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Mulu Gelaw Y, Worku Dagnew G, Degu Alene G, Gangneux JP, Robert-Gangneux F. Toxoplasma gondii seroprevalence among pregnant women in Africa: A systematic review and meta-analysis. PLoS Negl Trop Dis 2024; 18:e0012198. [PMID: 38781272 DOI: 10.1371/journal.pntd.0012198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 06/05/2024] [Accepted: 05/06/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Toxoplasmosis is a serious endemic zoonotic disease caused by the protozoan parasite Toxoplasma gondii. Toxoplasma infection during pregnancy can result in congenital transmission and serious fetal and neonatal complications. This systematic review and meta-analysis aimed to assess the pooled seroprevalence of T. gondii infection and its determinants among pregnant women in African countries. METHODS All articles reporting the seroprevalence of toxoplasmosis among pregnant women in African countries and published from 2010 to 2023 were searched using various databases. The pooled prevalence of toxoplasmosis was calculated using a random-effect model. The variation between the included studies was assessed using a funnel plot and I2 heterogeneity statistics. To identify the sources of heterogeneity, sub-group analysis was further conducted by country, diagnostic method, and sub-African region. The association of prevalence rates with the socio-economic level and geoclimatic parameters was also explored. RESULTS In total, 29,383 pregnant women from 60 articles were included for analysis. The pooled T. gondii seroprevalence was 42.89% with high heterogeneity (I2 = 99.4%, P < 0.001). Sub-group analysis revealed variation by country (ranging from 2.62% in Namibia to 80.28% in Congo), diagnostic method used (from 8.66% in studies using a rapid diagnostic test to 55.69% in those using an agglutination test), and sub-African region (from 4.14% in regions of Southern Africa to 53.96 in Central Africa). Cat ownership (OR = 1.58) and the consumption of raw meat (OR = 1.50) and raw vegetables (OR = 1.48) had a statistically significant combined effect on T. gondii seroprevalence. No association was found between T. gondii prevalence and the level of income of the country or geoclimatic parameters. CONCLUSION The prevalence of toxoplasmosis infection among pregnant women in Africa is high, particularly in Central and Eastern Africa. The determinants of prevalence are multifactorial. Therefore, efforts should be made to increase the awareness of women concerning the risk factors for toxoplasmosis.
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Affiliation(s)
- Yared Mulu Gelaw
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
- Irset (Institut de Recherche en Santé, Environnement et Travail), UMR_S 1085, Université de Rennes, CHU Rennes, Inserm, EHESP, Rennes, France
| | - Gizachew Worku Dagnew
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Getu Degu Alene
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
| | - Jean-Pierre Gangneux
- Irset (Institut de Recherche en Santé, Environnement et Travail), UMR_S 1085, Université de Rennes, CHU Rennes, Inserm, EHESP, Rennes, France
| | - Florence Robert-Gangneux
- Irset (Institut de Recherche en Santé, Environnement et Travail), UMR_S 1085, Université de Rennes, CHU Rennes, Inserm, EHESP, Rennes, France
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Pereira ELGM, Ferreira IB, Victorino RB, Lescano SAZ, Giuffrida R, Kmetiuk LB, Biondo AW, Santarém VA. Serosurvey of Toxoplasma gondii and Toxocara spp. co-infection in pregnant women in low-income areas of Brazil. Front Public Health 2024; 12:1340434. [PMID: 38333736 PMCID: PMC10850292 DOI: 10.3389/fpubh.2024.1340434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 01/09/2024] [Indexed: 02/10/2024] Open
Abstract
Introduction Despite human toxoplasmosis and toxocariasis having been listed among the top six most neglected parasitic zoonoses worldwide, presenting similar associated risk factors and transmission routes, few studies have been conducted in pregnant women and the consequences of concurrent infection remain to be fully established. Accordingly, the present study has serologically assessed the co-infection and associated risk factors for Toxoplasma gondii and Toxocara spp. in pregnant women, assisted by the public Unified National Health System (SUS) in southeastern Brazil. Materials and Methods Blood samples were collected and tested for IgG antibodies against Toxoplasma gondii by chemiluminescence immunoassay and against Toxocara spp. by enzyme-linked immunosorbent assay (ELISA). An epidemiological questionnaire was applied to gather socioeconomic information to assess the risk factors associated with seropositivity to toxocariasis/toxoplasmosis by univariate analysis followed by logistic regression. Results Overall, seropositivity was 69/280 (24.6, 95% CI: 19.96-30.01) for T. gondii and 56/280 (20.0, 95% CI: 15.73-25.08) for Toxocara spp. Co-infection was observed in 25/280 (8.9, 95% CI: 6.12-12.85) pregnant women, with increased odds (OR: 3.3, CI 95%: 1.77-6.14, p = 0.0002). Logistic regression revealed that a higher educational level (high school or college) significantly reduced the likelihood of co-infection seropositivity, owning cats increased the odds of toxocariasis, and older pregnant women presented significantly higher T. gondii seropositivity. Conclusion Co-infection herein highlights the importance of educational programs in the prevention of toxocariasis and toxoplasmosis in pregnant women and other high-risk populations.
