Sero-prevalence of latent Toxoplasma gondii infection among HIV-infected and HIV-uninfected people in Addis Ababa, Ethiopia: A comparative cross-sectional study

Assessment of Knowledge, Attitude, and Preventive Behavior Regarding Toxoplasmosis among Females in Riyadh, Saudi Arabia: A Cross-Sectional Study

Toxoplasmosis, a prevalent parasitic zoonotic disease, is influenced by various factors such as the climate, dietary habits, and hygiene practices. This study aimed to evaluate the knowledge, attitudes, and preventive behaviors regarding toxoplasmosis among females in Riyadh, Saudi Arabia. Utilizing a bilingual Google form, a cross-sectional online survey was distributed in both Arabic and English, and it was conducted between 11 January 2024 and 4 March 2024. Statistical analysis was conducted using SPSS Version 27, with a p-value ≤ 0.05 indicating significant qualitative data. The data were analyzed using descriptive statistics and the chi-square test. A total of 533 participants were included in the study. Participants aged 18-25 years old constituted the largest group (70.4%), with those aged 26-40 years old accounting for 14.4% and ages 41-60 years old comprising 15.2%. Among the participants, 76.4% were unmarried, and 21.4% were pregnant. Notably, 79.2% of participants reported being unaware of toxoplasmosis, with only 9.0% gaining awareness from doctors and a mere 3.6% from awareness campaigns. Any understanding of the disease's severity and causative factors was limited to 15.9%. Despite a generally positive attitude towards preventive measures, significant correlations were found between toxoplasmosis and age (p-value 0.093), as well as the consumption of medium-cooked meat (p-value 0.008). Other variables, such as social status, cat ownership, handwashing before meals, and washing fruits and vegetables did not show significant correlations. Diet and hygiene practices notably impact toxoplasmosis transmission. In Riyadh, 79% of participants did not own cats, and 67.7% avoided undercooked meat. However, 6.7% used unfiltered water, and 8.4% did not wash their hands after handling raw meat and vegetables. The study concludes that there is insufficient knowledge regarding toxoplasmosis among females in Riyadh. Despite low knowledge, there is a neutral to slightly positive attitude and a willingness to learn and adopt preventive measures when informed. With better education, attitudes towards toxoplasmosis could improve due to a desire to learn and act. While general hygiene practices were favorable, specific preventive behaviors for toxoplasmosis need enhancement to reduce infection risks.

Prevalence of Toxoplasma gondii in HIV-Infected Individuals in Iran: A Systematic Review and Meta-Analysis

INTRODUCTION

Toxoplasma gondii is an obligate intracellular protozoan that can infect almost all warm-blooded animals, including humans. Patients with co-infection with toxoplasmosis and HIV have a 30-40% risk of developing toxoplasmosis encephalitis. This study aimed to describe the epidemiology and burden of Toxoplasma gondii in HIV-infected individuals in Iran.

METHODS

We searched the five English databases (Science Direct, PubMed, Scopus, Ovid, Embase, and Cochrane) and four Persian databases (Scientific Information Database (SID), Iran Medex, Iran Doc, and Magiran) with the terms of (Toxoplasma gondii OR "toxoplasmosis") AND (HIV OR "AIDS" OR immunodeficiency OR acquired immune deficiency syndrome) AND (Seroprevalence) AND (Seroepidemiologic Studies) AND (Elisa OR IgG) AND (PCR) AND (Iran) by two authors up to Feb 2021. Studies were included if they investigated people with HIV infection and presented data that allowed us to establish the prevalence of Toxoplasma gondii infection in Iran.

RESULTS

According to the inclusion/exclusion criteria, 15 studies were selected. A total number of 2275 HIV-infected individuals were tested and evaluated for toxoplasmosis from 2005 up to 2018 in different regions of Iran. The weighted overall prevalence of toxoplasmosis in HIV-infected individuals with Elisa was obtained using a random-effects model, which was estimated at 47% (95% CI = 31% - 62%). Also, the Weighted overall prevalence of toxoplasmosis in HIV-infected individuals with PCR was obtained using a random-effects model, which was estimated at 7% (95% CI = 3% - 12%).

CONCLUSION

According to the results of this study, it can be clearly understood that a large population of HIV patients living in Iran have toxoplasmosis. Therefore, due to the high susceptibility of these groups to toxoplasmosis, healthcare professionals must consider measures such as training in the ways of transmission and prevention of the infection to this high-risk group in order to reduce the risk of infection.

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

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.

Seroprevalence and Risk Factors of Toxoplasma gondii Infection Among High-Risk Populations in Jiangsu Province, Eastern China

Toxoplasma gondii, an opportunistic protozoan, infects one-third of people worldwide and could lead to serious outcomes in immunodeficient or immunocompromised populations. The present study aimed to investigate the prevalence and risk factors for T. gondii infection among high-risk populations in Jiangsu Province, eastern China. We conducted a cross-sectional survey among 4 categories of populations in 13 prefectures including HIV/AIDS patients, livestock breeding/processing (B/P) staff, pregnant women, and cancer patients. We detected specific immunoglobulin G and M (IgG and IgM) levels for each participant using enzyme-linked immunosorbent assay (ELISA) and asked to complete a questionnaire for each participant that covered sociodemographic information as well as the basic knowledge of attitudes toward and the practices for the prevention of toxoplasmosis. A total of 5231 participants distributed across 13 prefecture-level cities was surveyed, including 2455 males and 2776 females. Total seropositivity rate in each population category was as follows: 9.08% (HIV/AIDS patients), 11.65% (livestock B/P staff), 5.50% (pregnant women), and 12.89% (cancer patients). We detected IgM positivity in HIV/AIDS patients (0.47%, 6/1289), livestock B/P staff (0.08%, 1/1330), and cancer patients (0.46%, 6/1303) but not in pregnant women. Further, we detected IgM+IgG positivity only in cancer patients (0.31%, 4/1303). The seropositivity rate for pregnant women was significantly lower, while cancer patients were significantly higher. Higher educational levels were associated with lower seropositivity rates for T. gondii infection. High seropositivity rates were associated with long period of HIV infection among HIV/AIDS patients, frequent contact with livestock among livestock breeding/processing staff and male older patients among cancer patients, respectively. Analysis of practices across all participants showed that frequent contact with pets in everyday life or using the same cutting board for both raw and cooked foods leads to higher seropositivity rates. Therefore, we obtained the seroprevalence and risk factors of toxoplasmosis among high-risk populations in Jiangsu Province which could provide evidence for the implementation of control measures in the near future.

Potential risk factors associated with seropositivity for Toxoplasma gondii among pregnant women and HIV infected individuals in Ethiopia: A systematic review and meta-analysis

BACKGROUND

Toxoplasma gondii is an obligate intracellular and neurotropic apicomplexan protozoan parasite infecting almost all warm-blooded vertebrates including humans. To date in Ethiopia, no systematic study has been investigated on the overall effects of potential risk factors associated with seropositivity for Toxoplasma gondii among pregnant women and HIV infected individuals. We intended to determine the potential risk factors (PRFs) associated with seropositivity for Toxoplasma gondii from published data among pregnant women and HIV infected individuals of Ethiopia.

