Toxoplasmosis in immunocompetent Saudi women: Correlation with vitamin D.

OBJECTIVE: Toxoplasma gondii (T. gondii) is a life-threatening parasite particularly infecting the immunocompromised women. Deficiency of vitamin D is well reported in several infectious disorders. This study was undertaken to investigate a correlation of vitamin D deficiency with the onset of T. gondii infection in immunocompetent women from the central of Saudi Arabia. METHODS: Blood samples were collected from 304 Saudi women from the Qassim region of Saudi Arabia. Specific immunoassays were used to determine the levels of T. gondii immunoglobulin G and vitamin D. The SPSS and the Prism Graph Pad statistical software were used for the data analysis. RESULTS: Out of 304 women, 18.8% were found to be positive for toxoplasmosis. Interestingly, the serum levels of vitamin D in toxoplasma positive cases were found to be significantly low as compared with the levels of vitamin D in toxoplasma negative cases. Moreover, sociodemographic risk factors such as age, residence location, and consumption of fruits/vegetables were also found to be associated with vitamin D deficiency and with the seroprevalence of toxoplasmosis. CONCLUSION: This study investigated a direct correlation of vitamin D deficiency with the severity of the toxoplasmosis in Saudi women. Therefore, it is predicted that vitamin D supplementation may provide protection against toxoplasma infection.

Human Toxoplasma gondii infection in Nigeria: a systematic review and meta-analysis of data published between 1960 and 2019.

BACKGROUND: Over 70% of the worlds' population is infected by Toxoplasma gondii; a pathogen capable of causing cerebral toxoplasmosis in HIV patients and neonatal complications like miscarriage, chorioretinitis, hydrocephalus, cerebral calcification and foetal death in the third trimester of pregnancy. In spite of this, the burden of this zoonotic pathogen is poorly understood in Nigeria. The aim of the present study therefore, is to determine the burden of T. gondii among normal individuals, HIV patients and pregnant women as well as the distribution of the infection across Nigeria. METHODS: Using the PRISMA guidelines, we conducted a systematic review and meta-analysis of data retrieved from six electronic databases (AJOL, Google Scholar, PubMed, Scopus, Science Direct and Web of Science). Pooled prevalence (PP) and heterogeneity were determined by the random-effects model and the Cochran's Q-test respectively. The quality of each study and publication bias were assessed by the 9 point Joanna Briggs Institute Critical Appraisal Instrument and the Egger's regression asymmetry test respectively, while the robustness of a pooled estimate was tested by the single study omission analysis. RESULTS: Exactly 5834 of the 16,230 individuals examined for T. gondii infection by 50 studies across 17 Nigerian States were positive for the infection. Overall PP was 32.92% (95% CI: 27.89, 38.37), with a range of 14.41% (95% CI: 5.32, 33.54) to 86.82% (95% CI: 66.13, 95.69) across sub-groups. Pooled prevalence was significantly higher (p < 0.001) among pregnant women (40.25%; 95% CI: 33.19, 47.73) and HIV patients (31.68, 95% CI: 20.53, 45.41) than normal individuals (23.32, 95% CI: 17.25, 30.75). T. gondii prevalence declined by over 58% during the 59 years reviewed. CONCLUSION: Toxoplasma gondii infection is moderately prevalent in Nigeria. Highest prevalence estimates were observed among pregnant women and in the south-south region. For effective control of the disease in Nigeria, a holistic approach involving on-farm, environmental, public health and animal components are suggested.

Patient and treatment pathways for toxoplasmosis in the United States: data analysis of the Vizient Health Systems Data from 2011 to 2017.

Toxoplasmosis causes substantial morbidity and mortality in the United States (US). Clinical manifestations to toxoplasmosis vary and there is limited information on incidence or treatment patterns in the US. Treatment pathways for pyrimethamine-based regimens and trimethoprim-sulfamethoxazole (TMP-SMX) for toxoplasmosis hospitalizations were investigated using the Vizient Health Systems inpatient and outpatient data. Between January 1st, 2011 and December 31st, 2017, 10,273 hospital visits from 4,736 unique patients received a primary or secondary ICD-9/ICD-10 diagnosis for toxoplasmosis. The projected annual hospital visits with a diagnosis of toxoplasmosis was 68,821, corresponding to a total annual incidence of 9,832 comprising ocular toxoplasmosis of 2,169, toxoplasmic encephalitis of 1,399, unspecified toxoplasmosis of 4,368, congenital toxoplasmosis of 381, multisystemic toxoplasmosis of 69 and other toxoplasmosis of 1,446. Only 16.3% of the study population received treatment with pyrimethamine-based regimens or TMP-SMX. Pyrimethamine-based regimens were used significantly more often than TMP-SMX in toxoplasmic encephalitis (88.7% vs 79.6%, p = 0.01), other toxoplasmosis (85.0% vs 79.2%, p = 0.04), and unspecified toxoplasmosis (87.6% vs 77.9%, p = 0.03) in hospitals with 300 beds or more. A significantly higher percentage of visits with TMP-SMX as first-line treatment switched to pyrimethamine-based regimens compared to visits initiated on pyrimethamine-based treatments (26.7% vs 4.1%, p < .001). Ocular toxoplasmosis patients receiving pyrimethamine-based therapy were more likely to be discharged home compared to TMP-SMC at rates of 72.4% and 55.2%, respectively. Our analysis of commercial insurance records suggest toxoplasmosis is undertreated. Overall, pyrimethamine-based regimens are favored over TMP-SMX, have higher rates of discharge home, and have lower switch rates.

