Toxoplasma gondii infection and liver disease: a case-control study in a northern Mexican population

The Association of Toxoplasma gondii IgG and Liver Injury in US Adults

BACKGROUND

Toxoplasma gondii (T. gondii) is a ubiquitous obligatory intracellular parasite which infects over 40 million Americans and causes toxoplasmosis. Inside the human body, T. gondii can damage tissues and invade vital organs.

METHODS

This study evaluated the association of T. gondii infection and liver disease using data from the National Health and Nutrition Examination Survey (NHANES) 2009-2010, with a sample size of 3371 participants (age 20-80 years). Toxoplasma infection was determined by the level of T. gondii IgG antibody in serum samples. Liver disease was assessed by liver injury biomarkers and the Fatty Liver Index (US-FLI). The evaluation of the association between T. gondii infection and liver disease included the calculation of the Mantel-Haenszel risk ratio (RRMH), Rho-Scott chi-square bivariate analyses, design-based t-tests, and linear and logistic regression models which were adjusted for demographic and anthropometric covariates.

RESULTS

Mean levels of aspartate aminotransferase (AST) and alkaline phosphatase (ALP) were significantly more elevated in the T. gondii IgG-positive (IgG+) participants as compared to T. gondii-negative (IgG-) participants, p = 0.0435 and 0.0310, respectively. In linear regression analysis, exposure to T. gondii IgG+ had statistically significant positive associations with AST (p = 0.0211), alanine aminotransferase (ALT) (p = 0.0221), and gamma-glutamyl transferase (GGT) (p = 0.0258) after adjusting for BMI, age, gender, and race. T. gondii exposure was associated with an elevated relative risk of chronic liver disease (CLD) (RRMH = 1.26, 95% CI: 1.05-1.51). This association was more pronounced in certain occupations, such as construction, agriculture, forestry, and fishing, where Toxoplasma infection is more common (p = 0.0477). Moreover, Toxoplasma infection increased the odds of nonalcoholic fatty liver disease (NAFLD) (OR = 6.99, 95% CI = 1.85-26.32, p = 0.0237).

CONCLUSION

T. gondii IgG+ antibody was significantly associated with liver injury biomarkers (ALT, AST, GGT, and ALP) and an increased risk of CLD and NAFLD. Moreover, the association of Toxoplasma with CLD was more evident in specific occupations where the prevalence of Toxoplasma was high. The findings of this study provide insight into utilizing liver biomarkers and US-FLI to assess the health complications of Toxoplasma when imaging tests are not accessible.

Prevalence of Toxoplasma gondii 36-KDa antigen and chronic Hepatitis C: another evidence of an Association

In chronic hepatitis C (CHC), Toxoplasma gondii infection can lead to more severe diseases and is capable of changing the disease course. Former studies were concerning anti-T. gondii IgG/IgM seroprevalence in CHC patients regardless the antigenic proteins that are associated with active infection. Therefore, this study aimed to evaluate association between prevalence of 36-KDa T. gondii antigen (TAg) and both CHC progression and liver and viral biochemical parameters. One hundred-twenty five CHC patients (65 with fibrosis and 60 with cirrhosis) and forty healthy controls constituted this study. Demographics and clinical data were collected. Both TAg and HCV-NS4 were identified using ELISA. In contrast to healthy controls (0%), both seropositivity (P = 0.043) and mean serum level (P = 0.025) of TAg were higher in cirrhotic patients (43.3 %; 1.2 ± 0.2 ng/mL) compared to fibrotic patients (26.2 %; 0.7 ± 0.1 ng/mL). T. gondii infection was significantly (P < 0.05) associated with liver and viral biochemical parameters including increased ALT and AST activities, total bilirubin and AFP levels and decreased albumin and platelets count levels. Interestingly, TAg positivity were associated with elevated HCV-NS4 level compared to negative TAg patients (212.5 ± 25.3 vs. 133.9 ± 17.4 µg/mL (P = 0.026); r = 0.559 (P < 0.0001)). In conclusion, this study highlighted association between T. gondii parasitemia and CHC progression since TAg was more prevalent among cirrhotic than fibrotic patients and healthy controls. The presence of TAg was associated with impaired liver functions and increased HCV-NS4 levels. Further studies are needed to define the mechanism of this association.

Infection with Toxoplasma gondii can promote chronic liver diseases in HIV-infected individuals

Liver pathologies and infection with Toxoplasma gondii (Nicolle et Manceaux, 1908) are widespread among HIV-infected patients. However, a possible contribution of toxoplasmosis to the development of various forms of liver diseases in HIV-infected individuals has not yet been determined. This research is a retrospective cohort study. Medical cards of 907 HIV-positive patients, including 119 individuals who died, were studied. The patients were divided into two groups: 531 patients were seropositive to T. gondii and 376 seronegative. General liver pathology was more widespread among patients seropositive to T. gondii than in seronegative patients (63.1 ± 2.1% and 51.9 ± 2.6%, respectively, p < 0.001). The association of seropositive to T. gondii with general liver pathology is weak both in the whole cohort (Pearson's contingency coefficient C = 0.112), and among the deceased patients (C = 0.228). Chronic HBV-HCV coinfection was more common in the seropositive than in seronegative individuals as it was found both in entire cohorts (26.0 ± 1.9% and 18.6 ± 2.0%, respectively, p = 0.010) and in died patients (31.0 ± 5.5% and 14.6 ± 5.1%, respectively, p = 0.041). Toxoplasma gondii had a weak role in distributing of HBV-HCV coinfection between cohorts (C = 0.187). In both cohorts in patients with chronic hepatitis, regardless of its etiology, there was no significant difference in alanine transaminase activity (ALT). Cirrhosis of the liver occurred 4.5 times more often in deceased seropositive patients than in the entire seropositive cohort (23.9 ± 5.1 and 5.3 ± 2.0, respectively, p = 0.0006) whereas it no significantly increased in seronegative cohort (10.4 ± 4.4 against 4.8 ± 1.1, p > 0.05). In them T. gondii is weakly involved in cirrhosis formation (C = 0.168). Thus, in HIV-infected patients, T. gondii is a weak nonspecific adjunct that supports chronic liver inflammation and progression of cirrhosis, regardless of etiology, but does not influence the degree of hepatitis activity. The increased prevalence of HBV-HCV coinfection in patients seropositive for T. gondii may be related to their risk factor behaviour associated with uncontrolled blood contacts.

