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Montalbano G, Kung VM, Franco-Paredes C, Vargas Barahona L, Chastain DB, Tuells J, Henao-Martínez AF, Montoya JG, Reno E. Positive Toxoplasma IgG Serology Is Associated with Increased Overall Mortality - A Propensity Score-Matched Analysis. Am J Trop Med Hyg 2024; 110:238-245. [PMID: 38109768 PMCID: PMC10859811 DOI: 10.4269/ajtmh.23-0537] [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: 08/12/2023] [Accepted: 10/06/2023] [Indexed: 12/20/2023] Open
Abstract
Toxoplasma gondii is a prevalent parasitic disease with significant morbidity and mortality in immunocompromised populations. We lack long-term outcomes for latent infections. We aimed to elucidate the relationship between latent T. gondii infection and mortality risk. We queried TriNetX, a international multicenter network, to validate mortality risk differences among patients with positive or negative toxoplasma IgG through propensity score matching (PSM). We excluded patients with toxoplasmosis disease by International Classification of Diseases codes or polymerase chain reaction testing. We found 28,138 patients with available toxoplasma IgG serology. Seropositive patients were older and had a male preponderance. More seropositive patients identified as Hispanic, Latino, or Black persons. Patients who were positive for T. gondii IgG serology were slightly more likely to have underlying heart failure, a transplanted organ or tissue, malignant neoplasms of lymphoid or hematopoietic tissues, and diseases of the nervous system than seronegative controls. After PSM of patients with positive (N = 6,475) and negative (N = 6,475) toxoplasma IgG serologies, toxoplasmosis-positive patients were more likely to have long-term drug use but less likely to suffer from behavioral disorders. The overall PSM 1- and 5-year mortality was higher among patients with a positive toxoplasma IgG serology. The risk of schizophrenia was increased at 5 years. We found a prevalence of toxoplasma IgG positivity of 0.03% during the last 3 years. Latent T. gondii associates with a higher overall mortality risk. The study of social determinants of health and follow-up studies are necessary to corroborate the findings and find possible causal mechanisms.
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Affiliation(s)
- Gabrielle Montalbano
- Division of Infectious Diseases, Department of Medicine, School of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, Colorado
| | - Vanessa M. Kung
- Division of Infectious Diseases, Department of Medicine, School of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, Colorado
| | - Carlos Franco-Paredes
- Hospital Infantil de México, Federico Gómez, Mexico City, Mexico
- Department of Microbiology, Immunology, and Pathology, Colorado State University, Fort Collins, Colorado
| | - Lilian Vargas Barahona
- Division of Infectious Diseases, Department of Medicine, School of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, Colorado
| | - Daniel B. Chastain
- Department of Clinical and Administrative Pharmacy, University of Georgia College of Pharmacy, Albany, Georgia
| | - Jose Tuells
- Department of Community Nursing, Preventive Medicine and Public Health and History of Science, University of Alicante, Spain
| | - Andrés F. Henao-Martínez
- Division of Infectious Diseases, Department of Medicine, School of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, Colorado
| | - José G. Montoya
- Jack S. Remington Laboratory for Specialty Diagnostics, National Reference Center for the Study and Diagnosis of Toxoplasmosis, Palo Alto, California
| | - Elaine Reno
- Department of Emergency Medicine, School of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, Colorado
