High performance of a novel point-of-care blood test for Toxoplasma infection in women from diverse regions of Morocco.

Point-of-care (POC) testing for Toxoplasma infection has the potential to revolutionize diagnosis and management of toxoplasmosis, especially in high-risk populations in areas with significant environmental contamination and poor health infrastructure precluding appropriate follow-up and preventing access to medical care. Toxoplasmosis is a significant public health challenge in Morocco, with a relatively heavy burden of infection and, to this point, minimal investment nationally to address this infection. Herein, we analyse the performance of a novel, low-cost rapid test using fingerstick-derived whole blood from 632 women (82 of whom were pregnant) from slums, educational centres, and from nomad groups across different geographical regions (i.e. oceanic, mountainous) of Morocco. The POC test was highly sensitive and specific from all settings. In the first group of 283 women, sera were tested by Platelia ELISA IgG and IgM along with fingerstick whole blood test. Then a matrix study with 349 women was performed in which fingerstick - POC test results and serum obtained by venipuncture contemporaneously were compared. These results show high POC test performance (Sensitivity: 96.4% [IC95 90.6-98.9%]; Specificity: 99.6% [IC95 97.3-99.9%]) and high prevalence of Toxoplasma infection among women living in rural and mountainous areas, and in urban areas with lower educational levels. The high performance of POC test confirms that it can reduce the need for venipuncture and clinical infrastructure in a low-resource setting. It can be used to efficiently perform seroprevalence determinations in large group settings across a range of demographics, and potentially expands healthcare access, thereby preventing human suffering.

Food safety assessment and risk for toxoplasmosis in school restaurants in Armenia, Colombia.

We assessed the risk for toxoplasmosis in 10 school restaurants in Armenia (Quindio, Colombia). We analyzed the presence of Toxoplasma gondii DNA in the food, water, and living and inert surfaces of school restaurants, and we correlated these findings with the results of food safety inspection scores and with the prevalence of specific anti-T. gondii antibodies in children who ate at these restaurants. Of the 213 samples, 6.1% were positive using PCR to test for T. gondii DNA. Positive samples were found in meat, water, cucumber, guava juice, inert surfaces, and living surfaces. In 60% (6/10) of the public school restaurants, there was at least one PCR T. gondii-positive sample. In 311 serum samples from children who attended the restaurants, 101 (33%) were positive for IgG and 12 (3.9%) for IgM anti-T. gondii. The median of the compound score for the fulfillment of inspection for food safety conditions was of 60.7% (range 50-72). Higher T. gondii PCR positivity in surfaces, food, or water at each restaurant was correlated with lower inspection scores for water supply and water storage conditions. Lower scores in physical infrastructure and disinfection procedures and higher scores in furniture were correlated with a higher prevalence of IgG anti-T. gondii in children who ate at those restaurants. Inspection scores can identify restaurants with a higher risk for the presence of T. gondii.

Toxoplasma Screening Results of 84587 Pregnant Women in a Tertiary Referral Center in Turkey.

Aim: To determine the seroprevalence of Toxoplasma in a tertiary referral center in Turkey and to discuss the benefits and drawbacks of routine antenatal screening. Materials and methods: A serologic test for Toxoplasma is free of charge for all pregnant women as part of routine antenatal care at their first prenatal visit. The study was conducted between 2008 and 2017. Results: The frequency of Toxoplasma IgG and IgM seropositivity was 22.3% and 0.64%, respectively. Low avidity was detected in 142 patients and 60 PCR tests were performed with no positive result. A total of 33 mothers with low IgG avidity and negative PCR received prophylactic treatment, and no congenital toxoplasmosis was documented in this study. Conclusion: Universal screening for Toxoplasma in pregnancy is a subject of debate. As the prevalence in Turkey is higher compared to other countries, more studies are needed to identify the necessity of routine screening.

Toxoplasma gondii: seroprevalence and associated risk factors among preschool-aged children in Osun State, Nigeria.

Background: Toxoplasma gondii is an ubiquitous apicomplexan parasite, which causes toxoplasmosis in animals and humans worldwide. However, little is known about T. gondii infection among preschool-aged children in Nigeria. Methods: A cross-sectional study of 272 preschool children aged 2.25±1.09 years from four communities (Edunabon, Erin-Ijesha, Ijebu-jesa and Ile-Ife) in Osun State, Nigeria was conducted between January and July 2016, and the demographic data was obtained via questionnaires. Antibody titres against T. gondii of serum samples were assessed by ELISA. Results: The overall seroprevalence of T. gondii infection was 6.9% (19/272). There was no significant difference in seroprevalence of T. gondii infection between boys (7.04%; 10/142) and girls (6.92%; 9/130; p=0.97). No associations were found between age, gender, parental educational level, occupation and religion, and T. gondii seropositivity. None showed statistical significance between the risk factors tested after multivariate adjustment; nevertheless, residing in Ijebu-jesa community was shown to be associated with an increased risk of infection (p=0.04). Conclusion: This is the first report of T. gondii infection among preschool children in Nigeria. Prevalence studies such as this could help in the development of strategies for the future for disease prevention and control of T. gondii transmission.

