1
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Fadel EF, EL-Hady HA, Ahmed AM, Tolba MEM. Molecular diagnosis of human toxoplasmosis: the state of the art. J Parasit Dis 2024; 48:201-216. [PMID: 38840888 PMCID: PMC11147977 DOI: 10.1007/s12639-024-01667-1] [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: 06/15/2023] [Accepted: 03/23/2024] [Indexed: 06/07/2024] Open
Abstract
Toxoplasma gondii (T. gondii) is an obligate intracellular apicomplexan protozoan that causes toxoplasmosis. Approximately one-third of the world's population is currently T. gondii-seropositive. Although most infections are symptomless, a few can produce retinal lesions and, in immunocompromised persons or when congenitally contracted, can progress to life-threatening central nervous system disseminated infections. Therefore, quick, and precise diagnosis is a must. Molecular techniques nowadays play a crucial role in toxoplasmosis diagnosis, particularly in immunocompromised patients or congenital toxoplasmosis. This review aimed to detail recent advancements in molecular diagnostics of T. gondii infections. The terms "Toxoplasmosis," "Molecular diagnostics," "PCR," "qPCR," "B1," and "rep529" were used to search the English-language literature. In developed nations, conventional PCR (PCR) and nested PCR have been supplanted by quantitative PCR (qPCR), although they are still widely employed in poor nations. The diagnosis of toxoplasmosis has been revolutionized by the emergence of molecular diagnostics. Unfortunately, there is still substantial interlaboratory variability. There is an immediate need for standardization to increase the comparability of results between laboratories and clinical trials. Graphical abstract A graphical abstract highlighting the summary of Toxoplasma molecular diagnostics, created using Biorender.com.
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Affiliation(s)
- Eman Fathi Fadel
- Department of Medical Parasitology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Hanaa Ahmed EL-Hady
- Department of Medical Parasitology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Amal Mostafa Ahmed
- Department of Medical Parasitology, Faculty of Medicine, Sohag University, Sohag, Egypt
| | - Mohammed Essa Marghany Tolba
- Department of Microbiology and Clinical Parasitology, Faculty of Medicine, King Khaled University, Abha, Saudi Arabia
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2
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Arkhis S, Rouges C, Dahane N, Guegan H, Yéra H, Robert-Gangneux F. Could PLATELIA Toxo IgM be the new gold standard for the serological diagnosis of congenital toxoplasmosis: a French multicenter study. J Clin Microbiol 2024; 62:e0122223. [PMID: 38259072 PMCID: PMC10865801 DOI: 10.1128/jcm.01222-23] [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: 09/18/2023] [Accepted: 12/05/2023] [Indexed: 01/24/2024] Open
Abstract
To assess the performance of PLATELIA Toxo IgM (Bio-Rad) and Toxo ISAGA (BioMérieux) to detect anti-Toxoplasma IgM in infants at risk of congenital toxoplasmosis, a retrospective multicenter study was conducted comparing serological results obtained in the framework of routine diagnosis work-up for congenital toxoplasmosis. All infants born to mothers infected with T. gondii during pregnancy from 2010 to 2020 with at least 6 months of serological follow-up were included (n = 1,010). One thousand ten cases were included, of which 250 infants (24.75%) had congenital toxoplasmosis. A total of 1039 sera were included. The concordance between the two techniques was 96%, with kappa coefficient of 0.87, showing an almost perfect agreement between ISAGA and PLATELIA. Cumulative sensitivity and specificity were 73.2% and 99.5.% and 74.8% and 100% for ISAGA and PLATELIA, respectively. The mean time to detect IgM using ISAGA and PLATELIA tests was 6.9 ± 20.1 days and 5.6 ± 14.7 days, respectively not significant (ns). Finally, the sensitivity of ISAGA and PLATELIA to detect IgM antibodies in infected neonates at 5 days of life was 62% and 64%, respectively. Performances of PLATELIA Toxo IgM assay were comparable to the gold standard ISAGA. This enzyme-linked immunosorbent assay is suitable for routine serology for the diagnosis of congenital toxoplasmosis in newborns. IMPORTANCE This study will help clinical microbiologists to chose an alternative serological method for the neonatal diagnosis of congenital toxoplasmosis, once the gold standard technique ISAGA will be withdrawn next year.
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Affiliation(s)
- Safya Arkhis
- Laboratory of Parasitology and Mycology, Centre Hospitalier Universitaire de Rennes, Rennes, France
| | - Celia Rouges
- Department of Parasitology and Mycology, Cochin University Hospital, AP-HP, Paris, France
| | - Naïma Dahane
- Department of Parasitology and Mycology, Cochin University Hospital, AP-HP, Paris, France
| | - Hélène Guegan
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé Environnement Travail), Rennes, France
| | - Hélène Yéra
- Department of Parasitology and Mycology, Cochin University Hospital, AP-HP, Paris, France
- Department of Parasitology and Mycology, Dupuytren University Hospital, Limoges, France
| | - Florence Robert-Gangneux
- Univ Rennes, CHU Rennes, Inserm, EHESP, Irset (Institut de Recherche en Santé Environnement Travail), Rennes, France
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3
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Fan F, Xue L, Yin X, Gupta N, Shen B. AP2XII-1 is a negative regulator of merogony and presexual commitment in Toxoplasma gondii. mBio 2023; 14:e0178523. [PMID: 37750704 PMCID: PMC10653792 DOI: 10.1128/mbio.01785-23] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 08/07/2023] [Indexed: 09/27/2023] Open
Abstract
IMPORTANCE Sexual development is vital for the transmission, genetic hybridization, and population evolution of apicomplexan pathogens, which include several clinically relevant parasites, such as Plasmodium, Eimeria, and Toxoplasma gondii. Previous studies have demonstrated different morphological characteristics and division patterns between asexual and sexual stages of the parasites. However, the primary regulation is poorly understood. A transition from the asexual to the sexual stage is supposedly triggered/accompanied by rewiring of gene expression and controlled by transcription factors and chromatin modulators. Herein, we discovered a tachyzoite-specific transcriptional factor AP2XII-1, which represses the presexual development in the asexual tachyzoite stage of T. gondii. Conditional knockdown of AP2XII-1 perturbs tachyzoite proliferation by endodyogeny and drives a transition to a morphologically and transcriptionally distinct merozoite stage. The results also suggest a hierarchical transcriptional regulation of sexual development by AP2 factors and provide a path to culturing merozoites and controlling inter-host transmission of T. gondii.
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Affiliation(s)
- Fuqiang Fan
- State Key Laboratory of Agricultural Microbiology, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, Hubei, China
| | - Lilan Xue
- State Key Laboratory of Agricultural Microbiology, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, Hubei, China
| | - Xiaoyan Yin
- State Key Laboratory of Agricultural Microbiology, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, Hubei, China
| | - Nishith Gupta
- State Key Laboratory of Agricultural Microbiology, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, Hubei, China
- Department of Molecular Parasitology, Institute of Biology, Humboldt University, Berlin, Germany
- Intracellular Parasite Education and Research Labs (iPEARL), Department of Biological Sciences, Birla Institute of Technology and Science, Pilani (BITS-P), Hyderabad, India
| | - Bang Shen
- State Key Laboratory of Agricultural Microbiology, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, Hubei, China
- Hubei Hongshan Laboratory, Wuhan, Hubei, China
- Shenzhen Institute of Nutrition and Health, Huazhong Agricultural University, Shenzhen, Guangdong, China
- Shenzhen Branch, Guangdong Laboratory for Lingnan Modern Agriculture, Genome Analysis Laboratory of the Ministry of Agriculture, Agricultural Genomics Institute at Shenzhen, Chinese Academy of Agricultural Sciences, Shenzhen, Guangdong, China
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4
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Rząd M, Kanecki K, Lewtak K, Goryński P, Tyszko P, Lewandowska-Andruszuk I, Nitsch-Osuch A. Congenital toxoplasmosis among hospitalized infants in Poland in the years 2007-2021: study based on the national hospital registry. Sci Rep 2023; 13:11060. [PMID: 37422492 PMCID: PMC10329637 DOI: 10.1038/s41598-023-38270-y] [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: 05/03/2023] [Accepted: 07/06/2023] [Indexed: 07/10/2023] Open
Abstract
Congenital toxoplasmosis (CT) is a rare entity and it may pose a life-threatening risk for the newborns. The aim of the study was to evaluate the incidence and other selected factors of CT in Poland. Our study is a population-based study on CT patients in 2007-2021. The study was based on 1504 hospitalization records of first-time diagnosis of CT in newborns. In the study group, we observed 763 males (50.7%) and 741 females (49.3%). The mean and median age was 31 days and 10 days, respectively. Based on the hospital registry, the mean annual CT incidence was estimated to be 2.6 per 10,000 live births (95% CI 2.0-3.2 per 10,000 live births). The incidence of CT cases fluctuated over the years 2007-2021, with the highest incidence in 2010 and the lowest one in 2014. There were no statistically significant differences between the incidence of CT in relation to sex or place of residence. The periodic fluctuations in the number of cases of congenital toxoplasmosis indicates the need to develop effective prevention programs to effectively counteract the disease and its consequences.
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Affiliation(s)
- Michał Rząd
- Department of Social Medicine and Public Health, Medical University of Warsaw, 3 Oczki Str., 02-007, Warsaw, Poland
- Doctoral School, Medical University of Warsaw, Warsaw, Poland
| | - Krzysztof Kanecki
- Department of Social Medicine and Public Health, Medical University of Warsaw, 3 Oczki Str., 02-007, Warsaw, Poland
| | - Katarzyna Lewtak
- Department of Social Medicine and Public Health, Medical University of Warsaw, 3 Oczki Str., 02-007, Warsaw, Poland.
| | - Paweł Goryński
- National Institute of Public Health NIH - National Research Institute, Warsaw, Poland
| | - Piotr Tyszko
- Department of Social Medicine and Public Health, Medical University of Warsaw, 3 Oczki Str., 02-007, Warsaw, Poland
- Institute of Rural Health in Lublin, Lublin, Poland
| | - Izabela Lewandowska-Andruszuk
- Department of Obstetrics, Gynaecology and Gynaecologic Oncology, Mazovian Specialist Hospital, Radom, Poland
- Faculty of Medical Sciences and Health Sciences, Kazimierz Pulaski University of Technology and Humanities, Radom, Poland
| | - Aneta Nitsch-Osuch
- Department of Social Medicine and Public Health, Medical University of Warsaw, 3 Oczki Str., 02-007, Warsaw, Poland
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5
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Ikuta K, Kanno R, Bessho T, Koshizuka T, Suzutani T. Evaluation of Toxoplasma gondii IgG avidity assays through a comparison of IgM serostatus. Diagn Microbiol Infect Dis 2023; 105:115901. [PMID: 36889215 DOI: 10.1016/j.diagmicrobio.2023.115901] [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: 07/22/2022] [Revised: 12/23/2022] [Accepted: 01/13/2023] [Indexed: 01/20/2023]
Abstract
Primary Toxoplasma gondii (T. gondii) infection during pregnancy could result in congenital disease with severe clinical complications. IgM antibodies are one of the indices of primary infection. The IgG avidity index (AI) is also known to remain low for at least 3 months after primary infection. Here, we evaluated and compared the performance of T. gondii IgG avidity assays as confirmed by T. gondii IgM serostatus and number of days post-exposure. Four assays preferentially used in Japan were employed to measure the T. gondii IgG AI. Results for the T. gondii IgG AI showed good concordance, particularly in cases with a low IgG AI. This study confirms that the combination of T. gondii IgM and IgG AI tests is a reliable and suitable method for identifying T. gondii primary infections. Our study proposes the necessity of measuring the T. gondii IgG AI as an additional indicator of T. gondii primary infection.
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Affiliation(s)
- Kazufumi Ikuta
- Department of Microbiology, Fukushima Medical University School of Medicine, Fukushima , Japan; Division of Microbiology, Tohoku Medical and Pharmaceutical University School of Medicine, Miyagi, Japan
| | - Ryoko Kanno
- Department of Microbiology, Fukushima Medical University School of Medicine, Fukushima , Japan
| | - Tomoaki Bessho
- Department of Vaccine and Diagnostics, Life Innovation Center, Denka Co., Ltd, Niigata, Japan
| | - Tetsuo Koshizuka
- Department of Microbiology, Fukushima Medical University School of Medicine, Fukushima , Japan; Laboratory of Microbiology and Immunology, Gifu Pharmaceutical University, Gifu, Japan
| | - Tatsuo Suzutani
- Department of Microbiology, Fukushima Medical University School of Medicine, Fukushima , Japan.
