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1.
Rev Soc Bras Med Trop ; 53: e20190164, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32187332

RESUMO

INTRODUCTION: Toxoplasmosis is a zoonosis caused by Toxoplasma gondii. This study investigated the prevalence and factors associated with toxoplasmosis among pregnant women. METHODS: We followed an analytical observational study. From July 2016 to June 2017, 218 pregnant women were selected. The infection was detected through serological dosage of anti-T.gondii Immunoglobulin(Ig) M and IgG antibodies. RESULTS: The seroprevalence was 35.8%; the factors associated with infection were consumption of non-drinking water, residence in an urban area, and threatened abortion during the current pregnancy. CONCLUSIONS: The seroprevalence of toxoplasmosis among pregnant women is high. The risk factors are dependent on environmental determinants.


Assuntos
Anticorpos Antiprotozoários/sangue , Complicações Parasitárias na Gravidez/epidemiologia , Complicações Parasitárias na Gravidez/parasitologia , Toxoplasmose/epidemiologia , Adulto , Feminino , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Peru/epidemiologia , Gravidez , Complicações Parasitárias na Gravidez/diagnóstico , Prevalência , Fatores de Risco , Estudos Soroepidemiológicos , Fatores Socioeconômicos , Toxoplasmose/diagnóstico
2.
Vet Res ; 50(1): 72, 2019 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-31551079

RESUMO

Early Neospora caninum infection dynamics were investigated in pregnant heifers intravenously inoculated with PBS (G-Control) or 107 tachyzoites of high (G-NcSpain7)- or low (G-NcSpain1H)-virulence isolates at 110 days of gestation. Serial culling at 10 and 20 days post-infection (dpi) was performed. Fever was detected at 1 dpi in both infected groups (P < 0.0001), and a second peak was detected at 3 dpi only in G-NcSpain7 (P < 0.0001). At 10 dpi, Nc-Spain7 was detected in placental samples from one animal related to focal necrosis, and Nc-Spain7 transmission was observed, although no foetal lesions were associated with this finding. The presence of Nc-Spain1H in the placenta or foetuses, as well as lesions, were not detected at 10 dpi. At 20 dpi, G-NcSpain7 animals showed almost 100% positive placental tissues and severe focal necrosis as well as 100% transmission. Remarkably, foetal mortality was detected in two G-NcSpain7 heifers. Only one animal from G-NcSpain1H presented positive placental samples. No foetal mortality was detected, and lesions and parasite transmission to the foetus were not observed in this group. Finally, 100% of G-NcSpain7 heifers at 20 dpi presented specific antibodies, while only 60% of G-NcSpain1H animals presented specific antibodies at 20 dpi. In addition, earlier seroconversion in G-Nc-Spain7 was observed. In conclusion, tachyzoites from Nc-Spain7 reached the placenta earlier and multiplied, leading to lesion development, transmission to the foetus and foetal mortality, whereas Nc-Spain1H showed delayed infection of the placenta and no lesional development or transmission during early infection.


Assuntos
Doenças dos Bovinos/imunologia , Coccidiose/veterinária , Feto/parasitologia , Neospora/patogenicidade , Placenta/parasitologia , Complicações Parasitárias na Gravidez/veterinária , Animais , Bovinos , Doenças dos Bovinos/parasitologia , Coccidiose/imunologia , Coccidiose/parasitologia , Feminino , Idade Gestacional , Neospora/fisiologia , Gravidez , Complicações Parasitárias na Gravidez/imunologia , Complicações Parasitárias na Gravidez/parasitologia , Vacinação/veterinária , Virulência/genética
3.
Malar J ; 18(1): 304, 2019 Sep 03.
Artigo em Inglês | MEDLINE | ID: mdl-31481075

RESUMO

BACKGROUND: Studies of the association between malaria in pregnancy (MiP) and malaria during infancy have provided mixed results. A systematic review was conducted to evaluate available evidence on the impact of Plasmodium falciparum malaria infection during pregnancy, and intermittent preventive treatment of malaria during pregnancy (IPTp), on the risk of clinical malaria or parasitaemia during infancy. METHODS: MEDLINE, EMBASE, Global Health, and Malaria in Pregnancy Library databases were searched from inception to 22 May 2018 for articles published in English that reported on associations between MiP and malaria risk in infancy. Search terms included malaria, Plasmodium falciparum, pregnancy, placenta, maternal, prenatal, foetal, newborn, infant, child or offspring or preschool. Randomized controlled trials and prospective cohort studies, which followed infants for at least 6 months, were included if any of the following outcomes were reported: incidence of clinical malaria, prevalence of parasitaemia, and time to first episode of parasitaemia or clinical malaria. Substantial heterogeneity between studies precluded meta-analysis. Thus, a narrative synthesis of included studies was conducted. RESULTS: The search yielded 14 published studies, 10 prospective cohort studies and four randomized trials; all were conducted in sub-Saharan Africa. Infants born to mothers with parasitaemia during pregnancy were at higher risk of malaria in three of four studies that assessed this association. Placental malaria detected by microscopy or histology was associated with a higher risk of malaria during infancy in nine of 12 studies, but only one study adjusted for malaria transmission intensity. No statistically significant associations between the use of IPTp or different IPTp regimens and the risk of malaria during infancy were identified. CONCLUSION: Evidence of an association between MiP and IPTp and risk of malaria in infancy is limited and of variable quality. Most studies did not adequately adjust for malaria transmission intensity shared by mothers and their infants. Further research is needed to confirm or exclude an association between MiP and malaria in infancy. Randomized trials evaluating highly effective interventions aimed at preventing MiP, such as IPTp with dihydroartemisinin-piperaquine, may help to establish a causal association between MiP and malaria in infancy.