[Seroepidemiology of Toxoplasma gondii in elderly individuals treated under the Family Health Strategy, Porto Alegre, Rio Grande do Sul, Brazil]. / Soroepidemiologia de Toxoplasma gondii em idosos atendidos pela Estratégia Saúde da Família, Porto Alegre, Rio Grande do Sul, Brasil.

The aim of this study was to evaluate the seroprevalence of Toxoplasma gondii and relate it to the socioeconomic, hygienic, sanitary and health conditions of the elderly of the Family Health Strategy (FHS) in the city of Porto Alegre, Rio Grande do Sul, Brazil. The research involved a cross-sectional study in which a questionnaire with epidemiologic questions was applied and blood samples were taken. The assessment of IgG and IgM anti-T. gondii was performed using the ELISA technique. Seroprevalence was evaluated among 599 elderly individuals with 88% for IgG anti-T. gondii and with 0.8% for IgM. In the multivariate analysis, the variables that associated themselves independently with positive IgG were age range, personal income and wearing spectacles. Those associated with positive IgM were age, self-rated health and wearing spectacles. The results call attention to the high prevalence of IgG anti-T. gondii in elderly individuals in the FHS in Porto Alegre, generating concern in the event that the reactivation of toxoplasmosis and the development of more severe symptoms of this infection occur.

Soroepidemiologia de Toxoplasma gondii em idosos atendidos pela Estratégia Saúde da Família, Porto Alegre, Rio Grande do Sul, Brasil / Seroepidemiology of Toxoplasma gondii in elderly individuals treated under the Family Health Strategy, Porto Alegre, Rio Grande do Sul, Brazil

O objetivo desse estudo foi avaliar a soroprevalência para Toxoplasma gondii e a relacionar com as condições socioeconômicas, higiênicas, sanitárias e de saúde nos idosos da Estratégia Saúde da Família - ESF, do município de Porto Alegre, Rio Grande do Sul, Brasil. A pesquisa realizada foi um estudo transversal, no qual foi aplicado um questionário de inquérito epidemiológico e realizada coleta de sangue. A avaliação de IgG e IgM anti-T. gondii foi realizada pela técnica de ELISA. Foram avaliados 599 idosos com soroprevalência para IgG anti-T. gondii de 88,0% e de 0,8% para IgM. Na análise multivariada, as variáveis que se associaram de forma independente para IgG positivo foram: faixa etária, renda pessoal e uso de óculos; e para IgM positivo: faixa etária, autopercepção de saúde e uso de óculos. Os resultados obtidos chamam a atenção pela alta prevalência de IgG anti-T. gondii nos idosos da ESF de Porto Alegre, gerando uma preocupação no caso de ocorrência de reativação da toxoplasmose e desenvolvimento dos sintomas mais graves dessa infecção.

The aim of this study was to evaluate the seroprevalence of Toxoplasma gondii and relate it to the socioeconomic, hygienic, sanitary and health conditions of the elderly of the Family Health Strategy (FHS) in the city of Porto Alegre, Rio Grande do Sul, Brazil. The research involved a cross-sectional study in which a questionnaire with epidemiologic questions was applied and blood samples were taken. The assessment of IgG and IgM anti-T. gondii was performed using the ELISA technique. Seroprevalence was evaluated among 599 elderly individuals with 88% for IgG anti-T. gondii and with 0.8% for IgM. In the multivariate analysis, the variables that associated themselves independently with positive IgG were age range, personal income and wearing spectacles. Those associated with positive IgM were age, self-rated health and wearing spectacles. The results call attention to the high prevalence of IgG anti-T. gondii in elderly individuals in the FHS in Porto Alegre, generating concern in the event that the reactivation of toxoplasmosis and the development of more severe symptoms of this infection occur.

Toxoplasmosis--a global threat. Correlation of latent toxoplasmosis with specific disease burden in a set of 88 countries.

BACKGROUND: Toxoplasmosis is becoming a global health hazard as it infects 30-50% of the world human population. Clinically, the life-long presence of the parasite in tissues of a majority of infected individuals is usually considered asymptomatic. However, a number of studies show that this 'asymptomatic infection' may also lead to development of other human pathologies. AIMS OF THE STUDY: The purpose of the study was to collect available geoepidemiological data on seroprevalence of toxoplasmosis and search for its relationship with mortality and disability rates in different countries. METHODS AND FINDINGS: Prevalence data published between 1995-2008 for women in child-bearing age were collected for 88 countries (29 European). The association between prevalence of toxoplasmosis and specific disease burden estimated with age-standardized Disability Adjusted Life Year (DALY) or with mortality, was calculated using General Linear Method with Gross Domestic Product per capita (GDP), geolatitude and humidity as covariates, and also using nonparametric partial Kendall correlation test with GDP as a covariate. The prevalence of toxoplasmosis correlated with specific disease burden in particular countries explaining 23% of variability in disease burden in Europe. The analyses revealed that for example, DALY of 23 of 128 analyzed diseases and disease categories on the WHO list showed correlations (18 positive, 5 negative) with prevalence of toxoplasmosis and another 12 diseases showed positive trends (p<0.1). For several obtained significant correlations between the seroprevalence of toxoplasmosis and specific diseases/clinical entities, possible pathophysiological, biochemical and molecular explanations are presented. CONCLUSIONS: The seroprevalence of toxoplasmosis correlated with various disease burden. Statistical associations does not necessarily mean causality. The precautionary principle suggests however that possible role of toxoplasmosis as a triggering factor responsible for development of several clinical entities deserves much more attention and financial support both in everyday medical practice and future clinical research.