Toxoplasma gondii infection as a potential risk for chronic liver diseases: A systematic review and meta-analysis

Toxoplasma gondii, the etiological agent of toxoplasmosis, can cause serious public health problems. Although Toxoplasma gondii tends more to neurotropic and ocular organs, some existing evidence suggest that this disease might induce serious pathological effects on liver. Hence, this study aimed to evaluate the relationship between chronic liver diseases and toxoplasmosis. Meanwhile, it attempted to assess whether patients with toxoplasmosis are susceptible to chronic liver diseases. To achieve this aim, the published studies related to the subject were systematically searched in five major electronic databases between the January 1, 1950 and October 1, 2019. The meta-analysis was carried out using the StatsDirect statistical software and a p-value less than 0.05 was considered significant for any test. Out of 691 identified studies, 10 studies met our inclusion criteria and entered this systematic review. The pooled prevalence rates of Toxoplasma gondii in patients with liver diseases (35.97%; 95% CI: 28.38-43.93) were higher than those in the control group (18.24%; 95% CI: 13.85-23.09). The meta-analysis indicated that the common Odd Ratio by a random effect model was 2.7 (95% CI: 2.30-3.24), revealing a significant association between chronic liver diseases and anti-Toxoplasma IgG antibody. The results of this systematic review confirmed the positive connection between toxoplasmosis and chronic liver diseases. Nonetheless, more studies are needed to clarify the detailed association between these diseases.

Seroprevalence and risk factors associated with Toxoplasma gondii infection in sheep of Veracruz State, southeast Mexico

Toxoplasma gondii is widely prevalent in sheep and their products pose a risk to public health. The aim of this study was to identify the seroprevalence and risk factors associated with T. gondii infection in sheep in Veracruz State, Mexico. The study was cross-sectional and it was carried out in thirteen municipalities distributed in three regions of Veracruz State. A total of 414 blood samples were collected from four districts of Veracruz State and analyzed for T. gondii antibodies using enzyme-linked immunosorbent assay. Total seroprevalence was 35.90% (149/414; 95.00% CI = 31.40-40.80). Seroprevalence by the municipality was 10.50% to 85.70% and for the district was 28.80% to 47.80%, respectively. Age, breed and productive status were identified as risk factors associated with T. gondii infection significantly. The infection by T. gondii is widely present in the districts of the Veracruz State with a high seroprevalence and risk factors associated with infection.

Treatment with Lycopodium clavatum 200dH Intensifies Kidney and Liver Injury in Mice Infected with Toxoplasma gondii

The effects of infection with Toxoplasma gondii vary from asymptomatic to the development of alterations in various organs (including the liver and kidneys) which may be irreversible, and lead to the death of the host. Whereas homeopathy is an alternative and effective method for treating various diseases, including those caused by protozoa, we questioned the effect of using Lycopodium clavatum in mice infected with T. gondii. One hundred male Swiss mice, 60 days old, were divided into four groups (n = 25/group): NIC (uninfected and untreated control), IC (infected and treated with un-dynamized 7% alcohol solution [vehicle]), G48 (infected and treated 48 h before infection and treated three more times; at 2, 4, and 6 days post-infection (dpi) with L. clavatum 200dH), and G72 (infected and treated for 3 consecutive days before infection with L. clavatum 200dH). In this study, physiological, histopathological, and immunological parameters were evaluated. The L. clavatum 200dH intensified renal damage in mice infected with T. gondii from 7 dpi, causing severe and progressive alterations during this period, such as various degrees of inflammation, edema, atrophy, and tubular cystic dilation, degenerated tubules with intra-cytoplasmic vacuoles and coalescing spots, severe vascular lesions, glomerulonephritis, and peri-glomerular congestion. In the G72 animals, which received L. clavatum 200dH, more severe cortex damage was observed (91.66-96.66%) as compared to the IC group (55-80%) and more renal corpuscle, and renal tubule injury was observed (80 ± 5 to 96.7% ± 2.89 of the total area) during all periods, as compared to the IC group (p < 0.05). Both groups presented high liver enzyme levels, and the highest values for AST were observable at 60 dpi. We observed significant increases of type I and III collagen, as well as high levels of TGF-β1 in both organs of the treated animals, the main factor involved in fibrosis in areas damaged by the process. L. clavatum 200dH intensifies kidney and liver alterations in mice infected with T. gondii. Our results reinforce caution when indicating administration schemes and dosages for ultra-diluted drugs.

Occurrence and genetic characterization of Toxoplasma gondii and Neospora caninum in slaughtered domestic rabbits in central China

Currently, information on the occurrence and genetic characterization of Toxoplasma gondii and Neospora caninum in tissues of rabbits in China is lacking. In this study, brain and heart samples from 470 slaughtered domestic rabbits were collected in Henan Province, Central China. The occurrence rate of T. gondii and N. caninum DNA detected by nested PCR was 2.8% and 2.1%, respectively. There were no significant differences (p > 0.05) in the frequency of the two parasite infections in relation to sex, breed, and region. Three out of 13 T. gondii-positive samples were completely or partially genotyped at 11 genetic markers using PCR-RFLP, and one was identified as ToxoDB genotype #9. For N. caninum, three different sequences at the ITS1 region and two genotypes at the MS5 microsatellite locus were identified. To our knowledge, this is the first genetic characterization of N. caninum isolates from rabbits.

Electrochemiluminescence Epidemiologic Detection of Toxoplasma gondii Infection in Pregnant Women With Direct and Indirect Diagnostic Techniques (ELISA Avidity Plus Biochemical Assay), Tehran, Iran

Background and aims: Toxoplasmosis is a very common disease in the world and has two types, including chronic and acute toxoplasmosis. In the chronic toxoplasmosis, the abnormality of tissue function is negligible, but in acute toxoplasmosis, the function of the reticuloendothelial system is interrupted and the assessment of Toxoplasma antibody with tissue enzymes is very essential in this stage. In addition, in some conditions, serum ferritin increases in the acute phase of the infectious disease. In congenital toxoplasmosis, the evaluation of biochemical factors and IgG avidity test is important for detecting the acute congenital toxoplasmosis in pregnant women. Based on the above-mentioned explanations, the present study aimed to evaluate the biochemical factors in patients with acute toxoplasmosis (congenital toxoplasmosis) among the Iranian population using electrochemiluminescence and IgG ELISA avidity. Methods: The study was based on a comparative abundance study and was conducted from March to June 2017. Material included 980 serum and amniotic fluid samples collected from human blood with a high level of IgG antibody against Toxoplasma gondii in Rajaie Center, Tehran, Iran. The standard and the main tests included the ELISA assay and the measurement of the liver transaminases (i.e., SGOT and SGPT), along with/namely bilirubin and ferritin used to detect IgG antibodies and to evaluate the acute toxoplasmosis, respectively. Finally, the results were analyzed by SPSS software. Results: The results showed that the level of liver transaminases, namely, serum bilirubin and ferritin increase in some patients with a high level of IgG avidity antibody against Toxoplasma gondii. For example, the mean serum levels of SGOT was 108 IU/L in 120 patients with acute toxoplasmosis and the mean serum bilirubin was about 5 mg/dL in 80 patients. Conclusion: Overall, in acute congenital toxoplasmosis, the evaluation of IgG AVIDITY is regarded as the first step and then the measurement of biochemical factors such as serum transaminases, serum bilirubin, and serum ferritin is important.

