Seroprevalence Estimates of Latent and Acute Toxoplasma Infections in HIV+ People-Call for Action in Underprivileged Communities.

We undertook a comprehensive, systematic review of observational studies to estimate respective seroprevalences of latent and acute Toxoplasma gondii infections in HIV+ people at the global, regional and country levels; related seroprevalence to socio-economic variables and CD4+ cell counts; and assessed temporal changes in prevalence and risk factors for this group. We systematically searched international databases for seroepidemiological surveys between 1 January 1980 and 31 July 2020. We used a random effects model to calculate pooled seroprevalences with 95% confidence intervals (CI), and estimated the numbers of HIV+ people inferred to harbour latent and acute T. gondii infections (LT or AT). We grouped seroprevalence data according to the geographic regions defined by the World Health Organization (WHO) and conducted subgroup and meta-regression analyses of the data. Of a total of 4024 studies identified, 150 and 65 of them met the inclusion criteria for LT and AT in HIV+ people, respectively. The overall, pooled seroprevalences of LT and AT were 37.4% (95% CI, 33.4-41.4) and 1.3% (95% CI, 0.9-1.8%), equating to ~14.2 and 0.5 million HIV+ people, respectively. Most HIV+ people with T. gondii infections originated from Africa, and the highest seroprevalences were in low-income countries with low human development indices. Significant risk factors for toxoplasmosis in HIV+ patients included the consumption of raw/undercooked meat, frequent contact with soil, a low CD4+ T lymphocyte number (<200 cells per µL) and age. Overall, the finding of high seroprevalences of particularly latent T. gondii infection in HIV+ people in underprivileged regions of the world, such as parts of Africa, calls for preventative action. Programs that include routine serological monitoring, counselling, care, animal control and/or prophylactic treatment measures are needed to prevent severe toxoplasmosis from developing in people living with HIV infection. Our study highlights the potential importance of parasite chemoprophylaxis in resource-poor settings, particularly in low-income countries.

The prevalence of latent and acute toxoplasmosis in HIV-infected pregnant women: A systematic review and meta-analysis.

OBJECTIVE: HIV in pregnancy is not only important for mother-to-child HIV transmission, but also it assumes additional importance because HIV increases susceptibility to opportunistic infections, leading to increased morbidity and mortality in mothers and neonates. Toxoplasmosis is one of the most important opportunistic infections in HIV-infected pregnant women. The present study was undertaken to assess the prevalence of latent toxoplasmosis (LT) and acute toxoplasmosis (AT) infection in HIV-infected pregnant women. METHODS: PubMed/MEDLINE, Scopus, Web of Science, EMBASE and SciELO were searched to identify relevant studies. A random-effects model was used to estimate the overall and subgroup-pooled prevalences across studies. Heterogeneity between studies was assessed via the I2 test. RESULTS: A total of 14 articles that included 3256 subjects in nine countries met the inclusion criteria. The overall prevalence rates of LT and AT in HIV-infected pregnant women were 45.7% (95% CI, 32.3-59.7%) and 1.1% (95% CI, 0.4-3.2%), respectively. The findings indicate that, worldwide, approximately 559,000 and 13,450 HIV-infected pregnant women are affected by LT and AT, respectively. From this review, it is estimated that approximately 3432 babies annually could be born with congenital toxoplasmosis (CT) from HIV-infected pregnant mothers. CONCLUSIONS: The present study indicates that a large number of HIV-infected mothers are affected by LT and AT. This can lead to adverse complications such toxoplasmic encephalitis in mothers and CT in neonates. Our results suggest a need for screening programs using well-validated diagnostic platforms for both LT and AT for all HIV-infected pregnant women.

The prevalence of Trichinella infection in domestic dogs in Finland.

In this study, we examined the prevalence of Trichinella infection in domestic dogs in Finland, which is known to have a high prevalence of Trichinella infection in sylvatic hosts. Altogether 727 dog serum samples were tested serologically by ELISA with ES-antigen in dilutions 1:50, 1:100, 1:200, and 1:400. Additionally, muscle samples from 102 dogs' front leg extensors were tested parasitologically by HCl-pepsin-digestion. The tested dogs originated from the University Veterinary Hospital (244 of the sera and all of the parasitologically tested muscle samples) and from a serum bank of the National Veterinary and Food Research Institute (465 serum samples), representing healthy dogs mostly from southern Finland. As negative controls, we tested sera from 18 experimental dogs known to be negative for Trichinella infection. Trichinella spp. was isolated from one dog (1%) with a low infection intensity. High OD% were found in both groups of serum samples. Of the hospitalized dogs, 4.9% were classified positive, and 8.6% of the healthy dogs were classified positive (7.3% in total). The sex or breed of the tested dogs did not correlate with the positive results, but the age correlated positively in the serum bank group. The serological results suggest that dogs may be exposed to Trichinella spp. in Finland; however, confirmation of low-level infections requires confirmation by direct testing methods.