Knowledge and practices regarding toxoplasmosis in housewives: A cross sectional study in a northern Mexican city

Anti-Toxoplasma gondii IgG seroprevalence in the general population in Iran: A systematic review and meta-analysis, 2000-2023

Toxoplasmosis ranks among the most prevalent parasitic diseases globally. It seems that chronic toxoplasmosis is associated with several neuropsychiatric and other harmful effects in infected people, therefore, there is a need to investigate the prevalence of toxoplasmosis across various world regions. In this study, we conducted a meticulous meta-analysis to estimate the seroprevalence of anti-Toxoplasma gondii IgG antibodies within the general population in Iran (GPI). International and national scientific databases for studies published between January 1, 2000, and September 30, 2023, were searched. Observational studies reporting anti-T. gondii IgG seroprevalence in the GPI was selected/included. The data were synthesized using a random-effects model to calculate with a 95% confidence interval (95% CI) the national and regional anti-T. gondii IgG seroprevalence rates in Iran. Additionally, subgroup analyses were conducted to investigate the frequency of exposition to T. gondii in different socio-demographic, climatic, and geographical scenarios. From 18661 identified studies, 327 were included in the present meta-analysis, encompassing 122,882 individuals across the 31 Iranian provinces. The pooled nationwide anti-T. gondii IgG seroprevalence among the GPI was determined to be 32.9% (95% CI: 30.9-35.1%). The highest anti-T. gondii IgG seroprevalence was observed in Mazandaran province (North of Iran) (61%), whereas the lowest was in Semnan province (12.5%).Anti-T. gondii IgG seroprevalence demonstrated a higher occurrence in provinces characterized by moderate temperatures of 16-21°C, high relative humidity, and annual precipitation. Additionally, a higher anti-T. gondii IgG seroprevalence was identified among individuals with a habit of consumption of undercooked meat, raw fruits or vegetables, and untreated water. Moreover, those reporting direct contact with cats, possessing a lower level of education, residing in rural areas, being engaged in farming occupations, or playing the role of housewives exhibited higher anti-T. gondii IgG seroprevalence figures.The anti-T. gondii IgG seroprevalence within GPI closely aligns with the estimated worldwide average exposition rates. This underscores the imperative for public health policymakers to prioritize educational efforts regarding toxoplasmosis transmission pathways and its link to harmful effects.

Cross-sectional community-based study to assess the awareness of toxoplasmosis in Saudi Arabia

A few reports have been published and documented low level of awareness on toxoplasmosis among Saudi women. Herein, a cross sectional community based study was undertaken to evaluate basic knowledge on toxoplasmosis among residents in the Eastern province (Sharqiyah). Thisstudy was conducted between December 2022 and January 2023 on 334 females from different ages and educational backgrounds. Analysis of their responses revealed that only (24.9%) had heard about the disease. However, (69.8%) properly identified cats as the source of Toxoplasma gondii (T. gondii), but a smaller percentage (47.7%) knew that they might become infected through handling cat feces, and a few (26.3%) believed that bad hand hygiene can result in T. gondii infection. A few males (n = 26) have also participated, for the first time in Saudi Arabia, and displayed also low level of knowledge on toxoplasmosis. We do recommend establishing educational programs for females, in various Saudi provinces, to raise awareness on toxoplasmosis.

Gestational toxoplasmosis treatment changes the child's prognosis: A cohort study in southern Brazil

BACKGROUND

We evaluate the drug treatment for pregnant women with acute toxoplasmosis to reduce the risk of congenital infection, side effects (prenatal and postnatal treatment in children) and the hazard of discontinuing the infant's medication.

METHODS

We conducted a prospective cohort study to assess the risks of congenital toxoplasmosis among children born to acutely infected women with and without treatment. We examined the relationship between "exposed" and "infected children", "number of infant neutrophils", "prenatal" and "postnatal treatment". Factor analysis of mixed data (FAMD) was used to analyze the data. All children started treatment at the hospital.

FINDINGS

Between 2017 and 2021, 233 pregnant women were evaluated at the University Hospital of Maringá; ninety-four met criteria for acute gestational toxoplasmosis. We followed up 61 children; eleven (18%) had the infection confirmed and 50 (82%) were free of toxoplasmosis (exposed). Children born to untreated mothers have 6.5-times higher risk of being infected; the transmission rate among untreated mothers was 50% versus 8.3% among treated ones. Three decreasing values of immunoglobulin G were a security parameter for stopping the child's medication in the exposed group (50/61). Neutropenia was the leading side effect among children and the infected had a 2.7 times higher risk. There was no correlation between maternal use of pyrimethamine and children's neutropenia.

