londrina, PR, Brazil
| | - Edna Maria Vissoci Reiche
- Department of Pathology, Clinical Analysis, and Toxicology, Health Sciences Center, Universidade Estadual de Londrina (UEL), Londrina, PR, Brazil
| |
Collapse
|
9
|
Messerer L, Bouzbid S, Gourbdji E, Mansouri R, Bachi F. [Seroprevalence of toxoplasmosis in pregnant women in Annaba, Algeria]. Rev Epidemiol Sante Publique 2014; 62:160-5. [PMID: 24661506 DOI: 10.1016/j.respe.2013.11.072] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2012] [Revised: 07/25/2013] [Accepted: 11/27/2013] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The aim of the study was to estimate the seroprevalence and risk factors of toxoplasmosis in pregnant women in the department of Annaba, Algeria. METHODS We performed a cross-sectional study with analytical purposes. The study was collaboration between the laboratory of Parasitology-Mycology, Faculty of Medicine of Annaba and Parasite Biology Department at the Pasteur Institute of Algeria. A total of 1028 pregnant women who underwent prenatal diagnosis/visit were included over a period of 4 years from January 2006 to December 2009. Immunoglobulin G and M were assayed, using the microparticle enzyme method. The avidity test was used to determine the date of contamination according to age of pregnancy. Search for the parasite was made by inoculation of the placenta and cord blood in white mice. The study compared mother-to-child serological profiles using Western Blot (WB) IgG and IgM. Direct (not well-cooked meat) and indirect (presence of cat, gardening) indicators were recorded to search for parasite exposure. RESULTS Seroprevalence was 47.8 % (95 % CI: 44.8 to 51.0) and the rate of active toxoplasmosis was 1.1 % (95 % CI 0.6 to 1.8). According to their immune status, this was the first serology for 41 % (CI95 %: 38.0-44.0) of women; 12 % (CI95 %: 10.5-14.6) of primiparous women had only one serology test during their entire pregnancy. Major risk factors were consumption of poorly-cooked meat and exposure to cats. CONCLUSION Toxoplasmosis during pregnancy is a serious issue and an effective prevention program is needed.
Collapse
Affiliation(s)
- L Messerer
- Laboratoire de parasitologie-mycologie, faculté de médecine, Annaba, Algérie.
| | - S Bouzbid
- Service d'épidémiologie et de médecine préventive, CHU d'Annaba, Annaba, Algérie
| | - E Gourbdji
- Service de biologie parasitaire, institut Pasteur d'Algérie, Alger, Algérie
| | - R Mansouri
- Laboratoire de parasitologie-mycologie, faculté de médecine, Annaba, Algérie
| | - F Bachi
- Service de biologie parasitaire, institut Pasteur d'Algérie, Alger, Algérie
| |
Collapse
|
10
|
Asproudis I, Koumpoulis I, Kalogeropoulos C, Sotiropoulos G, Papassava M, Aspiotis M. Case report of a neonate with ocular toxoplasmosis due to congenital infection: estimation of the percentage of ocular toxoplasmosis in Greece caused by congenital or acquired infection. Clin Ophthalmol 2013; 7:2249-52. [PMID: 24293989 PMCID: PMC3839798 DOI: 10.2147/opth.s51740] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
We report a case of a newborn male child with congenital toxoplasmosis. During pregnancy seroconversion occurred and positive titers of antitoxoplasmic antibodies (immunoglobulin M and G) were found in the mother, in the third trimester. She received treatment with spiramycin. After birth, the neonate presented with chorioretinitis and intracranial calcifications. The neonate received treatment with pyrimethamine, sulfadiazine, and leucovorin for 1 year. In addition to using a previously described method, we report for the first time in Greece an estimation regarding the percentage of ocular toxoplasmosis caused by congenital or acquired infection. We estimate that ocular toxoplasmosis in Greece is caused in 7% of the cases by congenital infection, and in 93% of the cases by acquired infection.
Collapse
Affiliation(s)
- Ioannis Asproudis
- Department of Ophthalmology, Medical School, University of Ioannina, Ioannina, Greece
| | | | | | | | | | | |
Collapse
|
11
|
Sappenfield E, Jamieson DJ, Kourtis AP. Pregnancy and susceptibility to infectious diseases. Infect Dis Obstet Gynecol 2013; 2013:752852. [PMID: 23935259 PMCID: PMC3723080 DOI: 10.1155/2013/752852] [Citation(s) in RCA: 133] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Accepted: 06/17/2013] [Indexed: 11/18/2022] Open
Abstract
To summarize the literature regarding susceptibility of pregnant women to infectious diseases and severity of resulting disease, we conducted a review using a PubMed search and other strategies. Studies were included if they reported information on infection risk or disease outcome in pregnant women. In all, 1454 abstracts were reviewed, and a total of 85 studies were included. Data were extracted regarding number of cases in pregnant women, rates of infection, risk factors for disease severity or complications, and maternal outcomes. The evidence indicates that pregnancy is associated with increased severity of some infectious diseases, such as influenza, malaria, hepatitis E, and herpes simplex virus (HSV) infection (risk for dissemination/hepatitis); there is also some evidence for increased severity of measles and smallpox. Disease severity seems higher with advanced pregnancy. Pregnant women may be more susceptible to acquisition of malaria, HIV infection, and listeriosis, although the evidence is limited. These results reinforce the importance of infection prevention as well as of early identification and treatment of suspected influenza, malaria, hepatitis E, and HSV disease during pregnancy.
