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Idro R, Ogwang R, Barragan A, Raimondo JV, Masocha W. Neuroimmunology of Common Parasitic Infections in Africa. Front Immunol 2022; 13:791488. [PMID: 35222377 PMCID: PMC8866860 DOI: 10.3389/fimmu.2022.791488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 01/18/2022] [Indexed: 11/13/2022] Open
Abstract
Parasitic infections of the central nervous system are an important cause of morbidity and mortality in Africa. The neurological, cognitive, and psychiatric sequelae of these infections result from a complex interplay between the parasites and the host inflammatory response. Here we review some of the diseases caused by selected parasitic organisms known to infect the nervous system including Plasmodium falciparum, Toxoplasma gondii, Trypanosoma brucei spp., and Taenia solium species. For each parasite, we describe the geographical distribution, prevalence, life cycle, and typical clinical symptoms of infection and pathogenesis. We pay particular attention to how the parasites infect the brain and the interaction between each organism and the host immune system. We describe how an understanding of these processes may guide optimal diagnostic and therapeutic strategies to treat these disorders. Finally, we highlight current gaps in our understanding of disease pathophysiology and call for increased interrogation of these often-neglected disorders of the nervous system.
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Affiliation(s)
- Richard Idro
- College of Health Sciences, Makerere University, Kampala, Uganda.,Centre of Tropical Neuroscience, Kitgum, Uganda.,Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom
| | - Rodney Ogwang
- College of Health Sciences, Makerere University, Kampala, Uganda.,Centre of Tropical Neuroscience, Kitgum, Uganda.,Kenya Medical Research Institute (KEMRI) - Wellcome Trust Research Programme, Nairobi, Kenya
| | - Antonio Barragan
- Department of Molecular Biosciences, The Wenner-Gren Institute, Stockholm University, Stockholm, Sweden
| | - Joseph Valentino Raimondo
- Division of Cell Biology, Department of Human Biology, Neuroscience Institute and Institute of Infectious Disease and Molecular Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Willias Masocha
- Department of Pharmacology and Therapeutics, Faculty of Pharmacy, Kuwait University, Safat, Kuwait
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Omonijo AO, Kalinda C, Mukaratirwa S. Toxoplasma gondii Infections in Animals and Humans in Southern Africa: A Systematic Review and Meta-Analysis. Pathogens 2022; 11:183. [PMID: 35215126 PMCID: PMC8880191 DOI: 10.3390/pathogens11020183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 01/15/2022] [Accepted: 01/17/2022] [Indexed: 11/25/2022] Open
Abstract
Background: Toxoplasma gondii is an apicomplexan parasite with zoonotic importance worldwide especially in pregnant women and immunocompromised people. This study is set to review the literature on T. gondii infections in humans and animals in southern Africa. Methods: We extracted data regarding T. gondii infections from published articles from southern Africa from 1955 to 2020 from four databases, namely Google Scholar, PubMed, EBSCO Host, and Science Direct. Forty articles from eight southern African countries were found eligible for the study. Results: This review revealed a paucity of information on T. gondii infection in southern African countries, with an overall prevalence of 17% (95% CI: 7–29%). Domestic felids had a prevalence of 29% (95% CI: 7–54%), wild felids 79% (95% CI: 60–94), canids (domestic and wild) 69% (95% CI: 38–96%), cattle 20% (95% CI: 5–39%), pigs 13% (95% CI: 1–29%), small ruminants (goats and sheep) 11% (95% CI: 0–31%), chicken and birds 22% (95% CI: 0–84%), and humans 14% (95% CI: 5–25%). Enzyme-linked immunosorbent assay (ELISA) and immunofluorescence antibody test (IFAT) constituted the most frequently used diagnostic tests for T. gondii. Conclusions: We recommend more focused studies be conducted on the epidemiology of T. gondii in the environment, food animals and human population, most especially the at-risk populations.