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Rabaan AA, Uzairue LI, Alfaraj AH, Halwani MA, Muzaheed, Alawfi A, Alshengeti A, Al Kaabi NA, Alawad E, Alhajri M, Alwarthan S, Alshukairi AN, Almuthree SA, Alsubki RA, Alshehri NN, Alissa M, Albayat H, Zaidan TI, Alagoul H, Fraij AA, Alestad JH. Seroprevalence, Risk Factors and Maternal-Fetal Outcomes of Toxoplasma gondii in Pregnant Women from WHO Eastern Mediterranean Region: Systematic Review and Meta-Analysis. Pathogens 2023; 12:1157. [PMID: 37764965 PMCID: PMC10537388 DOI: 10.3390/pathogens12091157] [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: 03/17/2023] [Revised: 09/07/2023] [Accepted: 09/08/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUND The protozoan parasite Toxoplasma gondii may cause serious illness in the immunocompromised. The Toxoplasma gondii seropositive prevalence in pregnant women in WHO Eastern Mediterranean Region countries is inconsistent in the literature and it is associated with outcomes that have not be fully elucidated, hence the need for a better understanding of the pooled seroprevalence and associated maternal and fetal outcomes. OBJECTIVE The objective was to conduct a systematic literature review and determine the pooled prevalence of WHO Eastern Mediterranean Regional countries' pregnant women's seroprevalence of Toxoplasma gondii and the maternal-fetal outcomes. METHODS This quantitative study examined WHO Eastern Mediterranean countries' maternal-fetal outcomes and Toxoplasma gondii prevalence in pregnant women. The targeted population was pregnant women, while the primary outcome was seropositivity of Toxoplasma gondii, while other outcomes such as maternal and fetal associations and risk factors were determined PubMed, SCOPUS, MEDLINE, and Index Medicus for the Eastern Mediterranean Region (IMEMR) databases were searched up until 30 January 2023. The search terms used were "Toxoplasma gondii" OR "Toxoplasma infection" AND "Pregnant woman" or pregnan* OR Antenatal OR Prenatal OR Gravidity OR Parturition OR Maternal AND WHO Eastern Mediterranean Region). OpenMeta-Analyst and Jamovi were used to analyze the generated data. RESULTS In total, 95 of 2947 articles meeting the inclusion criteria examined Toxoplasma gondii prevalence in pregnant women from WHO Eastern Mediterranean countries. The pooled prevalence of Toxoplasma gondii in pregnant women was 36.5% (95%CI: 32.6-40.4) with a median value of 35.64%, range values of 1.38-75.30%, with 99.61% heterogeneity. The pooled seroprevalence of IgG of Toxoplasma gondii was 33.5% (95%CI: 29.8-37.2) with a median value of 33.51%, and a range values of 1.38-69.92%; the pooled seroprevalence of IgM was 3.6% (95%CI: 3.1-4.1)) with a median value of 3.62 and range values of 0.20-17.47%, while cases of pooled seroprevalence of both IgG and IgM positivity was 3.0% (95%CI: 1.9-4.4) with a median value of 2.05 and a range values of 0.05-16.62%. Of the Toxoplasma gondii seropositive women, 1281/3389 (34.8%) 174/1765 (32.9%), 1311/3101 (43.7%), and 715/1683 (40.8%) of them had contact with cats, drank unprocessed milk, ate raw or undercooked meat and ate unwashed raw vegetables, respectively. The maternal-fetal outcomes associated with Toxoplasma gondii seropositivity were a history of abortions, miscarriage, stillbirth, intrauterine fetal death, and premature birth, which were found in 868/2990 (32.5%), 112/300 (36.1%), 111/375 (25.7%), 3/157 (1.9%) and 96/362 (20.1%) of women who tested positive for Toxoplasma gondii antibodies. CONCLUSION The study found a high proportion of Toxoplasma gondii seroprevalence in pregnant women in the WHO Eastern Mediterranean Region, which may be linked to poor outcomes for mothers and their babies. Thus, pregnant women require monitoring and comprehensive prevention strategies for Toxoplasma gondii infection.
