Gastrointestinal parasites of cats in the Middle East (2000-2023): A literature review

BACKGROUND/OBJECTIVE

Gastrointestinal parasites in stray cats are of significant clinical and zoonotic importance and pose a potential threat to public health. Hence, the current review has practical implications as it aims to present the diversity and the prevalence of cat parasites in Middle Eastern countries.

METHODS

The research process was rigorous and thorough, spanning from 2000 to 2023. Data collection and analysis were conducted utilizing multiple international and national databases, including Google Scholar, Scopus, PubMed, and Irandoc. This meticulous approach ensures the reliability and validity of the findings, providing a solid foundation for further research and preventive measures.

RESULTS

A total of 159 articles were collected and comprehensively reviewed. Among these, 85 articles were from Iran, 25 from Türkiye, 20 from Iraq, 11 from Egypt, five from Qatar, three from Cyprus, three from Kuwait, and one each from the UAE, Saudi Arabia, Syria, Lebanon, Jordan, Israel, and Palestine. Toxocara cati was the most prevalent nematode, exhibiting the highest prevalence in Iran, ranging from 8% to 90%, followed by Egypt, with a range of 8.23% to 58.7%. In comparison, the lowest prevalence was recorded in Qatar at 8%. Hydatigera taeniaeformis, a common cestode in the feline, showed the highest prevalence in Qatar, with a range of 73.6% to 75.8%, while the lowest was in Kuwait at 0.8%. In Iran, the prevalence ranged from 0.9% to 64.7%. Toxoplasma gondii, a cosmopolitan protozoan, showcased the highest prevalence in Lebanon at 78.1% and the lowest in the UAE at 0.8%. In Iran, the prevalence ranged between 1.2% and 90%. Additionally, noteworthy patterns regarding the distribution and potential risk factors associated with these parasites were observed. While gender variations were not significant, environmental conditions such as high humidity and absence of sunlight exposure, along with the age and behavior of cats, were among the risk factors associated with the prevalence of parasites.

CONCLUSION

The prevalence of parasites among stray cats in Iran and other Middle Eastern countries remains notably high. This emphasizes the urgent need for a series of control and preventive measures. Implementing effective anti-parasitic strategies and emphasizing the development of multiple diagnostic methods are essential.

First detection of Toxoplasma gondii Africa 4 lineage in a population of carnivores from South Africa

Introduction

There have only been a few molecular studies conducted on the detection of T. gondii in tissues of carnivores in South Africa, with no data on the genetic diversity of this parasite. That is why the aim of this study was to detect and genotype T. gondii DNA in tissues of selected wild and domestic carnivores in South Africa.

Methods

Samples were collected from 80 animals of 20 species (mainly road-killed) in the four provinces of Limpopo (n=57), Mpumalanga (n=21), Gauteng (n=1) and Free State (n=1) during the period 2014-2018. Samples of brain (n=31), heart (n=4), liver (n=40), spleen (n=2) and lung (n=3) were used to detect T. gondii by real-time PCR targeting a 529 bp repeating fragment of T. gondii DNA. Samples that were positive in real-time PCR were genotyped using 15 microsatellite markers.

Results

T. gondii DNA was detected in 4 (5 %) samples: in the brain from a Black-backed Jackal (Canis mesomelas), in the liver from a African Wildcat (Felis silvestris lybica) and in the liver and heart of two Rusty-spotted Genets (Genetta maculata) respectively. The DNA sample from Black-backed Jackal was genotyped and characterized as belonging to the type Africa 4 lineage (equivalent to RFLP genotype ToxoDB#20), that is a widespread lineage in Africa.

Discussion

This is the first genetic characterization of T. gondii isolated from a wild carnivore on the African continent and the first report of T. gondii in Black-backed Jackal. The Africa 4 lineage was also confirmed in the region of Southern Africa for the first time.

More people, more cats, more parasites: Human population density and temperature variation predict prevalence of Toxoplasma gondii oocyst shedding in free-ranging domestic and wild felids

Toxoplasma gondii is a ubiquitous zoonotic parasite that can infect warm-blooded vertebrates, including humans. Felids, the definitive hosts, drive T. gondii infections by shedding the environmentally resistant stage of the parasite (oocysts) in their feces. Few studies characterize the role of climate and anthropogenic factors in oocyst shedding among free-ranging felids, which are responsible for the majority of environmental contamination. We determined how climate and anthropogenic factors influence oocyst shedding in free-ranging domestic cats and wild felids using generalized linear mixed models. T. gondii oocyst shedding data from 47 studies were systematically reviewed and compiled for domestic cats and six wild felid species, encompassing 256 positives out of 9,635 total fecal samples. Shedding prevalence in domestic cats and wild felids was positively associated with human population density at the sampling location. Larger mean diurnal temperature range was associated with more shedding among domestic cats and warmer temperature in the driest quarter was associated with lower oocyst shedding in wild felids. Increasing human population density and temperature fluctuation can exacerbate environmental contamination with the protozoan parasite T. gondii. Management of free-ranging domestic cats could lower the burden of environmental oocysts due to their large population sizes and affinity with human settlements.

Seroprevalence of and Risk Factors for Toxoplasma gondii Infection in Cats from Greece

Toxoplasmosis is one of the most important protozoan diseases with a global impact on the health of domestic cats and with zoonotic significance. The aims of this study were to determine the prevalence of seropositivity for Toxoplasma gondii in different populations of cats in Greece and to assess risk factors for seropositivity. A total of 457 cats were prospectively enrolled, and a commercially available indirect immunofluorescence antibody testing (IFAT) kit was used for the detection of anti-T. gondii immunoglobulin G (IgG) in serum. Overall, 95 (20.8%) of the 457 cats were seropositive for T. gondii. Based on multivariate analysis, factors associated with seropositivity included older age [Odds ratio (OR), 1.33; p < 0.001]; a history of cat-fight trauma (OR, 3.88; p = 0.004); and lack of vaccination against calicivirus, herpesvirus-1, panleukopenia, and rabies (OR, 10; p = 0.002). This study shows a high prevalence of seropositivity for T. gondii in cats in Greece. This implies that toxoplasmosis is still a major public health concern and that optimal strategies for the prevention of infection with T. gondii in cats should be established.

