Toxoplasma gondii seroprevalence studies on humans and animals in Africa

Clinical and Serological Characteristics of Ocular Toxoplasmosis in the Democratic Republic of Congo

PURPOSE

To describe demographic data, clinical features, and serological profiles in a cohort of Congolese patients with ocular toxoplasmosis (OT).

METHOD

Cross-sectional study, carried out between March 2020 and July 2021 in two ophthalmic clinics in Kinshasa.

RESULTS

The study comprised 95 participants with OT. Fifty-three patients were male (55.8%). The mean age at presentation was 35.6 ± 14.1 years (range 8-69 years); 71 had active OT (74.7%), among them, 33 had primary OT (46.5%), and 38 had recurrences (53.5%). At presentation, 51 patients (53.7%) had visual impairment (VA < 6/18). Retinochoroidal lesions were located in the central retina in 60 patients (63.1%). Patients with primary OT tend to have higher IgG levels than those with recurrent OT (P = .01).

CONCLUSION

We report the largest cohort of patients with OT in sub-Saharan Africa. In our setting, most patients had recurrent OT with multiple, extensive, and central retinochoroidal lesions.

Risk factors for ocular toxoplasmosis among uveitis patients in Kinshasa, DR Congo

Objective

To identify the risk factors associated with ocular toxoplasmosis (OT) in a cohort of Congolese patients with uveitis.

Methods and analysis

A cross-sectional study was conducted between March 2020 and July 2021 in two ophthalmic clinics in Kinshasa. Patients with a diagnosis of uveitis were enrolled in the study. Each patient underwent an interview, an ophthalmological examination and serology testing. Logistic regression was performed to identify risk factors for OT.

Results

212 patients were included in the study with a mean age at presentation of 42.1±15.9 years (limits: 8–74 years) and a sex ratio of 1.1:1. OT concerned 96 patients (45.3%). The age of the patients below 60 years (p=0.001, OR=9.75 CI 95% 2.51 to37.80)), the consumption of cat meat (p=0.01, OR=2.65 CI 95% 1.18 to 5.96)) and undercooked meat (p=0.044, OR=2.30 CI 95% 1.02 to 5.21)) and living in rural area (p=0.021, OR=11.4 (CI 95% 1.45 to 89.84])) were identified as risk factors for OT.

Conclusion

OT affects more young people. It is associated with dietary habits. Informing and educating the population is necessary to avoid infection.

Toxoplasma gondii in African Wildlife: A Systematic Review

Toxoplasma gondii (T. gondii) is a protozoan parasite, which infects a wide variety of mammals and bird species globally. In large parts of the world, this parasite is relatively well documented in wildlife species, however, this topic is poorly documented in Africa. The current review systematically explores the presence and distribution of T. gondii in African wildlife species through a key word search in PubMed, Web of Science and CAB Direct. A total of 66 records were identified and included in the qualitative analysis, of which 19 records were retained for the quantitative synthesis. The presence of T. gondii was reported in a wide range of wildlife species, found in twelve countries, spread over the African continent. The retained records report a prevalence range of 6–100% in herbivores, 8–100% in omnivores and 14–100% in carnivores. In wild felines (cheetahs, leopards, and lions) a prevalence range of 33–100% was found. Reports from South Africa, and on the presence of T. gondii in lion were most common. Overall, the results indicate the scarcity of information on T. gondii in Africa and its circulation in wildlife. The lack of knowledge on the parasite in Africa, especially in areas at the human-livestock-wildlife interface, prevents us from understanding how prevalent it is on the continent, what strains are circulating in wildlife and what the most common routes of transmission are in the different habitats in Africa.

Toxoplasma gondii Infections in Animals and Humans in Southern Africa: A Systematic Review and Meta-Analysis

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.

A review of microbes and chemical contaminants in dairy products in sub-Saharan Africa

Animal milk types in sub-Saharan Africa (SSA) are processed into varieties of products using different traditional methods and are widely consumed by households to support nutritional intake and diet. Dairy products contain several microorganisms, their metabolites, and other chemical compounds, some with health benefits and many others considered as potential health hazards. Consumption of contaminated milk products could have serious health implications for consumers. To access the safety of milk products across SSA, studies in the region investigating the occurrences of pathogens as well as chemical compounds such as heat stable toxins and veterinary drug residues in animal milk and its products were reviewed. This is done with a holistic view in light of the emerging exposome paradigm for improving food safety and consumer health in the region. Herein, we showed that several published studies in SSA applied conventional and/or less sensitive methods in detecting microbial species and chemical contaminants. This has serious implications in food safety because the correct identity of a microbial species and accurate screening for chemical contaminants is crucial for predicting the potential human health effects that undermine the benefits from consumption of these foods. Furthermore, we highlighted gaps in determining the extent of viral and parasitic contamination of milk products across SSA as well as investigating multiple classes of chemical contaminants. Consequently, robust studies should be conducted in this regard. Also, efforts such as development cooperation projects should be initiated by all stakeholders including scientists, regulatory agencies, and policy makers to improve the dairy product chain in SSA in view of safeguarding consumer health.

