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Cárdenas Sierra DM, Domínguez Julio GC, Blanco Oliveros MX, Soto JA, Tórres Morales E. Seroprevalencia y factores de riesgo asociados a toxoplasmosis gestacional en el Nororiente Colombiano. REVISTA CUIDARTE 2022. [DOI: 10.15649/cuidarte.2287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Highlights:
La toxoplasmosis gestacional podría constituir una grave problemática en ascenso en la población atendida en zona fronteriza nororiental de Colombia.
La incrementada reactividad IgM específica a T.gondii en mujeres gestantes representa una alarma para la generación de estrategias de impacto en la prevención de esta problemática, como población priorizada.
La seronegatividad frente a T.gondii, aún predominante en población gestante evaluada en región nororiental de Colombia, constituye un factor de riesgo relevante de toxoplasmosis gestacional, reflejado en alta susceptibilidad.
La considerable exposición a factores de riesgo de toxoplasmosis en el embarazo implica una clara oportunidad de mejora de la calidad del control prenatal, mediante atención integral.
Introducción:La toxoplasmosis es una zoonosis prevalente en un tercio de la población mundial, que afecta negativamente la salud materno-fetal causando daños de grado variable al feto. Objetivo: Se propuso evaluar el estado serológico IgG e IgM anti-Toxoplasma gondii y factores de riesgo relacionados, en mujeres gestantes de primer trimestre en Cúcuta, Colombia, en el año 2018. Materiales y métodos: Estudio transversal y correlacional en 111 mujeres participando voluntariamente, a quienes se testeó para IgM e IgG específicas por inmunoensayo LIA. Resultados: Se halló 19,8% y 35,1% de seropositividad total para IgM e IgG, respectivamente, 11,7% lo fue únicamente para IgM y 53,2% corresponde a la frecuencia de seronegatividad global para T.gondii; Se identificaron factores de riesgo (IC=95%) como consumo de carne mal cocida (54,1% de los casos, OR=1,8, p=0,120), de agua del grifo (48,6%, OR=1,4, p=0,421), de leche cruda de cabra o de vaca (39,6%, OR=0,78, p=0,553), además de convivencia con gatos (23,4%), éste último asociado significativamente a seropositividad al parásito (OR=2,8, p=0,025). Discusión y Conclusiones: Nuestros hallazgos revelan un posible riesgo de primo-infección en más de la mitad de la población gestante dada su seronegatividad frente al parásito, pero también una frecuencia considerable de casos con sospecha de infección muy reciente, lo que además de asociarse a un factor de riesgo previamente reconocido, deja entrever otros aspectos de riesgo en torno a la alimentación que deben impactarse mediante estrategias de prevención durante el control prenatal, sugiriendo la necesidad de fortalecer la vigilancia en torno al evento.
Como citar este artículo: Cárdenas Sierra Denny Miley, Domínguez Julio Camila, Blanco Oliveros María Ximena, Soto Javier Andrés, Tórres Morales Elizabeth. Seroprevalencia y factores de riesgo asociados a toxoplasmosis gestacional en el Nororiente Colombiano. Revista Cuidarte. 2023;14(1):e2287. http://dx.doi.org/10.15649/cuidarte.2287
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Benitez ADN, Gomes JF, Dias MUSS, Navarro IT, Mitsuka-Breganó R, Bresciani KDS. Characterization of prenatal healthcare for implementation of congenital toxoplasmosis surveillance program: cross-sectional study. SAO PAULO MED J 2020; 138:368-376. [PMID: 33111919 PMCID: PMC9673859 DOI: 10.1590/1516-3180.2019.0512.r2.10062020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Accepted: 06/10/2020] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Prenatal toxoplasmosis remains a neglected disease worldwide and few government programs focusing on its prevention are available. Success in these programs has been extensively reported in the literature, yet the strategies used for their implementation, as a model for such actions in different communities, have not been described. OBJECTIVE To describe the aspects of prenatal care strategies in 13 municipalities within the regional healthcare unit of Araçatuba, in the northwestern region of the state of São Paulo in 2017, focusing on congenital toxoplasmosis. DESIGN AND SETTING Descriptive study on prenatal healthcare within the Brazilian National Health System, in 13 participating municipalities. METHODS Data on serological tests, referral clinics, notifications, healthcare strategies, health education and drugs for infected children were requested through a questionnaire that was sent via e-mail to people responsible for healthcare services in these municipalities. RESULTS Major differences relating to diagnoses, reference outpatient clinics, notifications, health education and healthcare and drugs for infected children were reported among the prenatal strategies of these 13 municipal healthcare services. CONCLUSION The lack of standardized prenatal strategy in the study area may compromise the prevention of infection. However, our identification of each aspect of prenatal care corroborates the need to implement a healthcare surveillance program relating to congenital toxoplasmosis.