Assuntos
Malária Falciparum/epidemiologia , Parasitemia/epidemiologia , Plasmodium falciparum/fisiologia , Complicações Parasitárias na Gravidez/epidemiologia , Antimaláricos/uso terapêutico , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Malária Falciparum/parasitologia , Masculino , Parasitemia/parasitologia , Gravidez , Complicações Parasitárias na Gravidez/parasitologia , Risco
4.
Vet Res ; 50(1): 68, 2019 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-31547877

RESUMO

Parameters such as pathogen dose and inoculation route are paramount in animal models when studying disease pathogenesis. Here, clinical findings, including foetal mortality, parasite transmission rates and lesion severity, and immune responses were evaluated in Asturiana pregnant heifers at day 110 of gestation challenged with a virulent (Nc-Spain7) Neospora caninum isolate. Four different doses of parasite tachyzoites were inoculated intravenously (IV1, 107 parasites, n = 6; IV2, 105, n = 6; IV3, 103, n = 6; and IV4, 102, n = 5), and the subcutaneous (SC) inoculation route was also assessed for the dose of 105 tachyzoites (SC, n = 6). In addition, a control group (n = 4 pregnant heifers) was evaluated. Foetal death was observed in all infected groups from 25 to 62 days post-infection, varying with the dose (IV1:4/6, IV2:3/6; IV4:2/5, IV3:1/6), and was three times less frequently associated with the SC route than IV inoculation (1/6 vs. 3/6). A dose-dependent effect for parasite loads in placental and foetal brain tissues was also detected. After SC challenge, a reduced number of tachyzoites were able to reach foetal brain tissues, and no lesions were observed. In calves, specific IgG responses in precolostral sera were mainly associated with high-dose groups (IV1 [100.0%] and IV2 [66.7%]), and cerebral parasite DNA detection was scarce (3/18). In dams, IFN-γ production and the dynamics of anti-N. caninum IgG antibodies varied with the dose, and the cell-mediated immune response was also found to be route-dependent. Our results confirm the influence of parasite dose and inoculation route on the outcome and dynamics of bovine neosporosis at mid-gestation.


Assuntos
Doenças dos Bovinos/mortalidade , Coccidiose/veterinária , Imunidade Celular , Neospora/imunologia , Complicações Parasitárias na Gravidez/veterinária , Animais , Bovinos , Doenças dos Bovinos/parasitologia , Coccidiose/mortalidade , Coccidiose/parasitologia , Feminino , Feto/parasitologia , Injeções Intravenosas/veterinária , Gravidez , Complicações Parasitárias na Gravidez/mortalidade , Complicações Parasitárias na Gravidez/parasitologia , Distribuição Aleatória , Vacinação/veterinária
5.
Acta Trop ; 199: 105127, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31394076

RESUMO

OBJECTIVES: Congenital Chagas Disease (CCD) has become a global health problem. Early diagnosis and treatment is essential for the cure of the disease. Our aim was to evaluate techniques and samples used for the diagnosis of CCD in order to improve diagnostic strategies. METHODS: A total of 181 children born in Spain from Latin American Chagas-infected mothers were consecutively enrolled and studied by microhematocrit, PCR and serology tests at 0-2, 6 and 9-12 months of age and followed up when it was required. Samples of cord blood and peripheral blood were collected for T. cruzi detection by PCR. Parasite culture was performed in patients with a positive PCR. RESULTS: Of 181 children, 7 children (3.9%) were lost to follow-up. A total of 174 children completed follow-up, 12 were diagnosed with CCD (6.9%) and 162 (93.1%) as uninfected children (negative serology tests at the end of the follow-up). Traditional parasitological diagnosis by microhematocrit had a poor performance (sensitivity was 10%), while PCR in peripheral blood showed high sensitivity (90.9%) and specificity (100%), allowing the early diagnosis of 9 infected children during the first 6-months-old. In the other 3 congenital cases, diagnosis was only possible at 12 months by serological and molecular techniques. However, PCR in cord blood showed low sensitivity (33.3%) and less specificity (96.4%) for the diagnosis. CONCLUSION: PCR in peripheral blood has proven to be the most adequate strategy for the diagnosis of CCD, allowing an early and reliable diagnosis.