Seroprevalence and risk factors of Toxoplasma gondii infection in rabbit of local Algerian population

AIM

The objective of this investigation was to determine the seroprevalence and identify the risk factors of Toxoplasma gondii infection in the rabbit of the local Algerian population from five districts of Northern Algeria.

MATERIALS AND METHODS

Blood samples of 350 rabbits were collected and analyzed for the presence of anti-T. gondii immunoglobulin G antibodies using the indirect enzyme-linked immunosorbent assay. Additional data concerning the farms and management practices were obtained through a questionnaire used in surveys and interviews.

RESULTS

The overall seroprevalence was 14.6% (51/350). The seroprevalence was significantly higher in outdoor rearing farms and was linked to the presence of animals from other species on the farm. A higher seroprevalence was found in older animals compared to younger ones. No difference in seroprevalence was noted with respect to the origin or gender of animals, type of cage, feed and water sources, presence of cats in the vicinity, hygiene status, or season.

CONCLUSION

This study has shown that T. gondii prevalence in rabbits of the local population is relevant and may have important implications for public health in rural areas.

Mononucleosis Epstein -Barr negativa: variación poco reconocida de enfermedad popular

Se reporta el caso de un paciente joven, inmunocompetente y sin factores de riesgo, con adenopatías cervicales, fiebre, malestar general compatible síndrome mononucleósico. La persistencia de síntomas a pesar de múltiples tratamientos con antibióticos lleva a los médicos tratantes a echar un segundo vistazo. El hallazgo y desenlace, los hallarás aquí.

Hepatitis in slaughterhouse workers

Slaughterhouse workers (SHW) are at increased risk of hepatitis which can occur due to different organisms and should be investigated for viral, bacterial, and parasitic organisms. Slaughter house personnel including butchers are at a higher risk of infections from cuts and blood-letting, with the possible risk of the transmission of blood-borne pathogens to their colleagues. The objective of this review is to evaluate the common etiologies of hepatitis in SHW which will assist in the assessment of these patients presenting with transaminitis. Types of Microorganisms causing hepatitis with their reservoirs, routes of transmission, laboratory diagnosis, clinical features, treatment options and preventive strategies are included in this review. Proper investigation and awareness is of utmost importance as it causes significant financial constraints derived from workers health cost and from livestock production losses when the disease is confirmed. The work up is essential because infected workers might be a source of infections to other colleagues, family and the consumers.

Is Toxoplasma gondii infection correlated with nonalcoholic fatty liver disease?- a population-based study

Background

Previous studies have suggested that Toxoplasma gondii (T. gondii) infection might be associated with fatty liver disease. However, the relationship between non-alcoholic fatty liver disease (NAFLD) and T. gondii infection has not been investigated in a large population. We aimed to study the relationship between those two diseases using a population-based dataset from the United States.

Methods

The data were collected from the third National Health and Nutrition Examination Survey (NHANES III) between 1988 and 1994. Statistical analysis was applied to compare the prevalence of NAFLD in anti-T. gondii antibody-positive participants with antibody-negative ones.

Results

A total of 9465 persons with a mean age of 44.33 ± 16.21 years, 46.9% of which were males, were included in the final analysis. Their mean BMI was 27.60 ± 5.96 kg/m². A total of 2520 participants (26.62%) were positive for the T. gondii antibody. There was an increasing trend of seroprevalence of T. gondii with age (P for trend < 0.001). The incidence of NAFLD in the seropositive group was higher than that in the seronegative group (27.10% vs 23.40%, p < 0.001). In addition to this, metabolic biomarkers, including serum lipid, fasting blood-glucose, and uric acid were also significantly higher in the seropositive group. However, multivariate analysis revealed that T. gondii infection was not an independent risk factor for NAFLD. Age was independently correlated with both the prevalence of T. gondii and NAFLD.

Conclusions

Patients with T. gondii infection may have a higher prevalence of NAFLD. Age may have an effect on the increase of NAFLD in the T. gondii seropositive population.

Seroprevalence of Toxoplasma gondii and Encephalitozoon cuniculi among domestic rabbits in central China

Rabbits (Oryctolagus cuniculus) are frequently reared for meat production in China. The aim of this study was to assess the seroprevalence of Toxoplasma gondii and Encephalitozoon cuniculi, and risk factors of infection in domestic rabbits raised in Henan province, central China. 1,213 serum samples of domestic rabbits were collected and tested for anti-T. gondii and anti-E. cuniculi antibodies using a modified agglutination test (MAT) and an enzyme-linked immunosorbent assay (ELISA), respectively. The serum positive rates of T. gondii and E. cuniculi were 128/1,213 (10.55%) and 235/1,213 (19.37%), respectively. Co-infection of T. gondii and E. cuniculi was demonstrated in 84 specimens; 44 rabbits were seropositive for T. gondii alone, while 151 rabbits were seropositive for E. cuniculi alone. The main risk factors simultaneously associated with T. gondii and E. cuniculi infection were the age of the rabbit, the type of food, and the rabbit rearing system. Serum positive rates of T. gondii and E. cuniculi among domestic rabbits were high, indicating the possibility of public health issues.

Seroepidemiology of Toxoplasma gondii infection in patients with liver disease in eastern China

The role of the protozoan parasite Toxoplasma gondii in the pathogenesis of liver disease has recently gained much interest. The aim of this study was to determine the prevalence and risk factors associated with T. gondii infection in patients with liver disease from three cities in Shandong and Henan provinces, China. A case-control study was conducted from December 2014 to November 2015 and included 1142 patients with liver disease and 1142 healthy controls. Serum samples were collected from all individuals and were examined with enzyme-linked immunosorbent assay for the presence of anti-T. gondii IgG and IgM antibodies. Information on the demographics, clinical, and lifestyle characteristics of the participants was collected from the medical records and by the use of a questionnaire. The prevalence of anti-T. gondii IgG was 19·7% in patients with liver disease compared with 12·17% in the controls. Only 13 patients had anti-T. gondii IgM antibodies compared with 12 control individuals (1·14% vs. 1·05%, respectively). The highest seroprevalence was detected in patients with liver cancer (22·13%), followed by hepatitis patients (20·86%), liver cirrhosis patients (20·42%), and steatosis patients (20%). Multivariate logistic regression analysis indicated that consumption of raw meat (odds ratio (OR) = 1·32; 95% confidence interval (CI) 1·01-1·71; P = 0·03) and source of drinking water from wells (OR = 1·56; 95% CI 1·08-2·27; P = 0·01) were independent risk factors for T. gondii infection in liver disease patients. These findings indicate that T. gondii infection is more likely to be present in patients with liver disease. Therefore, efforts should be directed toward health education of populations at high risk of T. gondii infection and measures should be taken to protect vulnerable patients with liver disease.