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Affiliation(s)
| | | | | | | | - Rogério Giuffrida
- Graduate College in Animal Sciences, University of Western São Paulo (UNOESTE), São Paulo, Brazil
| | | | - Alexander Welker Biondo
- Graduate College of Cell and Molecular Biology, Federal University of Paraná (UFPR), Curitiba, Brazil
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Kassie E, Kebede N, Kassa T, Garoma A, Girma M, Asnake Y, Alemu A, Degu S, Tsigie M. Seroprevalence and risk factors for Toxoplasma gondii infection among pregnant women at Debre Markos Referral Hospital, northwest Ethiopia. Trans R Soc Trop Med Hyg 2024; 118:61-68. [PMID: 37571984 DOI: 10.1093/trstmh/trad053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 07/05/2023] [Accepted: 08/01/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND To assess the seroprevalence and risk factors of Toxoplasma gondii infection in pregnant women at the Debre Markos Referral Hospital, northwest Ethiopia. METHODS A facility-based cross-sectional study was undertaken among pregnant women from March 2020 to May 2021. Sociodemographic and clinical data were collected from randomly selected participants. Five millilitres of blood was collected and an enzyme-linked immunosorbent assay kit was used to test for T. gondii immunoglobulin G (IgG) antibodies. A logistic regression model was computed to identify the risk factors. The adjusted odds ratio (aOR) was estimated along with the 95% confidence interval (CI). A statistically significant association was defined as p<0.05. RESULTS T. gondii IgG antibody positivity was found in 38.8% (n=132) of 340 pregnant women. Contact with cats (AOR 2.5 [95% CI 1.5 to 4.2]), eating raw/undercooked meat (AOR 5.7 [95% CI 3.2 to 10.3]), consuming unwashed vegetables (AOR 4.1 [95% CI 2.1 to 8.0]), a history of abortion (AOR 1.9 [95% CI 1.1 to 3.3]) and drinking water sources (AOR 2.5 [95% CI 1.2 to 5.2]) demonstrated a statistically significant association with T. gondii infection. CONCLUSIONS Toxoplasmosis was found to be fairly common in pregnant mothers. Proper cat excreta disposal, not eating raw/undercooked meat, maintaining hand cleanliness and following environmental sanitation protocols could be important to decrease T. gondii infection.