Toxoplasma gondii and Neospora caninum Antibodies in Dogs and Cats from Egypt and Risk Factor Analysis

BACKGROUND

Toxoplasma gondii and Neospora caninum are major protozoan parasites of worldwide distribution and significance in veterinary medicine and, for T. gondii, in public health. Cats and dogs, as final hosts for T. gondii and N. caninum, respectively, have a key function in environmental contamination with oocysts and, thus, in parasite transmission. Very little is known about the prevalence of T. gondii infections in dogs and cats in Egypt, and even less about the prevalence of N. caninum in the same hosts.

METHODS

In the current study, 223 serum samples of both dogs (n = 172) and cats (n = 51) were investigated for specific antibodies to T. gondii and N. caninum using commercially available ELISAs. A risk factor analysis was conducted to identify factors associated with seropositivity.

RESULTS & DISCUSSION

Exposure to T. gondii was reported in 23.3% of the dogs and in 9.8% of the cats, respectively. In addition, N. caninum-specific antibodies were recorded in 5.8% of dogs and in 3.4% of cats. A mixed infection was found in two dogs (1.2%) and in one cat (2%). Antibodies to T. gondii in dogs were significantly more frequent in dogs aged 3 years or more and in male German Shepherds. As this breed is often used as watchdogs and was the most sampled breed in Alexandria governorate, the purpose "watchdog" (compared to "stray" or "companion"), the male sex, and the governorate "Alexandria" also had a significantly higher seroprevalence for T. gondii. No factors associated with antibodies to N. caninum could be identified in dogs, and no significant factors were determined in cats for either T. gondii or N. caninum infection. Our study substantially adds to the knowledge of T. gondii infection in dogs and cats and presents data on N. caninum infection in cats for the first and in dogs in Egypt for the second time.

Gastrointestinal parasites of cats in Egypt: high prevalence high zoonotic risk

BACKGROUND

Several gastrointestinal parasites that infect cats pose potential health threats for humans and animals. The present study is the first to report gastrointestinal (GIT) parasites in feces of stray cats from Gharbia governorate, Egypt. Findings were combined with those published in the earlier surveys from various Egyptian governorates, and various meta-analyses were conducted to underline the parasitic zoonoses from cats in Egypt.

RESULTS

Out of 143 samples tested in Gharbia, 75 (52.4%) were found infected with 13 different parasites. Co-infections were observed in 49.3% of positives. Several parasites were detected, e.g., Toxocara cati (30.0%), Toxascaris leonina (22.4%), hookworms (8.4%), taeniids (4.2%), Strongyloides spp. (2.1%), Physaloptera spp. (2.1%), Alaria spp. (1.4%) and Dipylidium caninum (0.7%). Opisthorchis-like eggs were found in a single sample being the first report from cats in Africa. Oocysts of 4 coccidian parasites were identified, and a few Toxoplasma gondii-like oocysts were detected in 2 samples (1.4%). Results of the meta-analysis illustrated that occurrence of T. gondii oocysts in feces of cats from Egypt may have been overestimated in earlier studies; 1432 cats have been tested and displayed a 5 times higher pooled prevalence (11.9%) than the published global pooled prevalence for T. gondii oocysts in cats. This overestimation might have occurred because some small-sized oocysts that belong to other coccidian parasites were mis-identified as T. gondii. Toxocara cati had a high pooled prevalence (22.5%) in cats from Egypt, which is even greater than the published pooled prevalence in cats globally; however, several reports from Egypt have neglected the role of T. cati in human toxocarosis. Dipylidium caninum displayed also a high prevalence (26.7%).

CONCLUSION

Several zoonotic parasite species have been found in stray cats from Egypt, raising concerns about the risks to the Egyptian human population as well as environmental contamination. Prompt surveillance supervised by the government and accompanied by data dissemination will be helpful for developing effective control strategies.

Detección molecular de Toxoplasma gondii en carnes para consumo humano en Ibagué, Colombia

Introducción. Toxoplasma gondii es un parásito con gran potencial zoonótico que puede infectar un amplio rango de huéspedes de sangre caliente, incluidos los animales del sector pecuario, lo que causa pérdidas a la industria. En el humano, es patógeno en personas inmunosuprimidas y afecta el desarrollo del feto en infecciones congénitas. Además, se asocia con diversos trastornos del comportamiento en personas sanas. El humano puede adquirir T. gondii al consumir carnes contaminadas mal cocidas.Objetivo. Determinar la positividad de T. gondii en carnes de consumo humano (res, pollo y cerdo) en Ibagué, Colombia.Materiales y métodos. Se utilizó la PCR convencional anidada y la secuencia del gen B1 de T. gondii como blanco de amplificación. Se tomaron 186 muestras de carne comercializada en la zona urbana de Ibagué (62 de res, 62 de pollo y 62 de cerdo) y se obtuvo el porcentaje de positividad en cada tipo de carne evaluada.Resultados. Se encontró un porcentaje de positividad de 18,8 % en las muestras, siendo la carne de cerdo la del mayor porcentaje (22,5 %; 14/62), seguida por las muestras de carne de res (19,3 %; 12/62) y de pollo (14,5 %; 9/62). Los mejores productos amplificados fueron secuenciados en Macrogen, y alineados con las secuencias del gen B1 depositadas en el GenBank, con lo que se confirmó su identidad.Conclusiones. Este es el primer estudio sobre prevalencia de T. gondii en carnes para consumo humano en Ibagué y el departamento del Tolima. Se demostró que los tres tipos de carne representan un riesgo para la infección en humanos a nivel local.