Seroprevalence and risk factors associated with Toxoplasma gondii infection in domestic rabbits and humans

A cross-sectional study was conducted from September 2014 to December 2015 to determine seroprevalence and potential risk factors associated with Toxoplasma gondii (T. gondii) infection in domestic rabbits and humans in Egypt. In total 290 blood samples were collected from humans (n=140) and slaughtered rabbits (n=150) and were analyzed using ELISA for T. gondii IgM and IgG antibodies. T. gondii IgM and IgG antibodies were detected in, respectively, 9 (6%) and 40 (26.7%) of 150 rabbits raised in Cairo, Qalyubia, and Sharkia Governorates, Egypt. Corresponding overall seroprevalences for human participants were 5.7% and 35.7%, respectively. Rabbit age, management (farm, backyard and pet shop) and the presence of cats at rabbit raising areas were significantly associated with the seroprevalence of T. gondii IgG antibodies. T. gondii IgG antibodies seropositivity in pregnant participants and rabbit butchers were 0.17 and 0.63 times lower than immunocompromised participants, respectively. However, participants who consumed undercooked rabbit meat was 7.59 times higher than participants who consumed meat from other sources. The results indicate that domestic rabbits are a potential source of T. gondii infections in human in Egypt. Thus, dissemination of protective measures is essential, especially for rabbit butchers and immunocompromised individuals.

Toxoplasma gondii exposure and Parkinson's disease: a case-control study

OBJECTIVES

To determine the association between Toxoplasma gondii infection and Parkinson's disease and to investigate whether T. gondii seropositivity is associated with the general characteristics of patients with Parkinson's disease.

DESIGN

Case-control study.

SETTING

Cases and controls were enrolled in Durango City, Mexico.

PARTICIPANTS

65 patients with Parkinson's disease and 195 age- and gender-matched control subjects without Parkinson's disease.

PRIMARY AND SECONDARY OUTCOME MEASURES

Serum samples of participants were analysed for anti-T. gondii IgG and IgM antibodies by commercially available enzyme-linked immunoassays. Prevalence of T. gondii DNA was determined in seropositive subjects using PCR. The association between clinical data and infection was examined by bivariate analysis.

RESULTS

Anti-T. gondii IgG antibodies were found in 6/65 cases (9.2%) and in 21/195 controls (10.8%) (OR 0.84; 95% CI 0.32 to 2.18; p=0.81). The frequency of high (>150 IU/mL) antibody levels was similar among cases and controls (p=0.34). None of the anti-T. gondii IgG positive cases and four of the anti-T. gondii IgG positive controls had anti-T. gondii IgM antibodies (p=0.54). The prevalence of T. gondii DNA was comparable in seropositive cases and controls (16.7% and 25%, respectively; p=1.0). Seroprevalence of T. gondii infection was associated with a young age onset of disease (p=0.03), high Unified Parkinson Disease Rating Scale scores (p=0.04) and depression (p=0.02). Seropositivity to T. gondii infection was lower in patients treated with pramipexole than in patients without this treatment (p=0.01). However, none of the associations remained significant after Bonferroni correction.

CONCLUSIONS

The results do not support an association between T. gondii infection and Parkinson's disease. However, T. gondii infection might have an influence on certain symptoms of Parkinson's disease. Further research to elucidate the role of T. gondii exposure on Parkinson's disease is warranted.

Seroprevalence of Toxoplasma gondii Infection in Wild Boars, Wild Rabbits, and Wild Chickens in Hubei Province, China

Toxoplasma gondii causes serious infection worldwide in humans and animals. In this study, the seroepidemiology of toxoplasmosis was investigated in wild boars (Sus scrofa) (n=377), wild rabbits (cape hare, Lapus capensis) (n=331), and wild chickens (red junglefwol, Gallus gallus) (n=571) in 4 forested and country sided area of Hubei province of China. For this, blood samples were collected and tested by indirect hemagglutination test (IHA). The seroprevalence was found to be 7.2%, 5.1%, and 12.6% in wild boars, rabbits, and chickens, respectively, with significant differences among these species. The prevalence of T. gondii infection in male and female wild boars was found to be 7.9% and 6.5% (P<0.01), in male and female rabbits was 5.6% and 4.9% (P<0.01), and in male and female chickens was 17.1% and 7.7% (P<0.01), respectively, with significant differences between 2 genders of chickens (P<0.01). The findings of this study may help in planning of the prevention measures against T. gondii infection in wild animals in this area.

Toxoplasma gondii Infection and Chronic Liver Diseases: Evidence of an Association

Toxoplasmosis may present as a severe disease among some Egyptian patients with chronic liver disease (CLD) due to their impaired immune system, changing the course of the disease. The classical diagnosis of toxoplasmosis by serological tests is inadequate for such patients. This study was performed to highlight the role of real-time quantitative PCR (qrtPCR) test in the accurate diagnosis of toxoplasmosis among Egyptian patients with CLD. Seventy patients with CLD and 50 healthy controls were enrolled in this study. All were subjected to full clinical examinations, abdominal ultrasonography, and biochemical analysis of liver enzymes and they were investigated for markers of hepatitis B virus (HBV) and hepatitis C virus (HCV). In addition, Toxoplasma gondii (T. gondii) parasitemia was determined using qrtPCR. The results showed that T. gondii parasitemia was positive in 30% of CLD patients with highly statistically significant (p < 0.001) compared with the control group (6%). Co-infection in both T. gondii/HBV and T. gondii/HCV was 33.3% and 31.4%, respectively, with a highly significant association between T. gondii parasitemia and HCV viral load. Moreover, the results showed a significant increase of liver enzymes in the serum of patients positive for T. gondii compared with negative patients. An association between T. gondii infection and CLD was observed, and further studies will be needed to define the mechanism of this association.

Occurrence of Toxoplasma gondii in domestic rabbits of Northeastern Brazil

The present study aimed to conduct a serosurvey of toxoplasmosis in domestic rabbits of Northeastern Brazil. Blood samples and tissue fragments (brain, heart and diaphragm) were collected from 150 and 54 rabbits from the state of Pernambuco, Brazil, respectively. The serum samples were subjected to serological analysis (Modified Agglutination Test - MAT) and the tissue samples were assessed by PCR and histopathological analysis. Data collected through questionnaires were subjected to analysis of risk factors. According to the MAT and the PCR results, 6.7% (10/150; CI 3.2%-11.9%) of the rabbits were positive for anti-T. gondii antibodies and 9.25% (5/54) of the tissue fragments were positive for T. gondii DNA, respectively. Lesions associated with T. gondii infection, mainly characterized by granuloma, mononuclear cell infiltrates, degeneration areas and necrosis in brain and heart, were detected in the histopathological analysis. The risk factors associated with T. gondii infection identified in the present study were homemade food (odds ratio = 39.00) and contact between cats and rabbits (odds ratio = 52.00). This is the first report of toxoplasmosis in rabbits of Northeastern Brazil. The management problems identified in the present study must be corrected to reduce the frequency of positive animals in herds of rabbits.