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Affiliation(s)
- Enirsie Kassie
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Nigatu Kebede
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Tesfu Kassa
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Abebe Garoma
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Musse Girma
- National Animal Health Diagnostic and Investigation Center, Sebeta, Ethiopia
| | - Yewbnesh Asnake
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Ayinalem Alemu
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
- Aklilu Lemma Institute of Pathobiology, Addis Ababa University, Addis Ababa, Ethiopia
| | - Sileshi Degu
- Ethiopian Public Health Institute, Addis Ababa, Ethiopia
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Onyinye NP, Ikechukwu M, Chinedu N, Chukwuanugo N O, Nnamdi C OI, Nne AC. Recent and past toxoplasmosis infections, associated factors, and awareness among pregnant women in Nigeria. SAGE Open Med 2023; 11:20503121231202230. [PMID: 37915843 PMCID: PMC10617264 DOI: 10.1177/20503121231202230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 08/31/2023] [Indexed: 11/03/2023] Open
Abstract
Objectives The study determined the rate of recent and past Toxoplasma gondii infections, associated factors, and awareness among expectant mothers assessing antenatal care in a tertiary hospital in Nigeria. Methods This prospective cohort study was conducted among pregnant women. A questionnaire was used to gather information on socio-demographics, infection risk factors, and awareness of the infection. Using an ELISA kit, the IgG and IgM antibodies against Toxoplasma gondii were assessed in blood samples from these women. For samples that tested positive for IgM, a real-time polymerase chain reaction was used to amplify the DNA. SPSS version 23 was used for data entry and analysis. The p-value < 0.05 was adjudged to be significant. Results A total of 250 pregnant women participated in the study. The rate of recent infection (IgM antibody positivity) was 3.6% (9/250), while past infection (IgG antibody positivity) was 68.4% (171/250). Polymerase chain reaction confirmed 5/9 recent infections as positive. Factors significantly associated with toxoplasmosis were gardening (p = 0.037) and undercooked meat (p = 0.023). Only 27 out of 250 pregnant women in this research had heard of toxoplasmosis, which translates to a low awareness rate of 10.8%. Conclusions The recent infection among pregnant women in this study indicates the possibility of mother-to-child transmission with attendant sequelae. There was a significant association between past Toxoplasmosis gondii infections and stillbirth. Routine screening for toxoplasmosis should be incorporated into the antenatal program since none of the symptoms could significantly predict illness. In addition, regular antennal care instruction should cover toxoplasmosis education.
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Affiliation(s)
- Nnemelu Perpetua Onyinye
- Department of Medical Microbiology and Parasitology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
| | - Mbachu Ikechukwu
- Department of Obstetrics and Gynaecology, Nnamdi Azikiwe University, Nnewi Campus, Nnewi, Nigeria
| | - Ndukwe Chinedu
- Department of Anatomic Pathology and Forensic Medicine, Nnamdi Azikiwe University, Nnewi Campus, Nnewi, Nigeria
| | - Ogbuagu Chukwuanugo N
- Department of Medical Microbiology and Parasitology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
| | - Onyenyili Ikemefuna Nnamdi C
- Department of Medical Microbiology and Parasitology, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
| | - Akujobi Comfort Nne
- Department of Medical Microbiology and Parasitology, Nnamdi Azikiwe University, Nnewi Campus, Nnewi, Nigeria
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Hassan SA, Tamomh AG, Hassan DA, Ahmed NR. Seroprevalence of anti-Toxoplasma gondii antibodies and associated risk factors in pregnant women in Somalia. Acta Trop 2023; 238:106774. [PMID: 36417981 DOI: 10.1016/j.actatropica.2022.106774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 11/08/2022] [Accepted: 11/19/2022] [Indexed: 11/21/2022]
Abstract
Toxoplasma gondii infection is a worldwide protozoan parasitic disease caused by the parasite Toxoplasma gondii. T. gondii infection in gestation period can lead to fetal or neonatal death, and besides congenital defects. So far, there are no data available regarding T. gondii seropositivity and associated risk factors in pregnant women in Somalia. The investigations of these aspects were done in 403 pregnant women attending the antenatal care (ANC) at Benadir hospital, in Mogadishu city. Blood samples were collected and analyzed for anti-T. gondii antibodies by enzyme-linked immunosorbent assay (ELISA). IgG seropositivity to T. gondii was 45.2% (182/403). None of the women were positive for IgM antibodies. Considering the first, second, and third trimesters of pregnancy, women IgG seropositivity was 44.2%, 26.3%, and 67.7%, respectively (p < 0.05). There was no significant association between seropositivity and age, sociodemographic features, history of abortion, presence of cats in house, contact cats feces, contact with soil, consumption of raw vegetables/meats, blood transfusion, and drinking of unboiled milk (p>0.05). Routine serological screening for T. gondii should be integrated with other ANC services to identify potential infections with the parasite.