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Affiliation(s)
- Ali A. Rabaan
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, Dhahran 31311, Saudi Arabia
- College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia
- Department of Public Health and Nutrition, The University of Haripur, Haripur 22610, Pakistan
| | - Leonard Ighodalo Uzairue
- Department of Medical Laboratory Science, Federal University, Oye-Ekiti 371104, Ekiti State, Nigeria
| | - Amal H. Alfaraj
- Pediatric Department, Abqaiq General Hospital, First Eastern Health Cluster, Abqaiq 33261, Saudi Arabia
| | - Muhammad A. Halwani
- Department of Medical Microbiology, Faculty of Medicine, Al Baha University, Al Baha 47810, Saudi Arabia
| | - Muzaheed
- Department of Clinical Laboratory Science, College of Applied Medical Sciences, Imam Abdulrahman Bin Faisal University, Dammam 31441, Saudi Arabia
| | - Abdulsalam Alawfi
- Department of Pediatrics, College of Medicine, Taibah University, Al-Madinah 41491, Saudi Arabia
| | - Amer Alshengeti
- Department of Pediatrics, College of Medicine, Taibah University, Al-Madinah 41491, Saudi Arabia
- Department of Infection Prevention and Control, National Guard Health Affairs, Prince Mohammad Bin Abdulaziz Hospital, Al-Madinah 41491, Saudi Arabia
| | - Nawal A. Al Kaabi
- Department of Pediatric Infectious Disease, Sheikh Khalifa Medical City, Abu Dhabi 51900, United Arab Emirates
- College of Medicine and Health Science, Khalifa University, Abu Dhabi 127788, United Arab Emirates
| | - Eman Alawad
- Adult Infectious Diseases Department, Prince Mohammed Bin Abdulaziz Hospital, Riyadh 11474, Saudi Arabia
| | - Mashael Alhajri
- Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia
| | - Sara Alwarthan
- Department of Internal Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam 34212, Saudi Arabia
| | - Abeer N. Alshukairi
- College of Medicine, Alfaisal University, Riyadh 11533, Saudi Arabia
- Department of Medicine, King Faisal Specialist Hospital and Research Center, Jeddah 21499, Saudi Arabia
| | - Souad A. Almuthree
- Department of Infectious Disease, King Abdullah Medical City, Makkah 43442, Saudi Arabia
| | - Roua A. Alsubki
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, King Saud University, Riyadh 11362, Saudi Arabia
| | - Nada N. Alshehri
- Internal Medicine Department, College of Medicine, King Khalid University Medical City, Abha 61481, Saudi Arabia
| | - Mohammed Alissa
- Department of Medical Laboratory Sciences, College of Applied Medical Sciences, Prince Sattam Bin Abdulaziz University, Al-Kharj 11942, Saudi Arabia
| | - Hawra Albayat
- Infectious Disease Department, King Saud Medical City, Riyadh 7790, Saudi Arabia
| | - Tasneem I. Zaidan
- Pediatric Department, King Abdulaziz Hospital, Jeddah 23831, Saudi Arabia
| | - Hassan Alagoul
- Blood Bank Section, Dammam Regional Laboratory and Blood Bank, Dammam 31411, Saudi Arabia
| | - Ali Al Fraij
- Medical Laboratories & Blood Bank Department, Jubail Health Network, Eastern Health Cluster, Ministry of Health, Jubail 35514, Saudi Arabia
| | - Jeehan H. Alestad
- Immunology and Infectious Microbiology Department, University of Glasgow, Glasgow G1 1XQ, UK
- Microbiology Department, Collage of Medicine, Jabriya 46300, Kuwait
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El Saftawy EA, Turkistani SA, Alghabban HM, Albadawi EA, Ibrahim BEA, Morsy S, Farag MF, Al Hariry NS, Shash RY, Elkazaz A, Amin NM. Effects of Lactobacilli acidophilus and/or spiramycin as an adjunct in toxoplasmosis infection challenged with diabetes. Food Waterborne Parasitol 2023; 32:e00201. [PMID: 37719029 PMCID: PMC10504688 DOI: 10.1016/j.fawpar.2023.e00201] [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: 04/09/2023] [Revised: 06/25/2023] [Accepted: 06/26/2023] [Indexed: 09/19/2023] Open
Abstract
The current study assessed the anti-parasitic impact of probiotics on Toxoplasma gondii infection either solely or challenged with diabetes in Swiss albino mice. The study design encompassed group-A (diabetic), group-B (non-diabetic), and healthy controls (C). Each group was divided into infected-untreated (subgroup-1); infected and spiramycin-treated (subgroup-2); infected and probiotic-treated (subgroup-3); infected and spiramycin+ probiotic-treated (subgroup-4). Diabetic-untreated animals exhibited acute toxoplasmosis and higher cerebral parasite load. Overall, various treatments reduced intestinal pathology, improved body weight, and decreased mortalities; nevertheless, probiotic + spiramycin exhibited significant differences. On day 7 post-infection both PD-1 and IL-17A demonstrated higher scores in the intestine of diabetic-untreated mice compared with non-diabetics and healthy control; whereas, claudin-1 revealed worsening expression. Likewise, on day 104 post-infection cerebral PD-1 and IL-17A showed increased expressions in diabetic animals. Overall, treatment modalities revealed lower scores of PD-1 and IL-17A in non-diabetic subgroups compared with diabetics. Intestinal and cerebral expressions of IL-17A and PD-1 demonstrated positive correlations with cerebral parasite load. In conclusion, toxoplasmosis when challenged with diabetes showed massive pathological features and higher parasite load in the cerebral tissues. Probiotics are a promising adjunct to spiramycin by ameliorating IL-17A and PD-1 in the intestinal and cerebral tissues, improving the intestinal expression of claudin-1, and efficiently reducing the cerebral parasite load.