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6
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Kamus L, Belec S, Lambrecht L, Abasse S, Olivier S, Combe P, Bonnave PE, Vauloup-Fellous C. Maternal and congenital toxoplasmosis in Mayotte: Prevalence, incidence and management. PLoS Negl Trop Dis 2023; 17:e0011198. [PMID: 36940228 PMCID: PMC10063165 DOI: 10.1371/journal.pntd.0011198] [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: 09/15/2022] [Revised: 03/30/2023] [Accepted: 02/27/2023] [Indexed: 03/21/2023] Open
Abstract
BACKGROUND Toxoplasmosis is an infection caused by an intracellular protozoan, Toxoplasma gondii. It is usually asymptomatic, but toxoplasmosis acquired during pregnancy can cause congenital toxoplasmosis, potentially resulting in fetal damage. Epidemiological information is lacking for toxoplasmosis in Mayotte (a French overseas territory). We evaluated (1) the prevalence of maternal toxoplasmosis, (2) the incidence of maternal and congenital toxoplasmosis, and (3) the management of congenital toxoplasmosis in Mayotte. METHODOLOGY / PRINCIPAL FINDINGS We collected all the available data for toxoplasmosis serological screening during pregnancy and maternal and congenital cases of toxoplasmosis obtained between January 2017 and August 2019 at the central public laboratory of Mayotte (Mamoudzou). Using toxoplasmosis serological data from samples collected from 16,952 pregnant women we estimated the prevalence of toxoplasmosis in Mayotte at 67.19%. Minimum maternal toxoplasmosis incidence was estimated at 0.29% (49/16,952, 95% CI (0.0022-0.0038)), based on confirmed cases of maternal primary infection only. The estimated incidence of congenital toxoplasmosis was 0.09% (16/16,952, 95% CI (0.0005-0.0015). Missing data made it difficult to evaluate management, but follow-up was better for mothers with confirmed primary infection and their infants. CONCLUSIONS / SIGNIFICANCE The seroprevalence of toxoplasmosis among pregnant women and the incidence of toxoplasmosis are higher in Mayotte than in mainland France. There is a need to improve the antenatal toxoplasmosis screening and prevention programme, providing better information to physicians and the population, to improve management and epidemiological monitoring.
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Affiliation(s)
- Laure Kamus
- Department of Medical Biology, Félix-Guyon Hospital Center, Saint-Denis, La Réunion, France
- UMR Processus Infectieux en Milieu Insulaire Tropical (PIMIT), CNRS 9192, INSERM U1187, IRD 249, Université de La Réunion, Saint-Denis, La Réunion, France
- * E-mail:
| | - Sophie Belec
- Department of Obstetrics and Gynaecology, Mayotte Hospital Center, Mayotte, France
| | | | - Soumeth Abasse
- Paediatric Centre, Mayotte Hospital Centre, Mayotte, France
| | - Sophie Olivier
- Department of Medical Biology, Mayotte Hospital Centre, Mayotte, France
| | - Patrice Combe
- Department of Medical Biology, Mayotte Hospital Centre, Mayotte, France
| | | | - Christelle Vauloup-Fellous
- Universite Paris Saclay, INSERM U1193, AP-HP, Hôpital Paul Brousse, Virology Department, Villejuif, France
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7
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Damar Çakırca T, Can İN, Deniz M, Torun A, Akçabay Ç, Güzelçiçek A. Toxoplasmosis: A Timeless Challenge for Pregnancy. Trop Med Infect Dis 2023; 8:tropicalmed8010063. [PMID: 36668970 PMCID: PMC9867407 DOI: 10.3390/tropicalmed8010063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/08/2023] [Accepted: 01/10/2023] [Indexed: 01/18/2023] Open
Abstract
This study aimed to evaluate the prevalence of toxoplasmosis in pregnant women, as well as the general characteristics, clinical and laboratory findings, and pregnancy and fetal outcomes of pregnant women diagnosed with acute toxoplasma infection (ATI). The toxoplasma IgM, IgG, and IgG avidity test results of pregnant women who applied to our referral hospital between January 2016 and June 2022, and among them, those diagnosed with ATI, were analyzed. The 119 patients diagnosed with ATI during this time period were included for further analysis. The prevalence of toxoplasmosis in pregnant women was found to be 46.2%, and the rate of ATI was 4%. The total mother-to-child transmission rate was 5% (5/101). Congenital toxoplasmosis (CT) was observed in 1 (1.1%) child of the 87 pregnant women who received spiramycin prophylaxis, though it was found in 4 (30.8%) of the children of the 13 untreated mothers. With respect to prenatal treatment, CT rates were significantly higher in the children born to untreated mothers (p = 0.001). In conclusion, although toxoplasma seroprevalence was found to be high in our region, there was a paucity in diagnosis, follow-up, and treatment. Our findings support that prenatal spiramycin prophylaxis is effective in preventing the transmission of parasites from mother to child.
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Affiliation(s)
- Tuba Damar Çakırca
- Department of Infectious Diseases and Clinical Microbiology, Sanliurfa Training and Research Hospital, Sanliurfa 63250, Turkey
- Correspondence:
| | - İlkay Nur Can
- Department of Infectious Diseases and Clinical Microbiology, Sanliurfa Training and Research Hospital, Sanliurfa 63250, Turkey
| | - Melis Deniz
- Department of Pediatric Infectious Diseases, Sanliurfa Training and Research Hospital, Sanliurfa 63250, Turkey
| | - Ayşe Torun
- Department of Infectious Diseases and Clinical Microbiology, Sanliurfa Training and Research Hospital, Sanliurfa 63250, Turkey
| | - Çiğdem Akçabay
- Department of Obstetrics and Gynecology, Division of Maternal Fetal Medicine, Sanliurfa Training and Research Hospital, Sanliurfa 63250, Turkey
| | - Ahmet Güzelçiçek
- Department of Pediatrics, Harran University Faculty of Medicine, Sanliurfa 63290, Turkey
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8
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Sawers L, Wallon M, Mandelbrot L, Villena I, Stillwaggon E, Kieffer F. Prevention of congenital toxoplasmosis in France using prenatal screening: A decision-analytic economic model. PLoS One 2022; 17:e0273781. [PMID: 36331943 PMCID: PMC9635746 DOI: 10.1371/journal.pone.0273781] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 08/15/2022] [Indexed: 11/06/2022] Open
Abstract
Background Toxoplasma gondii is one of the world’s most common parasites. Primary infection of the mother during pregnancy can lead to transmission to the fetus with risks of brain and eye lesions, which may cause lifelong disabilities. France instituted a national program based on monthly retesting of susceptible pregnant women to reduce the number of severe cases through prompt antenatal and postnatal treatment and follow-up. Objective To evaluate the ability of the French prenatal retesting program to reduce the lifetime costs of congenital toxoplasmosis. Methods We measured and then compared the costs and benefits of screening vs. not screening using decision-tree modelling. It included direct and indirect costs to society of treatment and care, and the lifetime lost earnings of children and caregivers. A probabilistic sensitivity analysis was carried out. Findings Total lifetime costs per live born child identified as congenitally infected were estimated to be €444 for those identified through prenatal screening vs €656 for those who were not screened. Estimates were robust to changes in all costs of diagnosis, treatment, and sequelae. Interpretation Screening for the prevention of the congenital T. gondii infection in France is cost saving at €212 per birth. Compared with no screening, screening every pregnant woman in France for toxoplasmosis in 2020 would have saved the country €148 million in addition to reducing or eliminating the devastating physical and emotional suffering caused by T. gondii. Our findings reinforce the conclusions of other decision-analytic modelling of prenatal toxoplasmosis screening.
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Affiliation(s)
- Larry Sawers
- Department of Economics, American University, Washington, D.C., United States of America
| | - Martine Wallon
- Department of Parasitology and Medical Mycology, Hospices Civils de Lyon, Lyon, France
- Walking Team, Centre for Research in Neuroscience, Lyon, Bron, France
| | - Laurent Mandelbrot
- Obstetrics and Gynecology Department, Hôpital Louis Mourier, Assistance Publique-Hôpitaux de Paris, Colombes, France
- Université de Paris, Paris, France
- INSERM, IAME, UMR 1137, Paris, France
| | - Isabelle Villena
- Department of Parasitology and Medical Mycology, National Reference Centre on Toxoplasmosis, Hôpital Reims, Reims, France
- Team EA 7510, SFR CAP-SANTE, University of Reims Champagne Ardenne, Reims, France
| | - Eileen Stillwaggon
- National School of Tropical Medicine, Baylor College of Medicine, Houston, Texas, United States of America
| | - François Kieffer
- Department of Neonatology, Hôpital Armand Trousseau, Assistance Publique-Hôpitaux de Paris, Paris, France
- * E-mail:
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9
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Skvarč M. Diagnostic accuracy of adjusted low IgG avidity index to predict acute Toxoplasma gondii infection in the first trimester of pregnancy. Folia Parasitol (Praha) 2022; 69. [DOI: 10.14411/fp.2022.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 04/01/2022] [Indexed: 11/19/2022]
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10
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Zhang J, Fan F, Zhang L, Shen B. Nuclear Factor AP2X-4 Governs the Expression of Cell Cycle- and Life Stage-Regulated Genes and is Critical for Toxoplasma Growth. Microbiol Spectr 2022; 10:e0012022. [PMID: 35735977 PMCID: PMC9430314 DOI: 10.1128/spectrum.00120-22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 06/06/2022] [Indexed: 11/21/2022] Open
Abstract
Toxoplasma gondii is a ubiquitous pathogen infecting one third of the world's population and diverse animals. It has a complex life cycle alternating among different developmental stages, which contributes to its transmission and pathogenesis. The parasite has a sophisticated gene regulation network that enables timely expression of genes at designated stages. However, little is known about the underlying regulatory mechanisms. Here, we identified an AP2 family transcription factor named TgAP2X-4, which was crucial for parasite growth during the acute infection stage. TgAP2X-4 deletion leads to reduced expression of many genes that are normally upregulated during the M phase of the cell cycle. These include genes that encode rhoptry neck proteins that are key for parasite invasion. As a result, the Δap2X-4 mutant displayed significantly decreased efficiency of host cell invasion. Transcriptomic analyses suggested that TgAP2X-4 also regulates a large group of genes that are typically induced during chronic infection, such as BAG1 and LDH2. Given the diverse impacts on gene expression, TgAP2X-4 inactivation results in severely impaired parasite growth, as well as drastic attenuation of parasite virulence and complete inability to form chronic infection. Therefore, TgAP2X-4 represents a candidate for antitoxoplasmic drug and vaccine designs. IMPORTANCE Toxoplasma gondii has a complicated gene regulation network that allows "just in time" expression of genes to cope with the physiological needs at each stage during the complex life cycle. However, how such regulation is achieved is largely unknown. Here, we identified a transcription factor named TgAP2X-4 that is critical for the growth and life cycle progression of the parasite. Detailed analyses found that TgAP2X-4 regulated the expression of many cell cycle-regulated genes, including a subset of rhoptry genes that were essential for the parasites to enter host cells. It also regulated the expression of many genes involved in the development of chronic infection. Because of the diverse impacts on gene expression, TgAP2X-4 inactivation caused reduced parasite growth in vitro and attenuated virulence in vivo. Therefore, it is a potential target for drug or vaccine designs against Toxoplasma infections.
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Affiliation(s)
- Jingwen Zhang
- State Key Laboratory of Agricultural Microbiology, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, Hubei Province, People’s Republic of China
| | - Fuqiang Fan
- State Key Laboratory of Agricultural Microbiology, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, Hubei Province, People’s Republic of China
| | - Lihong Zhang
- State Key Laboratory of Agricultural Microbiology, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, Hubei Province, People’s Republic of China
| | - Bang Shen
- State Key Laboratory of Agricultural Microbiology, College of Veterinary Medicine, Huazhong Agricultural University, Wuhan, Hubei Province, People’s Republic of China
- Key Laboratory of Preventive Medicine in Hubei Province, Wuhan, Hubei Province, People’s Republic of China
- Hubei Hongshan Laboratory, Wuhan, Hubei Province, People’s Republic of China
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11
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Diagnosis of Congenital Toxoplasmosis: Performance of Four IgG and IgM Automated Assays at Birth in a Tricentric Evaluation. J Clin Microbiol 2022; 60:e0011522. [DOI: 10.1128/jcm.00115-22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
For postnatal diagnosis of congenital toxoplasmosis (CT), the gold standard for the detection of anti-
Toxoplasma
IgM in newborns relies on the immunosorbent agglutination assay (ISAGA), which is manufactured from whole
Toxoplasma
parasites that become difficult to maintain. For IgG, only the Platelia assay provides a validated assay for cord blood according to the manufacturer, allowing its use in this context.
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12
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Neß T, Winterhalter S, Stübiger N. Infectious Posterior Uveitis - Toxoplasmosis, Treponema, Tuberculosis (TTT). Klin Monbl Augenheilkd 2022; 239:666-675. [PMID: 35320874 DOI: 10.1055/a-1727-1951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Toxoplasma gondii, Treponema pallidum and Mycobacterium tuberculosis are the most important infectious causes of posterior uveitis. The epidemiology, clinical picture, diagnostic and treatment strategies of these diseases are presented.
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Affiliation(s)
- Thomas Neß
- Klinik für Augenheilkunde, Universitätsklinikum Freiburg, Albert-Ludwigs-Universität Freiburg, Deutschland.,Medizinische Fakultät, Albert-Ludwigs-Universität Freiburg, Deutschland
| | | | - Nicole Stübiger
- Klinik und Poliklinik für Augenheilkunde, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
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13
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Epidemiology of Toxoplasmosis in SERBIA: A Cross-Sectional Study on Blood Donors. Microorganisms 2022; 10:microorganisms10030492. [PMID: 35336068 PMCID: PMC8948843 DOI: 10.3390/microorganisms10030492] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 01/18/2022] [Accepted: 01/19/2022] [Indexed: 02/04/2023] Open
Abstract
Toxoplasmosis is a globally distributed parasitic zoonosis, affecting approximately one third of the human population. Epidemiological studies on toxoplasmosis conducted in Serbia so far have been focused on women of childbearing age, without a clear insight into the prevalence in the general population. We conducted a cross-sectional study in a representative sample of the healthy adult population consisting of 1095 blood donors of both genders to establish the prevalence and risk factors for Toxoplasma gondii infection. Data on the demographic and clinical characteristics of all study participants, as well as on their lifestyle habits, were collected by means of a questionnaire. The overall prevalence of infection was 20.5% (224/1095) and the avidity of the specific IgG antibodies detected was high in a vast majority of the seropositive donors (98.2%). Interestingly, the remaining 1.8% of the specific IgG positive samples were of borderline avidity (4/224), in complete absence of specific IgM. The multivariate logistic regression analysis showed that independent risk factors included age (from OR (95% CI) 1.9 (1.13−3.28) in the 30−39 age group, to 6.8 (3.27−14.24) in the age group of >60 years), suburban living (OR (95% CI) 2.2 (1.43−3.34)) and contact with soil (OR (95% CI) 1.4 (1.01−1.94)). This first large-scale study on toxoplasmosis in the general population in Serbia shows the lowest prevalence ever reported in this country. Moreover, the novel perspective on risk factors provides an updated basis for future prevention programs.