First isolation and genotyping of Toxoplasma gondii strains from domestic animals in Tunisia

The isolation and molecular typing of Toxoplasma gondii strains provide an essential basis for a better understanding of the parasite’s genetic diversity, determinants of its geographical distribution and associated risks to human health. In this study, we isolated and genetically characterized T. gondii strains from domestic animals in Southern and coastal area of Tunisia. Blood, hearts and/or brains were collected from 766 domestic animals (630 sheep and 136 free-range chickens). Strain isolation from these samples was performed using mouse bioassay and genotyping was carried out with a multiplex PCR technique using 15 microsatellite markers. Thirty viable strains of T. gondii were successfully isolated from tissues of sheep (19/142) and chickens (11/33). In addition, 3 strains could be successfully genotyped from animal tissues for which mouse bioassay was unsuccessful. A large predominance of type II strains (n = 29) was found in the sampled regions, followed by type III (n = 3) and, for the first time in Tunisia, a single isolate of Africa 4 lineage from a sheep. Analyses of population genetics showed the presence of a divergent population of type II lineage in Tunisia, supporting limited recent migrations of strains between Tunisia and other countries of the world.

<i>Toxoplasma gondii</i> Infection in Cattle Egret (<i>Bubulcus ibis</i>): First Report from Shebin El-Kom, Menoufia Governorate, Egypt

BACKGROUND AND OBJECTIVE

Toxoplasma gondii (T. gondii) is capable of infecting a broad range of intermediate hosts. Cattle egret (Bubulcus ibis) is a species of herons that is common in Egypt. This work aimed to study the prevalence of T. gondii in cattle egret which is an efficient tool of investigating environmental contamination with T. gondii.

MATERIALS AND METHODS

Serum, heart and brain tissues of 51 cattle egrets were collected from Shebin El-Kom, Menoufia, Egypt and tested using Modified Agglutination Test (MAT) and mice bioassay.

RESULTS

There was a detection rate of 13.7% (7/51) in these birds using MAT. By intraperitoneal injection of mice with heart and brain tissues digest of MAT positive birds, the parasite was isolated from two T. gondii sero-positive birds (28.6%). The mice bioassay was confirmed by MAT, Hematoxylin and Eosin (HAND E) staining of the brain of the infected mice, also by Polymerase Chain Reaction (PCR) and sequencing.

CONCLUSION

This is the first report of T. gondii infection in cattle egret from Egypt and more studies are needed on Egyptian wildlife to understand the sylvatic life cycle of the parasite.

Insights from ancient DNA analysis of Egyptian human mummies: clues to disease and kinship

The molecular Egyptology field started in the mid-eighties with the first publication on the ancient DNA (aDNA) analysis of an Egyptian mummy. Egypt has been a major interest for historians, archeologists, laymen as well as scientists. The aDNA research on Egyptian biological remains has been fueled by their abundance and relatively well-preserved states through artificial mummification and by the advanced analytical techniques. Early doubts of aDNA integrity within the Egyptian mummies and data authenticity were later abated with studies proving successfully authenticated aDNA retrieval. The current review tries to recapitulate the published studies presenting paleogenomic evidence of disease diagnosis and kinship establishment for the Egyptian human remains. Regarding disease diagnosis, the prevailing literature was on paleogenomic evidence of infectious diseases in the human remains. A series of reports presented evidence for the presence of tuberculosis and/or malaria. In addition, there were solitary reports of the presence of leprosy, diphtheria, bacteremia, toxoplasmosis, schistosomiasis and leishmaniasis. On the contrary, paleogenomic evidence of the presence of rare diseases was quite scarce and mentioned only in two articles. On the other hand, kinship analysis of Egyptian human remains, including that of Tutankhamen, was done using both mitochondrial DNA sequences and nuclear DNA markers, to establish family relationships in four studies. It is clear that the field of molecular Egyptology is still a largely unexplored territory. Nevertheless, the paleogenomic investigation of Egyptian remains could make significant contributions to biomedical sciences (e.g. elucidation of coevolution of human host-microbe interrelationship) as well as to evidence-based archeology.

Feline-Human Zoonosis Transmission in North Africa: A Systematic Review

Throughout human history, domestic animal species have represented a unique zoonotic disease risk for the transmission of pathogens ranging from viral, bacterial, parasitic, and fungal. In North Africa, cats have a particularly long record and occupy a specialized niche within many communities. This systematic review was conducted to analyze the current and historical literature documenting the breadth and variety of zoonoses in North Africa, specifically relating to the domesticated feline. Multiple electronic databases were searched on January 16, 2019, for published reports on feline zoonoses in North Africa. A total of 76 studies met the inclusion criteria for a full assessment. Articles selected for the review ranged in publication dates from 1939 to 2019 and included a case study, cross-sectional surveys, genomic analyses, and a book chapter. The most commonly studied pathogen was Toxoplasma gondii (n = 17) followed by a variety of helminths (n = 10). Of the countries in the target region, most publications were of studies conducted in Egypt (n = 53) followed by Tunisia (n = 12), Algeria (n = 11), Morocco (n = 5), and Libya (n = 3). The results of this review identify a variety of viral, bacterial, fungal, and parasitic zoonotic diseases associated with cats in North Africa, ranging from historically endemic diseases in both human and animal populations in the region, to emerging infections with recent confirmatory diagnoses. This review describes reported feline zoonoses in North Africa and provides recommendations for their prevention and control. In addition to vaccination campaigns for domesticated felines and postexposure prophylaxis for humans, prompt veterinary and medical care of exposure risks and subsequent infections are essential in limiting the zoonotic disease burden in North African communities of humans and cats.