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Fang EE, Nyasa RB, Ndi EM, Zofou D, Kwenti TE, Lepezeu EP, Titanji VPK, N. Ndip R. Investigating the risk factors for seroprevalence and the correlation between CD4+ T-cell count and humoral antibody responses to Toxoplasma gondii infection amongst HIV patients in the Bamenda Health District, Cameroon. PLoS One 2021; 16:e0256947. [PMID: 34855762 PMCID: PMC8638881 DOI: 10.1371/journal.pone.0256947] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 08/19/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Toxoplasmosis is caused by an obligate intracellular tissue protozoan parasite, Toxoplasma gondii that infect humans and other warm-blooded animals. Transmission to humans is by eating raw or inadequately cooked infected meat or through ingestion of oocysts that cats have passed in faeces. Studies have shown life-threatening and substantial neurologic damage in immunocompromised patients; however, 80% of humans remain asymptomatic. The aim of this study was to determine the seroprevalence of Toxoplasma gondii infection in HIV positive patients and the risk factors associated with the infection, and to investigate the correlation between CD4+ T-cell count and toxoplasma specific antibodies as possible predictors of each other amongst HIV patients in the Bamenda Health District of the North West Region of Cameroon. METHODS A cross-sectional study was conducted, in which 325 HIV patients were recruited for administration of questionnaire, serological diagnosis of T. gondii and measurement of CD4+ T-cell count. Bivariate and multivariate logistic regression was used to identify risk factors associated with T. gondii infection while the linear regression was used to investigate the relationship between CD4+ T-cell count and antibody levels against T. gondii. RESULTS The findings showed that, majority (45.8%) of HIV patients suffered from chronic (IgG antibody) infection, and 6.5% from acute (IgM and IgM/IgG antibody) toxoplasma infection. The overall sero-prevalence of T. gondii infection amongst HIV patients was 50.5%. On the whole, 43 men (45.7%) and 127 women (55%) presented with anti- T. gondii antibodies; however, there was no significant difference amongst males and females who were positive to T. gondii infection (p = 0.131). Marital status (p = 0.0003), contact with garden soil (p = 0.0062), and garden ownership (p = 0.009), were factors that showed significant association with T. gondii infection. There was no significant difference (p = 0.909) between the mean CD4+ T-cell count of HIV patients negative for toxoplasma infection (502.7 cells/mL), chronically infected with T. gondii (517.7 cells/mL) and acutely infected with T. gondii (513.1 cells/mL). CD4+ T-cell count was neither a predictor of IgM antibody titer (r = 0.193, p = 0.401), nor IgG antibody titer (r = 0.149, p = 0.519) amongst HIV patients acutely infected with T. gondii. CONCLUSION The findings from this study underscore the need to implement preventive and control measures to fight against T. gondii infection amongst HIV patients in the Bamenda Health District.
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Affiliation(s)
- Eugene Enah Fang
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Raymond Babila Nyasa
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Biotechnology Unit, Faculty of Science, University of Buea, Buea, South West Region, Cameroon
| | - Emmanuel Menang Ndi
- Biotechnology Unit, Faculty of Science, University of Buea, Buea, South West Region, Cameroon
| | - Denis Zofou
- Biotechnology Unit, Faculty of Science, University of Buea, Buea, South West Region, Cameroon
| | - Tebit Emmanuel Kwenti
- Department of Medical Laboratory Sciences, Faculty of Health Science, University of Buea, Buea, South West Region, Cameroon
| | | | - Vincent P. K. Titanji
- Biotechnology Unit, Faculty of Science, University of Buea, Buea, South West Region, Cameroon
- Cameroon Christian University, Bali, North West Region, Cameroon
| | - Roland N. Ndip
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- Laboratory for Emerging Infectious Diseases, University of Buea, Buea, South West Region, Cameroon
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Manuel L, Santos-Gomes G, Noormahomed EV. Human toxoplasmosis in Mozambique: gaps in knowledge and research opportunities. Parasit Vectors 2020; 13:571. [PMID: 33176884 PMCID: PMC7659051 DOI: 10.1186/s13071-020-04441-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 10/30/2020] [Indexed: 01/01/2023] Open
Abstract