Leptospira Exposure and Patients with Liver Diseases: A Case-Control Seroprevalence Study

The seroepidemiology of Leptospira infection in patients suffering from liver disease has been poorly studied. Information about risk factors associated with infection in liver disease patients may help in the optimal planning of preventive measures. We sought to determine the association of Leptospira IgG seroprevalence and patients with liver diseases, and to determine the characteristics of the patients with Leptospira exposure. We performed a case-control study of 75 patients suffering from liver diseases and 150 age- and gender-matched control subjects. Diagnoses of liver disease included liver cirrhosis, steatosis, chronic hepatitis, acute hepatitis, and amoebic liver abscess. Sera of participants were analyzed for the presence of anti- Leptospira IgG antibodies using a commercially available enzyme immunoassay. Anti-Leptospira IgG antibodies were found in 17 (22.7%) of 75 patients and in 15 (10.0%) of 150 control subjects (OR = 2.32; 95% CI: 1.09-4.94; P=0.03). This is the first age- and gender-matched case control study about Leptospira seroprevalence in patients with liver diseases. Results indicate that Leptospira infection is associated with chronic and acute liver diseases. Results warrants for additional studies on the role of Leptospira exposure in chronic liver disease.

Toxoplasmosis in Mexico: epidemiological situation in humans and animals

Toxoplasmosis is a parasitic disease widely distributed throughout the world, infecting a wide variety of animal species including humans. In Mexico, this parasite has been detected in different parts of the country, particularly in the tropical areas where the parasite can remain infective for long periods of time due to the environmental conditions (i.e. high temperature and humidity over the whole year). Several epidemiological studies have been conducted in both human and animal populations, but despite the wide distribution of the agent in the country, there is a significant lack of knowledge on the parasite transmission, treatment alternatives and control measures. The lack of feral cat populations and control measures in sites of meat production for human consumption are playing a role that has led to the wide spread of the disease in the country, particularly in tropical areas of Southeastern Mexico. For these reasons, this manuscript aims to review the published information on relevant epidemiological aspects of infection with T. gondii in humans and animals from Mexico.

Seroprevalence of Encephalitozoon cuniculi and Toxoplasma gondii in domestic rabbits (Oryctolagus cuniculus) in China

The breeding of domestic rabbits (Oryctolagus cuniculus) for human consumption has a long tradition in China. Infections that can affect the production of meat or even be transmitted from animals to humans are important to monitor, especially for public health reasons as well as for their impact on animal health. Thus, a total of 1,132 domestic rabbit sera from 4 regions in China were collected for serological screening for Encephalitozoon cuniculi and for Toxoplasma gondii by ELISA and modified agglutination test (MAT), respectively. Antibodies to E. cuniculi were detected in 248/1,132 (21.9%) sera tested while antibodies against T. gondii revealed a seroprevalence of 51/1,132 (4.5%). We believe that the present results are of epidemiological implications and public health importance due to the acknowledged susceptibility of humans to E. cuniculi and T. gondii infections. Therefore, routine screening tests of domestic rabbits are proposed considering the zoonotic potential of these parasites.

Is toxoplasmosis a potential risk factor for liver cirrhosis?

OBJECTIVE

To document Toxoplasma gondii (T. gondii) antibody status in patients with liver disease, blood samples were taken from 180 hepatic patients and 180 healthy controls.

METHODS

Toxoplasma IgG antibody was detected using enzyme-linked immunosorbent assay and histopathological assessment of liver biopsy METAVIR score was applied.

RESULTS

Anti-T. gondii IgG antibodies were found in 32.8% of patients and in 22.2% of controls (P = 0.02). Toxoplasma seropositivity was significantly associated with lymphadenopathy, history of blood transfusion and reflex impairment in patients. Chronic hepatitis C virus (HCV) and chronic HCV-related cirrhosis groups compared to chronic HBV and chronic HBV-related cirrhosis groups expressed significantly higher prevalence of T. gondii seropositivity (odds ratio (OR) = 4; 95% confidence interval (CI): 1.3-12.6; P = 0.013, OR = 4.8; 95% CI: 1.5-14.9; P = 0.006, respectively). Within the chronic HCV group, T. gondii seropositivity significantly associated disease evolution as regards to METAVIR histopathological system for fibrosis and inflammation (OR = 19.4; 95% CI: 2.3-165.2; P = 0.0008, OR = 0.29; 95% CI: 0.1-0.8; P = 0.01, respectively). Albumin, international normalized ratio (INR) and platelets count were the laboratory parameters significantly altered in Toxoplasma-positive chronic HCV patients (P = 0.001, 0.03, 0.04, respectively). Child-Pugh scoring for cirrhosis in chronic HCV group placed the majority of seropositive patient in class C with significant statistical difference compared to Child A reference group (OR = 0.08; 95% CI: 0.01-0.5; P = 0.003).

CONCLUSIONS

Toxoplasma seropositivity was high in patients with cirrhosis and associated higher grades of inflammation and necrosis signifying disease evolution, suggesting that cirrhotic patients may thus form a risk group for toxoplasmosis.

Toxoplasma gondii coinfection with diseases and parasites in wild rabbits in Scotland

In wild rabbits (Oryctolagus cuniculus) on an estate in Perthshire, central Scotland, the seroprevalence of Toxoplasma gondii was 18/548 (3·3%). The wild rabbit could be a T. gondii reservoir and it has potential value as a sentinel of T. gondii in environmental substrates. Toxoplasma gondii was associated with female sex (P < 0·001) and with relatively heavy infections by Eimeria stiedae (P = 0·036). It was not associated with the intensity of coccidial oocysts, the severity of myxomatosis caused by the virus Myxomatosis cuniculi, the intensity of roundworm eggs, the year or season, rabbit age or distance from farm buildings. Coinfections could have been affected by gestational down regulation of type 1 T helper cells. A sudden influx or release of T. gondii oocysts might have occurred. This is the first report of T. gondii in any wild herbivore in Scotland and also the first report of lapine T. gondii as a coinfection with E. stiedae, M. cuniculi and helminths.

Toxoplasma gondii infection among chronic hepatitis C patients: a case-control study

OBJECTIVE

To determine the detection rate of anti-Toxoplasma gondii (T. gondii) IgG and IgM in chronic HCV patients attending the Department of Tropical Medicine Mansoura University hospital in Egypt.

METHODS

This study included 120 adult chronic HCV patients, 81 decompensate cirrhosis (late-stage) and 39 chronic HCV non cirrhotic patients (early-stage) and 40 healthy blood donors as controls. Serum samples were examined for anti-Toxoplasma IgM and anti-Toxoplasma IgG antibodies by ELISA. Real-time RT-polymerase chain reaction assay was done for quantitation of hepatitis C virus.