METHODOLOGY

An systematic review of the previous reports was made. We searched PubMed, Science Direct, African Journals Online, and Google Scholar for studies with no restriction on the year of publication. All references were screened independently in duplicate and were included if they presented data on at least two risk factors. Meta-analysis using the random or fixed-effects model was made to calculate the overall effects for each exposure.

RESULTS

Of the 216 records identified, twenty-four reports met our eligibility criteria, with a total of 6003 individuals (4356 pregnant women and 1647 HIV infected individuals). The pooled prevalences of anti-Toxoplasma gondii antibodies were found at 72.5% (95% CI: 58.7% - 83.1%) in pregnant women and 85.7% (95% CI: 76.3% - 91.8%) in HIV infected individuals. A significant overall effect of anti-Toxoplasma gondii seropositivity among pregnant women (p < 0.05) was witnessed with age, abortion history, contact with cats, cat ownership, having knowledge about toxoplasmosis, being a housewife and having unsafe water source. Age, cat ownership, and raw meat consumption were also shown a significant effect (p < 0.05) to anti-Toxoplasma gondii seropositivity among HIV infected individuals.

CONCLUSIONS

This review showed gaps and drawbacks in the earlier studies that are useful to keep in mind to design accurate investigations in the future. The pooled prevalence of anti-Toxoplasma gondii antibodies was found to be higher among pregnant women and HIV infected individuals. This suggests that thousands of immunocompromised individuals (pregnant women and HIV infected patients) are at risk of toxoplasmosis due to the sociocultural and living standards of the communities of Ethiopia. Appropriate preventive measures are needed to reduce the exposure to Toxoplasma gondii infection. Further studies to investigate important risk factors are recommended to support the development of more cost-effective preventive strategies.

Human toxoplasmosis in Mozambique: gaps in knowledge and research opportunities

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.

A Review on the Present Advances on Studies of Toxoplasmosis in Eastern Africa

Toxoplasmosis is a zoonotic infection caused by the protozoan parasite, Toxoplasma gondii. It was discovered over 100 years ago and is credited as the most successful parasitic organism worldwide, able to infect and multiply in all warm blooded animals including an estimated 2.3 billion people. Toxoplasmosis is asymptomatic in immunocompetent individuals. Infection in the developing fetus and immunocompromised individuals can cause severe clinical disease. Toxoplasmosis is also a major cause of reproductive failure in livestock. The economic impact of toxoplasmosis is believed to be substantial. Factors associated with toxoplasmosis infection have been defined. Eastern Africa region is a high-risk area mainly due to the close association of humans and livestock as well as sociocultural practices, poor environmental hygiene, and poverty. The present paper provides a narrative review of published data on toxoplasmosis in Eastern Africa.

Human Toxoplasma gondii infection in Nigeria: a systematic review and meta-analysis of data published between 1960 and 2019

BACKGROUND

Over 70% of the worlds' population is infected by Toxoplasma gondii; a pathogen capable of causing cerebral toxoplasmosis in HIV patients and neonatal complications like miscarriage, chorioretinitis, hydrocephalus, cerebral calcification and foetal death in the third trimester of pregnancy. In spite of this, the burden of this zoonotic pathogen is poorly understood in Nigeria. The aim of the present study therefore, is to determine the burden of T. gondii among normal individuals, HIV patients and pregnant women as well as the distribution of the infection across Nigeria.

METHODS

Using the PRISMA guidelines, we conducted a systematic review and meta-analysis of data retrieved from six electronic databases (AJOL, Google Scholar, PubMed, Scopus, Science Direct and Web of Science). Pooled prevalence (PP) and heterogeneity were determined by the random-effects model and the Cochran's Q-test respectively. The quality of each study and publication bias were assessed by the 9 point Joanna Briggs Institute Critical Appraisal Instrument and the Egger's regression asymmetry test respectively, while the robustness of a pooled estimate was tested by the single study omission analysis.

RESULTS

Exactly 5834 of the 16,230 individuals examined for T. gondii infection by 50 studies across 17 Nigerian States were positive for the infection. Overall PP was 32.92% (95% CI: 27.89, 38.37), with a range of 14.41% (95% CI: 5.32, 33.54) to 86.82% (95% CI: 66.13, 95.69) across sub-groups. Pooled prevalence was significantly higher (p < 0.001) among pregnant women (40.25%; 95% CI: 33.19, 47.73) and HIV patients (31.68, 95% CI: 20.53, 45.41) than normal individuals (23.32, 95% CI: 17.25, 30.75). T. gondii prevalence declined by over 58% during the 59 years reviewed.

CONCLUSION

Toxoplasma gondii infection is moderately prevalent in Nigeria. Highest prevalence estimates were observed among pregnant women and in the south-south region. For effective control of the disease in Nigeria, a holistic approach involving on-farm, environmental, public health and animal components are suggested.

Seroprevalence of Toxoplasma gondii among pregnant women attending antenatal clinics at Hawassa University comprehensive specialized and Yirgalem General Hospitals, in Southern Ethiopia

BACKGROUND

Toxoplasmosis is caused by infection with the protozoan parasite Toxoplasma gondii. It is acquired by consumption of raw or undercooked meat containing tissue cyst, food or water contaminated with oocyst and congenital infection through the placenta leading to serious congenital abnormalities in the fetus like miscarriage, stillbirth, intrauterine death and neurologic defects. Therefore; this study was aimed to determine the prevalence of toxoplasmosis infection and its possible risk factors associated with pregnant women attending antenatal clinics in Hawassa and Yiregalem Hospitals, Southern Ethiopia.

METHODS

A hospital-based cross-sectional study was conducted from December 2016 to May 2017. The study was done in antenatal care clinics of Hawassa and Yiregalem Hospitals in Southern, Ethiopia. Five hundred pregnant women were interviewed with a pretested structured questionnaire to collect risk factors and socio-demographic data. Blood samples were collected and serum was separated and tested for anti- Toxoplasma gondii antibodies using ELISA (Enzyme-linked Immunosorbent Assay). Data were analyzed using SPSS version 20 statistical software. The risk factors were tested for significance using Bivariate and multivariate analysis. P-value < 0.05 was considered statistically significant.

RESULTS

The weighted prevalence of this study was 81.8% for the anti- Toxoplasma gondii antibody. Almost all participants (99.6%) had no information about the disease. A significant association was observed between seroprevalence and contact with domestic cats (OR = 1.206, 95% CI (1.627-2.206, P = 0.043), consumption of raw meat (OR = 0.848, 95% CI: 1.517-2.941, P = 0.019) and unpasteurized milk (OR = 0.871, 95% CI 1.531-2.221, P = 0.032). A significant association was not observed between seroprevalence and age, history of abortion, and blood transfusion.