Toxoplasmosis is a parasitic zoonotic disease caused by Toxoplasma gondii that afflicts humans worldwide and wild and domestic warm-blooded animals. In immunocompetent individuals, the acute phase of infection presents transient low or mild symptoms that remain unnoticed. In immunocompromised patients, T. gondii is a life-threatening opportunistic infection, which can result from the reactivation of latent infection or primary infection. Moreover, congenital toxoplasmosis, which results from the transplacental passage of tachyzoites into the fetus during a pregnant primary infection, can lead to miscarriage, stillbirth, or ocular and neurologic disease, and neurocognitive deficits in the newborns. Thus, the present review aims to address the current knowledge of T. gondii infection and toxoplasmosis in Africa and especially in Mozambique, stressing the importance of identifying risk factors and promote awareness among the health care providers and population, assessing the gaps in knowledge and define research priorities. In Mozambique, and in general in southern African countries, clinical disease and epidemiological data have not yet been entirely addressed in addition to the implications of T. gondii infection in immunocompetent individuals, in pregnant women, and its relation with neuropsychiatric disorders. The main gaps in knowledge in Mozambique include lack of awareness of the disease, lack of diagnostic methods in health facilities, lack of genetic data, and lack of control strategies.![]()
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Affiliation(s)
- Leonardo Manuel
- Faculty of Health Sciences, Universidade Lurio, Nampula, Mozambique
| | - Gabriela Santos-Gomes
- Global Health and Tropical Medicine (GHTM), Instituto de Higiene e Medicina Tropical (IHMT), Universidade Nova de Lisboa (UNL), Lisbon, Portugal
| | - Emilia V Noormahomed
- Department of Microbiology, Faculty of Medicine, Universidade Eduardo Mondlane (UEM), Maputo, Mozambique. .,Department of Medicine, Infectious Disease Division, University of California, San Diego, USA. .,Mozambique Institute for Health Education and Research (MIHER), Maputo, Mozambique.
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Abstract
BACKGROUND Neurological disorders in HIV infection are a common cause of morbidity and mortality. The aim of this paper is to provide a narrative overview of up to date information concerning neurological disorders affecting HIV infected persons in Africa. METHODS Seminal research concerning neurological disorders among HIV-infected adults in sub-Saharan Africa from prior to 2000 was combined with an in-depth search of PubMed to identify literature published from 2000 to 2017. The following Mesh terms were used. "Nervous System Diseases" "HIV Infections" and "Africa South of the Sahara" and "Seizures" or "Spinal Cord Diseases" or "Peripheral Nervous System Diseases" or "AIDS Dementia Complex" or "Opportunistic Infections" or "Immune Reconstitution Inflammatory Syndrome" or "Stroke". Only those articles written in English were used. A total of 352 articles were identified, selected and reviewed and 180 were included in the study. These included case series, observational studies, interventional studies, guidelines and reviews with metanalyses. The author also included 15 publications on the subject covering the earlier phase of the HIV epidemic in Africa from 1987 to 1999 making a total of 195 references in the study. This was combined with extensive personal experience diagnosing and treating these neurological disorders. RESULTS Neurological disorders were common, typically occurring in WHO stages III/IV. These were in three main categories: those arising from opportunistic processes mostly infections, direct HIV infection and autoimmunity. The most common were those arising from direct HIV infection occurring in >50%. These included HIV-associated neurocognitive dysfunction (HAND), neuropathy and myelopathy. Opportunistic infections occurred in >20% and frequently had a 6-9-month mortality rate of 60-70%. The main causes were cryptococcus, tuberculosis, toxoplasmosis and acute bacterial meningitis. Concurrent systemic tuberculosis occurred in almost 50%. CONCLUSION Neurological disorders are common in HIV in Africa and the main CNS opportunistic infections result in high mortality rates. Strategies aimed at reducing their high burden, morbidity and mortality include early HIV diagnosis and anti-retroviral therapy (ART), screening and chemoprophylaxis of main opportunistic infections, improved clinical diagnosis and management and programme strengthening.