Molecular Detection and Genetic Diversity of Toxoplasma gondii Oocysts in Cat Faeces from Klang Valley, Malaysia, Using B1 and REP Genes in 2018

The major route for Toxoplasma gondii (T. gondii) infection is through the ingestion of foods contaminated with oocyst from cat faeces. The microscopic detection of T. gondii oocysts in cat faeces is challenging, which contributes to the failure of detecting or differentiating it from other related coccidian parasites. This study aims to detect T. gondii oocysts in cat faeces using two multicopy-target PCR assays and to evaluate their genetic diversity. Cat faecal (200) samples were collected from pet cats (PCs; 100) and free-roaming cats (FRCs; 100) within Klang Valley, Malaysia, and screened for coccidian oocysts by microscopy using Sheather's sucrose floatation. PCR assays were performed on each faecal sample, targeting a B1 gene and a repetitive element (REP) gene to confirm T. gondii oocysts. Additionally, the PCR amplicons from the REP gene were sequenced to further confirm T. gondii-positive samples for phylogenetic analysis. Microscopy detected 7/200 (3.5%) T. gondii-like oocysts, while both the B1 gene and the REP gene detected 17/200 (8.5%) samples positive for T. gondii. All samples that were microscopically positive for T. gondii-like oocysts were also shown to be positive by both B1 and REP genes. The BLAST results sequenced for 16/200 (8.0%) PCR-positive T. gondii samples revealed homology and genetic heterogeneity with T. gondii strains in the GenBank, except for only one positive sample that did not show a result. There was almost perfect agreement (k = 0.145) between the two PCR assays targeting the B1 gene and the REP gene. This is the first report on microscopic, molecular detection and genetic diversity of T. gondii from cat faecal samples in Malaysia. In addition, the sensitivities of either the B1 gene or REP gene multicopy-target PCR assays are suitable for the accurate detection of T. gondii from cat faeces.

Toxoplasma gondii infections in birds, companion, food and recreational animals in Nigeria: A systematic review and meta-analysis

Toxoplasma gondii is a protozoan pathogen of zoonotic and economic importance with a global distribution. The pathogen is associated with abortion, stillbirth, neonatal mortalities and mummification in sheep and goats which may also serve as sources of human infections. In pregnant women, the parasite undergoes intrauterine transmission to cause neonatal complications like miscarriage, chorioretinitis, hydrocephalus, cerebral calcification and foetal death. Here, we determine the prevalence and geographical distribution of T. gondii infections in Nigeria using the PRISMA protocol. Prevalence estimates (PE) and heterogeneity were determined by the random-effects model and the Cochran's Q-test respectively. Twenty-eight articles identified, reported 2311 positive cases of Toxoplasma gondii from a total of 9847 animals examined across 15 Nigerian States. Overall PE was 20.70% (95% CI: 15.05-27.78) with a range of 10.18% (95% CI: 2.66-31.98) to 94.00% (95% CI: 89.73-96.56) across sub-groups. PEs varied significantly (p < .05) across host species, with a range of 4.06% (95% CI: 2.47-6.87) to 40.65% (95% CI: 19.88-65.40). PEs in females (22.65%, 95% CI: 15.78-31.72) was significantly higher (p < .05) than that in males (18.97%, 95% CI: 12.78-27.22), while those for adult and young animals were 20.23% (95% CI: 13.42-29.33) and 18.96% (95% CI: 11.11-30.45) respectively. The majority of the studies were published from the south-western region. Toxoplasma gondii infection is prevalent among birds, companion, food and recreational animals from Nigeria. Integrated control strategies including adequate sanitation, cat movement restrictions, public enlightenment are recommended to curtail the menace of T. gondii in animals and its public health consequences in humans.

All about toxoplasmosis in cats: the last decade

Toxoplasma gondii infections are common in humans and animals worldwide. Toxoplasmosis continues to be of public health concern. Cats (domestic and wild felids) are the most important host in the epidemiology of toxoplasmosis because they are the only species that can excrete the environmentally resistant oocysts in feces. Cats can excrete millions of oocysts and a single cat can spread infection to many hosts. The present paper summarizes information on prevalence, persistence of infection, clinical signs, and diagnosis of T. gondii infections in domestic and wild cats for the past decade. Special emphasis is paid to genetic diversity of T. gondii isolates from cats. Review of literature indicates that a unique genotype (ToxoDB genotype #9 or Chinese 1) is widely prevalent in cats in China and it has been epidemiologically linked to outbreaks of clinical toxoplasmosis in pigs and deaths in humans in China; this genotype has rarely been detected in other countries. This review will be of interest to biologists, parasitologists, veterinarians, and public health workers.

A review on toxoplasmosis in humans and animals from Egypt

The present paper summarizes prevalence, epidemiology and clinical disease of natural Toxoplasma gondii infections in humans and animals from Egypt. The current situation of toxoplasmosis in Egypt is confusing. There is no central laboratory or group of researchers actively investigating toxoplasmosis in humans or animals, and no reports on the national level are available. Based on various serological tests and convenience samples, T. gondii infections appear highly prevalent in humans and animals from Egypt. Living circumstances in Egypt favour the transmission of T. gondii. Up to 95% of domestic cats, the key host of T. gondii, are infected with T. gondii; they are abundant in rural and suburban areas, spreading T. gondii oocysts. Many women have been tested in maternity clinics, most with no definitive diagnosis. Toxoplasma gondii DNA and IgM antibodies have been found in blood samples of blood donors. Clinical toxoplasmosis in humans from Egypt needs further investigations using definitive procedures. Reports on congenital toxoplasmosis are conflicting and some reports are alarming. Although there are many serological surveys for T. gondii in animals, data on clinical infections are lacking. Here, we critically review the status of toxoplasmosis in Egypt, which should be useful to biologist, public health workers, veterinarians and physicians.

Comparison of indirect and modified agglutination tests for detection of antibodies to Toxoplasma gondii in domestic cats

Toxoplasma gondii is a protozoan parasite with worldwide distribution. The accurate detection of this zoonotic agent in cats and other hosts has public health importance. Blood samples from 89 domestic cats were tested for antibodies to T. gondii using 2 commercial agglutination test kits, an indirect (IHAT; Toxo-HAI FUMOUZE; Fumouze Diagnostics) and a modified (MAT; Toxoscreen DA; bioMérieux) agglutination test. Antibodies were found in 16 of 89 (18%) cats by the IHAT and in 23 of 89 (26%) cats by the MAT, with an overall agreement between the 2 serologic tests of 92% (κ = 0.77; i.e., substantial agreement beyond chance). Considering the MAT as the gold standard, the IHAT showed perfect relative specificity (100%) and lower relative sensitivity (70%). The suboptimal sensitivity of the IHAT limits its use in epidemiologic studies in cats.