RESULTS

Anti-T. gondii IgG antibodies were detected in 75 (92.6%) of 81 late-stage cirrhotic patients, 30 (76.9%) of the 39 chronic HCV non cirrhotic patients (early-stage) and in 6 (15%) of 40 controls with statistically significant difference (P<0.001). Anti-T. gondii IgM antibodies were found in 11 (13.6%) in late stage patients, 5 (12.8%) in early stage and in 3 (7.5%) of controls with no statistical significant difference (P=0.610). There was no correlation between stage of fibrosis and IgM or IgG antibodies positivity in our studied groups (P=0.526). High IgG levels significantly correlated with high viral load (P=0.026).

CONCLUSIONS

Our findings suggest that the serious opportunistic T. gondii infection represent a potential significant risk for chronic HCV patients. So, toxoplasmosis should be considered in their investigations and follow-up.

Toxoplasma gondii infection in interstate truck drivers: a case-control seroprevalence study

Background

Infection with Toxoplasma gondii can be acquired via the ingestion of undercooked or raw meat containing tissue cysts, or via ingestion of water contaminated with oocysts. Professional long distance truck driving may have epidemiological importance for food-borne infections since drivers eat out of home and in places where hygiene and cooking practices are uncertain. We aimed to determine whether interstate truck drivers in Durango, Mexico have an increased risk of infection with T. gondii as indicated by seropositivity; and to determine the socio-demographic, work, clinical, and behavioral characteristics associated with T. gondii seropositivity in interstate truck drivers.

Methods

Through a case–control study design, 192 truck drivers and 192 controls from the general population of the same region matched by gender and age were examined with enzyme-linked immunoassays for the presence of anti-Toxoplasma IgG and IgM antibodies. Socio-demographic, work, clinical and behavioral characteristics from the truck drivers were obtained.

Results

Anti-T. gondii IgG antibodies were found in 23 (12.0%) of 192 truck drivers and in 13 (6.8%) of 192 controls (OR = 21.0; 95% CI: 1.23-358.38; P = 0.002). Anti-T. gondii IgM antibodies were found in 7 (3.6%) cases and in 7 (3.6%) controls (P = 1.00). The seroprevalence of T. gondii infection was higher in drivers with reflex impairment than in those without this impairment (4/13, 30.8% vs 19/179, 10.6%, respectively; P = 0.05), and in drivers with hearing impairment than in those without this impairment (3/7, 42.9% vs 20/185, 10.8%, respectively; P = 0.03). Multivariate analysis of work and behavioral characteristics of truck drives showed positive associations of T. gondii exposure with trips to the south of Mexico (OR = 3.11; 95% CI: 1.02-9.44; P = 0.04) and consumption of horse meat (OR = 5.18; 95% CI: 1.62-16.55; P = 0.005).

Conclusions

Results suggest that interstate truck drivers may have an increased risk for T. gondii infection, and that T. gondii exposure may be impacting neurological functions in truck drivers. Contributing factors for T. gondii exposure should be taken into account for the design of optimal prevention measures against T. gondii infection.

Research progress on surface antigen 1 (SAG1) of Toxoplasma gondii

Toxoplasma gondii is an obligate intracellular parasitic protozoan that has a wide host range and causes a zoonotic parasitosis called toxoplasmosis. This infection causes significant morbidity, costs for care and loss of productivity and suffering. The most effective measures to minimize this parasite’s harm to patients are prompt diagnosis and treatment and preventing infection. A parasite surface antigen, SAG1, is considered an important antigen for the development of effective diagnostic tests or subunit vaccines. This review covers several aspects of this antigen, including its gene structure, contribution to host invasion, mechanisms of the immune responses and its applications for diagnosis and vaccine development. This significant progress on this antigen provides foundations for further development of more effective and precise approaches to diagnose toxoplasmosis in the clinic, and also have important implications for exploring novel measures to control toxoplasmosis in the near future.

High seroprevalence of Toxoplasma gondii infection in inmates: A case control study in Durango City, Mexico

PURPOSE

The seroprevalence of infection with the parasite Toxoplasma gondii and the association with risk factors has not been determined in inmates. Through a case-control study, 166 inmates from a state correctional facility in Durango City, Mexico and 166 age- and gender-matched non-incarcerated subjects were examined for the presence of anti-T. gondii IgG and IgM antibodies using enzyme-linked immunoassays.

RESULTS

Seroprevalence of anti-T. gondii IgG antibodies was higher in inmates (35, 21.1%) than in controls (14, 8.4%) (OR = 2.90; 95% CI: 1.43-5.94; P = 0.001). Anti-T. gondii IgM antibodies were detected in two (1.2%) inmates and in seven (4.2%) controls (P = 0.17). Multivariate analysis of socio-demographic, incarceration, and behavioral characteristics of inmates revealed that T. gondii seropositivity was associated with being born out of Durango State (OR = 3.91; 95% CI: 1.29-11.79; P = 0.01). In addition, T. gondii seroprevalence was higher (P = 0.03) in inmates that had suffered from injuries (17/56: 30.4%) than those without such history (18/110: 16.4%).

CONCLUSIONS

The seroprevalence of T. gondii infection in inmates in Durango City is higher than the seroprevalences found in the general population in the same city, indicating that inmates may represent a new risk group for T. gondii infection. Further research on T. gondii infection in inmates is needed.

Toxoplasma gondii infection and suicide attempts: a case-control study in psychiatric outpatients

The association of Toxoplasma gondii infection with suicide attempts has been scarcely evaluated. Two hundred eighty-three psychiatric outpatients (156 patients with history of suicide attempt and 127 control patients without history of suicide attempt) were examined with enzyme-linked immunoassays for Toxoplasma immunoglobulin G (IgG) and IgM antibodies. Seroprevalences of Toxoplasma IgG and IgM in the cases and the controls were similar: 7 (4.5%) and 3 (1.9%) vs. 10 (7.9%) and 3 (2.4%) (p = 0.23 and p = 0.55), respectively. In contrast, the Toxoplasma IgG levels higher than 150 IU/ml were more frequently observed in the cases than in the controls (100% vs. 50%, respectively; p = 0.04). The seroprevalence of Toxoplasma infection increased with age and with the number of suicide attempts. Toxoplasma seropositivity was associated with reflex impairment, national trips, and snake meat consumption. Our results suggest that although seroprevalence of Toxoplasma infection is not associated with suicide attempts, a high anti-Toxoplasma antibody level is, therefore warranting further research.