Assuntos
Doença de Chagas/diagnóstico , Complicações Parasitárias na Gravidez/diagnóstico , Adolescente , Adulto , Doença de Chagas/congênito , Doença de Chagas/parasitologia , Feminino , Sangue Fetal/parasitologia , Seguimentos , Saúde Global , Hematócrito , Humanos , Lactente , Recém-Nascido , Estudos Longitudinais , Masculino , Reação em Cadeia da Polimerase/métodos , Gravidez , Complicações Parasitárias na Gravidez/parasitologia , Sensibilidade e Especificidade , Testes Sorológicos , Espanha , Trypanosoma cruzi/genética , Trypanosoma cruzi/imunologia , Trypanosoma cruzi/isolamento & purificação , Adulto Jovem
6.
Malar J ; 18(1): 229, 2019 Jul 09.
Artigo em Inglês | MEDLINE | ID: mdl-31288835

RESUMO

BACKGROUND: Intermittent preventive treatment during pregnancy (IPTp) is a highly-recommended intervention to prevent maternal and neonatal complications associated with malaria infection. Despite fairly high antenatal care (ANC) coverage in Tanzania, low IPTp uptake rates represent a gap in efforts to decrease complications attributed to malaria in pregnancy. The objective of this study was to examine if availability, readiness and managing authority are associated with uptake of IPTp during ANC. METHODS: Data for this analysis come from a cross-sectional survey, the Tanzania Service Provision Assessment conducted between 2014 and 2015. Principal component analysis was used to create scores for availability of malaria services and readiness for the provision of services. Generalized estimating equation models with logit link and the binomial distribution assessed factors that impact the uptake of IPTp by pregnant women attending ANC. RESULTS: Higher fraction of women in their third trimester than second (68% versus 49%, OR = 2.6; 95% CI (2.1-3.3)), had received at least one dose of IPTp. There was a wide variation in the availability and readiness of malaria services provision and diagnostic tools by managing authorities. Public facilities were more likely than private to offer malaria rapid diagnostic test, and more providers at public facilities than private diagnosed and/or treated malaria. Women who attended facilities where direct observation therapy was practiced were more likely to have received at least one dose of IPTp (64% versus 46% who received none; p < 0.001). Women who attended ANC at a facility with a high readiness score were more likely to take IPTp than those attending facilities with low readiness scores (OR = 2.1; 95% CI (1.4-3.3)). Reported stock out on the day of interview was negatively associated with IPTp uptake (OR 0.09; 95% CI 0.07-0.1). CONCLUSION: Readiness of health facilities to provide malaria related services, the number of ANC visits and gestational age were associated with uptake of IPTp among women attending ANC. There are disparities in malaria service availability and readiness across geographical location and managing authorities. These findings could be used to assist the malaria programme and policymakers to appropriately decide when planning for malaria service deliveries and interventions.


Assuntos
Antimaláricos/uso terapêutico , Assistência à Saúde/estatística & dados numéricos , Malária/prevenção & controle , Complicações Parasitárias na Gravidez/prevenção & controle , Cuidado Pré-Natal/estatística & dados numéricos , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Malária/parasitologia , Pessoa de Meia-Idade , Gravidez , Complicações Parasitárias na Gravidez/parasitologia , Tanzânia , Adulto Jovem
7.
Vet Parasitol ; 269: 2-6, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31079823

RESUMO

Neospora caninum is an apicomplexan protozoan parasite that is a leading cause of abortion in cattle. Detection of parasite-specific DNA by PCR is a highly sensitive method for identifying the presence of N. caninum in a variety of tissues. We developed and validated a probe-based real-time PCR assay targeting the conserved Nc5 gene of N. caninum. Using N. caninum strain Nc-1 genomic DNA and a synthetic gene fragment as amplification standards, we determined the PCR amplification efficiency and the limit of detection to be 95.60% and 3 copies, respectively. Five pathogens frequently associated with bovine abortions, namely bovine viral diarrhea virus types I and II, bovine alphaherpesvirus-1, Chlamydia, and Leptospira, were tested to ensure analytical exclusivity. A total of 103 clinical samples from aborted fetuses were tested concurrently with a standard conventional PCR and the new probe-based real-time PCR assay. All tested samples showed 100% agreement between these two assays. In conclusion, the probe-based real-time PCR assay facilitates accurate and rapid detection of N. caninum from abortions in cattle.


Assuntos
Aborto Animal/diagnóstico , Doenças dos Bovinos/diagnóstico , Coccidiose/veterinária , Neospora/isolamento & purificação , Complicações Parasitárias na Gravidez/veterinária , Reação em Cadeia da Polimerase em Tempo Real/veterinária , Feto Abortado/parasitologia , Aborto Animal/parasitologia , Animais , Encéfalo/parasitologia , Bovinos , Doenças dos Bovinos/parasitologia , Coccidiose/diagnóstico , Coccidiose/parasitologia , Primers do DNA/genética , Sondas de DNA/genética , Feminino , Coração/parasitologia , Neospora/genética , Gravidez , Complicações Parasitárias na Gravidez/diagnóstico , Complicações Parasitárias na Gravidez/parasitologia
8.
BMC Public Health ; 19(1): 392, 2019 Apr 11.
Artigo em Inglês | MEDLINE | ID: mdl-30971223