Ocular Toxoplasmosis in Africa: A Narrative Review of the Literature

PURPOSE

To present a narrative review about ocular toxoplasmosis epidemiology, disease burden and prevalent African parasitic strains.

METHODS

An initial search for MeSH terms was conducted with a posterior advanced search in two electronic databases. Full text reading was performed.

RESULTS

Animal African studies have identified Toxoplasma gondii type II, type III, Africa 1, and Africa 3 strains. Seroprevalence varies from 6.4% to 74.5%. Nevertheless, there is a scarcity of epidemiology and serotyping information about ocular toxoplasmosis. African studies have demonstrated that uveitis patients present high frequencies of ocular toxoplasmosis. There is a lack of studies describing specific clinical characteristics, which can be related, to environmental and socioeconomic factors, parasite serotype and genotype, and genetic susceptibility of the host.

CONCLUSION

As Toxoplasma gondii has more virulent strains in the Southern hemisphere, it is relevant to determine African strain types and the correlation between the infecting strains and the clinical manifestations.

Seroprevalence of Toxoplasma gondii infection among pregnant women in Windhoek, Namibia, in 2016

Background

When a pregnant woman contracts Toxoplasma gondii (T. gondii) infection during pregnancy, it may be vertically transmitted to the foetus. Information on the incidence of congenital toxoplasmosis (CT) in developing countries is scarce. Most studies focus on the seroprevalence of T. gondii infection among pregnant women. This study aimed to determine the seroprevalence of T. gondii infection among pregnant women attending public antenatal care in Windhoek, Namibia, in 2016.

Methods

In this descriptive study, 344 urban pregnant women attending public antenatal care were voluntarily enrolled in the study. Seroprevalence of anti-T. gondii Immunoglobulin G (IgG) was determined by automated immunoassay. Samples with a positive T. gondii IgG result were tested for T. gondii Immunoglobulin M (IgM) and specific IgG avidity by using an enzyme-linked immunosorbent assay (ELISA) test. A questionnaire captured demographic data and exposure to risk factors. Data were analysed using Statistical Package for the Social Sciences (SPSS) and R.

Results

Anti-T. gondii IgG was found in nine (2.61%) pregnant women. There was no association of anti-T. gondii IgG with demographic characteristics or exposure to risk factors.Anti-T. gondii IgM was positive in one (0.3%) woman, while three (0.9%) women had borderline anti-T. gondii IgM results. Specific IgG avidity was low, equivocal and high in 0%, 33% and 67% of seropositive pregnant women, respectively.

Conclusion

Seroprevalence of anti-T. gondii IgG is much lower in Namibia than is reported in other developing countries. Investigation into specific IgM seropositivity and IgG avidity showed that pregnant women in the central region of Namibia are at low risk of vertical transmission and development of CT.

Species-specific differences in Toxoplasma gondii, Neospora caninum and Besnoitia besnoiti seroprevalence in Namibian wildlife

Background

Knowledge about parasitic infections is crucial information for animal health, particularly of free-ranging species that might come into contact with livestock and humans.

Methods

We investigated the seroprevalence of three tissue-cyst-forming apicomplexan parasites (Toxoplasma gondii, Neospora caninum and Besnoitia besnoiti) in 506 individuals of 12 wildlife species in Namibia using in-house enzyme linked immunosorbent assays (indirect ELISAs applying purified antigens) for screening and immunoblots as confirmatory tests. We included six species of the suborder Feliformia, four species of the suborder Caniformia and two species of the suborder Ruminantia. For the two species for which we had most samples and life-history information, i.e. cheetahs (Acinonyx jubatus, n = 250) and leopards (Panthera pardus, n = 58), we investigated T. gondii seroprevalence in relation to age class, sex, sociality (solitary, mother-offspring group, independent sibling group, coalition group) and site (natural habitat vs farmland).

Results

All but one carnivore species (bat-eared fox Otocyon megalotis, n = 4) were seropositive to T. gondii, with a seroprevalence ranging from 52.4% (131/250) in cheetahs to 93.2% (55/59) in African lions (Panthera leo). We also detected antibodies to T. gondii in 10.0% (2/20) of blue wildebeest (Connochaetes taurinus). Adult cheetahs and leopards were more likely to be seropositive to T. gondii than subadult conspecifics, whereas seroprevalence did not vary with sex, sociality and site. Furthermore, we measured antibodies to N. caninum in 15.4% (2/13) of brown hyenas (Hyaena brunnea) and 2.6% (1/39) of black-backed jackals (Canis mesomelas). Antibodies to B. besnoiti were detected in 3.4% (2/59) of African lions and 20.0% (4/20) of blue wildebeest.