Collapse
Affiliation(s)
- Elisabeth Sappenfield
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
| | - Denise J. Jamieson
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
| | - Athena P. Kourtis
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA
| |
Collapse
|
12
|
Aptouramani M, Theodoridou M, Syrogiannopoulos G, Mentis A, Papaevangelou V, Gaitana K, Daponte A, Hadjichristodoulou C. A dedicated surveillance network for congenital toxoplasmosis in Greece, 2006-2009: assessment of the results. BMC Public Health 2012; 12:1019. [PMID: 23173875 PMCID: PMC3533839 DOI: 10.1186/1471-2458-12-1019] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2012] [Accepted: 11/05/2012] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Toxoplasmosis is caused by infection with the protozoan parasite Toxoplasma gondii. Acute infections in pregnant women may be transmitted to the fetus and cause severe illness. The purpose of this study was to establish a dedicated surveillance network (DSN) for congenital toxoplasmosis (CT) in Greece, in order to assess the birth prevalence of CT. METHODS A DSN of thirty clinicians was established for reporting CT cases from hospitals throughout Greece. The clinicians were selected on the basis that there was a high possibility the suspected cases would be referred to them from district hospitals or private clinics. Suspected cases of CT were reported on a monthly basis with a zero reporting card during a surveillance period from April 2006 to December 2009. A questionnaire was sent for any suspected case to record information including demographic parameters, clinical signs and symptoms and laboratory results. Serological and molecular confirmation of cases was performed by the Pasteur Hellenic Institute. All newborns suspected of CT received treatment and were serologically and clinically followed up for one year. RESULTS The monthly response rate reached 100%, although only after reminders sent to 65% of the participant physicians. Sixty-three suspected CT cases were recorded by the DSN during the study period including fourteen confirmed and seven probable cases. Ten cases (47.6%) presented with symptoms at birth. Chorioretinitis was the most prominent manifestation, occurring in five symptomatic CT cases (50%). No other symptoms appeared by the end of the one year clinical follow up. No case was recorded by the existing surveillance system of the Hellenic Center of Disease Control and Prevention (HCDCP) during the same time period. Birth prevalence was estimated at 0.45, 0.51 and 0.51 per 10,000 births for 2007, 2008 and 2009 respectively. The incidence rate of symptomatic CT at birth was estimated at 0.10 cases per 10,000 births per year in Greece (for the period 2007-2009). CONCLUSION The DSN for CT proved to be more sensitive than the classical notification system, easy in application and very efficient in reporting rare diseases such as CT. Similar DSNs could be used to provide useful information on other rare diseases.
Collapse
Affiliation(s)
- Maria Aptouramani
- Greece-Cyprus Pediatric Surveillance Unit (GCPSU), Laboratory of Hygiene and Epidemiology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Dias RCF, Lopes-Mori FMR, Mitsuka-Breganó R, Dias RAF, Tokano DV, Reiche EMV, Freire RL, Navarro IT. Factors associated to infection by Toxoplasma gondii in pregnant women attended in Basic Health Units in the city of Rolândia, Paraná, Brazil. Rev Inst Med Trop Sao Paulo 2012; 53:185-91. [PMID: 21915460 DOI: 10.1590/s0036-46652011000400002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2011] [Accepted: 06/09/2011] [Indexed: 11/22/2022] Open
Abstract
The aim of the present work was to determine the prevalence of IgG and IgM anti-Toxoplasma gondii antibodies and the factors associated to the infection in pregnant women attended in Basic Health Units in Rolândia, Paraná, Brazil. The sample was divided in two groups: group I (320 pregnant women who were analyzed from July 2007 to February 2008) and group II (287 pregnant women who were analyzed from March to October 2008). In group I, it was found 53.1% of pregnant women with IgG reactive and IgM non-reactive, 1.9% with IgG and IgM reactive, 0.3% with IgG non-reactive and IgM reactive and 44.7% with IgG and IgM non-reactive. In group II, it was found 55.1% with IgG reactive and IgM non-reactive and 44.9% with IgG and IgM non-reactive. The variables associated to the presence of IgG antibodies were: residence in rural areas, pregnant women between 35-40 years old, low educational level, low family income, more than one pregnancy, drinking water which does not originate from the public water supply system and the habit of handling soil or sand. Guidance on primary prevention measures and the quarterly serological monitoring of the pregnant women in the risk group are important measures to prevent congenital toxoplasmosis.