The introduction of new hosts with human trade shapes the extant distribution of Toxoplasma gondii lineages

Toxoplasma gondii is a zoonotic protozoan with a worldwide occurrence, but the determinants of the current pattern in the geographical distribution of T. gondii lineages and strains remain poorly understood. To test the influence of human trade on T. gondii populations, we conducted a population genetic study of 72 T. gondii animal isolates from Senegal, a West African country in which the ongoing inland progress of invasive murine hosts (introduced in port cities of Senegal since the 16th century by European sailors) is well described. Isolates were mainly collected on free-range poultry, which are considered as relevant bioindicators of T. gondii strain diversity in the domestic environment. Sampling was conducted in two port cities of Senegal (Dakar and Saint-Louis) and in one inland region (Kedougou). Population genetic analyses using 15 microsatellite markers revealed different patterns between port cities where lineages non-virulent for mice (type II, type III, and Africa 4) were predominant, and Kedougou where the mouse-virulent Africa 1 lineage was the most common. By considering the current spatial pattern in the inland progress of invasive rodents in Senegal, our results suggest that the invasive house mouse Mus musculus domesticus counter-selects the Africa 1 lineage in the invaded areas. The comparison of the microsatellite alleles of type II strains from Senegal to type II strains from other areas in Africa and Western Europe, using discriminant analysis of principal components and Network analysis, point to a mainly Western European origin of the type II lineage in Senegal. Collectively, these findings suggest that human-mediated intercontinental migrations of murine hosts are important vectors of T. gondii strains. Differential susceptibility of endemic and introduced murine hosts to various T. gondii strains probably determines the persistence of these strains in the environment, and therefore their availability for human and animal infection.

Toxoplasma gondii infection and toxoplasmosis in North Africa: a review

Toxoplasmosis is an important zoonosis caused by an obligate intracellular parasitic protozoan, Toxoplasma gondii. The disease is distributed worldwide and can affect all warm-blooded vertebrates, including humans. The present review aimed to collect, compile and summarize the data on the prevalence of T. gondii infection in humans and animals in the five North African countries (Morocco, Algeria, Tunisia, Libya and Egypt). Published data from national and international databases were used. Distribution patterns and risk factors for T. gondii infection are discussed, focusing on biotic and abiotic factors. This review is a comprehensive epidemiological analysis of T. gondii infection in North Africa and will therefore be a useful tool for researchers. It can also be used to propose or enhance appropriate national toxoplasmosis control programs.

Seroprevalence of Toxoplasma gondii infection in children with central nervous system disorders in Mansoura, Egypt: a case-control study

Background

Toxoplasma gondii is a global infection with a crucial role in the development of neurological diseases. Data concerning the association between T. gondii and neurological illnesses in Egyptian children is scarce.

Methods

A case-control study was conducted on 60 patients divided into children suffering from central nervous system manifestations without apparent chromosomal anomalies (n=30) and children with Down syndrome (n=30) recruited from Mansoura University Children's Hospital, Mansoura, Egypt. A total of 30 healthy children were included as controls. Demographics and clinical data were collected from all cases and Toxoplasma immunoglobulin (Ig) M and G antibodies were assessed by enzyme-linked immunosorbent assay.

Results

Anti-T. gondii IgG was the most frequent antibody detected and the highest seropositivity rates were ranked for the neurologically disabled non-syndromic children, followed by Down syndrome, compared with controls (p≤0.001). Statistically significant (p=0.05) associations were found between Toxoplasma IgG seropositivity and hydrocephalus and between Toxoplasma IgM and a history of contact with farm animals, soil and cats in children with Down syndrome.

Conclusions

The association between Toxoplasma infection and neurological disorders in children should be kept in mind by paediatricians and assessment of T. gondii antibodies in early childhood is needed for timely management of afflicted patients.

A Comprehensive Review of Common Bacterial, Parasitic and Viral Zoonoses at the Human-Animal Interface in Egypt

Egypt has a unique geographical location connecting the three old-world continents Africa, Asia and Europe. It is the country with the highest population density in the Middle East, Northern Africa and the Mediterranean basin. This review summarizes the prevalence, reservoirs, sources of human infection and control regimes of common bacterial, parasitic and viral zoonoses in animals and humans in Egypt. There is a gap of knowledge conerning the epidemiology of zoonotic diseases at the human-animal interface in different localities in Egypt. Some zoonotic agents are “exotic” for Egypt (e.g., MERS-CoV and Crimean-Congo hemorrhagic fever virus), others are endemic (e.g., Brucellosis, Schistosomiasis and Avian influenza). Transboundary transmission of emerging pathogens from and to Egypt occurred via different routes, mainly importation/exportation of apparently healthy animals or migratory birds. Control of the infectious agents and multidrug resistant bacteria in the veterinary sector is on the frontline for infection control in humans. The implementation of control programs significantly decreased the prevalence of some zoonoses, such as schistosomiasis and fascioliasis, in some localities within the country. Sustainable awareness, education and training targeting groups at high risk (veterinarians, farmers, abattoir workers, nurses, etc.) are important to lessen the burden of zoonotic diseases among Egyptians. There is an urgent need for collaborative surveillance and intervention plans for the control of these diseases in Egypt.

First genetic characterization of Toxoplasma gondii in stray cats from Algeria

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

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.