RESUMO

BACKGROUND: In 2014, a study in Munyenge revealed a high prevalence of urogenital schistosomiasis (UGS) among pregnant women. This study investigated he prevalence and risk factors of UGS in pregnancy following scale-up of piped water sources from 2014 to 2017. Secondly, we compared stream usage, stream contact behaviour, infection rate and intensity with the findings of 2014. METHODS: Consenting pregnant women reporting for antenatal care (ANC) in the different health facilities were enrolled consecutively between November 2016 and January 2018. Information on age, gravidity status, residence, marital status, educational level, occupation, household water source, frequency of contact with water and stream activities were obtained using a semi-structured questionnaire. Urine samples were examined for the presence of microhaematuria and S. haematobium ova using test strip and filtration/microscopy methods respectively. Data were analysed using univariate and multivariate regression analyses and relative risk reductions calculated. RESULTS: Of the 368 women enrolled, 22.3% (82) were diagnosed with UGS. Marital status (single) (aOR = 2.24, 95% CI: 1.04-4.79), primary - level of education (aOR = 2.0; 95% CI: 1.04-3.85) and domestic activity and bathing in the stream (aOR = 3.3; 95% CI: 1.83-6.01) increased risk of S. haematobium infection. Meanwhile, fewer visits (< 3 visits/week) to stream (aOR = 0.35, 95% CI = 0.17-0.74) reduced exposure to infection. Piped water usage was associated with reduced stream usage and eliminated the risk of infection among women who used safe water only. Compared with the findings of 2014, stream usage (RRR = 23 95% CI: 19-28), frequency (≥ 3 visits) (RRR = 69 95% CI: 59-77) and intensity of contact with water (RRR = 37 95% CI = 22-49) has reduced. Similarly, we observed a decrease in infection rate (RRR = 52, 95% CI = 40-62) and prevalence of heavy egg intensity (RRR = 71, 95% CI = 53-81). CONCLUSION: Following increased piped water sources in Munyenge, S. haematobium infection has declined due to reduced stream contact. This has important implication in the control of UGS in pregnancy.


Assuntos
Complicações Parasitárias na Gravidez/epidemiologia , Schistosoma haematobium , Esquistossomose Urinária/epidemiologia , Abastecimento de Água/métodos , Água/parasitologia , Adolescente , Adulto , Animais , Camarões/epidemiologia , Estudos Transversais , Feminino , Filtração , Hematúria/epidemiologia , Hematúria/parasitologia , Humanos , Microscopia , Gravidez , Complicações Parasitárias na Gravidez/etiologia , Complicações Parasitárias na Gravidez/parasitologia , Cuidado Pré-Natal , Prevalência , Fatores de Risco , Rios/parasitologia , Esquistossomose Urinária/etiologia , Esquistossomose Urinária/parasitologia , Inquéritos e Questionários , Adulto Jovem
9.
J Infect Dis ; 220(3): 457-466, 2019 07 02.
Artigo em Inglês | MEDLINE | ID: mdl-30891605

RESUMO

BACKGROUND: Placental malaria is a major cause of adverse birth outcomes. However, data are limited on the relationships between longitudinal measures of parasitemia during pregnancy and placental malaria. METHODS: Data came from 637 women enrolled in a randomized controlled trial of intermittent preventive treatment of malaria in pregnancy (IPTp) from Uganda. Plasmodium falciparum parasitemia was assessed using microscopy and ultrasensitive quantitative PCR at intervals of 28 days from 12 to 20 weeks gestation through delivery. Multivariate analysis was used to measure associations between characteristics of parasitemia during pregnancy and the risk of placental malaria based on histopathology. RESULTS: Overall risk of placental malaria was 44.6%. None of the 34 women without parasitemia detected during pregnancy had evidence of placental malaria. Increasing proportion of interval assessments with parasitemia and higher parasite densities were independently associated with an increased risk of placental malaria. Higher gravidity and more effective IPTp were associated with a decreased risk of placental malaria. Women with parasitemia only detected before the third trimester still had an increased risk of placental malaria. CONCLUSIONS: The frequency, density, and timing of parasitemia are all important risk factors for placental malaria. Interventions should target the prevention of all levels of parasitemia throughout pregnancy.


Assuntos
Malária Falciparum/complicações , Malária Falciparum/parasitologia , Parasitemia/etiologia , Placenta/parasitologia , Complicações Infecciosas na Gravidez/parasitologia , Complicações Parasitárias na Gravidez/parasitologia , Adulto , Antimaláricos/uso terapêutico , Método Duplo-Cego , Feminino , Humanos , Estudos Longitudinais , Malária Falciparum/tratamento farmacológico , Parasitemia/tratamento farmacológico , Parasitemia/parasitologia , Plasmodium falciparum/efeitos dos fármacos , Gravidez , Complicações Infecciosas na Gravidez/tratamento farmacológico , Complicações Parasitárias na Gravidez/tratamento farmacológico , Uganda , Adulto Jovem
10.
J Infect Chemother ; 25(6): 427-430, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30824301

RESUMO

Primary infection with Toxoplasma gondii (T. gondii) during pregnancy may cause congenital infection of the infant. This study evaluated whether screening using IgG avidity and multiplex-nested polymerase chain reaction (PCR) methods was effective for detecting a high-risk pregnancy for congenital T. gondii infection. In a prospective cohort study serum T. gondii IgG avidity was measured in 469 pregnant women who had a positive test for T. gondii antibody plus a positive or equivocal test for IgM. Multiplex-nested PCR for T. gondii DNA on amniotic fluid, maternal blood, and neonatal blood was performed with informed consent. Low (<30%), borderline (30-35%), and high (>35%) IgG avidity indices were found in 104 (22.2%), 30 (6.4%), and 305 (71.4%), respectively. A total of 12 cases had a positive PCR test for amniotic fluids of the prenatal amniocentesis or at birth, or neonatal blood. Seven of the 12 cases were diagnosed as having congenital T. gondii infection, and they had low IgG avidity indices. Congenital T. gondii infection screening using of IgG avidity and multiplex-nested PCR methods for pregnant women with a positive test for T. gondii antibody plus a positive or equivocal test for T. gondii IgM was useful for detecting a high-risk pregnancy and diagnosing congenital T. gondii infection.