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Affiliation(s)
- William P Howlett
- Department of Internal Medicine, Kilimanjaro Christian Medical Centre, Moshi, Tanzania
- Center for International Health, University of Bergen, Norway
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Bavand A, Aghakhani A, Mohraz M, Banifazl M, Karami A, Golkar M, Babaie J, Saleh P, Mamishi S, Ramezani A. Prevalence of Toxoplasma gondii Antibodies and DNA in Iranian HIV Patients. Iran J Pathol 2018; 14:68-75. [PMID: 31531103 PMCID: PMC6708569 DOI: 10.30699/ijp.14.1.68] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/01/2018] [Accepted: 12/24/2018] [Indexed: 01/21/2023]
Abstract
Background & Objective: Toxoplasma gondii infection has public health importance and can lead to serious diseases in immunosuppressed patients, such as HIV cases. Appropriate control of T. gondii infection in HIV patients requires information about the prevalence of T. gondii antibodies and DNA in different population. In this study, we aimed to determine the prevalence of Toxoplasma gondii antibodies and DNA in HIV patients in Tehran, Iran. Methods: A total of 149 HIV patients from the Iranian Research Center for HIV/AIDS, Tehran, Iran were enrolled in the study. Anti-Toxoplasma IgG and IgM were detected by ELISA and T. gondii DNA was evaluated by PCR and quantita- tive real-time PCR. IgG positive samples were also assessed for their avidity. Results: Anti-Toxoplasma IgG and IgM were positive in 46.3% and 2.7% of cases respectively. 92.7% of our patients showed past infection and 4.3% revealed recently acquired toxoplasmosis based on their IgG avidity test. T. gondii DNA was not detected by PCR but real-time PCR results showed DNA in 4.7% of total patients and 13.1% of the IgG seropositive cases. Conclusion: Our findings indicated that latent toxoplasmosis was relatively prevalent in our study population, but new T. gondii infection had low prevalence. Almost half of our patients were IgG negative and at risk of acquiring toxoplasma infection. Low copy numbers of DNA were detected in 4.7% of the cases without any clinical manifestation. Therefore, detection and monitoring of anti-Toxoplasma antibodies and DNA in HIV patients is substantial to estimate the risk of reactivation and new infection.
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Affiliation(s)
- Anahita Bavand
- MSc, Dept. of Clinical Research, Pasteur Institute of Iran, Tehran, Iran
| | - Arezoo Aghakhani
- Anatomical & Clinical Pathologist, Dept. of Clinical Research, Pasteur Institute of Iran, Tehran, Iran
| | - Minoo Mohraz
- Infectious Diseases Specialist, Iranian Research Center for HIV/AIDS, Tehran, Iran
| | - Mohammad Banifazl
- Pediatrician, Iranian Society for Support of Patients with Infectious Disease, Tehran, Iran
| | - Afsaneh Karami
- Infectious Diseases Specialist, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Majid Golkar
- PhD, Molecular Parasitology Laboratory, Dept. of Parasitology, Pasteur Institute of Iran, Tehran, Iran
| | - Jalal Babaie
- PhD, Molecular Parasitology Laboratory, Dept. of Parasitology, Pasteur Institute of Iran, Tehran, Iran
| | - Parviz Saleh
- Infectious Diseases Specialist, Kidney Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Setareh Mamishi
- Pediatrician, Pediatric Infectious Disease Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Amitis Ramezani
- Infectious Diseases Specialist, Dept. of Clinical Research, Pasteur Institute of Iran, Tehran, Iran
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Ngobeni R, Samie A. PREVALENCE OF TOXOPLASMA GONDII IGG AND IGM AND ASSOCIATED RISK FACTORS AMONG HIV-POSITIVE AND HIV-NEGATIVE PATIENTS IN VHEMBE DISTRICT OF SOUTH AFRICA. Afr J Infect Dis 2017; 11:1-9. [PMID: 28670634 PMCID: PMC5476807 DOI: 10.21010/ajid.v11i2.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Background: Toxoplasma gondii is a zoonotic parasite that has arisen as an important opportunistic infection that causes morbidity and mortality especially in HIV positive patients. This study was carried out to determine the sero-prevalence of T. gondii (IgG and IgM) and the associated risk factors among HIV positive and negative patients in Northern South Africa. Materials and Methods: The study was conducted in the Vhembe District in Limpopo province from April 2012 to January 2013. A well-structured questionnaire was used to collect socio-demographic information and possible risk factor information on toxoplasmosis from participants. A total of 161 blood samples of both HIV positive and negative patients visiting the local clinics in the Vhembe district were collected. Serum samples were tested for IgG and IgM against T. gondii using commercially available ELISA protocol. Results: The prevalence of T. gondii IgG was 31.7% while that of T. gondii IgM was 4.9%. The prevalence of T. gondii IgG was higher in HIV positive patients (38%) compared to 16.7% among HIV negative patients (p=0.001). Toxoplasma gondii IgG antibodies were more common in patients who were not taking ARV’s (46.2%) compared to those who were taking ARV’s (35.2%) (P<0.001). Conclusions: The present study has shown a high prevalence of T. gondii (IgG) among patients attending different HIV clinics in the Vhembe district with no current infections among pregnant women. In addition to the sero-positive status of the patient to HIV, other significant risk factors for toxoplasmosis included high viral load, non-adherence to ARV therapy and age (>25 years).