Seroprevalence of Toxoplasma gondii infection in domestic rabbits in Durango State, Mexico

There is a lack of information concerning the seroprevalence of Toxoplasma gondii infection in rabbits in northern Mexico. Through a cross sectional study, antibodies to T. gondii were determined in 429 domestic rabbits in Durango State, Mexico using the modified agglutination test. Rabbits were raised in 29 properties in 6 municipalities. Overall, antibodies to T. gondii were found in 70 (16.3%) of 429 rabbits, with titers of 1:25 in 42, 1:50 in 19, 1:100 in 5, 1:200 in 3, and 1:800 in 1. Seropositive rabbits were found in 21 (72.4%) of 29 properties, including 16 of 21 homes, 4 of 5 farms, and 1 of 3 pet shops. This is the first study of T. gondii infection in rabbits in Durango, Mexico. Results indicate that infected rabbits are a potential source of T. gondii infection in humans in Durango State.

Hepatic stellate cells increase in Toxoplasma gondii infection in mice

BACKGROUND

Toxoplasma gondii is a ubiquitous protozoan parasite that can infect humans and animals. The severity of toxoplasmosis varies according to the immune status of the individual, parasite strain, and host species. In mammalian species, it has been observed that severe lesions of acute toxoplasmosis form in visceral organs such as the liver, lung, and spleen. Some epidemiological studies have reported an association of T. gondii infection with liver cirrhosis.

METHODS

Acute infection was induced in fifteen 30-day-old normal Swiss albino mice. The mice were infected by intraperitoneal inoculation of 5000 T. gondii RH strain tachyzoites. The mice were sacrificed in groups of 5 at 2, 4, and 6 days after inoculation. Another group of 5 mice were used as the controls. Anti-glial fibrillary acidic protein (GFAP) and anti-T. gondii antibodies were used to compare GFAP-immunoreactive cells and anti-T. gondii-immunopositive areas in the liver between the T. gondii-infected groups and the healthy controls, respectively.

RESULTS

There was a significant correlation between the numbers of GFAP-positive hepatic stellate cells (HSCs) when they were compared with T. gondii antigen immunostaining (p < 0.05). The amount of T. gondii immunostaining increased significantly with the increase in the number of HSCs.

CONCLUSIONS

There is a significant relationship between the number of HSCs and T. gondii antigens, which may represent an active role of HSCs in liver pathology and the pathobiology of T. gondii-related hepatitis.

Seroepidemiology of infection with Toxoplasma gondii in migrant agricultural workers living in poverty in Durango, Mexico

BACKGROUND

Migrant agricultural workers are a group of people living in poverty with poor housing, sanitary conditions and hygiene practices. Little is known about the epidemiology of infection with Toxoplasma gondii in migrant agricultural workers.

METHODS

We investigated the presence of anti-Toxoplasma IgG and IgM antibodies in 173 migrant workers hired for seasonal agricultural work in Durango State in northern Mexico using enzyme-linked immunoassays.

RESULTS

Of the 173 migrant workers (mean age 34.82 ± 14.01 years), 50 (28.9%) had anti-Toxoplasma IgG antibodies and 36 (20.8%) had anti-Toxoplasma IgM antibodies. Seroprevalence was not influenced by gender, age, birth place, or educational level. In contrast, seroprevalence was significantly higher in workers residing in rural areas than those in urban or suburban areas. Migrant workers suffering from memory impairment, dizziness, or syncope had significantly higher seroprevalence of anti-T. gondii IgG antibodies than those without such clinical features. Logistic regression analysis showed that T. gondii exposure was positively associated with consumption of unwashed raw vegetables (OR = 2.39; 95% CI: 1.06-5.35; P = 0.03) and low frequency of eating out of home (OR = 3.87; 95% CI: 1.43-10.42; P = 0.007), and negatively associated with national trips (OR = 0.30; 95% CI: 0.13-0.65; P = 0.003) and consumption of raw milk (OR = 0.40; 95% CI: 0.18-0.87; P = 0.02). Other behavioral characteristics including consumption of meat or untreated water were not associated with T. gondii infection.

CONCLUSIONS

This is the first report of T. gondii infection in internal migrant agricultural workers living in poverty. Results deserve further investigation of causal relations between clinical symptoms and infection, and may be useful for optimal planning of preventive measures.

Relationship between butyrylcholinesterase activity and liver injury in mice acute infected with Toxoplasma gondii

This study aimed to investigate the butyrylcholinesterase (BChE) activity in mice experimentally infected with Toxoplasma gondii during the acute phase. Twenty mice were divided in two groups with 10 animals each: group A was composed of uninfected mice while group B was formed by rodents infected with T. gondii. Five days after infection, blood was collected and serum separated, and fragments of liver and brain were obtained. In serum and liver homogenate was noted a significant reduction (P<0.05) in BChE activity in infected mice when compared with uninfected ones. In serum was observed an increase in the activity of alanine aminotransferase and urea, associated with reduction in alkaline phosphatase activity and in the levels of total protein and albumin. Histologically, there were foci of necrosis and parasites in the forms of tachyzoites and cysts, with bradyzoites in liver samples of infected animals. Based on these results, we conclude that toxoplasmosis reduces BChE activity in mice, and this alteration is probably related to the liver damage caused by the parasitism. Therefore, this enzymatic alteration can directly contribute to the pathogenesis of the disease.

A systematic review and meta-analysis of Toxoplasma gondii infection among the Mexican population

BACKGROUND

Toxoplasmosis is a disease caused by Toxoplasma gondii and at least one-third of the world's population has detectable T. gondii antibodies. The seroprevalence of T.gondii ranges from 15% to 50% among the Mexican general population. The aim of this work was to determine the mean prevalence and weighted mean prevalence of T. gondii infection, and to evaluate the epidemiological transition of infection in Mexico.

METHODS

Pub Med, Lilacs, Medline, Latindex, Google Scholar data bases were searched to retrieve reports from 1951 up to 2012 regarding prevalence data, diagnostic tests and risk factors of infection among the adult population. Data collection and criteria eligibility was established in order to determine the crude prevalence (proportion of positive cases) of each study, together with weighted population prevalence according to individual research group categories to limit the bias that may impose the heterogeneous nature of the reports. A Forest Plot chart and linear regression analysis were performed by plotting the prevalence of infection reported from each study over a period of sixty years.

RESULTS

A total of 132 studies were collected from 41 publications that included 70,123 individuals. The average mean prevalence was 27.97%, and weighted mean prevalence was 19.27%. Comparisons among different risk groups showed that the weighted prevalence was higher in women with miscarriages (36.03%), immunocompromised patients (28.54%), mentally-ill patients (38.52%) and other risk groups (35.13%). Toxoplasma infection among the Mexican population showed a downward trend of 0.1%/year over a period of sixty years that represents a 5.8% reduction in prevalence.

CONCLUSIONS

This analysis showed a downward trend of infection; however, there are individuals at high risk for infection such as immunocompromised patients, mentally-ill patients and pregnant women. Further research is required to provide better prevention strategies, effective diagnostic testing and medical management of patients. Educational efforts are required to avoid the transmission of infection in populations that cannot be controlled by drugs alone.