Assuntos
Anticorpos Antiprotozoários/isolamento & purificação , DNA de Protozoário/isolamento & purificação , Complicações Parasitárias na Gravidez/diagnóstico , Toxoplasma/isolamento & purificação , Toxoplasmose Congênita/diagnóstico , Adulto , Amniocentese , Líquido Amniótico/parasitologia , Anticorpos Antiprotozoários/sangue , Anticorpos Antiprotozoários/imunologia , Antiprotozoários , Criança , Pré-Escolar , DNA de Protozoário/sangue , Feminino , Seguimentos , Humanos , Imunoglobulina M/sangue , Imunoglobulina M/imunologia , Imunoglobulina M/isolamento & purificação , Lactente , Recém-Nascido , Gravidez , Complicações Parasitárias na Gravidez/sangue , Complicações Parasitárias na Gravidez/tratamento farmacológico , Complicações Parasitárias na Gravidez/parasitologia , Gravidez de Alto Risco , Estudos Prospectivos , Toxoplasma/genética , Toxoplasma/imunologia , Toxoplasmose Congênita/sangue , Toxoplasmose Congênita/tratamento farmacológico , Toxoplasmose Congênita/parasitologia , Resultado do Tratamento
11.
Clin Lab ; 65(1)2019 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-30775900

RESUMO

BACKGROUND: The onset of acute toxoplasmosis in pregnant women may pose a risk to their growing fetuses. The timely diagnosis of infection in managing the disease and preventing its harmful consequences on the fetus is very important. Therefore, the study was conducted to identify acute toxoplasmosis in the pregnant women by detecting the specific IgM antibody and Toxoplasma gondii B1 gene. METHODS: A total of 653 serum samples of women who attended to Fatemieh Hospital of Hamadan University of Medical Sciences were tested for IgG antibodies against Toxoplasma gondii by enzyme-linked immunosorbent as-say (ELISA). The IgG positive specimens were further examined for IgM by ELISA and polymerase chain reaction (PCR) for B1 gene. In the second phase, change in IgG titers was evaluated on 47 IgG positive samples after two weeks. RESULTS: ELISA data showed that 167 out of 653 and 2 out of 167 samples were positive for IgG (25.6%) and IgM (1.2%), respectively. However, PCR detection showed that 36 cases (21.6%) were positive for the B1 gene. Seven out of 47 IgG positive samples showed an increase in the antibody titer and positive for the B1 gene. The most cases of IgG positives and the B1 gene samples were associated with the third trimester of pregnancy with 49.7% and 14%, respectively, and the most common abundance of the B1 gene was 14.4% in the age group of 26 - 35. The most commonly reported clinical symptoms in the B1 gene-positive women were nausea 15 (41.7%), cough 13 (36.1%), headache 12 (33.3%), and vomiting 11 (30.5%). CONCLUSIONS: Using PCR and the B1 gene in serum samples of pregnant women to detect acute toxoplasmosis is a more appropriate and accurate method than IgM antibody.


Assuntos
Anticorpos Antiprotozoários/sangue , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Toxoplasma/imunologia , Toxoplasmose/imunologia , Adulto , Ensaio de Imunoadsorção Enzimática , Feminino , Genes de Protozoários/genética , Humanos , Pessoa de Meia-Idade , Reação em Cadeia da Polimerase , Gravidez , Complicações Parasitárias na Gravidez/diagnóstico , Complicações Parasitárias na Gravidez/imunologia , Complicações Parasitárias na Gravidez/parasitologia , Sensibilidade e Especificidade , Toxoplasma/genética , Toxoplasmose/diagnóstico , Toxoplasmose/parasitologia , Adulto Jovem
12.
PLoS One ; 14(1): e0210156, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30615644

RESUMO

BACKGROUND: Despite the adoption of campaigns to interrupt the main vector and to detect Trypanosoma cruzi in blood banks, millions of people are still chronically infected; however, the prevalence data are limited, and the epidemiology of Chagas disease has not been systematically evaluated. This study aimed to estimate the prevalence of Chagas disease in Colombia. METHODS: A systematic literature review and meta-analysis was conducted to select all observational studies reporting the prevalence of Chagas disease in Colombia, based on serological diagnosis in participants of any age and published between January 2007 and November 2017. Pooled estimates and 95% confidence intervals (95% CIs) were calculated using random-effects models. In addition, the I2 statistic was calculated. RESULTS: The literature search yielded a total of 1,510 studies; sixteen articles with relevant prevalence data were included in the systematic review. Of these, only 12 articles were included for entry in the meta-analysis. The pooled prevalence of Chagas disease across studies was 2.0% (95% CI: 1.0-4.0). A high degree of heterogeneity was found among studies (I2 > 75%; p < 0.001). The publication bias was not statistically significant (Egger's test, p = 0.078). The highest pooled prevalences were found in the adult population (3.0%, 95% CI: 1.0-4.0), pregnant women (3.0%, 95% CI: 3.0-4.0) and the Orinoco region (7.0%, 95% CI: 2.2-12.6). CONCLUSIONS: The results indicate that the T. cruzi-infected population is aging, the adult population, pregnant women and that the Orinoco region (department of Casanare) have the highest prevalences. These results highlight the need to maintain screening and surveillance programs to identify people with chronic T. cruzi infections.