Conclusions

Our results demonstrate that Namibian wildlife species were exposed to apicomplexan parasites at different prevalences, depending on parasite and host species. In addition to serological work, molecular work is also needed to better understand the sylvatic cycle and the clear role of wildlife in the epidemiology of these parasites in southern Africa.

Seroprevalence and associated risk factors of Toxoplasma gondii infection in domestic animals in southeastern South Africa

Toxoplasma gondii is a major neglected parasitic infection occurring in settings of extreme poverty in Africa. Apart from causing reproductive failure in animals it is also a significant zoonotic concern. The objective of this study was to determine the seroprevalence and associated risk factors of T. gondii infection in cats, chickens, goats, sheep and pigs in the southeast of South Africa, of which little is known. Sera was obtained from 601 domestic animals including 109 cats, 137 chickens, 128 goats, 121 sheep and 106 pigs managed under different production systems in different agro-ecological regions and evaluated by the Toxoreagent, a latex agglutination test for T. gondii antibody detection. Household-level and animal-level data were collected by interviewing animal owners and/or herders using a closed-ended questionnaire. The study revealed an overall farm seroprevalence of 83.33% (125/150 farms) with the highest rate of infection for the parasite found in sheep with 64.46% (78/121), followed by goats with 53.91% (69/128), pigs with 33.96% (36/106), cats with 32.11% (35/109 cats) and chickens with 33.58% (46/137). The risk factors that were found to be statistically significant (p 0.05) to different species of seropositivites were age, location, climate, animal production system, rodent control, seropositive cat, cat-feed access and cat faecal disposal. The relatively high seroprevalence of T. gondii detected in this region suggests that domestic animals may pose a substantial public health risk through the consumption of T. gondii-infected raw meat as well as via contact with cat faeces.

[Epidemiology and clinical pattern of ocular toxoplasmosis in Kinshasa]

PURPOSE

To determine the epidemiology and clinical pattern of Congolese patients with ocular toxoplasmosis.

PATIENTS AND METHODS

A retrospective study was conducted on records of patients with ocular toxoplasmosis examined in the Teaching Hospital of Kinshasa (DR Congo) from 2010 to 2012. Each patient underwent a complete ophthalmic examination. Sociodemographic data, clinical symptoms and signs, visual outcome, modality of treatment and type of complications were studied.

RESULTS

Thirty-five cases of ocular toxoplasmosis were diagnosed out of 18,144 patients, giving a frequency of 0.2 %. Eighteen men (51.4 %) were affected, with a sex ratio of 1.05. The mean age of the patients was 40.9±20 years (range: 10-72 years). The mean time until consultation was 10 months (range: 2 days-84 months). Ocular involvement was unilateral for 65.7 % of patients. Decreased visual acuity (77.1 %) and pain (7.1 %) were the main ocular complains. Chorioretinal lesions involved the central retina in 26 patients (74.3 %). Five patients (14.2 %) developed recurrences during follow-up. Complications affected 17 patients (48.6 %), with macular scarring (34.3 %) and cataract (17.1 %) being the most common. At the first consultation, 61.7 % of the affected eyes had visual impairment (VA<0.3). Visual impairment was associated with macular lesions (P<0.001, OR=3 [1.4-6.1]) and age greater than 45 years (P=0.002, OR=11 [2.2-53.6]).

CONCLUSION

In our context, complications are common with ocular toxoplasmosis,s and they lead to visual impairment in the majority of patients.

A review of the traditional use of southern African medicinal plants for the treatment of selected parasite infections affecting humans

ETHNOPHARMACOLOGICAL RELEVANCE

Worldwide, more than three billion cases of parasitic disease are reported yearly and it is likely that this figure is substantially under-estimated. Approximately one in six people globally are estimated to be infected with at least one parasite species annually. In South Africa, the prevalence of Schistosoma haematobium (bilharzia) and intestinal worms and helminths are particularly high, especially in children and in crowded or poorer rural communities with inadequate sanitation and nutrition. Despite alarmingly high estimates, medical research into parasitic diseases remains neglected and only malaria receives significant attention and funding. Traditional medicines have been used for centuries in Africa by multiple ethnic groups and many people rely on these healing systems as their primary healthcare modality. The traditional use of South African medicinal plants to treat parasite infestations is relatively well documented, and it is important to link these traditional uses to scientific evidence validating efficacy.

AIM OF THE STUDY

To document the medicinal plants used for parasitic infections and critically review the literature on the anti-parasitic properties of South African plants against some neglected parasitic diseases.