High seroprevalence of Toxoplasma gondii infection in a subset of Mexican patients with work accidents and low socioeconomic status

Background

Toxoplasma gondii has been associated with reflex impairment and traffic accidents. It is unknown whether Toxoplasma infection might be associated with work accidents. Therefore, using a case-control seroprevalence study design, 133 patients with a recent work accident and 266 control subjects of the general population from the same region were examined with enzyme-linked immunoassays for the presence and levels of anti-Toxoplasma IgG antibodies and anti-Toxoplasma IgM antibodies. Socio-demographic, work, clinical and behavioral characteristics from each worker were obtained.

Results

Eleven (8.3%) of 133 patients, and 14 (5.3%) of 266 controls had anti-T. gondii IgG antibodies. Anti-T. gondii IgG levels were higher than 150 IU/ml in 8 (6%) patients and 10 (3.8%) controls. Anti-T. gondii IgM antibodies were found in one (0.8%) of the workers, and in 6 (2.3%) of the controls. No statistically significant differences in the IgG seroprevalences, frequencies of high IgG levels, and IgM seroprevalences among patients and controls were found. In contrast, a low socio-economic level in patients with work accidents was associated with Toxoplasma seropositivity (P = 0.01). Patients with work accidents and low socioeconomic status showed a significantly (OR = 3.38; 95% CI: 0.84-16.06; P = 0.04) higher seroprevalence of T. gondii infection than controls of the same socioeconomic status (15.1% vs. 5%, respectively). Multivariate analysis showed a positive association of T. gondii infection with boar meat consumption (OR = 3.04; 95% CI: 1.03-8.94; P = 0.04). In contrast, a negative association between T. gondii infection and national trips (OR = 0.40; 95% CI: 0.17-0.96; P = 0.04), sausage consumption (OR = 0.20; 95% CI: 0.05-0.68; P = 0.01), and ham consumption (OR = 0.16; 95% CI: 0.05-0.51; P = 0.002) was found.

Conclusions

In the study described here seropositivity to T. gondii was associated to work accidents in a subset of patients with low socioeconomic status. This is the first report of an association of T. gondii infection and work accidents. Further studies to confirm our results are needed. Results may help in designing optimal prevention strategies to avoid T. gondii infection.

Toxoplasma gondii infection in workers occupationally exposed to unwashed raw fruits and vegetables: a case control seroprevalence study

Background

Through a case control seroprevalence study, we sought to determine the association of Toxoplasma gondii infection with occupational exposure to unwashed raw fruits and vegetables.

Methods

Subjects, numbering 200, who worked growing or selling fruits and vegetables, and 400 control subjects matched by age, gender, and residence were examined by enzyme immunoassays for the presence of anti-Toxoplasma IgG and IgM antibodies. Socio-demographic, clinical, and behavioral characteristics from the study subjects were obtained.

Results

Of the 200 fruit and vegetable workers, 15 (7.5%) of whom, and 31 (7.8%) of the 400 controls were positive for anti-Toxoplasma IgG antibodies (P = 0.96). Anti-Toxoplasma IgM antibodies were found in 2 (1%) of the fruit workers and in 11 (2.8%) of the control subjects (P = 0.23). Seroprevalence of Toxoplasma antibodies increased with age (P = 0.0004). In addition, seropositivity to Toxoplasma was associated with ill status (P = 0.04), chronic tonsillitis (P = 0.03), and reflex impairment (P = 0.03). Multivariate analysis showed that Toxoplasma infection was associated with consumption of raw meat (OR = 5.77; 95% CI: 1.15-28.79; P = 0.03), unwashed raw fruits (OR = 2.50; 95% CI: 1.11-5.63; P = 0.02), and living in a house with soil floors (OR = 3.10; 95% CI: 1.22-7.88; P = 0.01), whereas Toxoplasma infection was negatively associated with traveling abroad (OR = 0.28; 95% CI: 0.12-0.67; P = 0.005).

Conclusions

This is the first report of seroprevalence and contributing factors for Toxoplasma infection in workers occupationally exposed to unwashed raw fruits and vegetables, and the results may help in the design of optimal preventive measures against Toxoplasma infection especially in female workers at reproductive age.

Seroprevalence of Toxoplasma gondii infection in domestic sheep in Durango State, Mexico

The seroprevalence of Toxoplasma gondii infection in sheep (Ovis aries) in northern Mexico is largely unknown. Antibodies to T. gondii were determined in serum samples from 511 sheep from 8 farms in Durango State, Mexico, using the modified agglutination test (MAT). Sheep were raised in 3 geographical regions, i.e., mountainous (n  =  68), semi-desert (n  =  132), and valley (n  =  311). Overall, T. gondii antibodies were found in 77 (15.1%) of 511 sheep, with MAT titers of 1∶25 in 27, 1∶50 in 10, 1∶100 in 11, 1∶200 in 11, 1∶400 in 8, 1∶800 in 3, 1∶1,600 in 4, and 1∶3,200 in 3. The seroprevalence of T. gondii infection increased significantly with age, indicating post-natal transmission. In contrast, gender, breed, flock size, and geographic region did not significantly influence the seroprevalence. Seropositive sheep were found in 7 of 8 farms sampled. This is the first report of T. gondii infection in sheep in Durango State, Mexico. Results indicate that infected sheep are probably an important source of T. gondii infection for humans in Durango State.

Toxoplasma gondii infection and abdominal hernia: evidence of a new association

BACKGROUND

We performed a retrospective, observational study in 1156 adult subjects from the general population of Durango City, Mexico, Fifty five subjects with a history of abdominal hernia repair and 1101 subjects without hernia were examined with enzyme-linked immunoassays for the presence of anti-Toxoplasma IgG and IgM antibodies.

RESULTS

The seroprevalence of anti-Toxoplasma IgG antibodies and IgG titers was significantly higher in subjects with abdominal hernia repair than those without hernia. There was a tendency for subjects with hernia repair to have a higher seroprevalence of anti-Toxoplasma IgM antibodies than subjects without hernia. The seroprevalence of anti-Toxoplasma IgG antibodies in subjects with hernia repair was significantly higher in subjects ≥ 50 years old than those < 50 years old. Further analysis in subjects aged ≥ 50 years showed that the seroprevalence of anti-Toxoplasma IgG antibodies was also significantly higher in individuals with hernia repair than those without hernia (OR = 2.72; 95% CI: 1.10-6.57). Matching by age and sex further showed that the seroprevalence of Toxoplasma infection was significantly higher in patients with hernia repair than those without hernia (OR: 4.50; 95% CI: 1.22-17.33).

CONCLUSIONS

Results indicate that infection with Toxoplasma is associated with abdominal hernia. The contributing role of infection with Toxoplasma in abdominal hernia was observed mainly in subjects aged ≥ 50 years old. Our results might have clinical, prevention and treatment implications and warrant for further investigation.