Assuntos
Doença de Chagas/epidemiologia , Vetores de Doenças , Complicações Parasitárias na Gravidez/epidemiologia , Trypanosoma cruzi/isolamento & purificação , Animais , Doença de Chagas/diagnóstico , Doença de Chagas/parasitologia , Doença de Chagas/prevenção & controle , Doença Crônica/epidemiologia , Doença Crônica/prevenção & controle , Colômbia/epidemiologia , Feminino , Necessidades e Demandas de Serviços de Saúde , Humanos , Programas de Rastreamento/organização & administração , Programas de Rastreamento/estatística & dados numéricos , Gravidez , Complicações Parasitárias na Gravidez/diagnóstico , Complicações Parasitárias na Gravidez/parasitologia , Complicações Parasitárias na Gravidez/prevenção & controle , Prevalência
13.
Vector Borne Zoonotic Dis ; 19(3): 217-221, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30328792

RESUMO

Brucellosis and Toxoplasmosis are important zoonotic diseases, and Neospora caninum is a parasite causing disease in cattle and other animals. Brucella spp. and N. caninum can cause abortions in cattle, and Toxoplasmosis is a relevant cause of abortion for small ruminants, resulting in economic loses to farmers. In this study, from July 2015 to April 2017, a total of 535 Yanbian yellow cattle blood samples were collected from 3 cities in Jilin Province, China. We detected the frequency of N. caninum, Toxoplasma gondii, and Brucella spp. using enzyme-linked immunosorbent assays, indirect hemagglutination assay, and real-time PCR methods, respectively. The frequency of Brucella was 7.7% (41/535), and the seroprevalences of N. caninum and T. gondii were 6.2% (33/535) and 5.0% (27/535), respectively. The region, gender, and age of Yanbian yellow cattle were considered as risk factors when analyzed using a logistic regression model. These findings provide the foundation for the prevention and control of infection by these pathogens in Yanbian yellow cattle and humans.


Assuntos
Brucelose/veterinária , Doenças dos Bovinos/epidemiologia , Toxoplasmose Animal/epidemiologia , Aborto Animal/epidemiologia , Aborto Animal/parasitologia , Envelhecimento , Animais , Brucella , Brucelose/epidemiologia , Bovinos , Doenças dos Bovinos/parasitologia , China/epidemiologia , Feminino , Masculino , Neospora , Gravidez , Complicações Parasitárias na Gravidez/epidemiologia , Complicações Parasitárias na Gravidez/parasitologia , Complicações Parasitárias na Gravidez/veterinária , Fatores de Risco , Estudos Soroepidemiológicos
14.
Parasite Immunol ; 41(3): e12606, 2019 03.
Artigo em Inglês | MEDLINE | ID: mdl-30471137

RESUMO

Toxoplasma gondii is a zoonotic parasite which, depending on the geographical location, can infect between 10% and 90% of humans. Infection during pregnancy may result in congenital toxoplasmosis. The effects on the foetus vary depending on the stage of gestation in which primary maternal infection arises. A large body of research has focused on understanding immune response to toxoplasmosis, although few studies have addressed how it is affected by pregnancy or the pathological consequences of infection at the maternal-foetal interface. There is a lack of knowledge about how maternal immune cells, specifically macrophages, are modulated during infection and the resulting consequences for parasite control and pathology. Herein, we discuss the potential of T. gondii infection to affect the maternal-foetal interface and the potential of pregnancy to disrupt maternal immunity to T. gondii infection.


Assuntos
Relações Materno-Fetais/fisiologia , Complicações Parasitárias na Gravidez/imunologia , Toxoplasma/imunologia , Toxoplasmose/imunologia , Animais , Feminino , Feto/imunologia , Humanos , Macrófagos/imunologia , Gravidez , Complicações Parasitárias na Gravidez/parasitologia , Toxoplasmose/parasitologia
15.
Malar J ; 17(1): 425, 2018 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-30442132

RESUMO

BACKGROUND: A multi-country, community-based trial on scheduled screening and treatment for malaria in pregnancy was conducted in Benin, The Gambia and Burkina Faso. Despite standardized procedures and outcomes, the study became subject to rumours and accusations of placenta being sold for mystical and financial gain by trial staff, leading to drop-out rates of 30% and the consequent halting of placental biopsy sampling in Benin. This paper explores the role of socio-cultural beliefs related to placenta and identified additional factors contributing these rumours. METHODS: A qualitative comparative emergent-theory design was used to assess social factors related to trial implementation and uptake in the three countries. Data from participant observation, informal conversations, group discussions and interviews were triangulated and analysed with NVivo Qualitative Analysis software. RESULTS: Despite similar sociocultural beliefs about the sacred nature of the placenta in all three study countries, these beliefs did not affect participation rates in Burkina Faso and The Gambia and placenta-related rumours only emerged in Benin. Therefore, the presence of beliefs is not a sufficient condition to have generated placenta-selling fears. The rumours in Benin reflected the confluence of placenta-related beliefs and factors related to the implementation of the trial (including a catalysing adverse event and miscommunication during the informed consent procedure). Furthermore, distinct socio-political factors contributed to the emergence of rumours, including the historical distrust in governmental organizations and the tense relationship between some of the actors involved in the trial. CONCLUSION: Transdisciplinary social science research designs should accompany the implementation of the trial. The integration of multiple stakeholders' knowledge and involvement is required to define and solve upcoming barriers.