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Affiliation(s)
- Shafie Abdulkadir Hassan
- Department of Medical Laboratory Sciences, Faculty of Medicine and Health Sciences, Jamhuriya University of Science and Technology, Mogadishu, Somalia; Department of Microbiology, Faculty of Medical Laboratory Sciences, University of El Imam El Mahdi, Kosti 27711, Sudan
| | - Abdelhakam G Tamomh
- Department of Parasitology and Medical Entomology, Faculty of Medical Laboratory Sciences, University of El Imam El Mahdi, Kosti 27711, Sudan.
| | - Dahir Abdulkadir Hassan
- Department of Medical Laboratory Sciences, Faculty of Medicine and Health Sciences, Jamhuriya University of Science and Technology, Mogadishu, Somalia
| | - Nur Rasheed Ahmed
- Advance Medical Research Center, Jamhuriya University of Science and Technology, Mogadishu, Somalia
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Rosini AM, Teixeira SC, Milian ICB, Silva RJ, de Souza G, Luz LC, Gomes AO, Mineo JR, Mineo TWP, Ferro EAV, Barbosa BF. LPS-mediated activation of TLR4 controls Toxoplasma gondii growth in human trophoblast cell (BeWo) and human villous explants in a dependent-manner of TRIF, MyD88, NF-κB and cytokines. Tissue Cell 2022; 78:101907. [DOI: 10.1016/j.tice.2022.101907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 06/22/2022] [Accepted: 08/22/2022] [Indexed: 02/07/2023]
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Voyiatzaki C, Orovas C, Trapali M, Chaniotis DI, Kriebardis AG, Beloukas A, Thalassinos ND, Orovou E, Iatrakis G, Antoniou E. The Importance of Use of the On-line Databases as a Source for Systematic Review of Toxoplasmosis Screening During Pregnancy. Acta Inform Med 2021; 29:216-223. [PMID: 34759463 PMCID: PMC8563042 DOI: 10.5455/aim.2021.29.216-223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Accepted: 09/12/2021] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Infection with the parasite Toxoplasma gondii is a common infection in animals and humans worldwide. This infection can occur after ingestion of water or food contaminated with cat oocytes, ingestion of tissue cysts in mammalian and avian meat and congenitally. The prenatal infection can lead to Congenital Toxoplasmosis with miscarriage or stillbirth. After infection, laboratory tests are positive within 2-3 weeks and remain positive throughout life. However, testing for Toxoplasma infection during pregnancy is necessary in some countries, while in others it is not a mandatory "screening" test. OBJECTIVE The aim of this study was to review systematically the screening of toxoplasmosis in pregnancy in different countries worldwide. METHODS Cohorts, retrospective and cross-sectional studies were incorporated in our review, finally including 11 articles from an initial pool of 1532 related papers. RESULTS The seroprevalence of pregnant women varies from countries with low prevalence to regions with high prevalence and screening policies also differ. Most countries worldwide have control policies, while Germany and Mexico that do not have systematic screening for Toxoplasma during the prenatal period. CONCLUSION Our results show that Congenital Toxoplasmosis is very rare in some countries and it is very difficult to find a balance between potential risk and benefit of a screening program. For this reason, some countries are limited to prenatal counseling to reduce CT. In addition, the reduction of major sources of contamination especially in developing countries is the most important prevention measure.
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Dasa TT, Geta TG, Yalew AZ, Abebe RM, Kele HU. Toxoplasmosis infection among pregnant women in Africa: A systematic review and meta-analysis. PLoS One 2021; 16:e0254209. [PMID: 34283858 PMCID: PMC8291666 DOI: 10.1371/journal.pone.0254209] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Accepted: 06/22/2021] [Indexed: 11/20/2022] Open
Abstract
The epidemiology of toxoplasmosis in pregnancy is a major issue in public health. Toxoplasmosis is caused by the protozoan parasite. Toxoplasma parasite is at high risk for life-threatening diseases during pregnancy. Congenital toxoplasmosis results from a maternal infection acquired during gestation. Therefore, this systematic review and meta-analysis was aimed to determine the seropositive prevalence of toxoplasmosis infection among pregnant women who attended antenatal care in a health facility in Africa. A systematic review and meta-analysis of published and unpublished studies were included. Databases such as MEDLINE, PubMed, EMBASE, CINAHL, Web of Science, African Journals Online were used with relevant search terms. The quality of the articles was critically evaluated using the tool of the Joanna Briggs Institute. Data were extracted on Microsoft word 2016. Meta-analysis was conducted using STATA 14 software. The heterogeneity and publication bias were assessed using the I2 statistics and Egger’s test, respectively. Forest plots were used to present the pooled prevalence and odds ratio with a 95% confidence interval of meta-analysis using the random effect model. In total, 23 studies comprising 7,579 pregnant women across ten countries in Africa were included in this meta-analysis. The overall prevalence of seropositive toxoplasmosis among pregnant women in Africa was 51.01% (95% CI; 37.66, 64.34). The heterogeneity test showed that heterogeneity was high, I2 = 99.6%, P-value < 0.001. The variables responsible for the source of heterogeneity were included from Cameroon, the Democratic Republic of Congo, and Ethiopia. Overall prevalence of toxoplasmosis in Africa showed that more than one-half of pregnant women were infected. The risk of acquiring toxoplasmosis infection during pregnancy is high; hence, preventive measures to avoid exposure of pregnant women to Toxoplasma infection should be strictly applied.