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Affiliation(s)
- Aline do Nascimento Benitez
- MSc, PhD. Veterinarian, Specialist in Zoonoses and Public Health and Postdoctoral Student, Postgraduate Program on Child and Adolescent Health, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil.
| | - Jancarlo Ferreira Gomes
- MSc, PhD. Parasitologist, Specialist in Public Health and Professor, Postgraduate Program on Child and Adolescent Health, School of Medical Sciences, Universidade Estadual de Campinas (UNICAMP), Campinas (SP), Brazil.
| | - Milenne Ura Seixas Santos Dias
- RN. Nurse, Specialist in Occupational Health and Regional Director, Group XI (GVE), “Prof Alexandre Vranjac” Epidemiological Surveillance Center, State Health Department of São Paulo, Araçatuba (SP), Brazil.
| | - Italmar Teodorico Navarro
- MSc, PhD. Parasitologist, Specialist in Zoonoses and Public Health and Professor, Department of Preventive Veterinary Medicine, Universidade Estadual de Londrina (UEL), Londrina (PR), Brazil.
| | - Regina Mitsuka-Breganó
- MSc, PhD. Parasitologist, Specialist in Zoonoses and Public Health and Professor, Department of Preventive Veterinary Medicine, Universidade Estadual de Londrina (UEL), Londrina (PR), Brazil.
| | - Katia Denise Saraiva Bresciani
- MSc, PhD. Parasitologist, Specialist in Zoonoses and Public Health and Professor, Department of Animal Production and Health, School of Veterinary Medicine, Universidade Estadual Paulista (UNESP), Araçatuba (SP), Brazil.
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Mareze M, Benitez ADN, Brandão APD, Pinto-Ferreira F, Miura AC, Martins FDC, Caldart ET, Biondo AW, Freire RL, Mitsuka-Breganó R, Navarro IT. Socioeconomic vulnerability associated to Toxoplasma gondii exposure in southern Brazil. PLoS One 2019; 14:e0212375. [PMID: 30763391 PMCID: PMC6375698 DOI: 10.1371/journal.pone.0212375] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Accepted: 01/31/2019] [Indexed: 12/21/2022] Open
Abstract
Human toxoplasmosis, a protozoonosis caused by Toxoplasma gondii, has been described as a worldwide foodborne disease with important public health impact. Despite infection has reportedly varied due to differences in alimentary, cultural and hygienic habits and geographic region, social vulnerability influence on toxoplasmosis distribution remains to be fully established. Accordingly, the present study has aimed to assess T. gondii seroprevalence and factors associated to social vulnerability for infection in households of Ivaiporã, southern Brazil, with 33.6% population making half minimum wage or less, ranked 1,055th in population (31,816 habitants), 1,406th in per capita income (U$ 211.80 per month) and 1,021st in HDI (0.764) out of 5,570 Brazilian cities. Serum samples and epidemiological questionnaires were obtained from citizen volunteers with official City Secretary of Health assistance in 2015 and 2016. In overall, serosurvey has revealed 526/715 (73.57%) positive samples for anti-T. gondii antibodies by Indirect Fluorescent Antibody Test. Logistic regression has shown a significant increase associated to adults (p = 0.021) and elderly (p = 0.014) people, illiterates (p = 0.025), unemployment (p <0.001) and lack of household water tank (p = 0.039). On the other hand, sex (male or female), living area (urban or rural), yard hygiene, meat ingestion, sand or land contact, owning pets (dog, cat or both) were not significant variables of positivity for anti-T. gondii antibodies in the surveyed population. Although no significant spatial cluster was found, high intensity areas of seropositive individuals were located in the Kernel map where the suburban neighborhoods are located. In conclusion, socioeconomic vulnerability determinants may be associated to Toxoplasma gondii exposure. The increased risk due to illiteracy, adult or elderly age, unemployment and lack of household water tank were confirmed by multivariate analysis and the influence of low family income for seropositivity by the spatial analysis.
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Affiliation(s)
- Marcelle Mareze
- Department of Preventive Veterinary Medicine, Laboratory of Zoonoses and Public Health, Londrina State University, Londrina, Paraná, Brazil
| | | | | | - Fernanda Pinto-Ferreira
- Department of Preventive Veterinary Medicine, Laboratory of Zoonoses and Public Health, Londrina State University, Londrina, Paraná, Brazil
| | - Ana Carolina Miura
- Department of Preventive Veterinary Medicine, Laboratory of Zoonoses and Public Health, Londrina State University, Londrina, Paraná, Brazil
| | - Felippe Danyel Cardoso Martins
- Department of Preventive Veterinary Medicine, Laboratory of Zoonoses and Public Health, Londrina State University, Londrina, Paraná, Brazil
| | - Eloiza Teles Caldart
- Department of Preventive Veterinary Medicine, Laboratory of Zoonoses and Public Health, Londrina State University, Londrina, Paraná, Brazil
| | - Alexander Welker Biondo
- Department of Veterinary Medicine, Federal University of Paraná, Curitiba, Paraná Brazil
- Department of Comparative Pathobiology, Purdue University, West Lafayette, Indiana United States of America
| | - Roberta Lemos Freire
- Department of Preventive Veterinary Medicine, Laboratory of Zoonoses and Public Health, Londrina State University, Londrina, Paraná, Brazil
| | - Regina Mitsuka-Breganó
- Department of Preventive Veterinary Medicine, Laboratory of Zoonoses and Public Health, Londrina State University, Londrina, Paraná, Brazil
| | - Italmar Teodorico Navarro
- Department of Preventive Veterinary Medicine, Laboratory of Zoonoses and Public Health, Londrina State University, Londrina, Paraná, Brazil
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