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Affiliation(s)
- Enas A. El Saftawy
- Medical Parasitology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
- Medical Parasitology Department, Faculty of Medicine, Armed Forces College of Medicine, Cairo, Egypt
| | | | - Hadel M. Alghabban
- Department of Biochemistry and Molecular Medicine, College of Medicine, Taibah University, Saudi Arabia
| | - Emad A. Albadawi
- Department of Anatomy, College of Medicine, Taibah University, Saudi Arabia
| | - Basma EA Ibrahim
- Physiological Sciences Department, Fakeeh College for Medical Sciences, Saudi Arabia
- Faculty of Medicine, Cairo University, Egypt
| | - Suzan Morsy
- Pathological Sciences Department, Fakeeh College for Medical Sciences, Saudi Arabia
- Department of Clinical Pharmacology, Alexandria, Egypt
| | - Mohamed F. Farag
- Medical Physiology Department, Armed Forces College of Medicine, Cairo, Egypt
| | | | - Rania Y. Shash
- Medical Microbiology and Immunology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Aly Elkazaz
- Pediatric Department, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Noha M. Amin
- Medical Parasitology Department, Faculty of Medicine, Cairo University, Cairo, Egypt
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Development, structural, spectroscopic and in silico investigation of new complexes relevant as anti-toxoplasma metallopharmacs. J Mol Struct 2022. [DOI: 10.1016/j.molstruc.2022.133380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Thomas KM, Kibona T, Claxton JR, de Glanville WA, Lankester F, Amani N, Buza JJ, Carter RW, Chapman GE, Crump JA, Dagleish MP, Halliday JEB, Hamilton CM, Innes EA, Katzer F, Livingstone M, Longbottom D, Millins C, Mmbaga BT, Mosha V, Nyarobi J, Nyasebwa OM, Russell GC, Sanka PN, Semango G, Wheelhouse N, Willett BJ, Cleaveland S, Allan KJ. Prospective cohort study reveals unexpected aetiologies of livestock abortion in northern Tanzania. Sci Rep 2022; 12:11669. [PMID: 35803982 PMCID: PMC9270399 DOI: 10.1038/s41598-022-15517-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 06/24/2022] [Indexed: 11/15/2022] Open
Abstract
Livestock abortion is an important cause of productivity losses worldwide and many infectious causes of abortion are zoonotic pathogens that impact on human health. Little is known about the relative importance of infectious causes of livestock abortion in Africa, including in subsistence farming communities that are critically dependent on livestock for food, income, and wellbeing. We conducted a prospective cohort study of livestock abortion, supported by cross-sectional serosurveillance, to determine aetiologies of livestock abortions in livestock in Tanzania. This approach generated several important findings including detection of a Rift Valley fever virus outbreak in cattle; high prevalence of C. burnetii infection in livestock; and the first report of Neospora caninum, Toxoplasma gondii, and pestiviruses associated with livestock abortion in Tanzania. Our approach provides a model for abortion surveillance in resource-limited settings. Our findings add substantially to current knowledge in sub-Saharan Africa, providing important evidence from which to prioritise disease interventions.
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Affiliation(s)
- Kate M Thomas
- Centre for International Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
- Kilimanjaro Clinical Research Institute, Good Samaritan Foundation, Moshi, United Republic of Tanzania.