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Affiliation(s)
| | - Teshome Gensa Geta
- Department of Biomedical Science, Wolikite University, College of Health Sciences and Medicine, Wolikite, Ethiopia
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Kalantari N, Gorgani-Firouzjaee T, Moulana Z, Chehrazi M, Ghaffari S. Toxoplasma gondii infection and spontaneous abortion: A systematic review and meta-analysis. Microb Pathog 2021; 158:105070. [PMID: 34186117 DOI: 10.1016/j.micpath.2021.105070] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 06/18/2021] [Accepted: 06/22/2021] [Indexed: 10/21/2022]
Abstract
Toxoplasmosis is one of the most common parasitic infections in humans, which is caused by Toxoplasma gondii. It is usually asymptomatic but primary infection in a pregnant woman can cause severe consequences in the fetus such as miscarriage. This study aimed to estimate the global prevalence of T. gondii infection in women with spontaneous abortion. It also evaluates the possible relationship between recent Toxoplasma infection and miscarriage. Five electronic databases were reviewed. We used the random effects model and 95% confidence intervals(CI) to determine the overall prevalence and odds ratio (OR). Heterogeneity was calculated using Cochran's Q test and I2 statistic. The included studies were divided into three sub-groups based on antibody class against T. gondii and the existence of parasite DNA. Based on PCR, the pooled random-effects estimates that the prevalence of T. gondii infection in women with abortion was 10% (95% CI 7-14%). The pooled random effect favored a statistically significant increased risk of latent Toxoplasma infection [OR = 1.84; 95% CI: 1.41-2.40, P < 0.001] and recent infection [OR = 3.72; 95% CI: 2.21-6.26, P < 0.001] in women with spontaneous abortions. In recent infections, significant pooled ORs of positive association were observed in women with miscarriage [OR = 4.2; 95% CI: 2.04-8.85; χ2 = 17.2; I2 = 42.0%, P = 0.07]. This study demonstrates that recent T. gondii infection is associated with an elevated risk of spontaneous abortion. Further studies concerning all risk factors related to toxoplasmosis, and undertaking confirmatory tests at the time of abortion should be performed to investigate the impact of T. gondii infection and spontaneous abortion.
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Affiliation(s)
- Narges Kalantari
- Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Tahmineh Gorgani-Firouzjaee
- Infectious Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Zahra Moulana
- Department of Laboratory Sciences, Faculty of Paramedical Sciences, Babol University of Medical Sciences, Babol, Iran
| | - Mohammad Chehrazi
- Department of Biostatistics and Epidemiology, School of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Salman Ghaffari
- Department of Mycology and Parasitology, School of Medicine, Babol University of Medical Sciences, Babol, Iran.
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Laboudi M, Taghy Z, Duieb O, Peyron F, Sadak A. Toxoplasma gondii seroprevalence among pregnant women in Rabat, Morocco. Trop Med Health 2021; 49:21. [PMID: 33685529 PMCID: PMC7941977 DOI: 10.1186/s41182-021-00311-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Accepted: 02/22/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Toxoplasmosis is an infectious disease caused by a protozoan parasite named Toxoplasma gondii (T.gondii). Pregnant women are considered one of the risk groups. The objective of this retrospective study is to provide an updated estimate of the seroprevalence of anti-T. gondii antibodies among a group of Moroccan pregnant women monitored at the Parasitology Laboratory of the National Institute of Hygiene in Rabat in Morocco. METHODS Serum samples were tested for the presence of specific anti-T. gondii immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies using indirect enzyme-linked immunosorbent assay (ELISA). Anti-Toxoplasma IgM- and IgG-positive cases were also evaluated with the anti-Toxoplasma IgG avidity test. All cases were evaluated according to the age, parity, and historical of abortion. RESULTS Among 677 pregnant women, 94.1% (637/677) were serologically screened for the first time and therefore had no knowledge of their serological status, and only 5.9% (40/677) were screened for the second or third time. The overall anti-T. gondii IgG and IgM seropositivity among the 637 pregnant women included in the study analysis was 43% (274/637) and 3.9% (25/637), respectively. The use of the IgG avidity test allowed excluding recent infection among 83% of cases with IgG and IgM positive sera. The mean age was 29.4 ± 6.3 years. The result of the bivariate analysis revealed that the age influenced significantly the seroprevalence rate, while the parity and the existence of previous spontaneous abortion did not have any significant statistical correlation with seropositivity to T. gondii. CONCLUSION This study shows that 43% of pregnant women were positive and 57% of them had no antibody against the T. gondii infection. However, the pregnancy follow-up and the counseling of pregnant women remain essential for the prevention of congenital toxoplasmosis.