MATERIALS AND METHODS

A review of the literature (ethnobotanical books and publications documenting traditional plant use) was undertaken related to specific medicinal use for parasitic infections in Southern Africa. Inclusion criteria focused on human use. Exclusion criteria included veterinary use and malaria due to the extensive nature of these subject matters. An in-depth analysis of previous studies was undertaken and future prospectives are considered.

RESULTS

In particular, bilharzia, gastrointestinal worms and helminths, ectoparasites, trichomoniasis, leishmaniasis and trypanosomiasis are reviewed with special emphasis on the gaps in research.

CONCLUSIONS

Despite the availability of relatively extensive ethnobotanical records on the anti-parasitic properties of southern African medicinal plants, the antiparasitic properties of many plants have been poorly examined. There was in many instances a lack of evidence to support traditional use of many species towards some parasites and research is urgently needed in this area.

Molecular detection of Toxoplasma gondii and Neospora caninum in birds from South Africa

There are not any records on the detection of Toxoplasma gondii and Neospora caninum in tissues of wild birds in the African continent. The aim of the study was to investigate the occurrence of DNA from these protozoan parasites in brain tissue samples collected in years 2014-2015 from 110 wild and domestic birds of 15 orders. Birds came mainly from the province of Limpopo (n=103); the other seven birds came from other five provinces of South Africa. Parasite DNAs were detected by PCR in animal brains. While all samples were negative for N. caninum, T. gondii DNA was detected in three (2.7%) birds: a Red-eyed Dove (Streptopelia semitorquata), a Laughing Dove (S. senegalensis) and a Southern-Yellow-billed Hornbill (Tockus leucomelas), all from Limpopo province. Positive samples were selected for genotyping by a 15 microsatellite markers method in a single multiplex PCR assay. Only the sample from the Red-eyed Dove was successfully genotyped and characterized as type II. This is the first detection of T. gondii in tissue of native African wild birds and the first study focusing on N. caninum in birds from South Africa.

Prevalence of Toxoplasma gondii infection in HIV-infected patients and food animals and direct genotyping of T. gondii isolates, Southern Ghana

Toxoplasma gondii is of public health and veterinary importance causing severe diseases in immunocompromised individuals including HIV/AIDS patients and in congenital cases and animals. There is limited information on the epidemiology of T. gondii infection in humans, particularly HIV patients and food animals and the parasite genotypes in Ghana. A total of 394 HIV-infected patients from three hospitals were screened for T. gondii anti-IgG and IgM using ELISA. DNAs from blood samples of seropositve participants and 95 brain tissues of food animals were PCR assayed to detect Toxoplasma gra6. DNA positive samples were genotyped using multilocus nested polymerase chain reaction restriction fragment length polymorphism at 10 loci: sag1, alt.sag2, sag3, btub, gra6, l358, c22-8, c29-2, pk1, and apico. The overall seroprevalence was 74.37% (293/394). Toxoplasma DNAs were detected in 3.07% of the seropositive participants and 9.47% of the animals. Six of the human DNA positive samples were partly typed at sag3: 33.33, 50, and 16.67% isolates had type I, II, and III alleles, respectively. All nine isolates from food animals typed at nine loci except apico were atypical: six isolates were identical to ToxoDB #41 and #145, and one was identical to TgCkBrRj2 all identified in Brazil. The genotype of two isolates has not been reported previously and was named as TgCtGh1. T. gondii seroprevalence is high among the HIV-infected individuals with T. gondii circulating in Ghana being genetically diverse.

First genetic characterization of Toxoplasma gondii in stray cats from Algeria

Toxoplasmosis is a parasitic disease with worldwide distribution and a major public health problem. In Algeria, no data are currently available about genotypes of Toxoplasma gondii isolated from animals or humans. The present study assesses for the first time the seroprevalence of toxoplasmosis in stray cats, and provides molecular characterization of T. gondii strains circulating in this feline population in Algiers, the capital city of Algeria. Sera from 96 stray cats were tested for the presence of antibodies against T. gondii using the modified agglutination test. The seroprevalence was 50% (48/96) using 1:6 as the positivity cut-off. Different organs samples from stray cats, including heart samples, were tested for the presence of Toxoplasma DNA using real-time PCR. T. Gondii DNA was detected in 90.6% (87/96) of hearts. Of these parasitic DNAs, 22 were submitted to genotyping through the analysis of 15 microsatellite markers. The identified genotypes (12 of 22) mainly belonged to the type II lineage.

Endemic zoonoses in the tropics: a public health problem hiding in plain sight

Zoonotic diseases are a significant burden on animal and human health, particularly in developing countries. Despite recognition of this fact, endemic zoonoses often remain undiagnosed in people, instead being mistaken for febrile diseases such as malaria. Here, as part of Veterinary Record's ongoing series of articles on One Health, a multidisciplinary team of researchers from Scotland, Tanzania and New Zealand argues that a One Health approach is needed to effectively combat these diseases