CONCLUSIONS

The findings of this study demonstrated a relatively higher prevalence of seropositivity than studies reported from other countries. Existence of domestic cats at home, consumption of undercooked meat and unpasteurized milk were identified as risk factors for T. gondii infection. Therefore, a health education program to increase the mother's knowledge about toxoplasmosis towards avoiding eating undercooked meat, contact with cats and consumption of unpasteurized milk during pregnancy is recommended. Furthermore, our results suggested that the implementation of newborn screening and follow-up testing can lead to reducing of toxoplasmosis associated complications.

Toxoplasmosis in Pregnant Women and HIV/AIDS Patients in Ethiopia: A Systematic Review and Meta-Analysis

Background

Although Toxoplasma gondii infection in immune-competent individuals is usually asymptomatic or causes a mild flu-like illness, it may become severe and can occasionally be fatal in immune-compromised people, such as AIDS patients or pregnant women.

Method

Electronic English databases (Pubmed, Google Scholar, Science Direct, and Scopus), parasitology congresses, and theses of Ethiopian medical universities, were systematically searched (published or unpublished data). Full-length articles and abstracts were collected using keywords such as Toxoplasma gondii, Toxoplasmosis, pregnant women, HIV/AIDS, and Ethiopia.

Results

Analysis of seroprevalence estimates was pooled using a random effects meta-analysis. Seventeen studies were included in the present systematic review and meta-analysis. One of these studies reported seroprevalence of T. gondii in HIV/AIDS patients and pregnant women. In this review, a total of 4,030 individuals were included and analyzed. The pooled prevalence of T. gondii in this review was 81.00% (95% CI = 69.10–89.78). Sub-group analysis showed that 2,557 pregnant women were evaluated. In pregnant women, the pooled sero-prevalence was 71.2 (95% CI = [51.9%, 87.1%]. In HIV/AIDS patients, 1,473 individuals were evaluated and the pooled seroprevalence was 88.45 (95% CI = 80.87%–94.31%).

Conclusion

This systematic review and meta-analysis identified a high seroprevalence of Toxoplasma infection of 81% among immunocompromised patients. Scaling up prevention and control methods mainly strengthening educational efforts are necessary to avoid reactivation and to stop the spread of T. gondii infection.

Toxoplasma gondii in cancer patients receiving chemotherapy: seroprevalence and interferon gamma level

Toxoplasma gondii is an opportunistic parasite causing life-threatening diseases in immune-compromised patients. The purpose of the study is to determine the seroprevalence of Toxoplasma gondii in chemotherapy receiving cancer patients in relation to different types of malignancies, and to estimate the level of interferon gamma in Toxoplasma seropositive and seronegative cancer patients and healthy controls. Anti-Toxoplasma IgG and IgM antibodies, and interferon gamma were analyzed in 120 cancer patients receiving chemotherapy (60 having hematological malignancies and 60 with solid organ tumors) and 60 healthy controls using ELISA method. Toxoplasma (IgG and IgM) were determined in (66.7% and 9.2%) of the cancer group compared to (33.3% and 6.7%) of the control group with statistical significance only in IgG seropositivity (p < 0.001, OR = 4). Patients with hematological malignancies had higher IgG seropositivity than solid organ tumors (40% vs 26.7%). The difference between the groups was statistically significant (p = 0.002, OR = 3.5). Median level of interferon gamma was in the same range between cancer patients and control group. However, it was highly elevated in Toxoplasma seropositive (76 pg/ml) than seronegative (44.5 pg/ml) cases with statistical significance (p < 0.001). T. gondii infection remains a major threat to cancer patients and still needs proper screening, diagnosis and treatment.

Prevalence and risk factors profile of seropositive Toxoplasmosis gondii infection among apparently immunocompetent Sudanese women

Objectives

Toxoplasma gondii is an opportunistic parasite that causes a clinical manifestation known as toxoplasmosis. We investigated the prevalence and potential risk factors of T. gondii infection among women in Khartoum, Sudan. A sero-parasitological cross-sectional study included 100 women aging between 15 and 50 years old was conducted between January and November 2018. Serum samples were collected and investigated for the presence of anti-T. gondii immunoglobulins.

Results

Mean age of the women population included was 26.75 ± 8.25 with a range between 15 and 50 years. Sero-prevalence of T. gondii antibodies was 27% (27/100) with a 95% confidence interval (CI) of 18.6–36.8%. Among seropositive population 81% (22/27), 15% (4/27) and 4% (1/27) were seropositive for IgG antibodies, IgM antibodies and both antibodies respectively. Age group 21–30 years old had the highest frequency of detected IgG (10/45) and IgM (3/45). Married women had the highest frequency of detected IgG or IgM, 18/79 and 3/79, respectively. Risk factors analysis showed a total of 37/100 participants were having direct contact with cats and 66/100 have a frequent raw meat consumption, neither direct cats contact nor raw meat consumption had a statistically significant association with seropositivity to T. gondii (P value = 0.052 and 0.565, respectively).

Electronic supplementary material

The online version of this article (10.1186/s13104-019-4314-0) contains supplementary material, which is available to authorized users.

Prevalence of Toxoplasma gondii Antibodies and DNA in Iranian HIV Patients

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.

Toxoplasmosis an Overlooked Disease: Seroprevalence in Cancer Patients

Background

Toxoplasmosis is one of the most important cosmopolitan life-threatening diseases in immune-compromised patients. It is caused by an intracellular protozoon: Toxoplasma gondii (T. gondii). The parasite can cause pneumonia, encephalitis or disseminated disease in immune-deficient patients and dangerous congenital anomalies in infants born to mothers infected during early pregnancies. The present study aims to evaluate the prevalence of toxoplasmosis in Egyptian cancer patients and to correlate the prevalence with type of malignancy and the different cancer treatment modalities.

Materials and Methods

Blood samples from 150 cancer patients and 50 control subjects have been examined for presence of anti-toxoplasma antibodies using a lateral flow chromatographic immunoassay.

Results

Among cancer patients included in this study, the prevalence of anti- T.gondii antibodies was 20% for IgG and 4% for IgM, while in the control group it was 8% and 2% in the same order. This difference was statistically significant for IgG (P =0.003) but not for IgM (P = 0.44). Patients with solid organ tumors treated with chemotherapy had the highest prevalence rate of toxoplasmosis (28%). It was also found higher in males (26%) than females (10%) and higher among urban (18%) than rural dwellers (16%).

Conclusion

Cancer patients showed a significantly higher rate of infection with T. gondii than their cross-matched control. For that reason, we recommend the inclusion of a screening test for toxoplasmosis in their routine workup.