Assuntos
Biópsia/psicologia , Medo , Malária/psicologia , Placenta , Complicações Parasitárias na Gravidez/psicologia , Benin , Biópsia/economia , Feminino , Humanos , Consentimento Livre e Esclarecido , Malária/parasitologia , Gravidez , Complicações Parasitárias na Gravidez/parasitologia
16.
Malar J ; 17(1): 357, 2018 Oct 11.
Artigo em Inglês | MEDLINE | ID: mdl-30314489

RESUMO

BACKGROUND: Disruption of malaria control strategies during the West African 2014-2016 Ebola epidemic led to an increase in malaria-attributable mortality. However, recent data on malaria infection in vulnerable groups, such as pregnant women, are lacking in this post-Ebola scenario. This cross-sectional study aimed to assess the prevalence of Plasmodium falciparum infection and of molecular markers of drug resistance among pregnant women attending antenatal care in Monrovia, capital of Liberia. METHODS: From October 2016 to June 2017, all pregnant women attending their first antenatal care visit at the Saint Joseph's Catholic Hospital, Monrovia, were invited to participate in the study. In addition to their routine antenatal care tests, capillary blood spotted onto filter papers were collected from all consenting participants to determine presence of P. falciparum by real-time quantitative PCR. Molecular markers of anti-malarial drug resistance were assessed through Sanger sequencing and quantitative PCR in specimens positive for P. falciparum analysis. RESULTS: Of the 195 women participants, 24 (12.3%) were P. falciparum-positive by qPCR. Infected women tended to be more commonly primigravidae and younger than uninfected ones. Parasite densities were higher in primigravidae. Fever was more frequently detected among the infected women. No statistically significant association between P. falciparum infection and haemoglobin levels or insecticide-treated net use was found. While high prevalence of genetic polymorphisms associated with chloroquine and amodiaquine resistance were detected, no molecular markers of artemisinin resistance were observed. CONCLUSION: Plasmodium falciparum infections are expected to occur in at least one in every eight women attending first ANC at private clinics in Monrovia and outside the peak of the rainy season. Young primigravidae are at increased risk of P. falciparum infection. Molecular analyses did not provide evidence of resistance to artemisinins among the P. falciparum isolates tested. Further epidemiological studies involving pregnant women are necessary to describe the risk of malaria in this highly susceptible group outside Monrovia, as well as to closely monitor the emergence of resistance to anti-malarials, as recommended by the Liberian National Malaria Control Programme.


Assuntos
Antimaláricos/uso terapêutico , Resistência a Medicamentos , Malária Falciparum/epidemiologia , Plasmodium falciparum/efeitos dos fármacos , Complicações Parasitárias na Gravidez/epidemiologia , Cuidado Pré-Natal , Adolescente , Adulto , Feminino , Humanos , Libéria/epidemiologia , Malária Falciparum/parasitologia , Plasmodium falciparum/isolamento & purificação , Gravidez , Complicações Parasitárias na Gravidez/parasitologia , Cuidado Pré-Natal/estatística & dados numéricos , Prevalência , Adulto Jovem
17.
Turkiye Parazitol Derg ; 42(2): 118-121, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-30070642

RESUMO

OBJECTIVE: Echinococcus granulosus, the etiological agent of cystic echinococcosis (CE) in humans and livestock, is a widely distributed zoonotic pathogen tapeworm. The infection is transmitted to humans by the ingestion of E. granulosus eggs released in the feces of definitive hosts such as dogs. The larval stage of the parasite develops a slowly enlarging cyst in the visceral organs, particularly in the liver and/or lung. The aim of the present study was to evaluate the diagnostic value of an immunochromatographic test (ICT) for CE. METHODS: A total of 50 sera from surgically and/or pathologically confirmed patients with CE were included in the study as the study group; the control group comprised patients who tested negative for enzyme-linked immunosorbent assay (ELISA). Sera were selected from the collection at Adnan Menderes University, Faculty of Medicine, Parasitology Laboratory, by simple random sampling. The collection included sera obtained between 2010 and 2014; antibody titers of each serum sample were determined using in-house ELISA, before storage at -20°C. The presence of E. granulosus antibody in the sera was determined using a commercially available ICT (VIRAPID® HYDATIDOSIS) kit method. RESULTS: In the study group (E. granulosus-confirmed cases), two (4%) of the 50 sera were negative and 48 (96%) were positive with ICT. In the control group (ELISA-negative), all were negative with ICT. CONCLUSION: The rapid diagnostic test has been evaluated as a practical, easy-to-use method for detecting CE, and it can be used as a screening test in routine diagnosis and research.


