The congenital toxoplasmosis burden in Brazil: Systematic review and meta-analysis.

Congenital toxoplasmosis is a zoonosis caused by the intracellular Apicomplexa protozoan Toxoplasma gondii. This infection causes subclinical or clinical lesions, such as retinochoroiditis and central nervous system lesions. The severity of fetal infection is related to the stage of pregnancy and the efficacy of the gestational treatment on fetal infection, whether it is achieved, or if it starts early. South America is the region with the highest burden of congenital toxoplasmosis and the most pathogenic genotypes. Here, we present the results of a comprehensive systematic review and meta-analysis of the congenital toxoplasmosis in Brazil. PubMed, Web of Science, and CAPES databases were used to search for relevant studies that were published between 1 January 2007 and 31 December 2018. The final searching process yielded 21 papers. The studies accounted for 469 children with congenital toxoplasmosis. Of these, 269 (57%) had a diagnosis in the postnatal period. Concerning mothers, 209 (44.6%) underwent prenatal care, but 47 (22.5%) did not receive any drug for toxoplasmosis treatment. There were 226 (48.2%) children with retinochoroiditis; 83 (17.7%) with brain calcifications; 9 (1.9%) with neurosensory auditory dysfunction; and 2 (0.42%) with human immunodeficiency virus coinfection. A total of 460 (98%) children had a medical and multidisciplinary follow-up for at least one year and the most frequent genotype was #11(BRII), found in seven children. There was a statistical correlation between the mother's treatment and asymptomatic children. The gestational treatment seems to protects the fetus since children of mothers who received anti-T. gondii medications have a better prognosis. The retinochoroiditis was the main finding among children, followed by brain calcifications.

Analysis of cytokines IFN-γ, TNF-α, TGF-ß and nitric oxide in amniotic fluid and serum of pregnant women with toxoplasmosis in southern Brazil.

This study detected and compared the levels of IFN-γ, TNF-α, TGF-ß and nitric oxide (NO) in amniotic fluid (AF) and serum of pregnancies with acute toxoplasmosis, Southern Brazil. It also was compared the levels of the same mediators in the serum of pregnancies in acute and chronic toxoplasmosis with non-infected. Serological investigation, anti-T gondii IgM and IgG, of the 67 pregnancies was determined by Elisa MEIA. Forty two were uninfected, eight in chronic phase and 17 in acute phase. Among the acute phase, seven agreed to amniocentesis. The cytokines, in serum and in AF, were assessed by sandwich ELISA, and NO was estimated from the nitrite measurement with Griess reagent. The IFN-γ and TGF-ß levels in the AF and blood were similar, while TNF-α levels was lower in the AF. On the other hand, NO was higher in the AF. Chronically infected pregnant women have showed lower levels of INF-γ than those in acute and uninfected pregnancies. The serological levels of TNF-α were lower in pregnancies with toxoplasmosis, when compared with non-infected. TGF-ß levels were higher in pregnancies in acute phase when compared with uninfected or chronically infected. NO in the serum of the infected had lower levels than those non-infected. In summary, higher concentrations of NO and lower levels of TNF-α were observed in the AF than in the serum of acute pregnancies, while TGF-ß e INF-γ levels were similar in both biological material. In the serum of infected pregnancies was observed decrease in inflammatory mediators and increase of TGF-ß.

Genotyping of Giardia duodenalis in vegetables cultivated with organic and chemical fertilizer from street markets and community vegetable gardens in a region of Southern Brazil.

Background: In order to investigate the occurrence of Giardia duodenalis and its genotypes in vegetables that are consumed raw, we analyzed samples cultivated with organic or chemical fertilizer, sold in street markets and from community vegetable gardens in an urban area located in Southern Brazil. Methods: We analyzed 130 samples of vegetables such as crisp lettuce, regular lettuce, kale, chicory and rocket, from street markets, and 130 from community gardens. From each sample, 50 g were washed in Tween 80 solution (1%) and the solution obtained was filtered through a cellulose acetate membrane. The retained material was used for DNA extraction with the commercial kit Purelink®. GDH gene was amplified by semi-nested PCR using the GDHeF, GDHiR and GDHiF primers. Positive samples were genotyped using the PCR-RFLP technique with the restriction enzyme NlaIV. Results: We obtained 7.3% (19/260) positive samples for G. duodenalis, both from street markets (10/130) and from community gardens (9/130), including organic and non-organic products. The assemblage AI was predominant, but assemblages B and E were also found. Conclusions: The molecular technique revealed genotypes with zoonotic potential, evidencing the importance of investigating commercialized vegetables that are consumed raw and establishing a more rigid quality control.