- Ministry for Primary Industries, New Zealand Food Safety, Wellington, New Zealand.
| | - Tito Kibona
- Nelson Mandela African Institution of Science and Technology (NM-AIST), Tengeru, United Republic of Tanzania
| | - John R Claxton
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - William A de Glanville
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Felix Lankester
- Paul G. Allen School for Global Animal Health, Washington State University, Pullman, WA, USA
- Global Animal Health Tanzania, Arusha, United Republic of Tanzania
| | - Nelson Amani
- Kilimanjaro Clinical Research Institute, Good Samaritan Foundation, Moshi, United Republic of Tanzania
| | - Joram J Buza
- Nelson Mandela African Institution of Science and Technology (NM-AIST), Tengeru, United Republic of Tanzania
| | - Ryan W Carter
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Gail E Chapman
- School of Veterinary Medicine, University of Glasgow, Glasgow, UK
| | - John A Crump
- Centre for International Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
- Kilimanjaro Christian Medical University College, Moshi, United Republic of Tanzania
| | | | - Jo E B Halliday
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | | | | | | | | | | | - Caroline Millins
- School of Veterinary Medicine, University of Glasgow, Glasgow, UK
- Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK
| | - Blandina T Mmbaga
- Kilimanjaro Clinical Research Institute, Good Samaritan Foundation, Moshi, United Republic of Tanzania
- Kilimanjaro Christian Medical University College, Moshi, United Republic of Tanzania
| | - Victor Mosha
- Kilimanjaro Clinical Research Institute, Good Samaritan Foundation, Moshi, United Republic of Tanzania
| | - James Nyarobi
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Obed M Nyasebwa
- Ministry of Livestock and Fisheries, Zonal Veterinary Centre-Arusha, Arusha, United Republic of Tanzania
| | | | - Paul N Sanka
- Tanzania Veterinary Laboratory Agency, Arusha, United Republic of Tanzania
| | - George Semango
- Nelson Mandela African Institution of Science and Technology (NM-AIST), Tengeru, United Republic of Tanzania
| | - Nick Wheelhouse
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, UK
| | - Brian J Willett
- Medical Research Council, University of Glasgow Centre for Virus Research, Glasgow, UK
| | - Sarah Cleaveland
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
| | - Kathryn J Allan
- Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, UK
- School of Veterinary Medicine, University of Glasgow, Glasgow, UK
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Cook EAJ, Gitahi N, de Glanville WA, Thomas LF, Kariuki S, Kang'ethe E, Fèvre EM. Prevalence and risk factors for exposure to Toxoplasma gondii in slaughterhouse workers in western Kenya. BMC Infect Dis 2021; 21:944. [PMID: 34511066 PMCID: PMC8436527 DOI: 10.1186/s12879-021-06658-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 09/06/2021] [Indexed: 01/23/2023] Open
Abstract
Background Toxoplasma gondii is a zoonotic protozoan parasite infecting warm-blooded animals. Infection in people can occur through ingestion of oocysts passed in the faeces of the definitive hosts; ingestion of bradyzoites in the tissue of infected intermediate hosts; or exposure to tachyzoites in raw milk and eggs. Slaughterhouse workers are considered a high-risk group for T. gondii exposure because of their contact with raw meat, although a positive relationship between handling raw meat and T. gondii seropositivity has not been demonstrated in all studies. This study aimed to determine the seroprevalence of antibodies to T. gondii in slaughterhouse workers in Kenya and identify risk factors associated with seropositivity. Methods A survey of slaughterhouse workers was conducted in 142 slaughter facilities in the study area. Information regarding demographics, contact with livestock, meat consumption, and practices in the slaughterhouse was collected using structured questionnaires. Commercial ELISAs were used to detect IgM and IgG antibodies against T. gondii and a multi-level logistic regression model was used to identify potential risk factors for seropositivity in slaughterhouse workers. Results The apparent prevalence of antibodies to T. gondii was 84.0% (95% Confidence Interval (CI) 81.2–86.5%) for IgG and 2.2% (95% CI 1.3–3.5%) for IgM antibodies. All IgM positive individuals were IgG positive. Risk factors for exposure to T. gondii were: increasing age (Odds Ratio (OR) 1.03; 95% CI 1.01–1.05); owning poultry (OR 2.00; 95% CI 1.11–3.62); and consuming animal blood (OR 1.92; 95% CI 1.21–3.03). Conclusions The seroprevalence of antibodies to T. gondii was very high in this population and considerably higher than published values in the general population. Risk factors included age, owning poultry and drinking animal blood which were consistent with previous reports but none were specifically associated with working in the slaughterhouse. In this instance slaughterhouse workers may represent a useful sentinel for the general population where the level of exposure is also likely to be high and may signify an unidentified public health risk to vulnerable groups such as pregnant women. A detailed understanding of the epidemiology of infection is required, which should include an assessment of incidence, mortality, and burden since T. gondii infection is likely to have life-long sequelae.