Toxoplasma gondii Infection in Immunocompromised Patients: A Systematic Review and Meta-Analysis

Toxoplasma gondii has been suggested as an important opportunistic pathogen in immunocompromised patients. We conducted a global meta-analysis to assess the prevalence and odds ratios (ORs) of T. gondii infection in immunocompromised individuals. Electronic databases were reviewed for T. gondii infection in HIV/AIDS patients, cancer patients, and transplant recipients, and meta-analyses were conducted to calculate overall estimated prevalence and ORs using random or fixed-effects models. Totally, 72 eligible studies were included. The estimated pooled prevalence of T. gondii infection in immunocompromised patients and the control was 35.9 and 24.7% (p < 0.001), with an OR of 2.24, i.e., 42.1 and 32.0% for HIV/AIDS patients and the control (p < 0.05), 26.0 and 12.1% for cancer patients and the control (p < 0.001), and 42.1 and 34.5% for transplant recipients and the control (p > 0.05), whose estimated pooled ORs were 1.92 (95% CI, 1.44-2.55), 2.89 (95% CI, 2.36-3.55), and 1.51 (95% CI, 1.16-1.95), respectively. This study is the first to demonstrate that the immunocompromised patients are associated with higher odds of T. gondii infection, and appropriate prevention and control measures are highly recommended for these susceptible populations.

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

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.

Latent Toxoplasma Infection and Higher Toxoplasma gondii Immunoglobulin G Levels Are Associated With Worse Neurocognitive Functioning in HIV-Infected Adults

BACKGROUND

 Human immunodeficiency virus (HIV)-associated neurocognitive disorders persist despite suppressive antiretroviral therapy (ART). Because latent Toxoplasma infection (LTI) may adversely impact brain function, we investigated its impact on neurocognitive impairment (NCI) in people living with HIV disease.

METHODS

 Two hundred sixty-three HIV-infected adults underwent comprehensive neurocognitive assessments and had anti-Toxoplasma gondii immunoglobulin G (anti-Toxo IgG) measured by qualitative and quantitative enzyme-linked immunosorbent assays.

RESULTS

 Participants were mostly middle-aged white men who were taking ART (70%). LTI was detected in 30 (11.4%) participants and was associated with a significantly greater prevalence of global NCI (LTI positive [LTI⁺] = 57% and LTI negative [LTI^-] = 34%) (odds ratio, 1.67; 95% confidence interval, 1.17-2.40; P = .017). Deficits were more prevalent in the LTI⁺ vs the LTI^- group in 6 of 7 cognitive domains with statistical significance reached for delayed recall (P < .01). The probability of NCI increased with higher CD4⁺ T-cell counts among LTI⁺ individuals but with lower CD4⁺ T-cell counts in LTI^- persons. A strong correlation (r = .93) between anti-Toxo IgG levels and global deficit score was found in a subgroup of 9 patients. Biomarkers indicative of central nervous system inflammation did not differ between LTI⁺ and LTI^- participants.

CONCLUSIONS

 In this cross-sectional analysis, LTI was associated with NCI, especially in those with higher CD4⁺ T-cell counts. Longitudinal studies to investigate the role of neuroinflammation and neuronal injury in LTI patients with NCI and trials of anti-Toxoplasma therapy should be pursued.

Seroprevalence and risk factors of Toxoplasma gondii infection in pregnant women following antenatal care at Mizan Aman General Hospital, Bench Maji Zone (BMZ), Ethiopia

BACKGROUND

The intracellular parasite, Toxoplasma gondii (T.gondii) is found worldwide. Infection with T. gondii during pregnancy can result in fetal and neonatal death or various congenital defects. A serological survey during pregnancy represents a valuable tool for the effective diagnosis and treatment of infected neonates. The aim of this study was to assess the sero-prevalence and risk factors of T.gondii in pregnant women following ante natal care (ANC) services at Mizan Aman General Hospital, Bench Maji zone (BMZ), Ethiopia.

METHODS

An institution based cross-sectional study was conducted enrolling a sample of 232 pregnant women attending antenatal care at Mizan Aman General Hospital during 01 December, 2014 to 18 February, 2015. Systematic random sampling technique was used to obtain the required sample. About 5 ml of blood sample was collected aseptically by using properly labeled plain tube with the necessary information. The blood samples centrifuged at 3000 rpm for 10 min to separate serum. The serum was stored at a temperature of 20 °C below zero until the serological analysis was done for the presence of anti T.gondii antibodies (i.e. Immune globulin 'M' (IgM) and Immune globulin 'G' (IgG)) using enzyme linked immunosorbent assay (ELISA). Exit interview was conducted with eligible mothers to obtain socio-demographic and behavioral data using structured questionnaires. Multivariate logistic regression modeling was employed to identify the potential predictor variables for T.gondii infection. P-value less than 5 % was considered to declare a sound significant association.

RESULTS

The response rate of the study was 100 %. The overall sero-prevalence for T.gondii infection was 85.3 % (198/232). About 191 (82.3 %) of the pregnant women were reactive only for IgG anti-bodies. While about 7 (3.0 %) of them were seropositive for both IgG and IgM anti-bodies. None of the mothers were positive for IgM anti-bodies exclusively. On multivariate logistic regression analysis, contact with cat and gardening soil were significantly associated with T.gondii infection (AOR =2.37, 95 % CI = [1.16, 3.57] and AOR = 2.49, 95 % CI = [1.53, 3.86] respectively.

CONCLUSIONS

Sero-prevalence of T. gondii antibodies for IgM was relatively high among pregnant women. Contact with cat and soil were risk factors for T.gondii case. Creating awareness on the source of infection, modes of transmission and prevention of T. gondii should be given for pregnant women. Routine screening services for T. gondii infection should be integrated with other ANC services to identify potential infections of the parasite.

Seroprevalence of Toxoplasma gondii IgG and IgM antibodies and associated risk factors in women of child-bearing age in Njinikom, NW Cameroon

Background

Toxoplasmosis is a widely distributed zoonotic disease, caused by the protozoan parasite Toxoplasma gondii. T. Infections can result in stillbirths, abortions or congenital defects during pregnancy, as well as toxoplasmic encephalitis in HIV/AIDS patients. This study aimed to determine the seroprevalence and risk factors for T. gondii infection in women seeking antenatal and medical care in the locality of Njinikom, North West of Cameroon.

Methods

We conducted a cross-sectional study from August to December 2014 consecutively enrolling 178 consenting women aged 15 to 49 years attending antenatal care or medical check-ups at the hospital. A questionnaire survey was administered to study participants and potential risk factors for Toxoplasma exposure sought. Venous blood was collected and serum from each participant analysed for T. gondii infection as evidenced by the presence of anti-T. gondii IgG and IgM antibodies detected using the indirect enzyme-linked immunosorbent assay (ELISA) technique. The proportion of anti-T. gondii antibody positivity calculated as the percentage of antibody seropositivity to T. gondii antigens. Predictors of T. gondii infection were analysed by univariate and multivariate regression and association with T. gondii seropositivity assessed. Epi-Info 3.5.4 was used for statistical analyses. A p < 0.05 was considered significant for all analyses.