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Affiliation(s)
- Renay Ngobeni
- Molecular Parasitology and Opportunistic Infections Program, Department of Microbiology, School of Mathematical and Natural Sciences, University of Venda, South Africa
| | - Amidou Samie
- Molecular Parasitology and Opportunistic Infections Program, Department of Microbiology, School of Mathematical and Natural Sciences, University of Venda, South Africa
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Wang ZD, Wang SC, Liu HH, Ma HY, Li ZY, Wei F, Zhu XQ, Liu Q. Prevalence and burden of Toxoplasma gondii infection in HIV-infected people: a systematic review and meta-analysis. The Lancet HIV 2017; 4:e177-e188. [DOI: 10.1016/s2352-3018(17)30005-x] [Citation(s) in RCA: 121] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 11/16/2016] [Accepted: 11/29/2016] [Indexed: 11/30/2022]
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Rezanezhad H, Sayadi F, Shadmand E, Nasab SDM, Yazdi HR, Solhjoo K, Kazemi A, Maleki M, Vasmehjani AA. Seroprevalence of Toxoplasma gondii among HIV Patients in Jahrom, Southern Iran. Korean J Parasitol 2017; 55:99-103. [PMID: 28285515 PMCID: PMC5365268 DOI: 10.3347/kjp.2017.55.1.99] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/10/2016] [Revised: 09/26/2016] [Accepted: 10/04/2016] [Indexed: 11/23/2022]
Abstract
Toxoplasma gondii is an important opportunistic agent especially in immunocompromised hosts and can cause significant morbidity and mortality. Hence, detection and monitoring of anti-Toxoplasma antibodies are of a great interest in HIV-infected patients. A study on the prevalence of toxoplasmosis and associated risk factors was carried out among HIV-infected patients in Jahrom, southern Iran. The prevalence of anti-Toxoplasma IgG antibodies was 21.1% in HIV-infected patients by ELISA. PCR was performed on all of the samples, and 1 of the blood samples was positively detected. Among the HIV patients, anti-Toxoplasma IgG antibodies were significantly higher in age group of 30-39 years old (P=0.05). The seroprevalence of toxoplasmosis in patients with CD4+<100 cells/μl was 33.3% that was significantly higher than the other groups (P=0.042) with or without IgG antibodies. The CD4+ count mean of seropositive patients was lower than that of seronegative patients. The seroprevalence of toxoplasmosis in patients with highly active antiretroviral therapy was significantly less than patients without therapy (P=0.02). In conclusion, this study showed low seroprevalence of latent toxoplasmosis among HIV-infected patients in the region and confirmed the need for intensifying prevention efforts among this high-risk population and also the risk of toxoplasmosis reactivation which could be important among this population.