INTERPRETATION

The follow-up of women with acute T. gondii infection and their children, through a multidisciplinary team, availability of anti-T. gondii serology and pre- and post-natal treatments reduced the risk of toxoplasmosis transmission.

First report of knowledge and practices towards toxoplasmosis among cat owners: A cross-sectional survey in Bangladesh

Raising awareness about Toxoplasma gondii infection among cat owners in Bangladesh is indispensable to formulate persuasive management tactics to avoid zoonotic infections from pet cats. However, to the authors' best knowledge, no studies have been performed in Bangladesh to determine knowledge and practices of toxoplasmosis in cat owners. Therefore, the objectives of the current study were to cover this research gap. We carried out a cross-sectional study in Bangladesh from June 2020 through December 2021. A structured online questionnaire was distributed to cat owners, which were voluntarily completed by them. The questionnaire included socio-demographic data, aetiology, transmissions, clinical signs, and preventive practices towards toxoplasmosis. Overall, 1,019 cat owners participated voluntarily in the cross-sectional survey. Among them, 793 (77.82%) participants showed poor knowledge regarding toxoplasmosis. Under specific knowledge sections, 62.51% of the participants revealed incorrect knowledge that toxoplasmosis was a zoonotic disease. In the same way, (72.03-85.77) % of the cat owners were unaware that the disease could be transmitted from improperly washed vegetables, raw or undercooked meat and fish, and contaminated water and milk with cat faeces. Respondents' age, education, occupation, residence type, and marital status were significantly (p < .05) associated with their knowledge level. Besides, 94.11% of cat owners had a good practice level. They followed good practices in different issues; however, they practiced those activities without knowing their impacts on disease control. Cat owners' age, education, occupation, and residence type had a significant (p < .05) association with the practice level against toxoplasmosis. This is the first study highlighting the low level of knowledge among cat owners about toxoplasmosis in Bangladesh. These knowledge gaps could increase the risk and transmission of Toxoplasma gondii infection among them and their families. The survey recommends the arrangement of educational training and programmes to increase the awareness of toxoplasmosis among cat owners.

Risk ranking of food categories associated with Salmonella enterica contamination in the central region of Mexico

To prevent and control foodborne diseases, there is a fundamental need to identify the foods that are most likely to cause illness. The goal of this study was to rank 25 commonly consumed food products associated with Salmonella enterica contamination in the Central Region of Mexico. A multicriteria decision analysis (MCDA) framework was developed to obtain an S. enterica risk score for each food product based on four criteria: probability of exposure to S. enterica through domestic food consumption (Se); S. enterica growth potential during home storage (Sg); per capita consumption (Pcc); and food attribution of S. enterica outbreak (So). Risk scores were calculated by the equation Se*W₁ +Sg*W₂ +Pcc*W₃ +So*W₄ , where each criterion was assigned a normalized value (1-5) and the relative weights (W) were defined by 22 experts' opinion. Se had the largest effect on the risk score being the criterion with the highest weight (35%; IC95% 20%-60%), followed by So (24%; 5%-50%), Sg (23%; 10%-40%), and Pcc (18%; 10%-35%). The results identified chicken (4.4 ± 0.6), pork (4.2 ± 0.6), and beef (4.2 ± 0.5) as the highest risk foods, followed by seed fruits (3.6 ± 0.5), tropical fruits (3.4 ± 0.4), and dried fruits and nuts (3.4 ± 0.5), while the food products with the lowest risk were yogurt (2.1 ± 0.3), chorizo (2.1 ± 0.4), and cream (2.0 ± 0.3). Approaches with expert-based weighting and equal weighting showed good correlation (R²  = 0.96) and did not show significant differences among the ranking order in the top 20 tier. This study can help risk managers select interventions and develop targeted surveillance programs against S. enterica in high-risk food products.

Seroprevalence and associated risk factors of Toxoplasma gondii infection among slaughterhouse workers in Yangon Region, Myanmar: A cross-sectional study

BACKGROUND

Toxoplasmosis, having the significant consequences affecting mortality and quality of life, is still prevalent in various places throughout the world. The major gap in surveillance for Toxoplasma gondii infection among high-risk population, slaughterhouse workers, is an obstacle for the effective policies formulation to reduce the burden of toxoplasmosis in Myanmar. Therefore, this study aimed to assess the seroprevalence of toxoplasmosis and associated factors of seropositivity among slaughterhouse workers in Yangon Region, Myanmar.