Collapse
|
14
|
Anti-Toxoplasma antibody prevalence, primary infection rate, and risk factors in a study of toxoplasmosis in 4,466 pregnant women in Japan. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2011; 19:365-7. [PMID: 22205659 DOI: 10.1128/cvi.05486-11] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Toxoplasmosis is a zoonosis caused by infection with Toxoplasma gondii and is prevalent worldwide under various climatic conditions. It is usually asymptomatic, but infection in pregnant women can pose serious health problems for the fetus. However, epidemiological information regarding toxoplasmosis in Japanese pregnant women is limited. This study aimed to determine the prevalence of anti-Toxoplasma antibodies, the primary infection rate, and the risk factors for toxoplasmosis in Japanese pregnant women. We measured anti-Toxoplasma antibody titers in 4,466 pregnant women over a period of 7.5 years and simultaneously conducted interviews to identify the risk factors for toxoplasmosis. The overall prevalence of anti-Toxoplasma antibodies was 10.3%, and it was significantly higher in women aged above 35 years. The rate of primary Toxoplasma infection during pregnancy was estimated to be 0.25%. A possibility of infection in the later stages of pregnancy was identified for those women who were not infected in the early stages. A history of raw meat intake was identified to be a risk factor related to toxoplasmosis. Therefore, to lower the risk of toxoplasmosis, pregnant women should refrain from eating raw and undercooked meat and maintain personal hygiene.
Collapse
|
15
|
Adesiyun A, Campbell M, Rahaman S, Bissessar S, Stewart-Johnson A, Dookeran S, Gittens-St. Hilaire M. Frequency of Detection of Immunoglobulins ofToxoplasma gondii, Leptospiraspp., andBrucella abortusin Livestock/Farm and Abattoir Workers in Trinidad. J Agromedicine 2011; 16:200-9. [PMID: 21728871 DOI: 10.1080/1059924x.2011.581541] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
16
|
Sellami H, Amri H, Cheikhrouhou F, Sellami A, Makni F, Trabelsi H, Trabelsi K, Guermazi M, Ayadi A. [Toxoplasmosis in Sfax, Tunisia]. ACTA ACUST UNITED AC 2011; 103:37-40. [PMID: 20084482 DOI: 10.1007/s13149-009-0004-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2008] [Accepted: 04/14/2009] [Indexed: 11/25/2022]
Abstract
Abstract The frequency of toxoplasmosis depends on life-style and environment. Our objective was to study different epidemiological, clinical and biological aspects of toxoplasmosis in the Sfax area (Tunisia). This retrospective study has been performed on seria of 40,566 pregnant women in the Parasitology-Mycology Laboratory of Habib-Bourguiba Sfax hospital-Tunisia for 13 years from 1994 to 2006; 1,691 patients presenting with lymphadenopathy; 191 immunocompromised patients (78 HIV infected patients and 113 transplanted patients) and 21 patients presenting clinical signs of ocular toxoplasmosis. In pregnant women, the seroprevalence was 39.3% (15,952/40,567). Among 24,089 seronegative women, only 6,890 (28.6%) had been followed up during their pregnancy. An active toxoplasmosis possibly acquired during pregnancy was detected in 1.3% of cases. Sixteen congenital toxoplasmosis were detected. Toxoplasmosis was confirmed in 13.7% of the 169 patients with lymphadenitis. For HIV positive patients, 11.7% had cerebral toxoplasmosis. It revealed the HIV infection in four cases. Among transplant recipients, one case of active toxoplasmosis was diagnosed in a renal transplant recipient who received transplant from a seronegative donor. Twenty-one patients presenting toxoplasmic retinochoroiditis were treated by subconjonctival injections of clindamycin and systemic corticotherapy at a dose of 1 mg/kg per day. This clinical toxoplasmosis diversity explains the need for bioclinical confrontation to establish diagnosis.