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Affiliation(s)
- Elizabeth Anne Jessie Cook
- International Livestock Research Institute, Old Naivasha Road, P.O. Box 30709, Nairobi, 00100, Kenya. .,Institute of Infection Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Neston, CH64 7TE, UK.
| | - Nduhiu Gitahi
- University of Nairobi, P.O. Box 29053, Nairobi, 00625, Kenya
| | - William Anson de Glanville
- International Livestock Research Institute, Old Naivasha Road, P.O. Box 30709, Nairobi, 00100, Kenya.,Center for One Health, University of Global Health Equity, Kigali, Rwanda
| | - Lian F Thomas
- International Livestock Research Institute, Old Naivasha Road, P.O. Box 30709, Nairobi, 00100, Kenya.,Institute of Infection Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Neston, CH64 7TE, UK
| | - Samuel Kariuki
- Kenya Medical Research Institute, P.O. Box 19464, Nairobi, 00200, Kenya
| | | | - Eric Maurice Fèvre
- International Livestock Research Institute, Old Naivasha Road, P.O. Box 30709, Nairobi, 00100, Kenya.,Institute of Infection Veterinary and Ecological Sciences, University of Liverpool, Leahurst Campus, Neston, CH64 7TE, UK
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Deka S, Kalita D, Gupta P, Mathuria YP. A contemporary insight into the sero-epidemiology of Toxoplasma gondii infection in the foot-hills of Himalayas: A cross-sectional study from a tertiary care center in Northern India. Nepal J Epidemiol 2021; 11:937-948. [PMID: 33868740 PMCID: PMC8033644 DOI: 10.3126/nje.v11i1.34228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 03/28/2021] [Accepted: 03/28/2021] [Indexed: 11/18/2022] Open
Abstract
Background Toxoplasma gondii infects 30-50% of the world's population with high diversity in the geo-epidemiology and seroprevalence. The burden of toxoplasmosis and its determinants from remote and vulnerable regions of India is unknown. Therefore, this study aim to evaluate the prevalence of toxoplasma antibodies and factors associated with seropositivity among individuals from Uttarakhand and adjoining areas. Methods Serum samples from 442 cases were tested for anti-Toxoplasma IgG and IgM antibodies by Enzyme-linked Immunosorbent Assay. Association of seropositivity of toxoplasmosis with age, gender, place of residence, dietary habits, and comorbidities were analyzed using binary logistic regression analysis. Results The overall Toxoplasma seropositivity was found to be 36.88% [95% Confidence Interval (CI)=30.40-39.28]. While anti-T. gondii IgG was present in 34.84% [95% CI=30.40-39.28], anti-IgM was detected in 6.33% [95% CI=4.06-8.61]. The overall and IgG seroprevalence increased with age in both the genders and there was a sharp increase in the seropositivity after the age of 40 years [adjusted Odds Ratio (aOR)=2.98, p-value=0.030]. The seropositivity rate was significantly higher in individuals from Uttarakhand in both the hilly region (aOR=5.61; 95%CI:[2.14-14.68]) and plains (aOR=5.14; 95%CI:[2.2-12.02]). Multivariable logistic regression analysis also showed that being rural residents (aOR=3.23; 95%CI:[1.67-6.23]) and presence of comorbidities (aOR=8.64; 95%CI:[4.62-16.18]) were potential risk factors of Toxoplasmosis. On the other hand, consumption of vegetarian diet was found to have a protective effect (aOR=0.46; 95%CI:[0.28-0.75]). Conclusion Seroprevalence of T. gondii antibodies was relatively high in Uttarakhand, particularly in rural and hilly terrain, indicating a necessity for the implementation of integrated public health strategies to prevent and control toxoplasmosis in this region.