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Affiliation(s)
- Hassan Rezanezhad
- Zoonoses Research Center, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Fateme Sayadi
- Department of Student Research Committee, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Enayatollah Shadmand
- Department of Microbiology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | | | - Hadi Rezaei Yazdi
- Department of Microbiology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Kavous Solhjoo
- Zoonoses Research Center, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Akbar Kazemi
- Department of Microbiology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
| | - Monireh Maleki
- Department of Clinical Biochemistry, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Abbas Ahmadi Vasmehjani
- Department of Microbiology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
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Zeleke AJ, Melsew YA. Seroprevalence of Toxoplasma gondii and associated risk factors among HIV-infected women within reproductive age group at Mizan Aman General Hospital, Southwest Ethiopia: a cross sectional study. BMC Res Notes 2017; 10:70. [PMID: 28126016 PMCID: PMC5270335 DOI: 10.1186/s13104-017-2390-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2015] [Accepted: 01/17/2017] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Toxoplasmosis is serious in the case of immune suppression and prenatal transmission. In immunocompromised hosts, it is manifested primarily as a life-threatening condition, toxoplasmic encephalitis. Congenital toxoplasmosis results in abortion or congenitally acquired disorders which primarily affect the central nervous system. This study assessed seroprevalence of Toxoplasma gondii (T. gondii) infection and associated factors among HIV-infected women within the reproductive age group (18-49 years) at Mizan Aman General Hospital, Southwest Ethiopia. An institution based cross-sectional study was conducted from February 01 to May 30, 2015. Systematic random sampling technique was employed for participant selection. Enzyme linked immuno sorbent assay was used to test for T. gondii from venous blood specimens. Participants were interviewed using structured questionnaire for different variables. Descriptive statistics, binary and multivariable logistic regression analyses were performed during data analysis. P value of less than 0.05 was considered statistically significant. RESULTS A total of 270 HIV-infected women within the reproductive age group were included in the study. Mean age of the respondents was 31 years (SD = ±6.5). Of the total study participants, 255 (94.4%), 95% CI (91.6, 97.2%) were found to be seropositive for T. gondii anti-immunoglobulin G (IgG) antibody, and 6 (2.2%), 95% CI (1.3, 3.1%) for anti-immunoglobulin M (IgM). All the anti-IgM positive samples were also positive for IgG. Multivariate analysis showed that; age within 28-37 years (Adjusted Odds Ratio [AOR] 2.58, 95% CI 1.01, 6.60), level of education with unable or only able to read and write (AOR = 4.46, 95% CI 1.20, 16.60), and substance abuse (AOR = 4.49, 95 CI 1.60, 12.55) were significantly associated with seropositivity of T. gondii infection. CONCLUSIONS Seroprevalence of toxoplasmosis among the HIV-infected women in the childbearing age group in Mizan Aman was high. Age, educational status and drug addiction were identified as factors associated with T. gondii infection. Education of HIV-infected women about the transmission and prevention methods of T. gondii infection is important. Besides, studies on incidence of toxoplasmosis in newborns and infants are recommended.
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Affiliation(s)
- Ayalew Jejaw Zeleke
- Department of Parasitology, School of Biomedical and Laboratory Science, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Yayehirad Alemu Melsew
- Department of Epidemiology and Biostatistics, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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Haryati S, Prasetyo AA, Sariyatun R, Sari Y, Murkati. Interferon-γ +874A/T polymorphism associated with Toxoplasma gondii seropositivity in HIV patients. Asian Pacific Journal of Tropical Disease 2015. [DOI: 10.1016/s2222-1808(15)60933-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Domingos A, Ito LS, Coelho E, Lúcio JM, Matida LH, Ramos AN. Seroprevalence of Toxoplasma gondii IgG antibody in HIV/AIDS-infected individuals in Maputo, Mozambique. Rev Saude Publica 2014; 47:890-6. [PMID: 24626493 DOI: 10.1590/s0034-8910.2013047004661] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Accepted: 06/01/2013] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To analyze the prevalence of IgG antibodies to Toxoplasma gondii in patients infected with HIV/AIDS and the association of demographic and social variables. METHODS Descriptive cross-sectional study that included the analysis of sociodemographic data and laboratory findings of 200 patients infected with HIV/AIDS treated in a laboratory unit in Maputo, Mozambique, in 2010. Individual data for all participants were collected with a self-administered questionnaire. Plasma samples were tested for IgG testing of anti- T. gondii using hemagglutination for the analysis of antibodies. RESULTS The seroprevalence of IgG anti- T. gondii was 46.0% (95%CI 39.2;52.9), 39.3% (95%CI 29.5;50.0) in men and 50.9% (95%CI 41.9;59.8) in women, with no difference between sex (OR 1.30; 95%CI 0.95;1.77; p = 0.12). Ages ranged from 10 to 60 years, with a higher prevalence of infection in older age groups, but with no significant difference between them. Regularly consuming cattle meat (OR 1.74; 95%CI 1.04;2.89, p = 0.05), breeding cats/dogs (OR 6.18; 95%CI 3.60;10.62, p < 0.000) and having regular contact with soil (OR 3.38; 95%CI 2.19;5.21; p < 0.000) were significantly associated with risk of latent infection. CONCLUSIONS Toxoplasmosis is an infection with high prevalence in Mozambique. Cultural and behavioral aspects increase the risk. Toxoplasmosis can be responsible in our environment by the great burden of morbidity and mortality associated with meningoencephalic injuries in patients with HIV/AIDS.