Molecular investigation on the occurrence of Toxoplasma gondii oocysts in cat feces using TOX-element and ITS-1 region targets

One of the most important routes of transmission for Toxoplasma gondii infection is the ingestion of foods contaminated with cat feces containing sporulated oocysts. The diagnosis of T. gondii infection by fecal microscopy is complicated, as other similar coccidian oocysts are often present in the same fecal specimen. This study aimed to identify T. gondii oocysts in cat feces using a novel PCR technique. Feline fecal specimens (n = 254) were screened for coccidian oocysts by light microscopy using the Sheather's flotation method. PCR analysis performed on the same specimens targeted a 529 bp repeat element and internal transcribed spacer-1 (ITS-1) regions were used to confirm the presence of Toxoplasma oocysts. By light microscopy, 49/254 (19.3%) of specimens contained coccidian oocysts. PCR analysis demonstrated 2/254 (0.8%) and 17/254 (6.7%) positive results using Tox and ITS-1 primers, respectively. However, coccidian oocysts were not identified on microscopic examination of specimens that were PCR-positive by Tox primers. Coccidian oocysts were identified on microscopic examination of 6/17 (35.3%) of the PCR-positive fecal specimens using ITS-1 primers. The BLAST results of 16 ITS-1 sequences were identified as T. gondii (n = 12; 4.7%) and Hammondia hammondi (n = 4; 1.6%). There was slight agreement between the 529 bp and ITS-1 PCR results (κ = 0.148). This is the first report of the detection of Toxoplasma oocysts using PCR analysis on feline fecal specimens from Southern Thailand. The ITS-1 region has potential as an alternative marker to identify T. gondii oocysts in feline fecal specimens.

Seroprevalence of Toxoplasma gondii among turkeys on family farms in the state of Northeastern Brazil

The aim of the present study was to investigate the prevalence of antibodies against Toxoplasma gondii in turkeys and chickens on family farms in the semi-arid region of the state of Pernambuco, Brazil. In order to do so, 204 sera samples from turkeys were analyzed using the Modified Agglutination Test (MAT) and 322 sera samples from chickens were assessed using the Immunofluorescence Assay (IFA). Twenty-eight properties contained turkeys and 23 of these properties also contained chickens. The relative frequency of positive turkeys was 11% (21/204), with 46.6% (13/28) of the properties containing at least one positive turkey. The frequency of positive chickens was 25.8% (83/322), with 95.6% (22/23) of the properties containing at least one positive chicken. Based on the results of the present study, it was possible to conclude that turkeys can serve as an indicator of environmental contamination by oocysts of T. gondii. However, they are less effective than chickens bred in the same conditions. The increasing demand from consumers for naturally produced products should worry local sanitary authorities due to the high prevalence of antibodies against T. gondii found in this type of rearing system, particularly among chickens.

Toxoplasma gondii seroprevalence in pet cats in Norway and risk factors for seropositivity

OBJECTIVES

The aims of the study were to estimate Toxoplasma gondii seroprevalence in pet cats in Norway and to evaluate risk factors for seropositivity. Additionally, serum biochemistry and haematological variables for T gondii seropositive and seronegative cats were compared.

METHODS

A convenience sample of surplus sera submitted to the Central Laboratory, Norwegian University of Life Sciences, was collected. The samples were from healthy cats and cats with a variety of diseases. Analyses for IgG antibodies to T gondii were performed with a commercial direct agglutination test, with 1:40 as the threshold value. For risk factor analysis a logistic regression model of the relationship between predictors and the outcome was applied.

RESULTS

One hundred and ninety-six of 478 cats were seropositive for T gondii, and the estimated seroprevalence in the study sample was 41.0% (95% confidence interval 36.6-45.4). Compared with domestic cats, pedigree cats had reduced risk for Toxoplasma seropositivity (odds ratio [OR] 0.42). Males had increased risk (OR 1.63) compared with females. The effect of age was highly significant, and an increase in the cats' age across the interquartile range (IQR; 52-160 months/4-13 years of age) doubled the risk of Toxoplasma seropositivity (OR 2.11). The risk for Toxoplasma seropositivity among cats living in Oslo was significantly reduced (OR 0.51) when compared with the rest of Norway.

CONCLUSIONS AND RELEVANCE

Pet cats in Norway appear to be commonly exposed to T gondii. Signalment and geographical region influenced the odds of Toxoplasma seropositivity, whereas health status did not.

Causes of endogenous uveitis in cats presented to referral clinics in North Carolina

OBJECTIVE

To investigate the causes of endogenous uveitis in cats presenting to referral ophthalmology clinics in North Carolina.

PROCEDURE

Medical records of cats diagnosed with endogenous uveitis at North Carolina State University's College of Veterinary Medicine (NCSU-CVM) or Animal Eye Care Associates of Cary, NC between 2003 and 2015 were reviewed. Inclusion criteria were cats that had complete diagnostic workups, including clinical, clinicopathological, serological, and histopathological data, as well as imaging modalities. Serology was consistently completed for feline leukemia virus (FeLV), feline immunodeficiency virus (FIV), feline coronavirus (FCoV), Toxoplasma gondii, and Bartonella spp.

RESULTS

One hundred and twenty cats met the inclusion criteria. Seroprevalence of FeLV (2.7%), FIV (7.3%), FCoV (34.7%), T. gondii (23.7%), and Bartonella spp. (43.2%) was observed, with a combined seroprevalence of 59.2%. Nineteen cats (15.8%) were diagnosed with feline infectious peritonitis (FIP) based on clinical, hematological, serological, histopathological, and necropsy findings. The average age of all cases was 7.62 years, while the average age of cats diagnosed with FIP was 1.82 years. Neoplasia was diagnosed in six cats (5.0%). No underlying etiology was found in 49 cats (40.8%).

CONCLUSIONS

Both idiopathic and neoplastic causes of uveitis were less prevalent than previously reported in studies, while seropositivity was higher than previously reported for the study area. This may be due to improved diagnostic capabilities or that cats with infectious disease were more likely to be referred. Because of the high prevalence of FIP, young cats with uveitis should be evaluated for hyperglobulinemia and FCoV serology should be performed as minimal diagnostics.

The prevalence of antibodies to Toxoplasma gondii in sheep in the Western Cape, South Africa

The seroprevalence of Toxoplasma gondii antibodies in a sample of 292 merino sheep farmed in a semi-intensive manner in the Overberg region of the Western Cape, South Africa, was investigated. Antibody seroprevalence was determined by enzyme-linked immunosorbent assay. Of the total sample, 23 sheep tested positive for T. gondii antibodies (8%; 95% CI: 4.7688-10.9846). There was no statistically significant relationship between seroprevalence and age of the sheep. The highest seroprevalence was found in sheep between 28 and 40 months old; a total of 19 sheep were seropositive by 40 months. No seropositive sheep were found in the age group between 16 and 28 months. The seroprevalence reported in this study is higher than what has previously been reported for the Western Cape (6%) and across South Africa on average (4.7%). As sheep farming is economically significant in South Africa, the presence of T. gondii amongst sheep may pose a production threat to the small-stock industry as well as to public health and food security. We therefore recommend further surveillance to identify high-risk animal populations so that local control measures can be put in place.