Spatial and simultaneous representative seroprevalence of anti-Toxoplasma gondii antibodies in owners and their domiciled dogs in a major city of southern Brazil.

Toxoplasmosis, caused by Toxoplasma gondii, has traditionally been considered an important water and foodborne protozoonosis with important public health considerations. Although felids play a well-established role as definitive hosts, canine epidemiological involvement in the parasite's life cycle remains questionable and controversial. The increasing closeness of the human-dog bond, particularly seen in urban settings, has been recognized as a historically unprecedented worldwide movement. Sharing daily lives in the same households, dogs may be exposed to similar associated risks of T. gondii infection as their owners. Thus, epidemiological assessment of the intra-domiciled environment, especially among socio-economically different human populations, may provide novel information regarding the actual role of dogs in animal and human toxoplasmosis. Despite spatial approaches being recently used for other water and foodborne diseases, no study has been conducted on the simultaneous spatial seroprevalence of both human and animal IgG anti-T. gondii antibodies in urban areas of major cities. Accordingly, the aim of the present study was to assess the seroprevalence and associated variables of Toxoplasma infection in owners and their domiciled dogs in Londrina, southern Brazil. Human and canine seroprevalence rates and variables associated with seroprevalence were investigated through representative random sampling among 564 households, which included 597 owners and 729 dogs. Overall, statistically significant differences between the seroprevalence of human and dog anti-T. gondii antibodies were found by Immunofluorescence Antibody Testing in 248/597 (41.54%) owners and 119/729 (16.32%) dogs. Through multiple analysis, significant concomitant variables for seropositivity of household individuals (people and dogs) were determined, including public sewer service, yard cleaning frequency, and having a dirty yard. Although no statistically significant multiple logistic model was observed among owners, univariate analysis detected associations with monthly income, soil contact, and occupation. Among dogs, the absence of other dogs and the absence of a dirty yard were concomitant significantly protective associated factors. Age differences between seropositive and seronegative individuals was significant only for human beings, with the median age of negative individuals significantly higher than positive individuals. Although no spatial clusters were identified for humans or residences, a significant cluster was identified for dogs. In conclusion, characteristics of urban toxoplasmosis may include significantly higher owner seroprevalence than their owned dogs, with canine seroprevalence directly associated with having more dogs and a dirty backyard, and spatial differences in both human and dog exposures. Although not a good indicator for human foodborne diseases, dogs may be a reliable sentinel for environmental infection. Moreover, such a holistic approach may provide crucial information for more focused prevention and monitoring programs, particularly in households with multiple pets and trash-filled backyards.

[Awareness and infection of Toxoplasma gondii in married childbearing women in Chengde Region].

OBJECTIVE: To understand Toxoplasma gondii infection and awareness condition of married childbearing women in Chengde Region, so as to provide the evidence for the establishment of control measures. METHODS: Totally 733 married childbearing women who took physical examination in Chengde Hospital of Traditional Chinese Medicine from July to December in 2013 were investigated by questionnaire to understand the awareness condition on T. gondii infection, then 490 women among them from 3 counties and 2 districts were randomly chosen to detect the Toxoplasma antibodies by ELISA. RESULTS: A total of 733 questionnaires were returned, and 126 women knew related knowledge about T. gondii infection, and the awareness rate was 17.19%( 126/733). Sixty-three women were determined as infected cases, and the infection rate was 12.86%( 63/490). The infection rates of the women who with higher educational level, working as medical staff and living in urban were lower, and the awareness rates of them were higher. CONCLUSIONS: The infection rate of T. gondii among the married childbearing women in Chengde Region is high, and the awareness rate of them is low. In order to decrease the infection rate as well as to increase the awareness rate of the population, the health education should be strengthened.

Anti-Toxoplasma activity of natural products: a review.

Toxoplasma gondii is an intracellular parasite widely distributed in nature. Infection is asymptomatic in immunocompetent individuals; however, various clinical manifestations may occur in immunocompromised individuals. Although there are medications for the treatment of toxoplasmosis, such as pyrimethamine and sulfonamide, they cannot always be used due to adverse reactions or to therapeutic failures related to intolerance or malabsorption of drugs and to parasite drug resistance. In recent years, the search for new antimicrobial agents derived from plants has intensified because a quarter of synthetic drugs that are currently prescribed have been isolated from a plant source, demonstrating that natural products are important in the development of new drugs. A systematic literature search was conducted to evaluate the use of natural products as an alternative for the treatment of T. gondii infection. The search was conducted for the 2000-2014 period in Science Direct, Scopus, PubMed, EMBASE, and SciELO databases, using the following MeSH terms: anti-Toxoplasma activity, toxoplasma AND natural products, toxoplasma AND plant extracts. Ethnobotanical and experimental evidence (in vitro/in vivo) was found supporting the use of natural products as a source for the discovery of new therapies against T. gondii.

Prophylactic effect of tea on pathogenic microorganism infections to humans and animals. (II). Protozoacidal effect on Toxoplasma gondii in vitro and mice.

The trophozoites of Toxoplasma gondii strain (RH) obtained from the peritoneal exudate of infected mice were treated with tea in various concentrations of 0.5, 1, 3 and 5% for 0.5, 1 and 3 hours, respectively. After treatment, they were intraperitoneally inoculated into the mice to observe the protozoacidal effect of tea. The results obtained are as follows: 1) Oolong tea and green tea had stronger protozoacidal effect than black tea. 2) The lowest and effective concentration of tea tested to kill Toxoplasma was 0.5%. 3) A half hour was not enough for tea in any concentration tested to kill the parasites completely. 4) Phosphate buffer solution and normal saline were unable to destroy the protozoa, but distilled water could destroy them like tea.