METHODS

A cross-sectional study that was conducted from June to November 2020 included 139 slaughterhouse workers involving at five main slaughterhouses under Yangon City Development Committee, Myanmar. The presence of IgG and IgM anti-T. gondii antibodies in serum was detected using the OnSite Toxo IgG/IgM Combo Rapid Test. A face-to-face interview was also performed using pretested structured questionnaires to obtain the detail histories: sociodemographic characteristics, level of knowledge, occupational factors, and environmental factors related to T. gondii infection. Bivariate logistic regression was used to determine the factors associated with T. gondii infection.

RESULTS

Of all participants, the overall seroprevalence of anti-T. gondii was 43.9% (95% CI: 35.5-52.5%), of whom 98.4% (95% CI: 91.2-100.0%) were reactive only for IgG antibody and 1.6% (95% CI: 0.0-8.8%) were reactive for IgG and IgM antibodies. The significant factors associated with the seropositivity of T. gondii antibodies were blood transfusion history (OR: 5.74, 95% CI: 1.17-28.09), low level of knowledge (OR: 2.91, 95% CI: 1.46-5.83), contact with animal organs, muscles or blood (OR: 14.29, 95% CI: 1.83-111.51), and animals most frequently slaughtered (cattle) (OR: 3.22, 95% CI: 1.16-8.93).

CONCLUSIONS

A high seroprevalence of toxoplasmosis was detected among slaughterhouse workers in Yangon Region and it raises a significant public health concern. Therefore, providing health education regarding toxoplasmosis, enforcement of personal hygiene practices in workplaces, the establishment of training for occupational hygiene, and commencement of the risk assessment and serological screening for toxoplasmosis are crucial to curtail the prevalence of T. gondii infection among slaughterhouse workers.

Awareness of toxoplasmosis among postpartum women: a cross-sectional study in Morocco

Introduction

awareness and knowledge of toxoplasmosis are particularly important, as an intervention point for the management of the disease. The aim of this study was to evaluate the awareness and knowledge regarding toxoplasmosis in a sample of postpartum Moroccan women.

Methods

this was a cross-sectional descriptive survey carried out among 320 parturient at the National Reference Center for Neonatology and Nutrition at the Children's Hospital of Rabat.

Results

of 320 parturient women responding to the survey, 227 (71%) had never heard about toxoplasmosis. While 18.1% of parturient stated knowing the transmission routes for toxoplasmosis. Regarding the transmission route, 53 (16.6%) women pointed at a domestic cat and 31 (9.7%) at eating raw or undercooked meat. Out of all participants, 60 (18.8%) women said they had received prevention advice during their pregnancy. The great majority (90%) of participants were unaware of the severity of the congenital infection. None of the participants showed a high level of knowledge about transmission routes, measures of prevention, and severity of CT.

Conclusion

according to our survey, we observed that the majority of participants had never heard any information about toxoplasmosis. It is, therefore, necessary to educate women of childbearing age and pregnant women about the disease, especially concerning the transmission route and the prevention of infection and primary infection in non-immune women.

Control of human toxoplasmosis

Toxoplasmosis is caused by Toxoplasma gondii, an apicomplexan parasite that is able to infect any nucleated cell in any warm-blooded animal. Toxoplasma gondii infects around 2 billion people and, whilst only a small percentage of infected people will suffer serious disease, the prevalence of the parasite makes it one of the most damaging zoonotic diseases in the world. Toxoplasmosis is a disease with multiple manifestations: it can cause a fatal encephalitis in immunosuppressed people; if first contracted during pregnancy, it can cause miscarriage or congenital defects in the neonate; and it can cause serious ocular disease, even in immunocompetent people. The disease has a complex epidemiology, being transmitted by ingestion of oocysts that are shed in the faeces of definitive feline hosts and contaminate water, soil and crops, or by consumption of intracellular cysts in undercooked meat from intermediate hosts. In this review we examine current and future approaches to control toxoplasmosis, which encompass a variety of measures that target different components of the life cycle of T. gondii. These include: education programs about the parasite and avoidance of contact with infectious stages; biosecurity and sanitation to ensure food and water safety; chemo- and immunotherapeutics to control active infections and disease; prophylactic options to prevent acquisition of infection by livestock and cyst formation in meat; and vaccines to prevent shedding of oocysts by definitive feline hosts.

Toxoplasmosis and knowledge: what do the Italian women know about?