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Montoya JG, Laessig K, Fazeli MS, Siliman G, Yoon SS, Drake-Shanahan E, Zhu C, Akbary A, McLeod R. A fresh look at the role of spiramycin in preventing a neglected disease: meta-analyses of observational studies. Eur J Med Res 2021; 26:143. [PMID: 34895348 PMCID: PMC8665510 DOI: 10.1186/s40001-021-00606-7] [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: 12/21/2020] [Accepted: 11/14/2021] [Indexed: 12/18/2022] Open
Abstract
PURPOSE We aimed to investigate the effect of antepartum treatment with spiramycin with or without subsequent pyrimethamine-sulfonamide-folinic acid, compared to no treatment, on the rate of mother-to-child transmission (MTCT) of Toxoplasma gondii (T. gondii) and incidence/severity of sequelae in the offspring. METHODS Embase and PubMed were searched for literature on spiramycin in pregnant women suspected/diagnosed with T. gondii infection. Meta-analyses were performed using random-effects model. RESULTS Thirty-three studies (32 cohorts and 1 cross-sectional study), with a total of 15,406 mothers and 15,250 offspring, were pooled for analyses. The MTCT rate for all treated patients was significantly lower than the untreated [19.5% (95% CI 14-25.5%) versus 50.7% (95% CI 31.2-70%), p < 0.001]. The transmission rate in patients on spiramycin monotherapy was also significantly lower than untreated [17.6% (95% CI 9.9-26.8%) versus 50.7% (95% CI 31.2-70%), p < 0.001]. CONCLUSION Results indicate significant reduction in MTCT rates following spiramycin treatment of suspected/diagnosed maternal T. gondii infection.
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Affiliation(s)
- Jose G Montoya
- Jack S. Remington Laboratory for Specialty Diagnostics, Palo Alto, CA, USA
| | | | | | | | | | | | - Chengyue Zhu
- Department of General Medicines, Sanofi S.A, Bridgewater, NJ, USA
| | - Akbar Akbary
- Department of General Medicines, Sanofi S.A, Bridgewater, NJ, USA
| | - Rima McLeod
- Division of Biologic Sciences, Departments of Pediatrics (Infectious Diseases) and Ophthalmology and Visual Sciences, University of Chicago, Chicago, IL, USA.
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15
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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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16
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Robert MG, Brenier-Pinchart MP, Garnaud C, Fricker-Hidalgo H, Pelloux H. Molecular diagnosis of toxoplasmosis: recent advances and a look to the future. Expert Rev Anti Infect Ther 2021; 19:1529-1542. [PMID: 34112045 DOI: 10.1080/14787210.2021.1941867] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Toxoplasmosis is a globally distributed parasitic infection that can be particularly severe when opportunistic or congenital. Its diagnosis requires accurate and rapid techniques that rely mainly on serology and molecular methods. AREAS COVERED The aim of this review was to discuss the positioning of the molecular diagnosis of toxoplasmosis according to the different clinical situations possibly resulting from infection with T. gondii, and to detail recent developments in this technique. The English and French literature were searched with the following keywords: 'Toxoplasmosis', "Molecular diagnosis" and 'PCR'. EXPERT OPINION Molecular techniques have revolutionized the diagnosis of toxoplasmosis, and practices have considerably evolved over the past decades. However, there is still a high degree of inter-laboratory heterogeneity which impairs comparisons between results and studies. Efforts to standardize practices are underway.
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Affiliation(s)
- Marie Gladys Robert
- Service de Parasitologie-Mycologie, CHU Grenoble Alpes, Grenoble, France.,Université Grenoble Alpes, Institut pour l'Avancée des Biosciences (IAB), Grenoble, France
| | - Marie-Pierre Brenier-Pinchart
- Service de Parasitologie-Mycologie, CHU Grenoble Alpes, Grenoble, France.,Université Grenoble Alpes, Institut pour l'Avancée des Biosciences (IAB), Grenoble, France.,Centre National de Référence Toxoplasmose - Pôle Biologie Moléculaire, France
| | - Cécile Garnaud
- Service de Parasitologie-Mycologie, CHU Grenoble Alpes, Grenoble, France.,Université Grenoble Alpes, CNRS, CHU Grenoble Alpes, Grenoble INP, TIMC-IMAG, Grenoble, France
| | | | - Hervé Pelloux
- Service de Parasitologie-Mycologie, CHU Grenoble Alpes, Grenoble, France.,Université Grenoble Alpes, Institut pour l'Avancée des Biosciences (IAB), Grenoble, France.,Centre National de Référence Toxoplasmose - Pôle Biologie Moléculaire, France
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17
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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: 11] [Impact Index Per Article: 3.7] [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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18
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Taherimoghaddam M, Bahmanzadeh M, Maghsood AH, Fallah M, Tapak L, Foroughi-Parvar F. Toxoplasma gondii induced sperm DNA damage on the experimentally infected rats. J Parasit Dis 2021; 45:351-358. [PMID: 34295033 PMCID: PMC8254694 DOI: 10.1007/s12639-020-01305-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 10/29/2020] [Indexed: 10/23/2022] Open
Abstract
Toxoplasma gondii, as an obligate protozoan parasite, can infect a wide variety of animals as well as human. As some studies have shown, toxoplasmosis decreases the fertility potency in different hosts, so there is a necessity for studies to determine the effects of T. gondii on reproductive system. Therefore, this project was aimed to investigate the effect of toxoplasmosis on the male reproductive system and sperm DNA integrity. In this experimental study, 80 Wistar male rats were divided into two groups as follows: infected group (inoculated by T.gondii tachyzoites) and control group [injected by Phosphate-buffered saline (PBS)]. Afterward, data were collected in every 10 days interval. The detailed description of the sperm parameters were recorded, and then, chromatin integrity of the epididymal sperm was analyzed using Aniline blue (AB), Acridine orange (AO), Chromomycin A3 (CMA3), and Toluidine blue (TB) staining. Sperm parameters (motility, viability, count, and normal sperm) significantly decreased in the infected rats. Sperm stained by AO staining showed a higher percentage in the infected rats compared to the control group on day 70 (P = 0.03). The mean percentages of AB stained sperm on days 30 (P = 0.01) and 50 (P = 0.02) were higher than the healthy group. Also, the significant rising of the stained sperm was observed in the infected group on day 20 (P = 0.01). Sperm stained with TB in the infected group has significantly increased on days 30 to 60 [day 30 (P = 0.001), 40 (P < 0.001), 50 (P = 0.014), and 60 (P = 0.001)]. T. gondii infection leads to the diminished fertility parameters as well as the damaged DNA sperm. The parasite could temporarily interfere with the male reproductive system.
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Affiliation(s)
- Monir Taherimoghaddam
- Department of Parasitology and Mycology, School of Medicine, Hamadan University of Medical Sciences, P.O. Box: 65157838736, Hamadan, Iran
| | - Maryam Bahmanzadeh
- Endometrium and Endometriosis Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
- Department of Anatomical Sciences, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Amir Hossein Maghsood
- Department of Parasitology and Mycology, School of Medicine, Hamadan University of Medical Sciences, P.O. Box: 65157838736, Hamadan, Iran
| | - Mohammad Fallah
- Department of Parasitology and Mycology, School of Medicine, Hamadan University of Medical Sciences, P.O. Box: 65157838736, Hamadan, Iran
| | - Leili Tapak
- Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
- Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Faeze Foroughi-Parvar
- Department of Parasitology and Mycology, School of Medicine, Hamadan University of Medical Sciences, P.O. Box: 65157838736, Hamadan, Iran
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19
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Robinson E, de Valk H, Villena I, Le Strat Y, Tourdjman M. National perinatal survey demonstrates a decreasing seroprevalence of Toxoplasma gondii infection among pregnant women in France, 1995 to 2016: impact for screening policy. ACTA ACUST UNITED AC 2021; 26. [PMID: 33541484 PMCID: PMC7863230 DOI: 10.2807/1560-7917.es.2021.26.5.1900710] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Background Toxoplasmosis during pregnancy can result in congenital anomalies or fetal death. Universal antenatal screening is recommended in France, a strategy in place since the 1970s. Aim We determined the seroprevalence of toxoplasmosis among pregnant women participating in the 2016 national perinatal survey (ENP), compared results with previous ENPs, and investigated factors associated with Toxoplasma gondii infection. Methods Using the 2016 ENP data, which contain sociodemographic and clinical information from all women giving birth during a one week period, we calculated adjusted prevalence ratios (aPR) by sociodemographic factors. Using available data from prior ENPs (1995, 2003 and 2010), we calculated age-standardised seroprevalences and aPRs for French women. Results In 2016, seroprevalence was 31.3% overall. Among French women, associations with increasing age (aPR: 1.54; 95% CI: 1.39–1.70), residence in Paris (aPR: 1.19; 95% CI: 1.08–1.31) or south-western regions (aPR: 1.19; 95% CI: 1.08–1.31), and higher professional status (aPR: 1.12; 95%CI 1.04–1.21) were observed. An association with increasing age was also evident among women from North Africa and sub-Saharan Africa. Age-standardised seroprevalence decreased from 55.0% in 1995 to 33.7% in 2016. Among French women, significant associations with age, Paris and south-west regions persisted across all ENPs. Conclusion Higher prevalences in older women may reflect a higher past risk of exposure while persistent geographical differences may reflect dietary or environmental differences. Toxoplasma seroprevalence among pregnant women continues to fall and will impact screening effectiveness. This warrants a comprehensive review to determine the appropriate future of prevention in France.
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Affiliation(s)
- Eve Robinson
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden.,French National Public Health Agency (Santé publique France), Saint-Maurice, France
| | - Henriette de Valk
- French National Public Health Agency (Santé publique France), Saint-Maurice, France
| | - Isabelle Villena
- National Reference Centre for Toxoplasmosis, Maison Blanche Hospital, University Reims Champagne-Ardenne, France
| | - Yann Le Strat
- French National Public Health Agency (Santé publique France), Saint-Maurice, France
| | - Mathieu Tourdjman
- French National Public Health Agency (Santé publique France), Saint-Maurice, France
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20
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El-Sayad MH, Salem AI, Fazary H, Alzainny HN, Abd El-Latif NF. Detection of toxoplasmosis in aborted women in Alexandria, Egypt using ELISA and PCR. J Parasit Dis 2021; 45:539-545. [PMID: 34295052 DOI: 10.1007/s12639-020-01327-0] [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: 08/20/2020] [Accepted: 11/21/2020] [Indexed: 10/22/2022] Open
Abstract
Toxoplasmosis is a worldwide infection that can be acquired through the ingestion of tissue cysts in poorly cooked meat, and/or oblivious intake of sporulated oocysts in cat faeces, and transplacental. The infection in pregnant women is mainly asymptomatic. It produces abortion or congenital infection. The present study aimed to test the utility of polymerase chain reaction (PCR) on placental tissues in comparison to enzyme-linked immunosorbent assay (ELISA) to detect infections with Toxoplasma gondii in aborted women presented to Al-Shatby Maternity Hospital, Alexandria University, Egypt. Specific Toxoplasma gondii IgG and IgM were detected in serum by ELISA. Placental tissues from each participant were subjected to DNA extraction and PCR amplification. It was found that overall seroprevalence was 73%, DNA was detected in placenta tissues by using PCR analysis in 46% of cases. {× 2 (p) 18.124(< 0.001)}. Toxoplasma IgG/IgM by ELISA was positive in 23% of the cases, 20% showed amplified DNA by PCR. Positive IgG without IgM was seen in 27% cases, only 2% of them were positive by PCR. Moreover, positive PCR among positive ELISA IgM aborted women was 21 of the 23 cases. Positive PCR was obtained in three seronegative women. Our results showed that PCR sensitivity was 58.90 specificity 88.89, positive predictive value was 93.48%, and negative predictive value 44.44%. Although ELISA assay is still the gold standard of diagnosis of Toxoplasmosis, other diagnostic modalities are highly required particularly in those ELISA seronegative cases. PCR can be used as a sensitive and precise modality.