Results

The seroprevalence of anti-T. gondii antibodies (IgM or IgG) were 54.5 % (97/178). Among seropositive women, 88.7 % (86/97), 30.9 % (30/97), and 19.6 % (19/97) were respectively seropositive for IgG antibody, IgM antibody and both IgM and IgG antibodies. Among the risk factors evaluated, only the consumption of raw or undercooked meat (p = 0.02) was observed to be an independent risk factor of T. gondii infection. The consumption of unwashed vegetables and fruits was significant (p = 0.01) only with simple logistic regression analysis.

Conclusions

Our findings suggest recent T. gondii exposure is high in our study population, and may constitute a significant risk factor for stillbirths, abortions or congenital defects during pregnancy in women attending antenatal care, or toxoplasmic encephalitis in those who are immunosuppressed such as in HIV/AIDS. Education and screening of HIV-positive individuals and pregnant women for T. gondii infection may be important primary prevention strategies in this population.

Toxoplasmosis in HIV infection: An overview

Toxoplasma gondii is an obligate intracellular protozoan parasite presenting as a zoonotic infection distributed worldwide. In HIV-positive individuals, it causes severe opportunistic infections, which is of major public health concern as it results in physical and psychological disabilities. In healthy immunocompetent individuals, it causes asymptomatic chronic persistent infections, but in immunosuppressed patients, there is reactivation of the parasite if the CD4 counts fall below 200 cells/μl. The seroprevalence rates are variable in different geographic areas. The tissue cyst or oocyst is the infective form which enters by ingestion of contaminated meat and transform into tachyzoites and disseminate into blood stream. In immunocompetent persons due to cell-mediated immunity the parasite is transformed into tissue cyst resulting in life long chronic infection. In HIV-infected people opportunistic infection by T. gondii occurs due to depletion of CD4 cells, decreased production of cytokines and interferon gamma and impaired cytotoxic T-lymphocyte activity resulting in reactivation of latent infection. The diagnosis can be done by clinical, serological, radiological, histological or molecular methods, or by the combination of these. There is various treatment regimen including acute treatment, maintenance therapy should be given as the current anti T. gondii therapy cannot eradicate tissue cysts. In HIV patients, CD4 counts <100; cotrimoxazole, alternately dapsone + pyrimethamine can be given for 6 months. Hence, early diagnosis of T. gondii antibodies is important in all HIV-positive individuals to prevent complications of cerebral toxoplasmosis.

Toxoplasma gondii - Prevalence and Risk Factors in HIV-infected Patients from Songklanagarind Hospital, Southern Thailand

Toxoplasmosis is one of the most common opportunistic parasitic diseases in patients living with HIV/AIDS. This study aimed to determine the seroprevalence of Toxoplasma infection in HIV-infected patients and to identify associated risk factors in Toxoplasma seropositive patients. This study was conducted at a regional public hospital in Hat Yai, southern Thailand during October 2009 to June 2010. Blood samples were collected from 300 HIV-infected patients. Each subject also answered a socio-demographic and risk factors associated with Toxoplasma infection. The prevalence of anti-Toxoplasma IgG antibodies in HIV-infected patients was 109 (36.3%), of which 83 (76.2%) had past infection and 26 (23.9%) had recently acquired Toxoplasma infection as indicated by their IgG avidity. Multivariate analysis using logistic regression showed that gender difference (adjusted OR = 1.69, 95% CI = 1.05-2.72) was the only factor associated with Toxoplasma infection. From the results obtained, these HIV-infected patients could be at high risk of developing clinical evidence of severe toxoplasmosis. Therefore, it is necessary to introduce primary behavioral practices to prevent Toxoplasma infection among HIV-infected patients.

Sero-prevalence and associated risk factors of Toxoplasma gondii infection among pregnant women attending antenatal care at Felege Hiwot Referral Hospital, northwest Ethiopia

OBJECTIVE

To determine the prevalence of toxoplasmosis and to assess the possible risk factors associated with the infection among pregnant women attending antenatal care center at Felege Hiwot Referral Hospital, Bahir Dar town, northwest Ethiopia.

METHODS

A hospital based cross-sectional study was designed to determine the prevalence of toxoplasmosis among pregnant women. Three hundred eighty four serum samples were collected from November 2013 to January 2014. Data on socio-demographic and predisposing factors were collected from each study participant with simple random sampling technique. The serum samples were examined for anti-Toxoplasma gondii (T. gondii) antibodies using latex agglutination test.

RESULTS

The overall seroprevalence of T. gondii among the pregnant women was 18.5%. All of T. gondii positive cases found to be positive only for IgG antibody. Significant association was observed between seroprevalence and presence of domestic cats [AOR = 2.85, 95% CI: 1.66-4.90, P = 0.000], consumption of raw or undercooked meat [AOR = 1.98, 95% CI: 1.15-2.43, P = 0.014] and history of abortion [AOR = 2.47, 95% CI: 1.40-4.34, P = 0.002]. No significant association was observed between seroprevalence and socio-demographic characters, gestational age, gravidity, consumption of raw vegetable, and blood transfusion.

CONCLUSIONS

The seroprevalence of toxoplasmosis among pregnant women in Bahir Dar town was relatively high. Presence of domestic cats at home and consumption of raw or undercooked meat were identified as main risk factors for T. gondii infection. Therefore, health education towards avoiding eating raw or undercooked meat and avoiding contact with cats are recommended for prevention of miscarriage or defects during pregnancy.

Seroprevalence and risk factors of Toxoplasma gondii infection in humans in East Hararghe Zone, Ethiopia

A cross-sectional study was conducted from April 2013 to September 2013 to determine the seroprevalence and possible risk factors for human Toxplasma gondii infection in East Hararghe Zone, Ethiopia. Serum samples were analysed using direct agglutination test, and immunosorbent agglutination assay for detecting IgG (n = 354) and IgM (n = 167) T. gondii antibodies. The T. gondii IgG and IgM seroprevalences were 65·8% [95% confidence interval (CI) 60·62–70·75] and 8·98% (95% CI 5·11–14·38), respectively. Gender difference in IgG seroprevalence was not significant (P > 0·05), but 69·5% of adults exhibited an IgG seroresponse to T. gondii. Pregnant women showed 76·4% and 9·3% seropositivity to IgG and IgM antibodies, respectively. Multivariable logistic regression analysis identified the risk factors significantly associated with T. gondii seropositivity were district [odds ratio (OR) 2·24, 95% CI 1·25–4·01, P = 0·007], pipe water source (OR 6·70, 95% CI 2·70–16·64, P < 0·001), age, with adults (OR 4·32, 95% CI 1·91–9·75, P < 0·001), and keeping cats in the home (OR 2·01, 95% CI 1·11–3·65, P = 0·021). The high seroprevalence of toxoplasmosis in the human population in the study area and the corresponding level of IgM seropositivity may be indicative of reactivation or recent infection and further studies on the status of congenital toxoplasmosis in the study area merit consideration.