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Affiliation(s)
- Sangeeta Deka
- Department of Microbiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.,Fakhruddin Ali Ahmed Medical College and Hospital, Barpeta, Assam, India
| | - Deepjyoti Kalita
- Department of Microbiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Pratima Gupta
- Department of Microbiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Yogendra Pratap Mathuria
- Department of Microbiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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Elsheikha HM, Marra CM, Zhu XQ. Epidemiology, Pathophysiology, Diagnosis, and Management of Cerebral Toxoplasmosis. Clin Microbiol Rev 2021; 34:e00115-19. [PMID: 33239310 PMCID: PMC7690944 DOI: 10.1128/cmr.00115-19] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Toxoplasma gondii is known to infect a considerable number of mammalian and avian species and a substantial proportion of the world's human population. The parasite has an impressive ability to disseminate within the host's body and employs various tactics to overcome the highly regulatory blood-brain barrier and reside in the brain. In healthy individuals, T. gondii infection is largely tolerated without any obvious ill effects. However, primary infection in immunosuppressed patients can result in acute cerebral or systemic disease, and reactivation of latent tissue cysts can lead to a deadly outcome. It is imperative that treatment of life-threatening toxoplasmic encephalitis is timely and effective. Several therapeutic and prophylactic regimens have been used in clinical practice. Current approaches can control infection caused by the invasive and highly proliferative tachyzoites but cannot eliminate the dormant tissue cysts. Adverse events and other limitations are associated with the standard pyrimethamine-based therapy, and effective vaccines are unavailable. In this review, the epidemiology, economic impact, pathophysiology, diagnosis, and management of cerebral toxoplasmosis are discussed, and critical areas for future research are highlighted.
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Affiliation(s)
- Hany M Elsheikha
- Faculty of Medicine and Health Sciences, School of Veterinary Medicine and Science, University of Nottingham, Loughborough, United Kingdom
| | - Christina M Marra
- Departments of Neurology and Medicine, University of Washington School of Medicine, Seattle, Washington, USA
| | - Xing-Quan Zhu
- State Key Laboratory of Veterinary Etiological Biology, Key Laboratory of Veterinary Parasitology of Gansu Province, Lanzhou Veterinary Research Institute, Chinese Academy of Agricultural Sciences, Lanzhou, Gansu Province, People's Republic of China
- College of Veterinary Medicine, Shanxi Agricultural University, Taigu, Shanxi Province, People's Republic of China
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Prevalence and risk factors for typical signs and symptoms of toxoplasmosis in children born to at risk pregnant women attending prenatal care in Temeke district, Tanzania. SCIENTIFIC AFRICAN 2021. [DOI: 10.1016/j.sciaf.2020.e00690] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
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Li K, Grooms GM, Khan SM, Hernandez AG, Witola WH, Stec J. Novel acyl carbamates and acyl / diacyl ureas show in vitro efficacy against Toxoplasma gondii and Cryptosporidium parvum. Int J Parasitol Drugs Drug Resist 2020; 14:80-90. [PMID: 33011650 PMCID: PMC7529613 DOI: 10.1016/j.ijpddr.2020.08.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Revised: 08/07/2020] [Accepted: 08/19/2020] [Indexed: 11/28/2022]
Abstract
Toxoplasma gondii and Cryptosporidium parvum are protozoan parasites that are highly prevalent and opportunistically infect humans worldwide, but for which completely effective and safe medications are lacking. Herein, we synthesized a series of novel small molecules bearing the diacyl urea scaffold and related structures, and screened them for in vitro cytotoxicity and antiparasitic activity against T. gondii and C. parvum. We identified one compound (GMG-1-09), and four compounds (JS-1-09, JS-2-20, JS-2-35 and JS-2-49) with efficacy against C. parvum and T. gondii, respectively, at low micromolar concentrations and showed appreciable selectivity in human host cells. Among the four compounds with efficacy against T. gondii, JS-1-09 representing the diacyl urea scaffold was the most effective, with an anti-Toxoplasma IC50 concentration (1.21 μM) that was nearly 53-fold lower than its cytotoxicity IC50 concentration, indicating that this compound has a good selectivity index. The other three compounds (JS-2-20, JS-2-35 and JS-2-49) were structurally more divergent from JS-1-09 as they represent the acyl urea and acyl carbamate scaffold. This appeared to correlate with their anti-Toxoplasma activity, suggesting that these compounds' potency can likely be enhanced by selective structural modifications. One compound, GMG-1-09 representing acyl carbamate scaffold, depicted in vitro efficacy against C. parvum with an IC50 concentration (32.24 μM) that was 14-fold lower than its cytotoxicity IC50 concentration in a human intestinal cell line. Together, our studies unveil a series of novel synthetic acyl/diacyl urea and acyl carbamate scaffold-based small molecule compounds with micromolar activity against T. gondii and C. parvum that can be explored further for the development of the much-needed novel anti-protozoal drugs.
