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Lynn MK, Rodriguez Aquino MS, Cornejo Rivas PM, Miranda X, Torres-Romero DF, Cowan H, Meyer MM, Castro-Godoy WD, Kanyangarara M, Self SCW, Campbell BA, Nolan MS. Employing digital PCR for enhanced detection of perinatal Toxoplasma gondii infection: A cross-sectional surveillance and maternal-infant outcomes study in El Salvador. PLoS Negl Trop Dis 2024; 18:e0012153. [PMID: 38768194 PMCID: PMC11142657 DOI: 10.1371/journal.pntd.0012153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 05/31/2024] [Accepted: 04/16/2024] [Indexed: 05/22/2024] Open
Abstract
Toxoplasma gondii is a parasitic infection that can be transmitted in utero, resulting in fetal chorioretinitis and other long-term neurological outcomes. If diagnosed early, pregnancy-safe chemotherapeutics can prevent vertical transmission. Unfortunately, diagnosis of acute, primary infection among pregnant women remains neglected, particularly in low-and-middle-income countries. Clinically actionable diagnosis is complex due to the commonality of infection during childhood and early adulthood which spawn long-last antibody titers and historically unreliable direct molecular diagnostics. The current study employed a cross-sectional T. gondii perinatal surveillance study using digital PCR, a next generation molecular diagnostic platform, and a maternal-fetal outcomes survey to ascertain the risk of vertical toxoplasmosis transmission in the Western Region of El Salvador. Of 198 enrolled mothers at the time of childbirth, 6.6% had evidence of recent T. gondii infection-85% of these cases were identified using digital PCR. Neonates born to these acutely infected mothers were significantly more likely to meconium aspiration syndrome and mothers were more likely to experience labor and delivery complications. Multivariable logistic regression found higher maternal T. gondii infection odds were associated with the presence of pet cats, the definitive T. gondii host. In closing, this study provides evidence of maternal T. gondii infection, vertical transmission and deleterious fetal outcomes in a vulnerable population near the El Salvador-Guatemala border. Further, this is the first published study to show clinical utility potential of digital PCR for accurate diagnosis of congenital toxoplasmosis cases.
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Affiliation(s)
- Mary K. Lynn
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
| | | | | | - Xiomara Miranda
- Hospital Nacional “Dr Jorge Mazzini Villacorta”, Ministerio de Salud, Sonsonate, El Salvador
| | - David F. Torres-Romero
- Department of Chemistry and Pharmacy, University of El Salvador, San Salvador, El Salvador
| | - Hanson Cowan
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
| | - Madeleine M. Meyer
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
| | - Willber D. Castro-Godoy
- Health Research and Development Center (CENSALUD), University of El Salvador, San Salvador, El Salvador
- Department of Chemistry and Pharmacy, University of El Salvador, San Salvador, El Salvador
| | - Mufaro Kanyangarara
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
| | - Stella C. W. Self
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
| | - Berry A. Campbell
- Department of Obstetrics and Gynecology, Prisma Health, Columbia, South Carolina, United States of America
| | - Melissa S. Nolan
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
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A unique Toxoplasma gondii haplotype accompanied the global expansion of cats. Nat Commun 2022; 13:5778. [PMID: 36182919 PMCID: PMC9526699 DOI: 10.1038/s41467-022-33556-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 09/22/2022] [Indexed: 11/08/2022] Open
Abstract
Toxoplasma gondii is a cyst-forming apicomplexan parasite of virtually all warm-blooded species, with all true cats (Felidae) as definitive hosts. It is the etiologic agent of toxoplasmosis, a disease causing substantial public health burden worldwide. Few intercontinental clonal lineages represent the large majority of isolates worldwide. Little is known about the evolutionary forces driving the success of these lineages, the timing and the mechanisms of their global dispersal. In this study, we analyse a set of 156 genomes and we provide estimates of T. gondii mutation rate and generation time. We elucidate how the evolution of T. gondii populations is intimately linked to the major events that have punctuated the recent history of cats. We show that a unique haplotype, whose length represents only 0.16% of the whole T. gondii genome, is common to all intercontinental lineages and hybrid populations derived from these lineages. This haplotype has accompanied wildcats (Felis silvestris) during their emergence from the wild to domestic settlements, their dispersal in the Old World, and their expansion in the last five centuries to the Americas. The selection of this haplotype is most parsimoniously explained by its role in sexual reproduction of T. gondii in domestic cats.