Isolation and molecular characterization of Toxoplasma gondii isolated from pigeons and stray cats in Lisbon, Portugal

Cats and pigeons are important factors in the epidemiology of Toxoplasma gondii as felids are the only definitive hosts that can excrete environmentally resistant oocysts, and pigeons share the same places of cats and humans constituting a good model and indicator of the ground field contamination. We aimed to study the virulence and genotypes of T. gondii isolated from pigeons and stray cats in Lisbon, Portugal. Fresh samples of brain from 41 pigeons and 164 cats revealing antibodies to T. gondii were inoculated in mice. Three isolates (one isolated from a cat and two isolated from pigeons) were virulent in the mouse model. Sag2-based genotyping of T. gondii was achieved in 70.7% (29/41) of samples isolated from pigeons (26 samples were type II, two were type III, and one strain was type I). From the cat brain samples, 50% (82/164) yielded Sag2 positive results, where 72 belonged to genotype II and 10 were no type III (it was not possible to discriminate between type I and II). Further genotyping was obtained by multiplex PCR of 5 microsatellites (TUB2, TgM-A, W35, B17, B18), allowing the identification of two recombinant strains that had been previously identified as type II by Sag2 amplification (one isolated from cat brain and the other from pigeon brain). This is the first evidence of recombinant strains circulating in Portugal and the first report of T. gondii genotyping from cats in this country. This study also highlights the importance of environmental contamination in the synanthropic cycle constituting a potential source of human infection.

Genetic characterization of Toxoplasma gondii isolates and toxoplasmosis seroprevalence in stray cats of İzmir, Turkey

Currently, some Toxoplasma gondii genotypes are being associated with serious clinical presentations. A recent report showing the Africa 1 genotype in two local congenital toxoplasmosis cases acquired in Turkey formed the basis of this study because atypical Africa 1 genotype is most frequently detected in animals and patients from sub-Saharan Africa. Since stray cats are considered as the linkage between wild life and urban life in T. gondii transmission, the present study aimed to isolate and characterize T. gondii strains circulating in stray cats of İzmir (Western Turkey). A secondary objective was to determine toxoplasmosis seroprevalence in this cat population. Tissues obtained from 100 deceased stray cats were bioassayed and isolated strains were genotyped using 15 microsatellite markers. In addition, toxoplasmosis seroprevalence was analyzed in 1121 cat sera collected from several large veterinary clinics in İzmir. Among the 22 isolates, 19 were Type II (86.3%), two were Type III (9%) and one was Africa 1 genotype (4.5%). The overall seropositivity rates in cats were 42-48% and 33.4-34.4% according to IFA and ELISA, respectively. Seroprevalence in deceased cats was significantly higher than in healthy cats (P = 0.0033). Finding both the major clonal Type II lineage together with the Type III lineage also found in Middle East, and an atypical genotype, Africa 1 appears consistent with the specific geographic location of Turkey between three continents and raises the possibility of transportation of these strains between continents through trade routes or long distance migratory birds. In addition, the first large study of toxoplasma seroprevalence in a stray cat population was also reported. The relatively high seropositivity rates and the variety of T. gondii genotypes confirm the local stray cat population as a risk factor for human toxoplasmosis in İzmir.

Serotyping of Toxoplasma gondii in cats (Felis domesticus) reveals predominance of type II infections in Germany

Background

Cats are definitive hosts of Toxoplasma gondii and play an essential role in the epidemiology of this parasite. The study aims at clarifying whether cats are able to develop specific antibodies against different clonal types of T. gondii and to determine by serotyping the T. gondii clonal types prevailing in cats as intermediate hosts in Germany.

Methodology

To establish a peptide-microarray serotyping test, we identified 24 suitable peptides using serological T. gondii positive (n=21) and negative cat sera (n=52). To determine the clonal type-specific antibody response of cats in Germany, 86 field sera from T. gondii seropositive naturally infected cats were tested. In addition, we analyzed the antibody response in cats experimentally infected with non-canonical T. gondii types (n=7).

Findings

Positive cat reference sera reacted predominantly with peptides harbouring amino acid sequences specific for the clonal T. gondii type the cats were infected with. When the array was applied to field sera from Germany, 98.8% (85/86) of naturally-infected cats recognized similar peptide patterns as T. gondii type II reference sera and showed the strongest reaction intensities with clonal type II-specific peptides. In addition, naturally infected cats recognized type II-specific peptides significantly more frequently than peptides of other type-specificities. Cats infected with non-canonical types showed the strongest reactivity with peptides presenting amino-acid sequences specific for both, type I and type III.

Conclusions

Cats are able to mount a clonal type-specific antibody response against T. gondii. Serotyping revealed for most seropositive field sera patterns resembling those observed after clonal type II-T. gondii infection. This finding is in accord with our previous results on the occurrence of T. gondii clonal types in oocysts shed by cats in Germany.

Bartonella and Toxoplasma infections in stray cats from Iraq

Because of overpopulation, stray/feral cats were captured on military bases in Iraq as part of the US Army Zoonotic Disease Surveillance Program. Blood samples were collected from 207 cats, mainly in Baghdad but also in North and West Iraq, to determine the prevalence of Bartonella and Toxoplasma infections. Nine (4.3%) cats, all from Baghdad, were bacteremic with B. henselae type I. Seroprevalence was 30.4% for T. gondii, 15% for B. henselae, and 12.6% for B. clarridgeiae. Differences in Bartonella prevalence by location were statistically significant, because most of the seropositive cats were from Baghdad. There was no association between T. gondii seropositivity and either of the two Bartonella species surveyed. This report is the first report on the prevalence of Bartonella and T. gondii among stray cats in Iraq, which allows for better evaluation of the zoonotic risk potential to the Iraqi people and deployed military personnel by feral cat colonies.