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Affiliation(s)
- Mona Hassan El-Sayad
- Department of Parasitology, Medical Research Institute, Alexandria University, 165, Horreya Avenue, Hadara, Alexandria, Egypt
| | - Aziza Ibrahim Salem
- Department of Parasitology, Medical Research Institute, Alexandria University, 165, Horreya Avenue, Hadara, Alexandria, Egypt
| | - Hisham Fazary
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Haneen Nawaf Alzainny
- Department of Parasitology, Medical Research Institute, Alexandria University, 165, Horreya Avenue, Hadara, Alexandria, Egypt
| | - Naglaa Fathi Abd El-Latif
- Department of Parasitology, Medical Research Institute, Alexandria University, 165, Horreya Avenue, Hadara, Alexandria, Egypt
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21
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S Al-Malki E. Toxoplasmosis: stages of the protozoan life cycle and risk assessment in humans and animals for an enhanced awareness and an improved socio-economic status. Saudi J Biol Sci 2021; 28:962-969. [PMID: 33424388 PMCID: PMC7783816 DOI: 10.1016/j.sjbs.2020.11.007] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 10/29/2020] [Accepted: 11/01/2020] [Indexed: 12/14/2022] Open
Abstract
Toxoplasma gondii is a protozoan parasite distributed globally. It causes toxoplasmosis, which is prevalent in animals, birds, and soil. T. gondii infection leads to severe pathological impacts in immunodeficient patients and congenital cases. This review indicated that high prevalence groups had close contact with cats, dogs, consumed uncooked raw fruits, meat, or vegetables and the socio-economic level noted to be one of the crucial factors that influence toxoplasmosis. Toxoplasmosis infection is high in low-income countries and low in developed European countries. Immunosuppressed groups and pregnant women were the highly vulnerable groups. The epidemiology of the parasite enumerated various routes of infections; but consumption of T. gondii contaminated food was the major route of disease transmission. However, the role of meat and meat-producing animals on disease transmission remained unclear. Unfiltered water acts as the primary reservoir of toxoplasmosis transmission. The diagnostic methods for determining T. gondii infection are not the gold standard, and different approaches have been prescribed to analyze the infected populations based on the organs affected. Although toxoplasmosis was reported before 70 years, no appropriate solution noted to be recommended to treat this disease. Based on the present analyses, it concluded that the eradication of toxoplasmosis would be challenging from the world until people's socio-economic level is improved. The main aim of the present study was to analyze and update the disease transmission, epidemiology, and possible clinical interventions of toxoplasmosis.
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Affiliation(s)
- Esam S Al-Malki
- Department of Biology, College of Science in Zulfi, Majmaah University, Majmaah 11952, Saudi Arabia
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22
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Contribution of Foods and Poor Food-Handling Practices to the Burden of Foodborne Infectious Diseases in France. Foods 2020; 9:foods9111644. [PMID: 33187291 PMCID: PMC7697675 DOI: 10.3390/foods9111644] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/03/2020] [Accepted: 11/06/2020] [Indexed: 01/25/2023] Open
Abstract
The foodborne disease burden (FBDB) related to 26 major biological hazards in France was attributed to foods and poor food-handling practices at the final food preparation step, in order to develop effective intervention strategies, especially food safety campaigns. Campylobacter spp. and non-typhoidal Salmonella accounted for more than 60% of the FBDB. Approximately 30% of the FBDB were attributed to 11 other hazards including bacteria, viruses and parasites. Meats were estimated as the main contributing food category causing (50-69%) (CI90) of the FBDB with (33-44%), (9-21%), (4-20%) (CI90) of the FBDB for poultry, pork and beef, respectively. Dairy products, eggs, raw produce and complex foods caused each approximately (5-20%) (CI90) of the FBDB. When foods are contaminated before the final preparation step, we estimated that inadequate cooking, cross-contamination and inadequate storage contribute for (19-49%), (7-34%) and (9-23%) (CI90) of the FBDB, respectively; (15-33%) (CI90) of the FBDB were attributed to the initial contamination of ready-to-eat foods-without any contribution from final food handlers. The thorough implementation of good hygienic practices (GHPs) at the final food preparation step could potentially reduce the FBDB by (67-85%) (CI90) (mainly with the prevention of cross-contamination and adequate cooking and storage).
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Saki J, Sabaghan M, Arjmand R, Teimoori A, Rashno M, Saki G, Shojaee S. Spermatogonia apoptosis induction as a possible mechanism of Toxoplasma gondii-induced male infertility. IRANIAN JOURNAL OF BASIC MEDICAL SCIENCES 2020; 23:1164-1171. [PMID: 32963738 PMCID: PMC7491504 DOI: 10.22038/ijbms.2020.43535.10224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Objective(s): The protozoan Toxoplasma gondii as an intracellular protozoan is widely prevalent in humans and animals. Infection generally occurs through consuming food contaminated with oocysts and tissue cysts from undercooked meat. The parasite is carried in sexual fluids like semen but there is little information about the effect of T. gondii on the male reproductive system. In this study, we examined the effect of T. gondii tachyzoites on apoptosis induction in type B spermatogonia (GC-1) cells. Materials and Methods: Fresh tachyzoites taken of infected BALB/c mice, GC-1 spg cells were infected with increasing concentrations of tachyzoites of T. gondii, then apoptotic cells were identified and quantified by flow cytometry. The genes associated with apoptosis were evaluated by RT2 Profiler PCR Array. Results: PCR array analysis of 84 apoptosis-related genes demonstrated that 12 genes were up-regulated at least 4-fold and that one gene was down-regulated at least 2-fold in the T. gondii infection group compared with levels in the control group. The number of genes whose expression had increased during the period of infection with T. gondii was significantly higher than those whose expressions had decreased (18 versus 1) and Tnfrsf11b had the highest rate of gene expression. Conclusion: T. gondii induce in vitro apoptosis of GC-1 spg cells. This effect shows a trend of concentration-dependent increase so that with an increase in the ratio of parasite burden to spermatogonial cells, in addition to an increase in the number of genes whose expression has changed, the fold of these changes has increased as well.
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Affiliation(s)
- Jasem Saki
- Cellular and Molecular Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohamad Sabaghan
- Department of Parasitology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Reza Arjmand
- Department of Parasitology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ali Teimoori
- Virology Department, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mohammad Rashno
- Department of Immunology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Ghasem Saki
- Cellular and Molecular Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Physiology Research Center, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Saeedeh Shojaee
- Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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24
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Motoi S, Navolan DB, Malita D, Ciohat I, Nemescu D, Manciuc C, Gorun F, Vilibic-Cavlek T, Boda D, Craina M, Dobrescu A. A decreasing trend in toxoplasma gondii seroprevalence among pregnant women in Romania - results of a large scale study. Exp Ther Med 2020; 20:3536-3540. [PMID: 32905270 PMCID: PMC7465070 DOI: 10.3892/etm.2020.9012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 07/10/2020] [Indexed: 12/13/2022] Open
Abstract
Toxoplasmosis is a zoonotic infection caused by the obligate intracellular apicomplexan parasite Toxoplasma gondii (T. gondii). T. gondii infection is a cause of congenital infection worldwide. Primary infection or the reactivation of latent infection during pregnancy may lead to fetal infection and to congenital toxoplasmosis syndrome. Seropositive pregnant women are generally protected from maternal-fetal transmission of T. gondii, although exceptions exist. The aim of our study was to analyze the dynamics of T. gondii seroprevalence during a 10-year period and to correlate it with age and demographic features of pregnant women. We tested 6,889 pregnant women in Timisoara, Romania, for IgG-anti-T. gondii antibodies, in two successive periods: i) 2008-2010 (group 1: 1,457 participants); and ii) 2015-2018 (group 2: 5,432 participants). For each participant, data on age and area of residence were collected. Our results showed that in the Western Region of Romania T. gondii seroprevalence in pregnant women declined from 43.79 to 38.81% in the last ten years. This trend was observed in both urban (40.53 vs. 34.85%) and rural areas (52.22 vs. 46.22%). A higher seroprevalence rate was found in rural than in urban areas. In addition, we found an increasing tendency of seroprevalence related to the age of pregnant women.
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Affiliation(s)
- Sorin Motoi
- Department of Medical Imaging and Radiology, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Dan Bogdan Navolan
- Department of Obstetrics and Gynecology, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Daniel Malita
- Department of Medical Imaging and Radiology, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Ioana Ciohat
- Department of Antenatal Laboratory, Emergency Clinical City Hospital, 300202 Timisoara, Romania
| | - Dragos Nemescu
- Department of Obstetrics and Gynecology, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Carmen Manciuc
- Department of Infectious Diseases, 'Grigore T. Popa' University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Florin Gorun
- Department of Obstetrics and Gynecology, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Tatjana Vilibic-Cavlek
- Department of Virology, Croatian National Institute of Public Health and School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Daniel Boda
- Dermatology Research Laboratory, 'Carol Davila' University of Medicine and Pharmacy, 050474 Bucharest, Romania.,Department of Dermatology, 'Prof. N. Paulescu' National Institute of Diabetes, Nutrition and Metabolic Diseases, 79811 Bucharest, Romania
| | - Marius Craina
- Department of Obstetrics and Gynecology, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania
| | - Amadeus Dobrescu
- Department of Surgery, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania
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Onile OS, Ojo GJ, Oyeyemi BF, Agbowuro GO, Fadahunsi AI. Development of multiepitope subunit protein vaccines against Toxoplasma gondii using an immunoinformatics approach. NAR Genom Bioinform 2020; 2:lqaa048. [PMID: 33575600 PMCID: PMC7671309 DOI: 10.1093/nargab/lqaa048] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 06/04/2020] [Accepted: 06/21/2020] [Indexed: 12/28/2022] Open
Abstract
Approximately one-third of the world’s human population is estimated to have been exposed to the parasite Toxoplasma gondii. Its prevalence is reportedly high in Ethiopia (74.80%) and Zimbabwe (68.58%), and is 40.40% in Nigeria. The adverse effect of this parasite includes a serious congenital disease in the developing fetus of pregnant women. After several efforts to eliminate the disease, only one licensed vaccine ‘Toxovax’ has been used to avoid congenital infections in sheep. The vaccine has been adjudged expensive coupled with adverse effects and short shelf life. The potential of vaccine to likely revert to virulent strain is a major reason why it has not been found suitable for human use, hence the need for a vaccine that will induce T and B memory cells capable of eliciting longtime immunity against the infection. This study presents immunoinformatics approaches to design a T. gondii-oriented multiepitope subunit vaccine with focus on micronemal proteins for the vaccine construct. The designed vaccine was subjected to antigenicity, immunogenicity, allergenicity and physicochemical parameter analyses. A 657-amino acid multiepitope vaccine was designed with the antigenicity probability of 0.803. The vaccine construct was classified as stable, non-allergenic, and highly immunogenic, thereby indicating the safety of the vaccine construct for human use.
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Affiliation(s)
- Olugbenga S Onile
- Biotechnology Programme, Department of Biological Sciences, Elizade University, 340211, Ilara-Mokin, Nigeria
| | - Glory J Ojo
- Biotechnology Programme, Department of Biological Sciences, Elizade University, 340211, Ilara-Mokin, Nigeria
| | - Bolaji Fatai Oyeyemi
- Molecular Biology Group, Department of Science Technology, The Federal Polytechnic, 360231, Ado-Ekiti, Ekiti State, Nigeria
| | - Gbenga O Agbowuro
- Biotechnology Programme, Department of Biological Sciences, Elizade University, 340211, Ilara-Mokin, Nigeria
| | - Adeyinka I Fadahunsi
- Biotechnology Programme, Department of Biological Sciences, Elizade University, 340211, Ilara-Mokin, Nigeria
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Pleyer U, Gross U, Schlüter D, Wilking H, Seeber F. Toxoplasmosis in Germany. DEUTSCHES ARZTEBLATT INTERNATIONAL 2020; 116:435-444. [PMID: 31423982 DOI: 10.3238/arztebl.2019.0435] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 05/23/2019] [Accepted: 05/23/2019] [Indexed: 01/16/2023]
Abstract
BACKGROUND With approximately 30% of the world population infected, Toxoplasma gondii is one of the most widespread pathogenic parasites in both humans and animals and a major problem for health economics in many countries. METHODS This review is based on the findings of individual studies, meta-analyses, and Cochrane Reviews retrieved by a selective literature survey of the Medline and Google Scholar databases. RESULTS Current data indicate a high rate of Toxoplasma gondii infection in Germany, ranging from 20% to 77% depending on age (95% confidence interval for 18- to 29-year-olds [17.0; 23.1]; for 70- to 79-year-olds [72.7; 80.5]). Male sex, caring for a cat, and a body mass index of 30 or more are independent risk factors for seroconversion. Postnatally acquired (food-related) infec- tion is predominant, but maternal-to-fetal transmission still plays an important role. While most infections are asymptomatic, congenital toxoplasmosis and reactivated Toxoplasma encephalitis in immunosuppressed persons (transplant recipients and others) are sources of considerable morbidity. Toxoplasma gondii infection of the retina is the most common cause of infectious uveitis in Germany. The diagnosis and treatment of this type of parasitic infection are particular to the specific organs involved in the individual patient. CONCLUSION Desirable steps for the near future include development of an effective treatment for the cystic stage and identifica- tion of biomarkers to assess the risk of reactivation and predict the disease course.
