Evaluation of the acceptability of point of care diagnostic test for prenatal toxoplasmosis (translational research phase III).

BACKGROUND: A new point of care test (POC) was developed that is promising as a tool to enhance impact of prenatal care programs for toxoplasmosis, however, no reports exist about its use or acceptability for healthcare personnel and mothers in Colombia. METHODS: This was a translational research - phase III study of the acceptability of a new POC test (Toxoplasma ICT IgG-IgM, LDBio) for qualitative diagnosis of toxoplasmosis in 783 pregnant women and 30 health personnel in primary health care sites in the city of Armenia, Quindío (Colombia). Along with collection of the results of diagnostic POC and confirmatory test and demographic information, we evaluated acceptability through measure of the willingness, credibility, and satisfaction by using questionnaires with a Likert scale during routine prenatal care visits. RESULTS: POC positivity was 46.5% among pregnant participants and was significantly related to socioeconomic factors, including education level (p = 0.00000000) and insurance status (p = 0.00000015). A total of 93-97% of healthcare personnel indicated agreement to positive statements regarding total satisfaction and total credibility of the LDBio test, but qualitative questions identified "Difficulty in the test procedure" as the most common response about barriers to apply the test. Greater than 90% of pregnant participants agree that POC test should be routine for all pregnant woman and permanently implemented. CONCLUSIONS: The test had near complete acceptability. In future studies it is necessary to examine the effect of non-differentiation between IgG and IgM isotypes.

High frequency of ocular toxoplasmosis in Quindío, Colombia and risk factors related to the infection.

OBJECTIVES: To determine the frequency of retinochoroidal lesions by ocular toxoplasmosis and their relationships with risk factors, in residents of two districts with high exposure to Toxoplasma, in Armenia-Quindío, Colombia. METHODS: Cross-sectional analyses of fundoscopy screening, serological tests, and questionnaires were performed to determine risk factors associated with ocular toxoplasmosis retinochoroidal lesions. Differences in proportions were analyzed using the chi-squared test. RESULTS: Of 161 individuals examined, 17 (10.5%) exhibited retinochoroidal scars suggestive of old inactive Toxoplasma gondii infection. All 17 individuals were seropositive for T. gondii antibodies. Consumption of bottled water was protective against T. gondii infection among individuals in this study. There were no specific epidemiological risk factors associated with ocular toxoplasmosis retinochoroidal lesions. CONCLUSION: Ocular toxoplasmosis is an important cause of visual impairment in Armenia-Quindío, Colombia. The consumption of boiled or bottled water is a major preventive public health measure to reduce infection by T. gondii and the subsequent onset of OT.

Clinical, Socio-economic and Environmental Factors Related with Recurrences in Ocular Toxoplasmosis in Quindío, Colombia.

PURPOSE: To identify the sociodemographic, clinical, and environmental factors associated with recurrences in ocular toxoplasmosis (OT). METHODS: Retrospective analysis of clinical records of patients who consulted in the Health Centre at Universidad del Quindío between 2004 and 2017. Patients with retinochoroiditis due to Toxoplasma gondii infection and follow up >12 months were included. Comparisons were made with a recurrence index adjusted for months of follow up. For the statistical analysis, the Kruskal-Wallis test and analysis of variance (ANOVA) tests were performed in Epi Info 7.2 and SPSS 14.0. A statistical significance is shown if p ≤ 0.05. RESULTS: A total of 58 patients were included, with median age of 28 years (range 1-61) and 55.1% were women. The median of recurrences was 1.4 (range 0.6-16.6). High recurrence index was present in 43.1% of the patients. A higher size of lesions was observed in low socioeconomic groups (p = .016) and patients with congenital infection had more bilateral compromise (p = .002). Intake of boiled water was related to a lower recurrence index (p = .04). CONCLUSIONS: Low socioeconomic level was associated with bigger lesions and congenital infection was related with higher frequency of bilateral OT. Finally, intake of boiled water is related to a lower recurrence index of OT.