A meta-analysis of the prevalence of Toxoplasma gondii in animals and humans in Ethiopia

BACKGROUND

Toxoplasmosis is a worldwide zoonosis. The objectives of this study were to estimate the prevalence and assess the potential risk factors of Toxoplasma gondii infections in animals and humans in Ethiopia by using meta-analytical methods.

METHODS

Published studies on T. gondii in animals and humans in Ethiopia were searched in Medline, Google Scholar and the lists of references of articles. Eligible studies were selected by using inclusion and exclusion criteria. The risks of within and across study biases, and the variations in prevalence estimates attributable to heterogeneities were assessed. Pooled prevalence was estimated by the DerSimonian and Laird random effects model.

RESULTS

Thirty two studies were eligible and data from 5689 animals and 5718 humans were used for quantitative syntheses. The pooled IgG seroprevalence in cats, small ruminants and humans were estimated at 87.72% (95% CI = 78.63, 93.28), 34.59% (95% CI = 21.08, 51.12) and 74.73% (95% CI = 61.85, 84.36), respectively. The odds of infections were higher in pregnant than in non pregnant women (OR = 3.96), in individuals that had contact with cats than those with no contact (OR = 2.53), and in urban than in rural inhabitants (OR = 2.06).

CONCLUSIONS

Toxoplasmosis is highly prevalent and could be a cause of considerable reproductive wastage in small ruminants and multiple diseases in humans in Ethiopia. Public education on preventive measures could help reduce the transmission of the parasite to humans.

Seroprevalence of Toxoplasma gondii infection and associated risk factors among pregnant women in Debre Tabor, Northwest Ethiopia

Background

Toxoplasma gondii is an obligate intracellular protozoan organism that infects both birds and mammals. Human infections are particularly serious if they occur during pregnancy and may result in abortion or congenitally acquired disorders which primarily affect the central nervous system. This study assessed seroprevalence of Toxoplasma gondii infection and associated risk factors among pregnant women at Debre Tabor, Northwest Ethiopia.

Methods

An institution based cross-sectional study was conducted from February to May, 2013. A total of 263 pregnant women who came to Debre Tabor public health facilities for antenatal care were selected and included in the study. The venous blood serum was tested using toxolatex agglutination test. Data on socio-demographic and potential risk factors were collected using structured questionnaire through face-to-face interview. Data were entered and analyzed using SPSS version 20.0. Both bivariate and multivariate analyses were carried out to identify associations between dependent and independent variables.

Results

Of 263 pregnant women included in the study, 180 (68.4%, 95% CI: 63.1-71.4%) were found to be seropositive for anti-toxoplasma antibody. Multivariable analysis showed; age group ≥36 years (Adjusted Odds Ratio [AOR] = 3.56; 95% CI: 1.01–12.5), cannot read and write (AOR = 4.77; 95% CI: 1.01-30.3), and cat ownership (AOR = 3.36; 95% CI: 1.39-8.12) were significantly associated with seropositivity of T.gondii infection.

Conclusions

Seroprevalence of T.gondii infection in Debre Tabor town was high. Age, educational status and presence of cats in home were identified as factors associated with T.gondii infection. Education of pregnant women about the transmission and prevention methods of this infection through health extension and in antenatal care clinics is important. Besides, studies on incidence of toxoplasmosis in newborns and infants are recommended.

High prevalence of anti-toxoplasma antibodies and absence of Toxoplasma gondii infection risk factors among pregnant women attending routine antenatal care in two Hospitals of Addis Ababa, Ethiopia

OBJECTIVE

Toxoplasmosis is an infection caused by the protozoan parasite Toxoplasma gondii. It is acquired mainly by eating raw or undercooked meat containing Toxoplasma gondii tissue cyst, eating food or water contaminated with oocyst, and acquiring congenital infection through the placenta. This study was conducted to determine the prevalence of toxoplasmosis and assess possible risk factors associated with the infection among pregnant women in Addis Ababa, Ethiopia.

METHOD

Cross sectional study was designed, and 288 serum samples were collected from November 1(st) 2010 to January 2011. The serum samples were tested for anti- Toxoplasma gondii antibodies using latex agglutination test. The risk factors were tested for significance using Bivariate and multivariate analysis. P-value <0.05 was considered statistically significant.

RESULT

85.4% were positive for anti Toxoplasma gondii antibody. No significant association was observed between seroprevalence and age, gestational age, socio demographic characters, history of abortion, consumption of raw or undercooked meat, consumption of raw vegetable, owning of cat, and blood transfusion.

CONCLUSION

Prevalence of toxoplasmosis among pregnant women in Addis Ababa, Ethiopia is higher than that reported from other countries. Efforts to describe risk factors for toxoplasma infection among Ethiopians should focus in children.

Latent Toxoplasma gondii Infection and Associated Risk Factors among HIV-Infected Individuals at Arba Minch Hospital, South Ethiopia

Toxoplasmosis is a parasitic disease caused by Toxoplasma gondii (T. gondii). The parasite has cosmopolitan distribution, infecting almost all species of warm-blooded animals. Latent T. gondii infection in HIV/AIDS patients is a risk for development of cerebral toxoplasmosis (CT). The aim of this study is to determine seroprevalence of latent T. gondii infection and assess its associated factors among individuals infected with HIV in Arba Minch Hospital, south Ethiopia. A facility-based cross-sectional study involving 170 HIV-infected individuals attending Arba Minch Hospital antiretroviral therapy (ART) clinic was conducted from April to June 2013. Data on demographic profile of the study participants and factors associated with T. gondii infection were gathered using a questionnaire. Serum was tested for IgG anti-T. gondii antibody by enzyme-linked immunosorbent assay (ELISA). Data were analyzed using SPSS version 20 software. Seroprevalence of latent T. gondii infection among the study participants was 88.2%. Consumption of raw meat (AOR = 4.361; 95% CI: 1.409-13.496) and involvement in farming/gardening activities (AOR = 4.051; 95% CI: 1.112-14.758) were independent predictors of T. gondii seropositivity. This study revealed high prevalence of latent T. gondii infection, similar to other studies. Monitoring of the patients to prevent reactivation of the latent T. gondii infection is recommended.

Frequency of Toxoplasma gondii in HIV Positive Patients from West of Iran by ELISA and PCR

BACKGROUND

Toxoplasma gondii, the obligate intracellular parasite is life threatening in AIDS patients. Diagnosis of toxoplasmosis is based on serological methods especially increasing of IgM and IgG titers, but finding of parasite or its components (antigenemia) may be beneficial method in order to detection of acute toxoplasmosis in immunocompromised patients.

METHODS

Ninety-four serum samples from HIV positive patients were collected from Sanandaj, Kordistan west of Iran. These patients were lived in Sanandaj of whom 26 were prisoners infected with HIV virus in prison. Toxoplasma gondii antibodies were determined by IgG ELISA. T. gondii antigen was identified by capture-ELISA. PCR was performed on samples with T. gondii antigenemia. CD4+ T cells counts had been determined by flowcytometry and were obtained from records of each patient.