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Affiliation(s)
- Kun Li
- Department of Pathobiology, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Urbana, IL 61802, USA
| | - Gregory M Grooms
- Chicago State University, College of Pharmacy, Department of Pharmaceutical Sciences, 9501 S. King Drive, Chicago, IL 60628, USA
| | - Shahbaz M Khan
- Department of Pathobiology, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Urbana, IL 61802, USA
| | - Anolan Garcia Hernandez
- Chicago State University, College of Pharmacy, Department of Pharmaceutical Sciences, 9501 S. King Drive, Chicago, IL 60628, USA
| | - William H Witola
- Department of Pathobiology, College of Veterinary Medicine, University of Illinois at Urbana-Champaign, Urbana, IL 61802, USA.
| | - Jozef Stec
- Chicago State University, College of Pharmacy, Department of Pharmaceutical Sciences, 9501 S. King Drive, Chicago, IL 60628, USA; Marshall B. Ketchum University, College of Pharmacy, Department of Pharmaceutical Sciences, 2575 Yorba Linda Blvd., Fullerton, CA 82831, USA.
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11
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Ahlers AA, Wolf TM, Aarrestad O, Windels SK, Olson BT, Matykiewicz BR, Dubey JP. Survey of Toxoplasma gondii Exposure in Muskrats in a Relatively Pristine Ecosystem. J Parasitol 2020; 106:346-349. [PMID: 32294183 DOI: 10.1645/19-126] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Waterborne transmission of Toxoplasma gondii is assumed to be enhanced in areas with human-altered landscapes (e.g., urbanization, agriculture) and increased populations of non-native domestic and feral cats (Felis catus). However, little is known concerning T. gondii exposure risks in more natural watersheds (e.g., reduced human footprint, no domestic or feral cats) to establish a baseline for comparisons. In this study, muskrats (Ondatra zibethicus) were used as sentinels to assess baseline T. gondii exposure in a relatively pristine watershed in the Greater Voyageurs Ecosystem, northern Minnesota, during the summers of 2018-2019. Toxoplasma gondii antibodies were assayed in sera of live-trapped muskrats (n = 70) using a modified agglutination test. None of our samples were positive for T. gondii antibodies (P = 0.00, 95% Wald Score Confidence Interval = 0.00-0.05). This study establishes a baseline to compare T. gondii waterborne transmission risks in other human-modified watersheds.
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Affiliation(s)
- A A Ahlers
- Kansas State University, Department of Horticulture and Natural Resources, 1712 Claflin Road, Manhattan, Kansas 66506
| | - T M Wolf
- University of Minnesota, Department of Veterinary Population Medicine, 1988 Fitch Avenue, St. Paul, Minnesota 55108
| | - O Aarrestad
- University of Minnesota, Department of Veterinary Population Medicine, 1988 Fitch Avenue, St. Paul, Minnesota 55108
| | - S K Windels
- United States National Park Service, Voyageurs National Park, 360 Highway 11 East, International Falls, Minnesota 56649
| | - B T Olson
- United States National Park Service, Voyageurs National Park, 360 Highway 11 East, International Falls, Minnesota 56649
| | - B R Matykiewicz
- Kansas State University, Department of Horticulture and Natural Resources, 1712 Claflin Road, Manhattan, Kansas 66506
| | - J P Dubey
- United States Department of Agriculture, Agricultural Research Service, Beltsville Agricultural Research Center, Animal Parasitic Diseases Laboratory, Beltsville, Maryland 20705
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12
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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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