Seroprevalence of Toxoplasma gondii in unmarried women in Qazvin, Islamic Republic of Iran.

In a cross-sectional study, we evaluated the seroprevalence of Toxoplasma gondii among 400 women referred to Qazvin community health centre laboratory for pre-marriage examinations. Indirect immunofluorescent antibody test was used to detect IgG anti-toxoplasma. Titres > or = 1: 20 were considered positive. The overall seropositivity was 34%. Mean age was significantly higher in seropositive women (P < 0.05). Seropositivity was highest among unemployed women (38.3%) and lowest among students (22.6%), and was significantly higher in women with less than high-school education (P < 0.05). With two-thirds of these unmarried women seronegative, they represent a high-risk group in pregnancy. Such women need to be educated to prevent congenital toxoplasmosis.

Assessment of the value of detecting specific IgA antibodies for the diagnosis of a recently acquired primary Toxoplasma infection.

OBJECTIVE: To assess the value of detecting IgA antibodies for the diagnosis of a recently acquired primary Toxoplasma infection. METHODS: IgA antibodies were screened in sera from 87 women with different serological profiles of Toxoplasma gondii IgM and IgG antibodies and Toxoplasma-specific IgG avidity. The IgM and IgG antibodies and the IgG avidity were measured with an automated Vitek Immuno Diagnostic Assay System (VIDAS). Anti-T.gondii IgA was measured with Platelia Toxo IgA TMB kits. RESULTS: All 12 sera obtained from women with clinical and/or serological evidence of a recently acquired Toxoplasma infection were positive for IgA. In 42 serum samples obtained more than 6 months after T. gondii infection from women with no clinical evidence of infection, but who had a positive IgM test and a high IgG avidity index, the IgA-enzyme linked immunosorbent assay (ELISA) test results were positive, negative, and doubtful in 16 (38.1%), 23 (54.8%), and 3 (7.1%) sera, respectively. In eight women, IgA was detected in sera collected more than 9 months after the onset of infection. The IgA test result was also positive in 11 of 12 sera (91.7%) obtained from women with no clinical evidence of toxoplasmosis, but who had a positive IgM test and a borderline IgG avidity index. The IgA-ELISA was negative in 21 sera obtained more than 2 years after the onset of T. gondii infection from women with no clinical evidence of toxoplasmosis, but who had a negative IgM test and a positive IgG test. CONCLUSION: These results show that IgA is not a dependable marker for a recently acquired primary Toxoplasma infection.

[Avidity of IgG anti-Toxoplasma gondii. Study to establish a new decision tree for screening]. / Avidité des IgG anti Toxoplasma gondii. Etude en vue d'établir un nouvel arbre décisionnel dans le dépistage de la maladie.

Toxoplasmosis infection is commonly asymptomatic, but it may have severe teratogenic consequences. The authors review the literature on serologic screening in the first trimester of pregnancy.

Assessment of latex indirect agglutination test (Toxolatex Fumouze) for the detection of Toxoplasma specific antibodies in human sera in Turkey.

Sera from 50 patients were examined with conventional ELISA, IFA and Toxolatex Fumouze. Out of 50 specimens only 3 false positive cases were detected with Toxolatex Fumouze as compared with the results of ELISA & IFA tests. Toxolatex Fumouze represents a rapid, highly sensitive and specific technique for screening of specific antibodies against toxoplasmosis, but due to false negative results, sera from patients at risk of severe toxoplasmosis (fetus, HIV+, transplant, immunosupressed) should be tested with other serological methods such as the dye test, DS-ELISA and ISAGA.

Assessment of interferon production in patients with chronic nonviral diseases by whole blood or whole bone marrow techniques.

Hundred and fifty-four samples of heparinized blood from patients with chronic toxoplasmosis, chronic brucellosis, lung diseases, psychiatric affective disorders, healthy individuals and neonates, were obtained. The experimental material included also 14 bone marrow samples from patients with hematological diseases or lung cancer. The whole cell populations were treated with several classical IFN inducers and supernatants were assayed for IFN activity in human lung adenocarcinoma cell line A 549 using VSV or EMC viruses as challenge. The response of WBC to NDV or PHA + PMA was high and remarkably stable in majority of cases except listed below. The levels of IFN induced by LPS were low. The response of WBMC to IFN inducers closely resembled the response of WBC. Low IFN levels in samples of stimulated WBMC from some hematological patients were connected with low cellularity. WBC from psychiatric patients with affective disorders weakly responded to stimulation with NDV. This suggested an existence of deficiency of IFN alpha production connected with affective disorders. Also WBC from cord blood failed to react to PHA + PMA and were poorly responsive to NDV.