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Affiliation(s)
- Uwe Pleyer
- Department of Ophthalmology, Charité Campus Virchow, University Faculty of Medicine, Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health; Institute of Medical Microbiology and German Reference Laboratory for Toxoplasma Infection, Faculty of Medicine University of Göttingen; Institute of Medical Microbiology and Hospital Epidemiology, Hannover Medical School (MHH); Unit 35: Gastrointestinal Infections, Zoonoses and Tropical Infections, Robert Koch Institute, Berlin; Unit 16: Mycotic and parasitic agents and mycobacteria, Robert Koch Institute, Berlin
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Picone O, Fuchs F, Benoist G, Binquet C, Kieffer F, Wallon M, Wehbe K, Mandelbrot L, Villena I. Toxoplasmosis screening during pregnancy in France: Opinion of an expert panel for the CNGOF. J Gynecol Obstet Hum Reprod 2020; 49:101814. [PMID: 32428782 DOI: 10.1016/j.jogoh.2020.101814] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 05/12/2020] [Indexed: 11/15/2022]
Abstract
Prenatal screening to prevent congenital toxoplasmosis as performed in France for several decades has been questioned in view of the decreasing incidence of this infection and the cost of testing. The French College of Obstetrics and Gynecology mandated a multidisciplinary panel of experts to perform a reassessment of the screening program in accordance with international good practice. In France, about 70% of pregnant women are not immune to T. gondii, and 0.2-0.25% become infected during pregnancy. The risk of maternal-fetal transmission of infection is on average 25-29% and depends greatly on the gestational age at seroconversion. In case of fetal transmission, the outcome is livebirth in 95% of cases, with latent congenital toxoplasmosis in 90% of cases and symptomatic forms in 10% of cases, of which 1/3 are severe and 2/3 moderate. Biological techniques have satisfactory performance regarding serologies for the diagnosis of maternal infections and PCR on amniotic fluid for the prenatal diagnosis of congenital toxoplasmosis. Primary prevention of toxoplasmosis is based on hygiene measures that are relatively simple, but poorly implemented. In case of maternal seroconversion, there is a strong case for prenatal prophylactic treatment as soon as possible (ideally within 3 weeks of seroconversion), spiramycin before 14 weeks of gestation (WG), and with a tendency to superiority of the pyrimethamine/sulfadiazine association over spiramycin beyond 14 W G, in order to reduce the risk of symptomatic congenital toxoplasmosis. In case of congenital toxoplasmosis, prompt initiation of treatment reduces the occurrence of cerebral signs and symptoms, as well as retinal lesions. Several medico-economic evaluations of the French toxoplasmosis screening program have been conducted including an individual cost-effectiveness approach with decision analysis which concluded on the profitability of prenatal screening as carried out in France (monthly surveillance of seronegative women, prenatal treatment in case of seroconversion, termination of pregnancy in severe forms). Though most international societies do not recommend systematic screening for mainly financial reasons, if congenital toxoplasmosis appears benign in France today, it is probably thanks to screening and the possibility of early treatment of fetuses and/or newborns. Thus, the panel recommends continuing for now the program in France for prevention of congenital toxoplasmosis.
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Affiliation(s)
- Olivier Picone
- Assistance Publique-Hôpitaux de Paris, Service de Gynécologie-Obstétrique, Hôpital Louis Mourier, Colombes, France; Université de Paris; Inserm IAME-U1137, Paris, France; FHU PREMA; Groupe de Recherche sur les Infections pendant la grossesse (GRIG)
| | - Florent Fuchs
- Service de Gynécologie Obstétrique CHU de Montpellier, Hopital Arnaud de Villeneuve, Montpellier, France; Inserm, CESP Centre de recherche en Epidémiologie et Santé des Populations, U1018, Reproduction et Développement de l'enfant, 94807 Villejuif, France; EA2415: Aide à la décision médicale Personnalisée, Axe B: Méthode en épidémiologie Clinique, Université de Montpellier
| | | | - Christine Binquet
- Inserm, CIC1432, module Epidémiologie Clinique, Dijon, France; CHU Dijon-Bourgogne, Centre d'Investigation Clinique, Module Epidémiologie Clinique/Essais Cliniques, Dijon, France
| | - François Kieffer
- Assistance Publique-Hôpitaux de Paris, Service de néonatologie, Hôpital Armand Trousseau, Paris, France
| | - Martine Wallon
- Hospices Civils de Lyon, Hôpital de la Croix-Rousse, Service de Parasitologie - Mycologie Médicale, Lyon, France; Université Lyon-1, Equipe Waking, Physiologie Intégrée du Système d'éveil, Centre de Recherche en Neurosciences de Lyon (INSERM U1028 - CNRS UMR 5292), Bron, France
| | - Karl Wehbe
- Centre Hospitalier Universitaire de Strasbourg, Service de Gynécologie-Obstétrique, Strasbourg, France
| | - Laurent Mandelbrot
- Assistance Publique-Hôpitaux de Paris, Service de Gynécologie-Obstétrique, Hôpital Louis Mourier, Colombes, France; Université de Paris; Inserm IAME-U1137, Paris, France; FHU PREMA; Groupe de Recherche sur les Infections pendant la grossesse (GRIG)
| | - Isabelle Villena
- Université Reims Champagne -Ardenne, EA7510 et Centre National de Référence de la Toxoplasmose, Centre de Ressources Biologiques Toxoplasma, Service de Parasitologie-Mycologie, Centre Hospitalier Universitaire de Reims, Reims, France
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The cross-sectional study of Toxoplasma gondii seroprevalence in selected groups of population in Slovakia. Folia Microbiol (Praha) 2020; 65:871-877. [PMID: 32415566 DOI: 10.1007/s12223-020-00797-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 05/06/2020] [Indexed: 10/24/2022]
Abstract
Toxoplasma gondii is an obligate intracellular protozoan parasite with domestic or free-living members of family Felidae known as the only definitive hosts of the parasite. The study aimed to evaluate the seroprevalence of toxoplasmosis in selected population groups in Slovakia and to analyse the infection risk factors. Totally 1536 serum samples of voluntary respondents were examined by EIA Toxoplasma IgG (Test-Line Ltd., Clinical Diagnostics, Brno, Czech Republic). IgG antibodies to T. gondii were detected in 322 (21.0%) sera, with the highest seropositivity recorded among farmers (42.5%) and hunters (28.5%). According to age, the highest seropositivity was recorded in 12-18-year-old Roma children (46.2%), what confirms increased risk of infection in this minority that often lives in inadequate hygiene conditions. When only adult participants were taken into account, the highest seroprevalence was observed in the age group of ≥ 70 years. Higher risk of infection (p < 0.05) was connected with cat ownership, living in rural residency and consumption of raw meat and meat processing. The results underline the importance of preventive measures and ongoing need to improve the knowledge on toxoplasmosis in both professionals and public.
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Nayeri T, Sarvi S, Moosazadeh M, Amouei A, Hosseininejad Z, Daryani A. The global seroprevalence of anti-Toxoplasma gondii antibodies in women who had spontaneous abortion: A systematic review and meta-analysis. PLoS Negl Trop Dis 2020; 14:e0008103. [PMID: 32168351 PMCID: PMC7069604 DOI: 10.1371/journal.pntd.0008103] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 01/30/2020] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Toxoplasma gondii (T. gondii) is an intracellular pathogen that can lead to abortion in pregnant women infected with this parasite. Therefore, the present study aimed to estimate the global seroprevalence of anti-T. gondii antibodies in women who had spontaneous abortion based on the results of published articles and evaluate the relationship between seroprevalence of anti-T. gondii antibodies and abortion via a systematical review and meta-analysis. METHODS Different databases were searched in order to gain access to all studies on the seroprevalence of anti- T. gondii antibodies in women who had spontaneous abortion and association between seroprevalence of anti-T. gondii antibodies and abortion published up to April 25th, 2019. Odds ratio (OR) and the pooled rate seroprevalence of T. gondii with a 95% confidence interval (CI) were calculated using the random effects model. RESULTS In total, 8 cross-sectional studies conducted on 1275 women who had abortion in present pregnancy, 40 cross-sectional studies performed on 9122 women who had a history of abortion, and 60 articles (involving 35 cross-sectional studies including 4436 women who had spontaneous abortion as case and 10398 as control and 25 case-control studies entailing 4656 cases and 3178 controls) were included for the final analyses. The random-effects estimates of the prevalence of anti-T. gondii IgG antibody in women who had abortion in present pregnancy and women who had a history of abortion were 33% (95% CI: 17%-49%) and 43% (95% CI: 27%-60%), respectively. In addition, the pooled OR for anti-T. gondii IgG antibody in cross-sectional and case-control studies among women who had spontaneous abortion were 1.65 (95% CI: 1.31-2.09) and 2.26 (95% CI: 1.56-3.28), respectively. Also, statistical analysis showed that the pooled OR of the risk of anti-T. gondii IgM antibody 1.39 (95% CI: 0.61-3.15) in cross-sectional and 4.33 (95% CI: 2.42-7.76) in case-control studies. CONCLUSION Based on the results of the current study, T. gondii infection could be considered a potential risk factor for abortion. It is recommended to carry out further and more comprehensive investigations to determine the effect of T. gondii infection on abortion to prevent and control toxoplasmosis among pregnant women around the world.
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Affiliation(s)
- Tooran Nayeri
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Shahabeddin Sarvi
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mahmood Moosazadeh
- Health Sciences Research Center, Addiction Institute, Mazandaran University of Medical Sciences, Sari, Iran
| | - Afsaneh Amouei
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Zahra Hosseininejad
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
- Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ahmad Daryani
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran
- Department of Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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Performance of Zika Assays in the Context of Toxoplasma gondii, Parvovirus B19, Rubella Virus, and Cytomegalovirus (TORCH) Diagnostic Assays. Clin Microbiol Rev 2019; 33:33/1/e00130-18. [PMID: 31826871 DOI: 10.1128/cmr.00130-18] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Infections during pregnancy that may cause congenital abnormalities have been recognized for decades, but their diagnosis is challenging. This was again illustrated with the emergence of Zika virus (ZIKV), highlighting the inherent difficulties in estimating the extent of pre- and postnatal ZIKV complications because of the difficulties in establishing definitive diagnoses. We reviewed the epidemiology, infection kinetics, and diagnostic methods used for Toxoplasma gondii, parvovirus B19, rubella virus, and cytomegalovirus (TORCH) infections and compared the results with current knowledge of ZIKV diagnostic assays to provide a basis for the inclusion of ZIKV in the TORCH complex evaluations. Similarities between TORCH pathogens and ZIKV support inclusion of ZIKV as an emerging TORCH infection. Our review evaluates the diagnostic performance of various TORCH diagnostic assays for maternal screening, fetal screening, and neonatal screening. We show that the sensitivity, specificity, and positive and negative predictive value of TORCH complex pathogens are widely variable, stressing the importance of confirmatory testing and the need for novel techniques for earlier and accurate diagnosis of maternal and congenital infections. In this context it is also important to acknowledge different needs and access to care for different geographic and resource settings.
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Bobić B, Villena I, Stillwaggon E. Prevention and mitigation of congenital toxoplasmosis. Economic costs and benefits in diverse settings. Food Waterborne Parasitol 2019; 16:e00058. [PMID: 32095628 PMCID: PMC7034037 DOI: 10.1016/j.fawpar.2019.e00058] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 05/13/2019] [Accepted: 05/13/2019] [Indexed: 11/27/2022] Open
Abstract
Congenital toxoplasmosis (CT), the result of a primary infection of pregnant women with Toxoplasma gondii which was transmitted to the fetus, may result in mild to deep injuries occurring in the newborn or later in its development or in adolescence. The visual and cognitive impairment that can result imposes substantial economic costs on the individual and society. Numerous observational studies favor the conclusion that, with preventive measures currently available, it is possible to reduce the incidence of infections in pregnant women, the incidence of fetal infection by preventing transplacental transmission, and the gravity of injury in infected newborns. Treatment of infected newborns can also reduce the severity of consequences and the frequency of their occurrence later in life. Prevention programs, however, are applied in only a few countries; in most countries implementation of a national prevention program has not been considered or has been thought to be too expensive. This article lists the methods of prevention of CT and describes existing national prevention programs in France and Austria. It analyzes the economic costs and benefits of maternal screening for CT prevention and mitigation for society and for health systems. The economic feasibility of implementing national screening in low-prevalence, high-cost countries is illustrated with the example of the United States. New diagnostic tools are discussed and the implication of lower costs is considered, for countries with well-established screening programs as well as those with inadequate prenatal care networks.
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Affiliation(s)
- Branko Bobić
- Institute for Medical Research, University of Belgrade, Centre of Excellence for Food- and Vector-borne Zoonoses, National Reference Laboratory for Toxoplasmosis, Serbia
| | - Isabelle Villena
- EA 7510, UFR Médecine, University Reims Champagne-Ardenne, National Reference Center on Toxoplasmosis, Hospital Reims, France
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32
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Molecular genotyping and serological evaluation of Toxoplasma gondii in mothers and their spontaneous aborted fetuses in Southwest of Iran. Comp Immunol Microbiol Infect Dis 2019; 66:101342. [PMID: 31437675 DOI: 10.1016/j.cimid.2019.101342] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 07/22/2019] [Accepted: 07/24/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND Given the lack of routine screening and the high prevalence of toxoplasmosis in pregnant women in Iran, the current study aimed to find out the rate and features of Toxoplasma gondii infection in the spontaneously aborted human fetuses in Kohgiluyeh and Boyer-Ahmad Province, Southwestern Iran. METHODS This cross-sectional study was performed on 100 spontaneously aborted fetuses' tissues and their mother blood samples. The mothers' sera were evaluated for anti-Toxoplasma antibodies while their buffy coat and aborted fetuses tissues were evaluated for Toxoplasma DNA. PCR product at GRA6 locus was sequenced and phylogenetic analysis was done. Likewise, quantitative Real-Time PCR was performed to find out the parasite burdens in mothers buffy coat and fetuses tissues. RESULTS Using serological method, anti-Toxoplasma IgG and IgM antibodies were detected in 7 (7%) and 3 (3%) out of 100 sera from women with spontaneous abortion. Real-time PCR method detected T. gondii DNA in the buffy coat of one seronegative and 2 (out of 3) IgM seropositive cases. None of the samples from aborted fetuses were infected with T. gondii. BLAST and phylogenetic analysis showed that the sequenced isolates belonged to type I of T. gondii and two identified T. gondii isolates were taxonomically grouped into one clade. CONCLUSION Our findings revealed type I genotype of T. gondii in two mothers with spontaneous abortion, without fetus involvement. It is necessary to examine more aborted fetuses' samples from different geographical areas to determine the association between Toxoplasma genotype and abortion.