High prevalence of Toxoplasma gondii oocyst shedding in stray and pet cats (Felis catus) in Virginia, United States

Background

The protozoan Toxoplasma gondii is the causative agent of toxoplasmosis, with complications varying from mental disease to death. While human infection can occur via ingestion of tissue cysts from infected meat, most human infection comes from oocysts. Cats are the only definitive host, and thus shedding of oocysts by cats provides the ultimate source of toxoplasmosis.

Methods

While most studies in the area use seroprevalence to monitor Toxoplasma incidence in cat populations, this provides only a history of infection. This study used PCR detection of oocysts from cat feces to more accurately estimate the numbers of cats producing oocysts and thus posing an active health risk. DNA sequencing was use to confirm the identity of the PCR products.

Results

Of the 49 cats tested, 9 yielded PCR products of the expected size. Six of the nine were determined by sequence analysis to be false positives, while three products were true positives. Overall, 6% of cats examined were found to be actively shedding oocysts.

Conclusions

The incidence of oocyst shedding in the cat population studied was significantly higher than expected and higher than found in most cat populations world-wide. Of equal importance, the primers tested were shown to produce PCR products of multiple sizes and non-target products of expected size. We detected false positives at a higher rate than true positives, emphasizing the need for confirmatory analysis. Further research may produce better protocols for Toxoplasma detection from cat fecal samples.

Genetic characterization of viable Toxoplasma gondii isolates from stray dogs from Giza, Egypt

Stray dogs are considered as sentinels in the epidemiology of Toxoplasma gondii because they are carnivores and eat variety of foods, including garbage. In the present study, tissues and sera of 51 stray dogs (Canis familiaris) from Giza, Egypt were examined for T. gondii infection. Sera were examined for antibodies to T. gondii by the modified agglutination test (MAT); 50 of 51 (98%) were seropositive with titers of 20 in four, 40 in four, 80 in one, 100 in eight, 200 in 17, 400 in 11, 800 or higher in five. Hearts of 43 seropositive dogs were bioassayed in mice. Viable T. gondii was isolated from 22 dogs; these isolates were designated TgDogEg1 to TgDogEg22. DNA isolated from cell culture derived tachyzoites of 22 isolates was genotyped using 10 PCR-restriction fragment length polymorphism markers (SAG1, SAG2, SAG3, BTUB, GRA6, c22-8, c29-2, L358, PK1, and Apico). The results revealed three genotypes and one mixed infection. The three genotypes are ToxoDB PCR-RFLP #2 (type III, four isolates), #3 (type II variant, 11 isolates), #20 (six isolates), 1 mixed infection. These results revealed the dominance of clonal type II, III and ToxoDB #20 lineages of T. gondii in stray dogs from Giza, Egypt.

Prevalence of Toxoplasma gondii infection in antenatal population in Menoufia governorate, Egypt

Knowledge of the prevalence of Toxoplasma gondii infection in pregnant women would be a valuable approach for planning appropriate preventive strategies. However, no enough data currently exist as to the magnitude of T. gondii infection among pregnant women in Egypt. In view of paucity of reports on this issue, the current cross-sectional study aimed to determine the rate of T. gondii infection and maternal-fetal transmission in antenatal population in Menoufia governorate, Egypt. Out of 323 pregnant women who were screened for Toxoplasma-specific IgG and IgM antibodies with ELFA, 218 samples were IgG seropositive, of which, 9 samples were IgM seropositive. Therefore, seropositivity rates of 67.5% (95% CI: 62.39%, 72.61%), and 2.8% (95% CI: 1%, 4.6%) for IgG and IgM, respectively were found. Analysis of serological patterns revealed that a large proportion of subjects were immune to Toxoplasma infection (IgG+/IgM-), as prevalence of chronic infection was 64.7% (209 cases), and 32.5% of cases were susceptible to primary infection (IgG-/IgM-). Meanwhile, the rate of probable acute Toxoplasma infection (IgG+/IgM+) was 2.8%, with one case (0.3%) confirmed for recent infection, as she had low avidity index with positive amniotic fluid analysis with both PCR and mouse inoculation. Significant relations were seen between Toxoplasma-specific IgG and knowledge about transmission modes, consumption of milk/milk products and unwashed raw vegetable/fruit, hand hygiene, contact with soil and farm animals. In conclusion, we reported high prevalence for T. gondii infection among antenatal population in Menoufia governorate. Thus, the susceptibility for toxoplasmosis is relatively low. Sources of infection revealed herein might represent potential threats for primary infection in seronegative women. Accordingly, there is urgent need for implementation of health education programs as an appropriate approach for prevention.

Genetic diversity of Toxoplasma gondii isolates in Egyptian feral cats reveals new genotypes

Cats are important in the epidemiology of Toxoplasma gondii because they are the only hosts that excrete environmentally resistant oocysts in feces. In the present study, 115 viable T. gondii isolates from tissues of cats from Egypt were genotyped using 10 PCR-restriction fragment length polymorphism markers (SAG1, SAG2, SAG3, BTUB, GRA6, c22-8, c29-2, L358, PK1, and Apico) and DNA from tachyzoites. Seven genotypes were recognized including the clonal Type II, Type III (2 genotypes), and 4 atypical genotypes. Ninety percent (103 of 115) of isolates were clonal, i.e., Type II (n  =  61) and Type III (n  =  42) strains. Of the 61 Type II strains, all had the Type II alleles at all loci, except for 2 strains that had allele I at Apico. Eight isolates were divided into 4 atypical genotypes. One of these genotypes (with 4 isolates) was previously reported in dogs from Sri Lanka and in sand cats from the United Arab Emirates. Four isolates had mixed infections. These results revealed a strong clonal population structure with the dominance of clonal Type II and III lineages of T. gondii in feral cats from Egypt.