RESULTS

Among the examined HIV seropositive individuals, 19.1% (18/94) and 5.3% (5/94) were positive for Toxoplasma-IgG and antigenemia, respectively. Besides, one of the samples was positively detected by PCR method. Mean age of participants was 37.9 ± 9.5 year. Prevalence of IgG antibody and antgenemia was higher in age group of 40-50 years old. The Mean of CD4+ T cells counts of participants (total of HIV+ patients, IgG positive patients and patients with antigenemia) was 699.2 ± 345.2, 655.1 ± 237.9 and 620.2 ± 215.1 respectively.

CONCLUSION

Capture-ELISA and PCR could confirm the T. gondii acute infection in HIV positive patients. For precise diagnosis of acute toxoplasmosis in HIV positive patient, performance of more studies based on more sensitive types of PCR is suggested.

Sero-epidemiology and risk factors for Toxoplasma gondii among pregnant women in Arab and African countries

The epidemiology of toxoplasmosis in pregnancy is a major issue for public health. Primary infection in pregnant women can lead to serious sequelae. This review examined current sero-epidemiology and risks factor data for Toxoplasma gondii in pregnant women in Arab and African countries. A systematic electronic search of published literature was conducted. Data were extracted from relevant studies. Seropositivity is high in both regions. African countries have higher seropositivity than Arab countries due to differences in risk factors. Data on T. gondii infection in pregnancy are scant in many countries, especially where there is lack of political stability. Identified risk factors included eating raw meat, proximity with cats, undercooked food, and increasing maternal age. Toxoplasmosis in pregnancy in Arab and African countries is an underestimated health problem. Further research is needed. This report is a foundation for strategies and policies for intervention needed to combat the consequences of congenital toxoplasmosis.

Seroprevalence of Toxoplasma gondii IgG antibody in HIV/AIDS-infected individuals in Maputo, Mozambique

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.

Seroprevalence and Associated Risk Factors of Toxoplasma gondii in Pregnant Women Attending in Northwest Ethiopia

BACKGROUND

Toxoplasmosis is a major public health problem among immuno-compromised individuals. This study aimed to determine the seroprevalence and associated risk factors of Toxoplasma gondii infection among pregnant women with and out HIV infections.

METHODS

This cross sectional study was conducted among consecutive 385 pregnant women attended Antenatal Clinic from May 2010 to October 2011 at the Gondar University Teaching Hospital, Northwest Ethiopia. Venous blood was collected from each pregnant woman for testing HIV-1/2 and anti- Toxoplasma antibodies using rapid test kits. Data were entered and analyzed using SPSS version 20 statistical package.

RESULTS

The overall magnitude of T. gondii and HIV was 88.6% (341/385) and 11.2% (43/385), respectively. The seroprevalence of T. gondii was not different among HIV infected and non-infected pregnant women (88.4%, 38/ 43 vs 88.6%, 303/342). Keeping cats in house showed statistically significant association with seropositivity of toxoplasmosis (P<0.05).

CONCLUSION

Irrespective of HIV infection, high rate of T. gondii was detected among pregnant women. These high prevalences indicate the need for an intensified public health awareness to reduce both infections.

Communities and community genetics in Ethiopia

The rates of congenital and genetic disorders in low and middle income countries are similar or might be higher than in high income countries due to a multitude of risk factors and the dearth of community genetic services. To direct effective preventive, diagnostic and counseling services, collecting data on the incidence and prevalence of various congenital and genetic disorders and their risk factors is a pre-requisite for establishing genetic services at the community level and mainly at the primary health care setting. This brief review is meant to assess the available epidemiological data in Ethiopia pertaining to congenital and genetic disorders on which the future community genetic services could be built. Existing epidemiological data on congenital and genetic disorders in Ethiopia is limited, and the few studies conducted revealed that folate and iodine deficiencies are prevalent among women in the reproductive age. Pregnant women's infection with syphilis and rubella is prevailing. Based on available data, cleft lip and palate, congenital heart diseases, club-foot, and gastro-intestinalmalformations are the most common birth defects in Ethiopia. Community based studies to accurately demonstrate the incidence and prevalence levels of these disorders are almost unavailable. To plan for organization and implementation of community genetic services at the primary health care level in Ethiopia, conducting standardized epidemiological studies is currently highly recommended.

Antenatal screening for Toxoplasma gondii, Cytomegalovirus, rubella and Treponema pallidum infections in northern Benin

OBJECTIVES

Toxoplasma gondii, cytomegalovirus (HCMV) and rubella virus infections are among the most serious of those contracted during pregnancy in terms of foetal consequences. Toxoplasma, HCMV and rubella antibody screening is unusual in Africa, and there are few published data. The aim of this study was to evaluate the prevalence of these markers among pregnant women in northern Benin on the occasion of routine syphilis screening.

METHODS

Toxoplasma, HCMV and rubella IgG and IgM antibodies were determined in the serum of 283 women attending Saint Jean de Dieu de Tanguiéta hospital, using an enzyme immunoassay, and IgM were confirmed using an enzyme-linked fluorescent assay (ELFA). In the case of IgM positivity, the avidity of anti-HCMV and anti-Toxoplasma IgG was measured. Total anti-Treponema pallidum antibodies were determined using an enzyme immunoassay and confirmed by immunoblotting. In the case of positivity, the Venereal Disease Research Laboratory (VDRL) test was used.

RESULTS

The prevalence of anti-Toxoplasma, anti-HCMV, anti-rubella IgG and total anti-Treponema antibodies was, respectively, 30.0%, 100%, 94% and 2.5%. The VDRL test was positive in 62.5% of the anti-Treponema-positive samples. The prevalence of anti-Toxoplasma, anti-HCMV and anti-rubella IgM was, respectively, 0.4%, 1.4% and 0%. There were no statistically significant differences in terms of age class or trimester of pregnancy. Anti-Toxoplasma and anti-HCMV IgG avidity was always high.

CONCLUSIONS

The prevalence of HCMV and rubella antibodies is high in northern Benin, whereas that of Toxoplasma antibodies is lower. As nearly two-thirds of the pregnant women were anti-Toxoplasma seronegative, antibody screening should be introduced.

Seroepidemiology of toxoplasma gondii infection in women with first trimester spontaneous miscarriage in qena governorate, egypt

INTRODUCTION

To determine seroprevalence and risks factors for T. gondii in women with early miscarriage, Sera of 76 women were analyzed infection by indirect enzyme linked immunosorbent assay (ELISA). Seropositive cases were further examined histopathologically for evidence of Toxoplasma gondii organisms.

MATERIAL AND METHODS

Demographic data were obtained from participants to gather information on risk factors.