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Innes EA, Hamilton C, Garcia JL, Chryssafidis A, Smith D. A one health approach to vaccines against Toxoplasma gondii. Food Waterborne Parasitol 2019; 15:e00053. [PMID: 32095623 PMCID: PMC7034027 DOI: 10.1016/j.fawpar.2019.e00053] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Revised: 03/30/2019] [Accepted: 03/31/2019] [Indexed: 12/22/2022] Open
Abstract
Toxoplasmosis is a serious disease with global impact, now recognised as one of the most important food borne diseases worldwide and a major cause of production loss in livestock. A one health approach to develop a vaccination programme to tackle toxoplasmosis is an attractive and realistic prospect. Knowledge of disease epidemiology, parasite transmission routes and main risk groups has helped to target key host species and outcomes for a vaccine programme and these would be to prevent/reduce congenital disease in women and sheep; prevent/reduce T. gondii tissue cysts in food animal species and to prevent/reduce T. gondii oocyst shedding in cats. Most animals, including humans, develop good protective immunity following infection, involving cell mediated immune responses, which may explain why live vaccines are generally more effective to protect against T. gondii. Recent advances in our knowledge of parasite genetics and gene manipulation, strain variation, key antigenic epitopes, delivery systems and induction of immune responses are all contributing to the prospects of developing new vaccines which may be more widely applicable. A key area in progressing vaccine development is to devise standard vaccine efficacy models in relevant animal hosts and this is where a one health approach bringing together researchers across different disciplines can be of major benefit. The tools and technologies are in place to make a real impact in tackling toxoplasmosis using vaccination and it just requires a collective will to make it happen.
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Affiliation(s)
- Elisabeth A. Innes
- Moredun Research Institute, Pentlands Science Park, Edinburgh, Scotland EH26 OPZ, United Kingdom of Great Britain and Northern Ireland
| | - Clare Hamilton
- Moredun Research Institute, Pentlands Science Park, Edinburgh, Scotland EH26 OPZ, United Kingdom of Great Britain and Northern Ireland
| | - Joao L. Garcia
- Universidade Estadual de Londrina, Campus Universitario, Rodovia Celso Garcia Cid, Pr 380, CEP 86057-970 Londrina, Parana, Brazil
| | - Andreas Chryssafidis
- Universidade Estadual de Londrina, Campus Universitario, Rodovia Celso Garcia Cid, Pr 380, CEP 86057-970 Londrina, Parana, Brazil
- Department of Veterinary Medicine, Universidade do Estado de Santa Catarina, Lages, SC, Brazil
| | - David Smith
- 5740A Medical Science Building II, 1150 W. Medical Centre Dr, University of Michigan, Ann Arbor, MI 48109-5620, USA
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Sarvi S, Nayeri Chegeni T, Sharif M, Montazeri M, Hosseini SA, Amouei A, Hosseininejad Z, Anvari D, Saberi R, Gohardehi S, Daryani A. Congenital toxoplasmosis among Iranian neonates: a systematic review and meta-analysis. Epidemiol Health 2019; 41:e2019021. [PMID: 31096746 PMCID: PMC6635660 DOI: 10.4178/epih.e2019021] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 05/17/2019] [Indexed: 11/25/2022] Open
Abstract
Toxoplasmosis is a serious zoonotic disease that can lead to abortion and congenital disorders and has a widespread global distribution in humans and animals. The objective of this review was to investigate the incidence of toxoplasmosis in Iranian neonates in order to obtain a comprehensive assessment of the overall situation of the disease for use in developing future interventions. Original studies investigating the incidence of Toxoplasma gondii infections in Iranian neonates were systematically searched in a number of English-language and Persian-language electronic databases. The search process resulted in the inclusion of a total of 11 studies in the systematic review, 10 of which were entered into the meta-analysis. The reviewed articles included 2,230 Iranian neonates investigated through January 1, 2018. Based on the retrieved studies, the overall weighted incidence rates of toxoplasmosis in the Iranian neonatal population and neonates with suspected congenital toxoplasmosis were estimated to be 0.64% (95% confidence interval [CI], 0.31 to 1.09) and 4.10% (95% CI, 2.68 to 5.77), respectively, using a fixed-effects model. The findings of the reviewed studies demonstrate that the incidence of toxoplasmosis is high in Iranian neonates. Accordingly, it can be concluded that toxoplasmosis is a serious public health concern that has been ignored by the Ministry of Health. Therefore, it is essential to perform further studies, in addition to implementing screening and detection programs, using standardized methods to estimate the incidence of toxoplasmosis in Iran and to determine its associated risk factors.
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Affiliation(s)
- Shahabeddin Sarvi
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Tooran Nayeri Chegeni
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.,Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Mehdi Sharif
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Parasitology, School of Medicine, Sari Branch, Islamic Azad University, Sari, Iran
| | - Mahbobeh Montazeri
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Seyed Abdollah Hosseini
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Afsaneh Amouei
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Zahra Hosseininejad
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.,Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Davood Anvari
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.,Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Reza Saberi
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.,Student Research Committee, Mazandaran University of Medical Sciences, Sari, Iran
| | - Shaban Gohardehi
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
| | - Ahmad Daryani
- Toxoplasmosis Research Center, Mazandaran University of Medical Sciences, Sari, Iran.,Department of Medical Parasitology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
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Hwang JS, Friedlander S, Rehan VK, Zangwill KM. Diagnosis of congenital/perinatal infections by neonatologists: a national survey. J Perinatol 2019; 39:690-696. [PMID: 30914779 DOI: 10.1038/s41372-019-0364-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 02/20/2019] [Accepted: 03/05/2019] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To describe the clinical approach used by neonatologists for diagnosis of congenital/perinatal infections (CPI); no such data currently exist. STUDY DESIGN A national survey regarding the diagnosis of toxoplasma, syphilis, rubella, cytomegalovirus, and herpes simplex virus (HSV) infection in neonates. RESULT We received 553 (11%) responses. Central nervous system calcification or hydrocephalus was the commonest trigger to pursue a CPI diagnosis (98%); maternal history was the least frequent (67%). Four hundred twenty-two (76%) used general screening such as "TORCH titer screen" (57%) or total IgG or IgM (39%). Further evaluation targeted known clinical sequelae; but cerebrospinal fluid testing was used in only 65% of those suspected of having HSV or syphilis. Fifty-six percent chose a treponemal instead of a non-treponemal test for syphilis. Multivariable analyses did not identify factors associated with the clinical diagnostic approach. CONCLUSION We observed clinically important deviations from CPI diagnostic test recommendations in a national cohort of neonatologists.
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Affiliation(s)
- Jung S Hwang
- Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Scott Friedlander
- Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Virender K Rehan
- Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA, USA.,Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Kenneth M Zangwill
- Department of Pediatrics, Harbor-UCLA Medical Center, Torrance, CA, USA. .,Los Angeles Biomedical Research Institute, Harbor-UCLA Medical Center, Torrance, CA, USA.
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Olariu TR, Press C, Talucod J, Olson K, Montoya JG. Congenital toxoplasmosis in the United States: clinical and serologic findings in infants born to mothers treated during pregnancy. ACTA ACUST UNITED AC 2019; 26:13. [PMID: 30838974 PMCID: PMC6402364 DOI: 10.1051/parasite/2019013] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2019] [Accepted: 02/21/2019] [Indexed: 11/15/2022]
Abstract
We assessed clinical and serologic findings in 25 infants with congenital toxoplasmosis born to mothers treated during pregnancy in the United States. Results indicate a lower prevalence of eye findings and hydrocephalus in the group of infants born to treated mothers (62.5% and 38.5%, respectively) compared to results on the same pathologies reported in our previous cohort of infants born to untreated mothers (92.2% and 67.7%, respectively). The sensitivity of the IgM ISAGA and IgA ELISA in the present study were lower (44% and 60%, respectively) compared to sensitivity of these methods in our previously studied group of infants born to untreated mothers (86.6% and 76.5%, respectively). These findings provide further evidence that anti-parasitic treatment if administered during pregnancy can contribute to better clinical outcomes, even in countries where systematic screening and treatment have not been routinely implemented.
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Affiliation(s)
- Tudor Rares Olariu
- Palo Alto Medical Foundation Toxoplasma Serology Laboratory, Palo Alto, CA, USA - Department of Medicine and Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA - Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Cindy Press
- Palo Alto Medical Foundation Toxoplasma Serology Laboratory, Palo Alto, CA, USA
| | - Jeanne Talucod
- Palo Alto Medical Foundation Toxoplasma Serology Laboratory, Palo Alto, CA, USA
| | - Kjerstie Olson
- Palo Alto Medical Foundation Toxoplasma Serology Laboratory, Palo Alto, CA, USA
| | - José Gilberto Montoya
- Palo Alto Medical Foundation Toxoplasma Serology Laboratory, Palo Alto, CA, USA - Department of Medicine and Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA, USA
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El Bissati K, Levigne P, Lykins J, Adlaoui EB, Barkat A, Berraho A, Laboudi M, El Mansouri B, Ibrahimi A, Rhajaoui M, Quinn F, Murugesan M, Seghrouchni F, Gómez-Marín JE, Peyron F, McLeod R. Global initiative for congenital toxoplasmosis: an observational and international comparative clinical analysis. Emerg Microbes Infect 2018; 7:165. [PMID: 30262847 PMCID: PMC6160433 DOI: 10.1038/s41426-018-0164-4] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 07/30/2018] [Accepted: 08/06/2018] [Indexed: 12/14/2022]
Abstract
Globally, congenital toxoplasmosis remains a significant cause of morbidity and mortality, and outbreaks of infection with T. gondii represent a significant, emerging public health burden, especially in the developing world. This parasite is a threat to public health. Disease often is not recognized and is inadequately managed. Herein, we analyze the status of congenital toxoplasmosis in Morocco, Colombia, the United States, and France. We identify the unique challenges faced by each nation in the implementation of optimal approaches to congenital toxoplasmosis as a public health problem. We suggest that developed and developing countries use a multipronged approach, modeling their public health management protocols after those in France. We conclude that education, screening, appropriate treatment, and the development of novel modalities will be required to intervene successfully in caring for individuals with this infection. Gestational screening has been demonstrated to be cost-effective, morbidity-sparing, and life-saving. Recognition of the value and promise of public health interventions to prevent human suffering from this emerging infection will facilitate better patient and societal outcomes.
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Affiliation(s)
- Kamal El Bissati
- Department of Ophthalmology and Visual Sciences, University of Chicago, Chicago, IL, 60637, USA.