Toxoplasmosis is a worldwide zoonotic infectious disease caused by Toxoplasma gondii. This infection is estimated to affect about a third of the world's population. The aim of this study was to evaluate the knowledge of Italian women about toxoplasmosis and its forms of transmission, clinical manifestations, diagnosis and prevention through two different modalities (e-research and traditional research). In a cross-sectional study, 808 Italian women were interviewed, using a self-administered questionnaire, through two different modalities: an e-research or web survey and a traditional paper research and 84% reported to have heard about toxoplasmosis, but from most of the sample, it resulted that the knowledge of the protozoan disease was superficial and incomplete.The assessment of the dimensionality related to the toxoplasmosis knowledge's instrument showed that the scale is composed by two stable and reliable factors which explain 58.6% of the variance: (a) the basic knowledge (α = 0.83), which explains the 45.2% of the variance and (b) the specialist knowledge (α = 0.71), which explains the 13.4% of the variance. The variance and the multiple linear regression data analysis showed significant predictors of correct basic knowledge of toxoplasmosis: the highest age, the highest degree of study, to have previously contracted illness or to know someone who had contracted it, to be working or to be housewives. In conclusion, this study showed limited awareness of toxoplasmosis and suggested the implementation of effective education and learning programs. The results also showed that online data collection, in academic research, might be a valid alternative to more traditional (paper-and-pencil) surveys.

Toxoplasma gondii infection in pregnant women: a cross-sectional study in Matehuala City, Mexico

OBJECTIVES

This study aimed to determine the seroprevalence of Toxoplasma gondii (T. gondii) infection in pregnant women in Matehuala City, Mexico; and the associated risk factors.

DESIGN

A cross-sectional study.

SETTING

Matehuala City, Mexico.

PARTICIPANTS

311 pregnant women.

PRIMARY AND SECONDARY OUTCOME MEASURES

Sera of women were analysed for anti-T. gondii IgG and IgM antibodies by commercially available immunoassays. Bivariate and multivariate analyses were used to assess the association between T. gondii seroprevalence and the characteristics of the pregnant women.

RESULTS

Thirteen (4.2%) of the 311 pregnant women studied were positive for anti-T. gondii IgG antibodies. No anti-T. gondii IgM antibodies were found in anti-T. gondii IgG seropositive women. No association between seropositivity and history of blood transfusion, transplantation, caesarean sections, deliveries, miscarriages or number of pregnancies was found. Logistic regression analysis of sociodemographic, behavioural and housing variables showed that availability of potable water at street represented a risk factor for T. gondii infection (age-adjusted OR=2.18; 95% CI: 1.05 to 4.53; p=0.03), whereas being born in Mexico was a protective factor for infection (age-adjusted OR=0.01; 95% CI: 0.001 to 0.35; p=0.008).

CONCLUSIONS

In this first study on the seroepidemiology of T. gondii infection in pregnant women in Matehuala, we conclude that the seroprevalence of T. gondii infection is low and similar to those reported in pregnant women in other Mexican cities. However, the seroprevalence found is lower than those reported in pregnant women in other countries in the Americas and Europe. Two risk factors associated with T. gondii infection were identified. Results of the present study may help for the optimal planning of preventive measures against toxoplasmosis in pregnant women.

Virus-like particle vaccine displaying Toxoplasma gondii apical membrane antigen 1 induces protection against T. gondii ME49 infection in mice

Toxoplasmosis is an intracellular parasitic disease caused by the protozoa Toxoplasma gondii, which affects about half of the world's population. In spite of the strenuous endeavors, a T. gondii vaccine for clinical use remains unreported to date. In the present study, we generated virus-like particles (VLPs) containing T. gondii apical membrane antigen 1 (AMA1) and assessed its efficacy in a murine model. VLPs were characterized using western blot and TEM. T. gondii-specific IgG and IgA antibody responses in sera, germinal center B cell responses in spleen, brain cyst counts and their sizes were determined. Elevated T. gondii-specific IgG and IgA antibody responses were observed from the sera of AMA1 VLP-immunized mice. Immunization with AMA1 VLPs enhanced T. gondii-specific antibody-secreting cell responses and germinal center B cell responses upon antigen stimulation. Brain tissue analysis revealed that AMA1 VLP-immunization reduced cyst formation and its size compared to control. Also, VLP-immunized mice were less susceptible to body weight loss and displayed enhanced survival rate compared to the control group. Our results demonstrated that the immune response induced by T. gondii AMA1 VLPs confer partial protection against T. gondii infection and provides important insight into potential T. gondii vaccine design strategy.