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Affiliation(s)
- Majda Laboudi
- Department of Parasitology, National Institute of Hygiene, 27 Avenue Ibn Batouta, BP: 769, Rabat, Agdal, Morocco.
| | - Zoubida Taghy
- Faculty of Science, University Mohamed V, Rabat, Morocco
| | - Oussama Duieb
- Faculty of Science, University Mohamed V, Rabat, Morocco
| | - François Peyron
- Institut de Parasitologie et de Mycologie Médicale Hôpital de la Croix Rousse, Lyon, France
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Tarekegn ZS, Dejene H, Addisu A, Dagnachew S. Potential risk factors associated with seropositivity for Toxoplasma gondii among pregnant women and HIV infected individuals in Ethiopia: A systematic review and meta-analysis. PLoS Negl Trop Dis 2020; 14:e0008944. [PMID: 33320848 PMCID: PMC7771857 DOI: 10.1371/journal.pntd.0008944] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 12/29/2020] [Accepted: 11/03/2020] [Indexed: 02/06/2023] Open
Abstract
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.
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Affiliation(s)
- Zewdu Seyoum Tarekegn
- Department of Paraclinical Studies, College of Veterinary Medicine and Animal Sciences, University of Gondar, Gondar, Ethiopia
| | - Haileyesus Dejene
- Department of Veterinary Epidemiology and Public Health, College of Veterinary Medicine and Animal Sciences, University of Gondar, Gondar, Ethiopia
| | - Agerie Addisu
- Department of Biology, College of Natural and Computational Sciences, University of Gondar, Gondar, Ethiopia
| | - Shimelis Dagnachew
- Department of Paraclinical Studies, College of Veterinary Medicine and Animal Sciences, University of Gondar, Gondar, Ethiopia
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Ducrocq J, Simon A, Lemire M, De Serres G, Lévesque B. Exposure to Toxoplasma gondii Through Consumption of Raw or Undercooked Meat: A Systematic Review and Meta-Analysis. Vector Borne Zoonotic Dis 2020; 21:40-49. [PMID: 33202167 DOI: 10.1089/vbz.2020.2639] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Toxoplasma gondii is a globally distributed protozoan that mainly causes health issues in the fetuses of pregnant women who have never been exposed to this parasite and patients with deficient immune systems. Except in these vulnerable populations, the primary infection generally goes unnoticed in most healthy individuals. Apart from transplant/transfusion, congenital transmission, direct contact with infected cats or their feces, and environmental contamination (i.e., oocysts in food, water, and soil) pathways, humans can acquire the parasite through consumption of animal tissues infected by T. gondii. This meta-analysis estimated the risk of acquiring T. gondii by consuming raw or undercooked meat, regardless of which animal species are eaten. Using a random-effect model, crude and adjusted pooled measures of association (risk and odds ratio) were estimated according to study design (cohort, case-control, and cross-sectional studies). The meta-analysis included measures of heterogeneity as well as quality rating scales for each study design. Our results suggest that individuals who eat raw or undercooked meat have, respectively, 1.2-1.3 times the risk and 1.7-3.0 times the odds of T. gondii infection compared to those who thoroughly cook meat, regardless of the animal species they consume. These results align with the current understanding that adequately cooking meat inactivates the parasite and decreases the risk of transmission. Seroprevalence ranged from 1.3% to 88.6%, while the proportion of individuals eating raw or undercooked meat fluctuated from 0.7% to 98.3% across the studies in the meta-analysis. These numbers reflect various preferences with regard to eating meat (i.e., eating tartar, sausages, or salamis) as well as individual, cultural and religious food habits, and personal awareness.