Collapse
Affiliation(s)
- H Sellami
- Laboratoire de parasitologie-mycologie, CHU Habib-Bourguiba, Sfax, Tunisie.
| | | | | | | | | | | | | | | | | |
Collapse
|
17
|
Pappas G, Roussos N, Falagas ME. Toxoplasmosis snapshots: global status of Toxoplasma gondii seroprevalence and implications for pregnancy and congenital toxoplasmosis. Int J Parasitol 2009; 39:1385-94. [PMID: 19433092 DOI: 10.1016/j.ijpara.2009.04.003] [Citation(s) in RCA: 636] [Impact Index Per Article: 42.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2009] [Revised: 04/22/2009] [Accepted: 04/23/2009] [Indexed: 01/17/2023]
Abstract
Toxoplasma gondii's importance for humans refers mainly to primary infection during pregnancy, resulting in abortion/stillbirth or congenital toxoplasmosis. The authors sought to evaluate the current global status of T. gondii seroprevalence and its correlations with risk factors, environmental and socioeconomic parameters. Literature published during the last decade on toxoplasmosis seroprevalence, in women who were pregnant or of childbearing age, was retrieved. A total of 99 studies were eligible; a further 36 studies offered seroprevalence data from regions/countries for which no data on pregnancy/childbearing age were available. Foci of high prevalence exist in Latin America, parts of Eastern/Central Europe, the Middle East, parts of south-east Asia and Africa. Regional seroprevalence variations relate to individual subpopulations' religious and socioeconomic practices. A trend towards lower seroprevalence is observed in many European countries and the United States of America (USA). There is no obvious climate-related gradient, excluding North and Latin America. Immigration has affected local prevalence in certain countries. We further sought to recognise specific risk factors related to seropositivity; however, such risk factors are not reported systematically. Population awareness may affect recognition of said risks. Global toxoplasmosis seroprevalence is continuingly evolving, subject to regional socioeconomic parameters and population habits. Awareness of these seroprevalence trends, particularly in the case of women of childbearing age, may allow proper public health policies to be enforced, targeting in particular seronegative women of childbearing age in high seroprevalence areas.
Collapse
|
18
|
Galanakis E, Manoura A, Antoniou M, Sifakis S, Korakaki E, Hatzidaki E, Lambraki D, Tselentis Y, Giannakopoulou C. Outcome of Toxoplasmosis Acquired during Pregnancy following Treatment in Both Pregnancy and Early Infancy. Fetal Diagn Ther 2007; 22:444-8. [PMID: 17652934 DOI: 10.1159/000106352] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2006] [Accepted: 09/06/2006] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Congenital toxoplasmosis is associated with clinical dilemmas as untreated infants may have a guarded prognosis and as treatment may induce severe side effects. The aim of this study was to investigate the outcome of infants born to mothers with toxoplasmosis acquired during pregnancy, following administration of appropriate regimens both during pregnancy and early infancy. STUDY DESIGN All 35 infants, born to mothers with toxoplasmosis acquired during pregnancy, and referred to the major Neonatal Department in Crete, Greece, during the 7-year period 1997-2003 were included. All neonates were evaluated soon after birth and on a regular follow-up. RESULTS Almost all mothers received spiramycin from diagnosis through labor and 2 received pyrimethamine and sulfadiazine. At birth, infants had IgG antibody titers ranging from 1/1,350 to 1/109,350. All infants initially received pyrimethamine, sulfadiazine and folinic acid but in only 4 cases treatment was continued beyond the second month of life. Transient neutropenia was commonly observed. A follow-up period of 1.2-8.2 years did not reveal any remarkable sequelae. CONCLUSIONS Our findings suggest that effective treatment both during pregnancy and early infancy is safe and may contribute to a good outcome of infants born to mothers with toxoplasmosis acquired during pregnancy.
Collapse
Affiliation(s)
- Emmanouil Galanakis
- Department of Neonatology, University Hospital of Heraklion, Heraklion, Greece.
| | | | | | | | | | | | | | | | | |
Collapse
|
19
|
Song KJ, Shin JC, Shin HJ, Nam HW. Seroprevalence of toxoplasmosis in Korean pregnant women. THE KOREAN JOURNAL OF PARASITOLOGY 2005; 43:69-71. [PMID: 15951643 PMCID: PMC2712002 DOI: 10.3347/kjp.2005.43.2.69] [Citation(s) in RCA: 66] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
This study was performed in order to evaluate the sero-epidemiological status of toxoplasmosis in pregnant Korean women. Among 5,175 sera and 750 amniotic fluid samples obtained from pregnant women, 41 serum samples (0.79%) and 10 (1.33%) amniotic fluid samples tested positive for IgG antibodies by ELISA. Fifty one cases showing a score more than 0.25 on ELISA were tested for PCR reaction against the SAG1 gene. Only one case of the 51 ELISA positive cases exhibited a positive reaction on all tests. This case had a history of acute nephropyelitis during early pregnancy, but fortunately, had delivered a phenotypically healthy baby. In this study, the seroprevalence of toxoplasmosis in pregnant women was found to be comparatively low, consistent with previous reports from Korea. However our trials, performed with a variety of diagnostic tools, were considered to be useful for the precise diagnosis of congenital toxoplasmosis.
Collapse
Affiliation(s)
- Kyoung-Ju Song
- Department of Microbiology, Ajou University School of Medicine, Suwon, Korea
| | | | | | | |
Collapse
|