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Bouchard É, Sharma R, Hernández-Ortiz A, Buhler K, Al-Adhami B, Su C, Fenton H, G.-Gouin G, Roth JD, Rodrigues CW, Pamak C, Simon A, Bachand N, Leighton P, Jenkins E. Are foxes (Vulpes spp.) good sentinel species for Toxoplasma gondii in northern Canada? Parasit Vectors 2022; 15:115. [PMID: 35365191 PMCID: PMC8972674 DOI: 10.1186/s13071-022-05229-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 03/02/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In changing northern ecosystems, understanding the mechanisms of transmission of zoonotic pathogens, including the coccidian parasite Toxoplasma gondii, is essential to protect the health of vulnerable animals and humans. As high-level predators and scavengers, foxes represent a potentially sensitive indicator of the circulation of T. gondii in environments where humans co-exist. The objectives of our research were to compare serological and molecular assays to detect T. gondii, generate baseline data on T. gondii antibody and tissue prevalence in foxes in northern Canada, and compare regional seroprevalence in foxes with that in people from recently published surveys across northern Canada. METHODS Fox carcasses (Vulpes vulpes/Vulpes lagopus, n = 749) were collected by local trappers from the eastern (Labrador and Québec) and western Canadian Arctic (northern Manitoba, Nunavut, and the Northwest Territories) during the winters of 2015-2019. Antibodies in heart fluid were detected using a commercial enzyme-linked immunosorbent assay. Toxoplasma gondii DNA was detected in hearts and brains using a magnetic capture DNA extraction and real-time PCR assay. RESULTS Antibodies against T. gondii and DNA were detected in 36% and 27% of foxes, respectively. Detection of antibodies was higher in older (64%) compared to younger foxes (22%). More males (36%) than females (31%) were positive for antibodies to T. gondii. Tissue prevalence in foxes from western Nunavik (51%) was higher than in eastern Nunavik (19%). At the Canadian scale, T. gondii exposure was lower in western Inuit regions (13%) compared to eastern Inuit regions (39%), possibly because of regional differences in fox diet and/or environment. Exposure to T. gondii decreased at higher latitude and in foxes having moderate to little fat. Higher mean infection intensity was observed in Arctic foxes compared to red foxes. Fox and human seroprevalence showed similar trends across Inuit regions of Canada, but were less correlated in the eastern sub-Arctic, which may reflect regional differences in human dietary preferences. CONCLUSIONS Our study sheds new light on the current status of T. gondii in foxes in northern Canada and shows that foxes serve as a good sentinel species for environmental circulation and, in some regions, human exposure to this parasite in the Arctic.
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Affiliation(s)
- Émilie Bouchard
- Department of Veterinary Microbiology, University of Saskatchewan, Saskatoon, SK Canada
- Research Group On Epidemiology of Zoonoses and Public Health (GREZOSP), Université de Montréal, Saint-Hyacinthe, QC Canada
| | - Rajnish Sharma
- Department of Veterinary Microbiology, University of Saskatchewan, Saskatoon, SK Canada
| | | | - Kayla Buhler
- Department of Veterinary Microbiology, University of Saskatchewan, Saskatoon, SK Canada
| | - Batol Al-Adhami
- Centre for Food-Borne and Animal Parasitology, Saskatoon, SK Canada
| | - Chunlei Su
- Department of Microbiology, University of Tennessee, Knoxville, TN USA
| | - Heather Fenton
- Ross University School of Veterinary Medicine, Basseterre, Saint Kitts and Nevis
| | | | - James D. Roth
- Department of Biological Sciences, University of Manitoba, Winnipeg, MB Canada
| | | | - Carla Pamak
- Nunatsiavut Research Centre, Nain, NL Canada
| | - Audrey Simon
- Research Group On Epidemiology of Zoonoses and Public Health (GREZOSP), Université de Montréal, Saint-Hyacinthe, QC Canada
| | - Nicholas Bachand
- Department of Veterinary Microbiology, University of Saskatchewan, Saskatoon, SK Canada
| | - Patrick Leighton
- Research Group On Epidemiology of Zoonoses and Public Health (GREZOSP), Université de Montréal, Saint-Hyacinthe, QC Canada
| | - Emily Jenkins
- Department of Veterinary Microbiology, University of Saskatchewan, Saskatoon, SK Canada
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Dubey JP, Murata FHA, Cerqueira-Cézar CK, Kwok OCH, Su C. Epidemiological Significance of Toxoplasma Gondii Infections in Wild Rodents: 2009-2020. J Parasitol 2021; 107:182-204. [PMID: 33662119 DOI: 10.1645/20-121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Toxoplasma gondii infections are common in humans and animals worldwide. Rodents are one of the most important intermediate hosts for T. gondii because they are preyed on by cats, who in turn excrete the environmentally resistant oocysts in their feces and thus spread the infection. Information on T. gondii infections is spread in numerous reports and is not easily accessible to readers. Here, we review prevalence, persistence of infection, clinical disease, epidemiology, and genetic diversity of T. gondii infections in wild rodents worldwide. Data are tabulated by country, by each rodent species alphabetically, and chronologically. Recent genetic diversity of T. gondii strains in rodents is critically evaluated.
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Affiliation(s)
- J P Dubey
- United States Department of Agriculture, Agricultural Research Service, Animal Parasitic Diseases Laboratory, Beltsville Agricultural Research Center, Building 1001, Beltsville, Maryland 20705-2350
| | - F H A Murata
- United States Department of Agriculture, Agricultural Research Service, Animal Parasitic Diseases Laboratory, Beltsville Agricultural Research Center, Building 1001, Beltsville, Maryland 20705-2350
| | - C K Cerqueira-Cézar
- United States Department of Agriculture, Agricultural Research Service, Animal Parasitic Diseases Laboratory, Beltsville Agricultural Research Center, Building 1001, Beltsville, Maryland 20705-2350
| | - O C H Kwok
- United States Department of Agriculture, Agricultural Research Service, Animal Parasitic Diseases Laboratory, Beltsville Agricultural Research Center, Building 1001, Beltsville, Maryland 20705-2350
| | - C Su
- Department of Microbiology, University of Tennessee, Knoxville, Tennessee 37996-0845
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