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Affiliation(s)
- Julie Ducrocq
- Université Laval, Department of Social and Preventive Medicine, Québec, Canada.,Axe des Populations et Pratiques Optimales en Santé, Centre Hospitalier Universitaire de Québec, Québec, Canada
| | - Audrey Simon
- Faculté de Médecine Vétérinaire, Université de Montréal, Saint-Hyacinthe, Canada
| | - Mélanie Lemire
- Université Laval, Department of Social and Preventive Medicine, Québec, Canada.,Axe des Populations et Pratiques Optimales en Santé, Centre Hospitalier Universitaire de Québec, Québec, Canada
| | - Gaston De Serres
- Université Laval, Department of Social and Preventive Medicine, Québec, Canada.,Axe des Populations et Pratiques Optimales en Santé, Centre Hospitalier Universitaire de Québec, Québec, Canada.,Direction de la Santé Environnementale et de la Toxicologie, Institut de Santé Publique du Québec, Québec, Canada
| | - Benoit Lévesque
- Université Laval, Department of Social and Preventive Medicine, Québec, Canada.,Axe des Populations et Pratiques Optimales en Santé, Centre Hospitalier Universitaire de Québec, Québec, Canada.,Direction des Risques Biologiques et Santé au Travail, Institut de Santé Publique du Québec, Québec, Canada
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13
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Li J, Wang Z, Karim MR, Zhang L. Detection of human intestinal protozoan parasites in vegetables and fruits: a review. Parasit Vectors 2020; 13:380. [PMID: 32727529 PMCID: PMC7392835 DOI: 10.1186/s13071-020-04255-3] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 07/21/2020] [Indexed: 02/07/2023] Open
Abstract
Diarrheal diseases caused by intestinal protozoan parasites are a major food-borne public health problem across the world. Vegetables and fruits provide important nutrients and minerals, but are also common sources of some food-borne human pathogenic microorganisms. The contamination of raw vegetables and fruits with human pathogenic parasites are now a global public health threat, despite the health benefits of these foods in non-pharmacological prophylaxes against diseases. A large number of reports have documented the contamination of vegetables or fruits with human pathogenic microorganisms. In this paper, we reviewed the contamination and detection methods of human pathogenic intestinal protozoans that are frequently recovered from raw vegetables and fruits. The protozoan parasites include Cryptosporidium spp., Giardia duodenalis, Cyclospora cayetanensis, Entamoeba spp., Toxoplasma gondii, Balantioides coli, Blastocystis sp., Cystoisospora belli and Enterocytozoon bieneusi. The risk factors involved in the contamination of vegetables and fruits with parasites are also assessed.
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Affiliation(s)
- Junqiang Li
- Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou, 450046 China
- College of Animal Science and Veterinary Medicine, Henan Agricultural University, Zhengzhou, 450046 China
| | - Zhenzhen Wang
- Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou, 450046 China
| | - Md Robiul Karim
- Department of Medicine, Bangabandhu Sheikh Mujibur Rahman Agricultural University, Gazipur, 1706 Bangladesh
| | - Longxian Zhang
- College of Animal Science and Veterinary Medicine, Henan Agricultural University, Zhengzhou, 450046 China
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14
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Abstract
Toxoplasmosis is a global health threat in which occurrence in pregnant women poses grave consequences to fetal wellbeing. Studies on prenatal Toxoplasma gondii infection are generally limited in sub-Saharan African countries, including Nigeria. The risk of transmission of toxoplasmosis is very high in Nigeria due to the favourable climatic conditions and prevailing behavioural and socio-economic factors that could aid transmission. Currently, there are no systematic and organized procedures for diagnosis and treatment of maternal toxoplasmosis in Nigeria. These conditions forecast possible unabated transmission in many areas and exponential impact on associated adverse events of the disease during pregnancy. This paper highlights the importance of early diagnosis and treatment during pregnancy which may forestall subsequent development of infection in children delivered by infected mothers. Inclusion of toxoplasmosis control policy in the routine antenatal care of pregnant women is therefore strongly recommended.
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