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Affiliation(s)
- K Hammond-Aryee
- Division of Molecular Biology and Human Genetics, Stellenbosch University
| | - M Esser
- NHLS Immunology Unit, Tygerberg; Division of Medical Microbiology, Department of Pathology, Stellenbosch University
- Pediatrics Clinical Immunology and Rheumatology Clinics, Department of Pediatrics and Child Health, Tygerberg Hospital
- Primary Immunodeficiency Register of South Africa
| | - PD Van Helden
- Division of Molecular Biology and Human Genetics, Stellenbosch University
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Kestler A, Caruso N, Chandra A, Goldfarb D, Haas M. CT before lumbar puncture in suspected meningitis in Botswana: How established guidelines may not apply. Afr J Emerg Med 2014; 4:76-82. [DOI: 10.1016/j.afjem.2013.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Ogoina D, Obiako RO, Onyemelukwe GC, Musa BO, Hamidu AU. Clinical presentation and outcome of toxoplasma encephalitis in HIV-infected patients from Zaria, Northern Nigeria: a case series of 9 patients. J Int Assoc Provid AIDS Care 2013; 13:18-21. [PMID: 23962913 DOI: 10.1177/2325957413500529] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Toxoplasma encephalitis (TE) is the most common cause of focal deficits in patients living with HIV/AIDS. Among 257 HIV-infected adult patients seen between January 2006 and December 2010 in a tertiary hospital in Zaria, northern Nigeria, 9 (3.5%) patients had clinical, serological, and brain imaging evidence of TE. All 9 patients had CD4 count of less than 50 cells/mm(3). Of the 9 patients, 7 were antiretroviral therapy (ART)-naive, while 2 were cases of ART-induced TE-immune reconstitution inflammatory syndrome. After administering intravenous dexamethasone for cerebral decompression and specific antitoxoplasma therapy, symptoms and signs resolved in 8 patients within 4 to 14 days, but 1 patient died. Our data suggest that even in the ART era in Nigeria, TE remains a fairly common cause of morbidity among HIV-infected patients due to late HIV diagnosis and significant immunosuppression at diagnosis. Early HIV diagnosis, early initiation of highly active ART, and routine prophylaxis against TE are imperative in combating the challenge of HIV/AIDS-related TE in Nigeria.
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Affiliation(s)
- Dimie Ogoina
- Department of Medicine, College of Health Sciences, Niger Delta University, Wilberforce Island, Amassoma, Bayelsa, Nigeria
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Walle F, Kebede N, Tsegaye A, Kassa T. Seroprevalence and risk factors for Toxoplasmosis in HIV infected and non-infected individuals in Bahir Dar, Northwest Ethiopia. Parasit Vectors 2013; 6:15. [PMID: 23324409 PMCID: PMC3556116 DOI: 10.1186/1756-3305-6-15] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Accepted: 01/04/2013] [Indexed: 11/20/2022] Open
Abstract
Background Toxoplasmosis, a zoonotic disease distributed worldwide, is an infection caused by the ubiquitous obligatory intracellular coccidian protozoan organism, Toxoplasma gondii. It is a major public health concern because the disease is serious in terms of mortality or physical and /or psychological sequellae in patients with HIV disease. The aim of the study was to assess the seroprevalence of Toxoplasma gondii IgG and IgM antibodies and associated risk factors in HIV infected and non-infected individuals attending Felege Hiwot referral hospital, Bahir Dar, Northwest Ethiopia. Methods A cross sectional study was conducted at Felege Hiwot referral hospital, Bahir Dar, Amhara National Regional State. Venous blood samples were collected from 103 HIV infected pre anti-retroviral therapy patients at Felege Hiwot referral hospital and 101 HIV negative apparently healthy voluntary blood donors at the blood bank. Serum samples were analyzed for anti-Toxoplasma gondii IgG and IgM antibodies using a commercially available ELISA kit. Socio-demographic and associated risk factors for Toxoplasmosis from each individual were also obtained and the data was analyzed using SPSS version 18. Results Of the examined HIV seropositive individuals, 87.4% (90/103) and 10.7% (11/103) were positive for anti-T. gondii IgG and IgM antibodies, respectively. Multivariate analysis using logistic