| | - Pauline Levigne
- Institut de Parasitologie et de Mycologie Médicale Hôpital de la Croix Rousse, 103 grande rue de la Croix Rousse, 69317, Lyon, France
| | - Joseph Lykins
- Department of Emergency Medicine, Department of Internal Medicine, Virginia Commonwealth University Health System, Richmond, VA, 23219, USA
| | | | - Amina Barkat
- Research Team on Mother-Child Health and Nutrition, Faculté de Médecine et de Pharmacie de Rabat, Université Mohammed V, Rabat, Morocco
| | - Amina Berraho
- Department d'Ophtalmologie, Hôpital des Spécialités, CHU, P6220, Rabat, Morocco
| | | | | | - Azeddine Ibrahimi
- Faculté de Médecine et de Pharmacie de Rabat, Université Mohammed V, Rabat, Morocco
| | | | - Fred Quinn
- Department of Infectious Diseases, College of Veterinary Medicine, University of Georgia, Athens, GA, 30602, USA
| | | | | | - Jorge Enrique Gómez-Marín
- Grupo de Estudio en Parasitología Molecular (GEPAMOL), Centro de Investigaciones Biomédicas, Universidad del Quindio, Av. Bolivar 12N, Armenia, Quindio, Colombia
| | - François Peyron
- Institut de Parasitologie et de Mycologie Médicale Hôpital de la Croix Rousse, 103 grande rue de la Croix Rousse, 69317, Lyon, France
| | - Rima McLeod
- Department of Ophthalmology and Visual Sciences, Department of Pediatrics (Infectious Diseases), Institute of Genomics, Genetics, and Systems Biology, Global Health Center, Toxoplasmosis Center, CHeSS, The College, University of Chicago, Chicago, IL, 60637, USA
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Piao LX, Cheng JH, Aosai F, Zhao XD, Norose K, Jin XJ. Cellular immunopathogenesis in primary Toxoplasma gondii
infection during pregnancy. Parasite Immunol 2018; 40:e12570. [DOI: 10.1111/pim.12570] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2018] [Revised: 06/28/2018] [Accepted: 06/29/2018] [Indexed: 12/15/2022]
Affiliation(s)
- Lian Xun Piao
- Key Laboratory of Natural Resources of Changbai Mountain & Functional Molecules, Ministry of Education, Molecular Medicine Research Center, College of Pharmacy; Yanbian University; Yanji China
| | - Jia Hui Cheng
- Key Laboratory of Natural Resources of Changbai Mountain & Functional Molecules, Ministry of Education, Molecular Medicine Research Center, College of Pharmacy; Yanbian University; Yanji China
| | - Fumie Aosai
- Department of Infection and Host Defense; Graduate School of Medicine; Chiba University; Chiba Japan
- Department of Infection and Host Defense; Graduate School of Medicine; Shinshu University; Matsumoto Japan
| | - Xu Dong Zhao
- Key Laboratory of Natural Resources of Changbai Mountain & Functional Molecules, Ministry of Education, Molecular Medicine Research Center, College of Pharmacy; Yanbian University; Yanji China
| | - Kazumi Norose
- Department of Infection and Host Defense; Graduate School of Medicine; Chiba University; Chiba Japan
| | - Xue Jun Jin
- Key Laboratory of Natural Resources of Changbai Mountain & Functional Molecules, Ministry of Education, Molecular Medicine Research Center, College of Pharmacy; Yanbian University; Yanji China
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Prusa AR, Kasper DC, Sawers L, Walter E, Hayde M, Stillwaggon E. Congenital toxoplasmosis in Austria: Prenatal screening for prevention is cost-saving. PLoS Negl Trop Dis 2017; 11:e0005648. [PMID: 28692640 PMCID: PMC5503164 DOI: 10.1371/journal.pntd.0005648] [Citation(s) in RCA: 52] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Accepted: 05/17/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Primary infection of Toxoplasma gondii during pregnancy can be transmitted to the unborn child and may have serious consequences, including retinochoroiditis, hydrocephaly, cerebral calcifications, encephalitis, splenomegaly, hearing loss, blindness, and death. Austria, a country with moderate seroprevalence, instituted mandatory prenatal screening for toxoplasma infection to minimize the effects of congenital transmission. This work compares the societal costs of congenital toxoplasmosis under the Austrian national prenatal screening program with the societal costs that would have occurred in a No-Screening scenario. METHODOLOGY/PRINCIPAL FINDINGS We retrospectively investigated data from the Austrian Toxoplasmosis Register for birth cohorts from 1992 to 2008, including pediatric long-term follow-up until May 2013. We constructed a decision-analytic model to compare lifetime societal costs of prenatal screening with lifetime societal costs estimated in a No-Screening scenario. We included costs of treatment, lifetime care, accommodation of injuries, loss of life, and lost earnings that would have occurred in a No-Screening scenario and compared them with the actual costs of screening, treatment, lifetime care, accommodation, loss of life, and lost earnings. We replicated that analysis excluding loss of life and lost earnings to estimate the budgetary impact alone. Our model calculated total lifetime costs of €103 per birth under prenatal screening as carried out in Austria, saving €323 per birth compared with No-Screening. Without screening and treatment, lifetime societal costs for all affected children would have been €35 million per year; the implementation costs of the Austrian program are less than €2 million per year. Calculating only the budgetary impact, the national program was still cost-saving by more than €15 million per year and saved €258 million in 17 years. CONCLUSIONS/SIGNIFICANCE Cost savings under a national program of prenatal screening for toxoplasma infection and treatment are outstanding. Our results are of relevance for health care providers by supplying economic data based on a unique national dataset including long-term follow-up of affected infants.
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Affiliation(s)
- Andrea-Romana Prusa
- Department of Pediatrics and Adolescent Medicine, Toxoplasmosis Reference Laboratory, Medical University of Vienna, Vienna, Austria
| | - David C. Kasper
- Department of Laboratory Medicine, Medical University of Vienna, Vienna, Austria
| | - Larry Sawers
- Department of Economics, American University, Washington DC, United States of America
| | - Evelyn Walter
- Institute for Pharmaeconomic Research, Vienna, Austria
| | - Michael Hayde
- Department of Pediatrics and Adolescent Medicine, Toxoplasmosis Reference Laboratory, Medical University of Vienna, Vienna, Austria
| | - Eileen Stillwaggon
- Department of Economics, Gettysburg College, Gettysburg, Pennsylvania, United States of America
- * E-mail:
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40
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Sousa JADS, Corrêa RDGCF, de Aquino DMC, Coutinho NPS, da Silva MACN, Nascimento MDDSB. Knowledge and perceptions on toxoplasmosis among pregnant women and nurses who provide prenatal in primary care. Rev Inst Med Trop Sao Paulo 2017; 59:e31. [PMID: 28591259 PMCID: PMC5459538 DOI: 10.1590/s1678-9946201759031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Accepted: 02/22/2017] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Toxoplasmosis is an infection that affects almost a third of the world population. In adults, it is often asymptomatic, although having important manifestation in children- infected by placental transmission. The prenatal is an important moment, requiring actions in women's care during pregnancy, in order to prevent diseases that could compromise the mother and the child's life. METHODS This is a descriptive study of qualitative approach aimed to understand the perception of nurses and pregnant women about toxoplasmosis during primary - prenatal care. The study was conducted in five selected primary health care units, in the municipality of São Luis - MA. The sample consisted of 15 nurses working in nursing consultation and 15 pregnant women attended in prenatal care. For data collection, a semi-structured questionnaire and an interview guide covering issues related to knowledge and conduct on toxoplasmosis were used. For analysis, the content analysis technique was used. RESULTS The answers were transcribed, organized and grouped thematically, where the following categories emerged: knowledge about examination requests; knowledge about toxoplasmosis; guidance during prenatal consultation; knowledge of nurses about the avidity test; procedures and guidelines on reagent cases. Pregnant women showed unawareness about toxoplasmosis and its effects. Nurses, although having basic knowledge about the subject, showed little applicability regarding pregnant women's guidance. CONCLUSION The nurse plays an important role in educational activities regarding pregnant women, contributing to the quality of prenatal care. Pregnant women were shown to have some knowledge about toxoplasmosis, although they said they did not have assurance about prevention.
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Affiliation(s)
- Jayra Adrianna da Silva Sousa
- Universidade Federal do MaranhãoUniversidade Federal do MaranhãoSão LuísMaranhãoBrazilUniversidade Federal do Maranhão, Programa de Pós-Gaduação em Saúde do Adulto e da Criança, São Luís, Maranhão, Brazil
| | - Rita da Graça Carvalhal Frazão Corrêa
- Universidade Federal do MaranhãoUniversidade Federal do MaranhãoSão LuísMaranhãoBrazilUniversidade Federal do Maranhão, Programa de Pós-Gaduação em Saúde do Adulto e da Criança, São Luís, Maranhão, Brazil
| | - Dorlene Maria Cardoso de Aquino
- Universidade Federal do MaranhãoUniversidade Federal do MaranhãoSão LuísMaranhãoBrazilUniversidade Federal do Maranhão, Programa de Pós-Graduação em Enfermagem, São Luís, Maranhão, Brazil
| | - Nair Portela Silva Coutinho
- Universidade Federal do MaranhãoUniversidade Federal do MaranhãoSão LuísMaranhãoBrazilUniversidade Federal do Maranhão, Programa de Pós-Graduação em Enfermagem, São Luís, Maranhão, Brazil
| | - Marcos Antonio Custódio Neto da Silva
- Universidade Federal do MaranhãoUniversidade Federal do MaranhãoFaculdade de MedicinaSão LuísMaranhãoBrazilUniversidade Federal do Maranhão, Faculdade de Medicina, São Luís, Maranhão, Brazil
| | - Maria do Desterro Soares Brandão Nascimento
- Universidade Federal do MaranhãoUniversidade Federal do MaranhãoSão LuísMaranhãoBrazilUniversidade Federal do Maranhão, Programa de Pós-Gaduação em Saúde do Adulto e da Criança, São Luís, Maranhão, Brazil
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Dard C, Chemla C, Fricker-Hidalgo H, Brenier-Pinchart MP, Baret M, Mzabi A, Villena I, Pelloux H. Late diagnosis of congenital toxoplasmosis based on serological follow-up: A case report. Parasitol Int 2017; 66:186-189. [DOI: 10.1016/j.parint.2016.12.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Revised: 12/03/2016] [Accepted: 12/05/2016] [Indexed: 10/20/2022]
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Berghold C, Herzog SA, Jakse H, Berghold A. Prevalence and incidence of toxoplasmosis: a retrospective analysis of mother-child examinations, Styria, Austria, 1995 to 2012. ACTA ACUST UNITED AC 2017; 21:30317. [PMID: 27562876 PMCID: PMC4998422 DOI: 10.2807/1560-7917.es.2016.21.33.30317] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 01/19/2016] [Indexed: 11/30/2022]
Abstract
In Austria, mandatory screening for the prevention of congenital toxoplasmosis stipulates a serological test for antibodies against Toxoplasma gondii as early as possible in pregnancy. In the case of a seronegative result, subsequent tests at intervals of 8 weeks are requested. We analysed serological data from Styria, an Austrian federal state, to determine the seroprevalence and incidence of Toxoplasma infections. The study included 353,599 tests from 103,316 women during 158,571 pregnancies from 1995 to 2012. The age-adjusted seroprevalence decreased from 43.3% in 1995 to 31.5% in 2012, with a yearly decline of 0.84% (95% confidence interval (CI): 0. 79 -0.88). The intergravid incidence showed an annual decrease of 4.2%. The average yearly incidence of intragravid and intergravid seroconversions was 0.52% (95% CI 0.45–0.61) and 0.72% (95% CI 0.67–0.77), respectively. If the difference between these rates (p < 0.001) can be explained by the effect of primary prevention such as avoiding raw meat and taking hygiene precautions when encountering cats or preparing vegetables, only ca two of seven (28%) infections were avoided by hygiene measures taken by pregnant women. Primary prevention may therefore have its limits.
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Bolais PF, Vignoles P, Pereira PF, Keim R, Aroussi A, Ismail K, Dardé ML, Amendoeira MR, Mercier A. Toxoplasma gondii survey in cats from two environments of the city of Rio de Janeiro, Brazil by Modified Agglutination Test on sera and filter-paper. Parasit Vectors 2017; 10:88. [PMID: 28212681 PMCID: PMC5316176 DOI: 10.1186/s13071-017-2017-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 02/07/2017] [Indexed: 11/10/2022] Open
Abstract
Background Toxoplasma gondii is a protozoan with a worldwide distribution, in warm-blood animals, including humans. Local conditions and environmental disturbances may influence transmission dynamics of a zoonotic agent. This study evaluates the epidemiology of T. gondii based on toxoplasmosis prevalence in two populations of cats living in distinct urbanization conditions in Rio de Janeiro, Brazil. Methods Among 372 domestic cats sampled, 265 were from a public shelter located downtown Rio and 107 from a relatively preserved wild environment in a residential area. Sera and eluates from dried blood spots were tested for detection of IgG antibodies against T. gondii by modified agglutination test (MAT). Results Antibodies to T. gondii were detected in 32/265 (12.08%) animals from the public shelter and in 4/107 (3.74%) cats from the residential area. Identical results were observed for sera and eluates. Conclusions Filter paper provides a reliable accurate alternative storage option when conditions of sample collection and transportation in the field are unfavorable. The significantly lower prevalence in the residential area is discussed in terms of environmental, biological and behavioral features.
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Affiliation(s)
- Paula F Bolais
- Univ. Limoges, INSERM UMR-S 1094 Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, 2 Rue du Dr. Marcland, Limoges, 87025, France. .,Toxoplasmosis and other Protozoosis Laboratory of Oswaldo Cruz Institute, Av. Brasil 4365, Rio de Janeiro, 21045-900, Brazil.