RESULT AND DISCUSSION

Of 76 women with spontaneous abortion screened for Toxoplasma-specific IgG and IgM antibodies with ELISA, 35 were IgG seropositive, of which, 14 samples were IgM seropositive. Therefore, seropositivity rates of 46.1% (95% CI: 35.1%, 57.3%), and 18.4% (95% CI: 10.89%, 28.32%) for IgG and IgM, respectively were found. These indicate that, 27.6 % (21 cases) of studied women (IgG+/IgM-) were immune to toxoplasmosis and 53.94 %(41 cases) were susceptible to primary infection (IgG-/IgM-). Mean while acute toxoplasmosis (IgG+/IgM+) was 18.4 %( 14 cases) with one case (1.3%) confirmed for recent infection as she had Tachyzoites on histopathology study. On the basis of multivariate logistic regression, living in a rural area was found to be the only independent predictor of toxoplasmosis (OR=3.800, CI= 1.100-10.813, p=0.034).

CONCLUSION

The seroprevalence of T. gondii infection in women with first trimester abortion in Qena governorate of Egypt is high. Pregnant women living in rural area are at a higher risk for acquiring infection during pregnancy. Antenatal screening of pregnant women and educational program about risks for Toxoplasmosis in rural areas is needed.

Seroprevalence of toxoplasmosis in mentally retarded patients in Iranian rehabilitation centers

Toxoplasma gondii is one of the most common causes of latent infections in humans and animals. Although T. gondii infection is widely prevalent in the world, most acquired cases of the disease are asymptomatic. The important aspect of this parasitic infection is the probable danger of congenital transmission and its severe effects on the fetus. There have been many reports about the prevalence of anti-T. gondii antibody among different groups of people in Iran; however the epidemiological data in mentally retarded patients are rare. The present study was conducted on 158 mentally retarded persons (94 males, 64 females) in the rehabilitation centers of Khoramabad from autumn 2012 to winter 2013. The overall prevalence of anti-T. gondii antibody was 30.4 % (48 cases). There were no significant difference between sex and toxoplasmosis (p > 0.05). However, there were no statistically significant difference between age and toxoplasmosis, nevertheless the prevalence of toxoplasmosis in the patients less than 10-years-old had significantly the lowest rate. The highest infection rates were found in the two age groups of 10-19 and ≥30 years old. Our results showed that the prevalence of toxoplasmosis in the mentally retarded persons in the rehabilitation centers of Khorramabad was similar to the prevalence in pregnant women in this city. Therefore, the disease does not cause additional danger to this group of women.

Seroepidemiology of Toxoplasma gondii infection in women of child-bearing age in central Ethiopia

Background

Toxoplasma gondii infections during pregnancy can result in abortion or congenital defects. Prevalence and risk factors of toxoplasmosis in women of child-bearing age in Ethiopia are unknown. The current study was conducted with the objectives of estimating the seroprevalence and potential risk factors in acquiring T. gondii infection by women of child-bearing age in Central Ethiopia.

Methods

A cross-sectional study was conducted from March 2011 to September 2011. Sera of 425 women were analyzed by indirect enzyme linked immunosorbent assay (ELISA). A questionnaire survey was administered for all study participants to gather information on risk factors.

Results

The study revealed that anti- T. gondii IgG antibodies were detected in 81.4% of the samples of which 78.4% were positive for only IgG and 3.06% positive for both IgG and IgM antibodies. Seroprevalence of IgM antibodies to T. gondii (4.0%, 95% CI: 2.14, 5.86) was suggestive of recent infections. Of the 213 pregnant women 9 (4.2 %) were IgM reactive. Out of 17 potential risk factors investigated, univariate logistic regression showed significant association of T. gondii infection with study area, age, pregnancy status, raw vegetable consumption, source of water, presence of cats at home, contact with cats, HIV status and precaution during cats’ feces cleaning (P ≤ 0.05). The final logistic regression model revealed that: the probability of acquiring T. gondii infection by women of Debre-Zeit was 4.46 times (95% CI of adjusted odds ratio [aOR]: 1.67, 11.89; P =0.003) higher compared to women of Ambo, pregnant women were twice (95% CI aOR: 1.13, 3.59; P = 0.018) more likely to be seropositive than non-pregnant women and women who consume raw vegetable were at increased risk of infection (aOR = 2.21, 95% CI: 1.03, 4.78; P = 0.043) than women who didn’t consume.

Conclusion

The seroprevalence of T. gondii infection in women of child-bearing age in Central Ethiopia is high. Study area, pregnancy and raw vegetable consumption are risk factors to acquire T. gondii infection. Educational program, antenatal screening of pregnant women and further epidemiological studies to uncover the economic and health impact of toxoplasmosis are suggested.

Seroprevalence and risk factors for Toxoplasmosis in HIV infected and non-infected individuals in Bahir Dar, Northwest Ethiopia

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.

Comparative study on toxoplasma serology among HIV positive and HIV negative illicit drug users in Ahvaz, Iran

BACKGROUND

Toxoplasmosis is a common parasitic infection in human around the world and can cause life-threatening encephalitis in human immunodeficiency virus (HIV) infected host. The aim of this study was to assess the frequency of toxoplasma infection in illicit drug users (IDUs) with and without HIV infection in Iran.

METHODS

This study was carried out on 84 IDUs (42 HIV positive as case group and 42 HIV negative subjects as control group) from 2008 to 2009. Serum samples were tested for T. gondii IgG antibodies by Enzym linked immunosorbant assay (ELISA). Based on the company brochure kit, the test was defined positive if the antibody titer was 3 IU/ml or more. The data from these two groups were collected and analyzed.

RESULTS

The mean age of HIV positive cases was 34.4±8.6 and for HIV negative cases was 35.9±9.3 year. The mean age and distribution of sex in both groups were equal. The frequency of toxoplasma-IgG in HIV positive and HIV negative was 73.8% and 81%, respectively (p=0.19).

CONCLUSION

The results show that prevalence of toxoplasmosis infection in the illicit drug users with HIV positive or negative is equal.

A review of toxoplasmosis in humans and animals in Ethiopia

Toxoplasmosis caused by the protozoan parasite, Toxoplasma gondii, is a worldwide zoonosis. In this paper published information on toxoplasmosis in humans and other animals in Ethiopia is reviewed. Limited data indicate that the prevalence of T. gondii in humans in Ethiopia is very high, up to 41% of children aged 1-5 years were reported to be seropositive. There is little information on seroprevalence data in pregnant women and no data on congenital toxoplasmosis in children. About 1 million adults in Ethiopia are considered to be infected with HIV with less than one-third likely receive highly active antiviral therapy. Based on a conservative T. gondii seroprevalence of 50%, thousands might die of concurrent opportunistic infections, including toxoplasmosis. However, exact figures are not available, and most serological surveys are not current. Serological surveys indicate up to 79% of goats and sheep have T. gondii antibodies. However, there is no information on losses due to toxoplasmosis in livestock or the presence of viable T. gondii in any host in Ethiopia.

Preliminary report of HIV and Toxoplasma gondii occurrence in pregnant women from Mozambique

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.