regression showed that anti-T. gondii seropositivity was independently significantly associated with undercooked or raw meat consumption (adjusted OR=5.73, 95% CI=1.35-24.39; P=0.02) and having contact with cat (adjusted OR= 4.29, 95% CI=1.08-16.94; P=0.04) in HIV positive individuals. In HIV negative apparently healthy blood donors, prevalence of anti-T. gondii antibodies were 70.29% and 2.97% for IgG and IgM, respectively. Multivariate analysis showed that undercooked or raw meat consumption (adjusted OR=6.45, 95% CI=2.16-19.28; p=0.001) and sex (OR=6.79, 95% CI=2.14-21.60; p=0.001) were independently significantly associated with anti-T. gondii IgG seropositivity, with a significantly higher number of males affected than females. Conclusion The present findings showed a high sero-prevalence of anti-T. gondii antibodies in HIV infected pre-ART and HIV non-infected apparently healthy blood donors in Bahir Dar. Consumption of undercooked or raw meat might greatly contribute towards acquiring T. gondii infection in HIV infected pre-ART and HIV non-infected apparently healthy blood donors. It may be appropriate to include routine serological screening test for determination of anti-T. gondii antibodies in HIV infected pre-ART individuals and HIV negative apparently healthy blood donors. In addition, health education towards avoiding eating undercooked and raw meat, and avoiding contact with cats were recommended.
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Affiliation(s)
- Fisseha Walle
- Department of Immunology and Hematology, Bahir Dar Regional Health Research Laboratory, Bahir Dar, Ethiopia
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Sitoe SPBL, Rafael B, Meireles LR, Andrade HFD, Thompson R. Preliminary report of HIV and Toxoplasma gondii occurrence in pregnant women from Mozambique. Rev Inst Med Trop Sao Paulo 2011; 52:291-5. [PMID: 21225211 DOI: 10.1590/s0036-46652010000600002] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2010] [Accepted: 09/17/2010] [Indexed: 11/22/2022] Open
Abstract
Toxoplasmosis, a protozoan disease, causes severe disease in fetuses during pregnancy and deadly encephalitis in HIV patients. There are several studies on its seroprevalence around the world, but studies focusing on African countries are limited in number and mostly anecdotal. We studied two groups of samples from Mozambique by ELISA, using serum samples from 150 pregnant women and six Cerebrospinal fluid (CSF) samples from AIDS patients with encephalitis. HIV status was confirmed, and CD4 blood counts were obtained from HIV-positive pregnant women. IgG seroprevalence of the group as a whole was 18.7% (28/150), with a higher prevalence in HIV-positive individuals compared to those who were HIV-negative (31.3%, [18/58] vs. 10.9%, [10/92]) patients. These data may be biased due to cumulative effects of exposition affecting disease prevalence. If corrected, this data may indicate an interaction of HIV and T. gondii. Prevalence of both diseases increases with age, but this is more clearly seen for toxoplasmosis (p < 0.005) than HIV infection, possibly explained by higher transmission of HIV after childhood. In HIV patients suffering from encephalitis, CSF serology showed that 33% of specific IgG CSF had a high avidity, which was in accordance with the data from the group of pregnant women. Lower prevalence rates of both infections in older groups could be explained by more deaths in the infected groups, resulting in an artificially lower prevalence. Using CD4 counts as a marker of time of HIV infection, and correcting for age, patients with contact with T. gondii had fewer CD4 cells, suggesting prolonged HIV disease or other causes. Toxoplasma IgG prevalence is higher in HIV+ groups, which could be ascribed to HIV- and T. gondii-associated risk factors, such as exposure to higher and more diverse social contacts. The low incidence of Toxoplasma IgG in younger age groups shows that transmission could be related to better access to cyst-containing meat in adulthood, as environmental transmission due to oocysts is usually blamed for higher incidence in children. Taken together, these data support the urgent need of research in toxoplasmosis in Africa, especially in the presence of HIV epidemics.
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