| | - Philippe Vignoles
- Univ. Limoges, INSERM UMR-S 1094 Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, 2 Rue du Dr. Marcland, Limoges, 87025, France
| | - Pamela F Pereira
- Toxoplasmosis and other Protozoosis Laboratory of Oswaldo Cruz Institute, Av. Brasil 4365, Rio de Janeiro, 21045-900, Brazil
| | - Rafael Keim
- Quatro Elementos Veterinary Medicine and Environmental consulting, Rua Coronel Moreira Cesar, 211 Bl. 2/502, Niteroi, 24.230-052, Brazil
| | - Abdelkrim Aroussi
- Univ. Limoges, INSERM UMR-S 1094 Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, 2 Rue du Dr. Marcland, Limoges, 87025, France
| | - Khadja Ismail
- Univ. Limoges, INSERM UMR-S 1094 Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, 2 Rue du Dr. Marcland, Limoges, 87025, France
| | - Marie-Laure Dardé
- Univ. Limoges, INSERM UMR-S 1094 Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, 2 Rue du Dr. Marcland, Limoges, 87025, France
| | - Maria Regina Amendoeira
- Toxoplasmosis and other Protozoosis Laboratory of Oswaldo Cruz Institute, Av. Brasil 4365, Rio de Janeiro, 21045-900, Brazil
| | - Aurélien Mercier
- Univ. Limoges, INSERM UMR-S 1094 Tropical Neuroepidemiology, Institute of Neuroepidemiology and Tropical Neurology, 2 Rue du Dr. Marcland, Limoges, 87025, France
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Peyron F, Mc Leod R, Ajzenberg D, Contopoulos-Ioannidis D, Kieffer F, Mandelbrot L, Sibley LD, Pelloux H, Villena I, Wallon M, Montoya JG. Congenital Toxoplasmosis in France and the United States: One Parasite, Two Diverging Approaches. PLoS Negl Trop Dis 2017; 11:e0005222. [PMID: 28207736 PMCID: PMC5312802 DOI: 10.1371/journal.pntd.0005222] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Affiliation(s)
- Francois Peyron
- Hospices Civils de Lyon, Institut de Parasitologie et mycologie médicale, Hôpital de la Croix Rousse, Lyon, France
- * E-mail:
| | - Rima Mc Leod
- Department of Ophthalmology and Visual Science, Department of Pediatrics (Infectious Diseases), The University of Chicago, Chicago, Illinois, United States of America
- Toxoplasmosis Center, Institute for Genomics and Systems Biology, The University of Chicago, Chicago, Illinois, United States of America
- Global Health Center, CHeSS, The University of Chicago, Chicago, Illinois, United States of America
| | - Daniel Ajzenberg
- Centre National de Référence (CNR) Toxoplasmose / Toxoplasma Biological Resource Center (BRC), Centre Hospitalier-Universitaire Dupuytren, Limoges, France
- INSERM UMR 1094, Neuroépidémiologie Tropicale, Laboratoire de Parasitologie-Mycologie, Faculté de Médecine, Université de Limoges, Limoges, France
| | - Despina Contopoulos-Ioannidis
- Department of Pediatrics, Division of Infectious Diseases, Stanford University School of Medicine, Stanford, California, United States of America
| | - François Kieffer
- Neonatal Intensive Care Unit, Armand Trousseau Hospital–Assistance Publique–Hopitaux de Paris, Paris, France
| | - Laurent Mandelbrot
- Hopital Louis Mourier, Assistance Publique–Hopitaux de Paris, Colombes, France
- Centre de Recherche en Epidémiologie et Sante des Populations, INSERM U1018, Le Kremlin-Bicêtre, France, Université Paris Diderot—Paris 7, Paris, France
| | - L. David Sibley
- Department of Molecular Microbiology, Washington University School of Medicine, St. Louis, Missouri, United States of America
| | - Hervé Pelloux
- Parasitologie-Mycologie Pole Biologie, CHU A. Michallon, Grenoble, France
- UMR 5163 CNRS/Université Grenoble Alpes, Grenoble, France
| | - Isabelle Villena
- Laboratoire de Parasitologie-Mycologie, Centre National de Référence de la Toxoplasmose, Centre de Ressources Biologiques Toxoplasma, Hôpital Maison Blanche Reims, France
- EA 3800, SFR CAP-SANTE, Université Champagne-Ardenne, Reims, France
| | - Martine Wallon
- Hospices Civils de Lyon, Institut de Parasitologie et mycologie médicale, Hôpital de la Croix Rousse, Lyon, France
- Physiologie intégrée du système d'éveil Centre de recherche en neurosciences de Lyon, INSERM U1028-CNRS UMR 5292, Lyon, France
| | - Jose G. Montoya
- Department of Medicine and Division of Infectious Diseases, Stanford University School of Medicine, Stanford, California, United States of America
- Palo Alto Medical Foundation Toxoplasma Serology Laboratory, Palo Alto, California, United States of America
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Maldonado YA, Read JS. Diagnosis, Treatment, and Prevention of Congenital Toxoplasmosis in the United States. Pediatrics 2017; 139:peds.2016-3860. [PMID: 28138010 DOI: 10.1542/peds.2016-3860] [Citation(s) in RCA: 115] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Abstract
BACKGROUND Population seroprevalence and rates of mother-to-child transmission are important in determining the incidence of congenital toxoplasmosis. (CT) Mother-to-child transmission depends on the timing of acute maternal infection and treatment during pregnancy. The incidence of CT varies widely across geographic regions, ranging from 1 to 10 cases per 10,000 live births. The incidence of symptomatic disease varies from 0.15 to 0.34 cases per 10,000. METHODS This is a review of patients treated at a pediatric CT clinic at a university hospital in the south of Brazil, from 2004 to 2014. RESULTS The annual incidence of CT varied from 0 to 14 cases per 10,000 live births, with a mean incidence of 6 cases per 10,000 during the 10 years studied (CI 95%: 3.02-8.91). The incidence of symptomatic CT varied from 0 to 9 cases per 10,000 live births, with a mean incidence of 5 per 10,000 (CI 95%: 2.44-6.94). There were 5 (14.3%) asymptomatic cases. The main findings were retinochoroiditis (54%), intracranial calcifications (37.5%) and altered cerebrospinal fluid (37.5%). CONCLUSIONS The incidence of CT and the rate of symptomatic cases were in accordance with the previous data from other studies in Brazil, being significantly higher than in previous North American and European studies.
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Hide G. Role of vertical transmission of Toxoplasma gondii in prevalence of infection. Expert Rev Anti Infect Ther 2016; 14:335-44. [PMID: 26807498 DOI: 10.1586/14787210.2016.1146131] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The parasite, Toxoplasma gondii, is a highly successful pathogen that infects around 30% of the global human population. Additionally, it is able to infect all warm blooded animals with high prevalence. This is surprising as it is a parasite of the cat and can only complete its full sexual cycle in that host. This review examines the important key routes of transmission: infective oocysts from the cat, ingestion of raw infected tissue and vertical transmission. The latter route of transmission has traditionally been thought to be rare. In this review, this assumption is examined and discussed in the light of the current literature. The available evidence points to the possibility that vertical transmission occurs frequently in natural populations of mice however the evidence in sheep is currently ambivalent and controversial. In humans, the situation appears as though vertical transmission may be rare although there is still much that is unexplained.
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Affiliation(s)
- Geoff Hide
- a Ecosystems and Environment Research Centre and Biomedical Research Centre, School of Environment and Life Sciences , University of Salford , Salford , UK
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Armengol C, Cassaing S, Roques-Malecaze C, Chauvin P, Iriart X, Berry A, Fillaux J. Time before anti-Toxoplasma IgG seroconversion detection by 7 commercial assays in French pregnant women. Diagn Microbiol Infect Dis 2016; 87:103-107. [PMID: 27884549 DOI: 10.1016/j.diagmicrobio.2016.10.020] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Revised: 10/18/2016] [Accepted: 10/19/2016] [Indexed: 11/28/2022]
Abstract
We assessed the ability to early detect a toxoplasmic seroconversion between 1 immunoblot (LDBIO II®) and 6 automated assays (TGS TA®, Architect®, Vidas II®, Liaison II®, Platelia®, and Elecsys®), comparing the time before anti-Toxoplasma gondii IgG detection during infection in pregnant women. From 2007 to 2015, 620 sera of 269 women were included. The median durations before positive IgG detection with Vidas II®, Liaison II®, Platelia®, and Elecsys® were significantly longer than Architect® with differential times from 11 to 28days (P<0.001). This time was significantly shortened by the use of LDBIO®, resulting in a saving of 13days (P<0.001). The detection of a positive rate of IgG with TGS TA® was as early as Architect® (P=0.105). The ability to early detect a toxoplasmic seroconversion is not equivalent between the assays and has to be considered when selecting the reagents to reduce the time to therapeutic intervention.
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Affiliation(s)
- Catherine Armengol
- Service de Parasitologie-Mycologie, Hôpital Purpan, Toulouse, 31059, France
| | - Sophie Cassaing
- Service de Parasitologie-Mycologie, Hôpital Purpan, Toulouse, 31059, France; Pharmacochimie et Biologie Pour le Développement (PHARMA-DEV), IRD UMR 152 Université Paul Sabatier, Toulouse, 31400, France
| | | | - Pamela Chauvin
- Service de Parasitologie-Mycologie, Hôpital Purpan, Toulouse, 31059, France
| | - Xavier Iriart
- Service de Parasitologie-Mycologie, Hôpital Purpan, Toulouse, 31059, France
| | - Antoine Berry
- Service de Parasitologie-Mycologie, Hôpital Purpan, Toulouse, 31059, France
| | - Judith Fillaux
- Service de Parasitologie-Mycologie, Hôpital Purpan, Toulouse, 31059, France; Pharmacochimie et Biologie Pour le Développement (PHARMA-DEV), IRD UMR 152 Université Paul Sabatier, Toulouse, 31400, France.
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Help in the Choice of Automated or Semiautomated Immunoassays for Serological Diagnosis of Toxoplasmosis: Evaluation of Nine Immunoassays by the French National Reference Center for Toxoplasmosis. J Clin Microbiol 2016; 54:3034-3042. [PMID: 27733631 DOI: 10.1128/jcm.01193-16] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2016] [Accepted: 09/28/2016] [Indexed: 11/20/2022] Open
Abstract
Toxoplasmosis, a benign infection, is asymptomatic or paucisymptomatic in over 80% of cases, except in immunocompetent patients suffering from ocular toxoplasmosis or in immunocompromised patients with opportunistic or congenital toxoplasmosis. Diagnosis is based mainly on serology testing. Thus, we compared the performance of the nine most commonly used commercial automated or semiautomated immunoassays for IgG and IgM Toxoplasma gondii antibody detection, that is, the Advia Centaur, Architect, AxSYM, Elecsys, Enzygnost, Liaison, Platelia, VIDAS, and VIDIA assays. The assays were conducted on four panels of serum samples derived during routine testing from patients with an interfering disease and who exhibited a low IgG antibody level in one of two clinical settings, namely, acute or chronic toxoplasmosis. As a result, IgG sensitivities ranged from 97.1% to 100%, and IgG specificities ranged from 99.5% to 100%. For IgG quantification, strong differences in IgG titers (expressed in IU/ml) were noted depending on the assay used. IgM sensitivities ranged from 65% to 97.9%, and IgM specificities ranged from 92.6% to 100%. For defining the best serological strategies to be implemented, it appears crucial to compare the diagnostic performance of the different tests with respect to their specificity and sensitivity in detecting the presence of IgG and IgM antibodies.
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Lassen B, Janson M, Viltrop A, Neare K, Hütt P, Golovljova I, Tummeleht L, Jokelainen P. Serological Evidence of Exposure to Globally Relevant Zoonotic Parasites in the Estonian Population. PLoS One 2016; 11:e0164142. [PMID: 27723790 PMCID: PMC5056716 DOI: 10.1371/journal.pone.0164142] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 09/20/2016] [Indexed: 12/27/2022] Open
Abstract
We investigated Estonian population and its selected subgroups for serological evidence of exposure to Ascaris lumbricoides, Echinococcus spp., Taenia solium, Toxocara canis, Toxoplasma gondii, and Trichinella spiralis. Serum samples from 999 adults representing general population, 248 children aged 14-18, 158 veterinarians, 375 animal caretakers, and 144 hunters were tested for specific immunoglobulin G antibodies against the selected parasites using commercial enzyme immunoassays (ELISA). Sera yielding positive or twice grey zone Echinococcus spp, T. solium, T. canis, and T. spiralis results were subjected to western blot (WB) analysis. In the general population, based on the ELISA results, the A. lumbricoides seroprevalence was 12.7%, Echinococcus spp. seroprevalence was 3.3%, T. solium seroprevalence was 0.7%, T. canis seroprevalence was 12.1%, T. gondii seroprevalence was 55.8%, and T. spiralis seroprevalence was 3.1%. Ascaris lumbricoides seroprevalences were higher in children and in animal caretakers than in the general population, and T. canis seroprevalence was higher in animal caretakers than in the general population. Compared with the general population, Echinococcus spp. seroprevalence was higher in children. By contrast, T. gondii seroprevalence was higher in animal caretakers, and lower in children, than in the general population. In the general population, the WB-confirmed Echinococcus spp. seroprevalence was 0.5%, T. solium cysticercosis seroprevalence was 0.0%, Toxocara spp. seroprevalence was 14.5%, and Trichinella spp. seroprevalence was 2.7%. WB-confirmed Toxocara spp. seroprevalence was higher in animal caretakers than in the general population. We found serological evidence of exposure to zoonotic parasites in all tested groups. This calls for higher awareness of zoonotic parasitic infections in Estonia.
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Affiliation(s)
- Brian Lassen
- Department of Basic Veterinary Sciences and Population Medicine, Institute of Veterinary Medicine and Animal Science, Estonian University of Life Sciences, Tartu, Estonia
- Department of Veterinary Disease Biology, University of Copenhagen, Frederiksberg C, Denmark
| | - Marilin Janson
- Department of Basic Veterinary Sciences and Population Medicine, Institute of Veterinary Medicine and Animal Science, Estonian University of Life Sciences, Tartu, Estonia
| | - Arvo Viltrop
- Department of Basic Veterinary Sciences and Population Medicine, Institute of Veterinary Medicine and Animal Science, Estonian University of Life Sciences, Tartu, Estonia
| | - Kädi Neare
- Department of Basic Veterinary Sciences and Population Medicine, Institute of Veterinary Medicine and Animal Science, Estonian University of Life Sciences, Tartu, Estonia
| | - Pirje Hütt
- Institute of Biomedicine and Translational Medicine, Chair of Medical Microbiology and Virology, Faculty of Medicine, University of Tartu, Tartu, Estonia
| | - Irina Golovljova
- Department of Virology, National Institute for Health Development, Tallinn, Estonia
| | - Lea Tummeleht
- Department of Basic Veterinary Sciences and Population Medicine, Institute of Veterinary Medicine and Animal Science, Estonian University of Life Sciences, Tartu, Estonia
| | - Pikka Jokelainen
- Department of Basic Veterinary Sciences and Population Medicine, Institute of Veterinary Medicine and Animal Science, Estonian University of Life Sciences, Tartu, Estonia
- Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland
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