Assuntos
Equinococose Hepática/diagnóstico , Equinococose/diagnóstico , Complicações Parasitárias na Gravidez/diagnóstico , Diagnóstico Pré-Natal , Adulto , Idoso , Animais , Anticorpos Anti-Helmínticos/sangue , Estudos de Casos e Controles , Equinococose/sangue , Equinococose/parasitologia , Equinococose Hepática/sangue , Equinococose Hepática/parasitologia , Echinococcus granulosus/imunologia , Ensaio de Imunoadsorção Enzimática/métodos , Feminino , Hospitalização , Maternidades , Humanos , Pessoa de Meia-Idade , Gravidez , Complicações Parasitárias na Gravidez/sangue , Complicações Parasitárias na Gravidez/parasitologia , Primeiro Trimestre da Gravidez , Estudos Retrospectivos , Turquia , Adulto Jovem
18.
Microb Pathog ; 124: 183-190, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30142466

RESUMO

Recent evidence indicates that macrophages at the maternal-fetal interface adapt to a phenotype characterized by alternative activation (M2 polarization) and exhibit immunosuppressive functions that favor the maintenance of pregnancy. The bias of M2 decidual macrophages toward M1 has been clinically linked to pregnancy-related complications, such as preeclampsia and preterm delivery. The aim of this study was to investigate the effect of Toxoplasma gondii PRU strain infection on the bias of decidual macrophage polarization and its contribution to adverse pregnancy outcomes. A mouse model with adverse pregnancy outcome was established by infection with T. gondii PRU strain and the expression levels of functional molecules in decidual macrophages of mice were measured. The results showed that T. gondii infection caused seriously adverse pregnancy outcome in mice. The placentae of infected mice showed obvious congestion and inflammatory cell infiltration. The expression of CD206, MHC-II, and arginase-1 considered as M2 markers was decreased in decidual macrophages after T. gondii infection, whereas the expression of CD80, CD86, iNOS, and cytokines TNF-α and IL-12 considered as M1 markers was increased. Furthermore, iNOS-positive expression was observed in the decidua basalis of infected mice. Our results indicated that T. gondii infection was responsible for the bias of M2 decidual macrophages toward M1, which changes the immunosuppressive microenvironment at the maternal-fetal interface and contributes to adverse pregnancy outcomes.


Assuntos
Polaridade Celular , Decídua/parasitologia , Macrófagos/imunologia , Complicações Parasitárias na Gravidez/imunologia , Toxoplasma/fisiologia , Toxoplasmose/imunologia , Animais , Decídua/imunologia , Feminino , Humanos , Interleucina-12/genética , Interleucina-12/imunologia , Macrófagos/citologia , Camundongos , Gravidez , Complicações Parasitárias na Gravidez/genética , Complicações Parasitárias na Gravidez/parasitologia , Toxoplasmose/genética , Toxoplasmose/parasitologia , Fator de Necrose Tumoral alfa/genética , Fator de Necrose Tumoral alfa/imunologia
19.
PLoS Med ; 15(7): e1002606, 2018 07.
Artigo em Inglês | MEDLINE | ID: mdl-30016328

RESUMO

BACKGROUND: Intermittent preventive treatment of malaria in pregnancy (IPTp) with dihydroartemisinin-piperaquine (IPTp-DP) has been shown to reduce the burden of malaria during pregnancy compared to sulfadoxine-pyrimethamine (IPTp-SP). However, limited data exist on how IPTp regimens impact malaria risk during infancy. We conducted a double-blinded randomized controlled trial (RCT) to test the hypothesis that children born to mothers given IPTp-DP would have a lower incidence of malaria during infancy compared to children born to mothers who received IPTp-SP. METHODS AND FINDINGS: We compared malaria metrics among children in Tororo, Uganda, born to women randomized to IPTp-SP given every 8 weeks (SP8w, n = 100), IPTp-DP every 8 weeks (DP8w, n = 44), or IPTp-DP every 4 weeks (DP4w, n = 47). After birth, children were given chemoprevention with DP every 12 weeks from 8 weeks to 2 years of age. The primary outcome was incidence of malaria during the first 2 years of life. Secondary outcomes included time to malaria from birth and time to parasitemia following each dose of DP given during infancy. Results are reported after adjustment for clustering (twin gestation) and potential confounders (maternal age, gravidity, and maternal parasitemia status at enrolment).The study took place between June 2014 and May 2017. Compared to children whose mothers were randomized to IPTp-SP8w (0.24 episodes per person year [PPY]), the incidence of malaria was higher in children born to mothers who received IPTp-DP4w (0.42 episodes PPY, adjusted incidence rate ratio [aIRR] 1.92; 95% CI 1.00-3.65, p = 0.049) and nonsignificantly higher in children born to mothers who received IPT-DP8w (0.30 episodes PPY, aIRR 1.44; 95% CI 0.68-3.05, p = 0.34). However, these associations were modified by infant sex. Female children whose mothers were randomized to IPTp-DP4w had an apparently 4-fold higher incidence of malaria compared to female children whose mothers were randomized to IPTp-SP8w (0.65 versus 0.20 episodes PPY, aIRR 4.39, 95% CI 1.87-10.3, p = 0.001), but no significant association was observed in male children (0.20 versus 0.28 episodes PPY, aIRR 0.66, 95% CI 0.25-1.75, p = 0.42). Nonsignificant increases in malaria incidence were observed among female, but not male, children born to mothers who received DP8w versus SP8w. In exploratory analyses, levels of malaria-specific antibodies in cord blood were similar between IPTp groups and sex. However, female children whose mothers were randomized to IPTp-DP4w had lower mean piperaquine (PQ) levels during infancy compared to female children whose mothers received IPTp-SP8w (coef 0.81, 95% CI 0.65-1.00, p = 0.048) and male children whose mothers received IPTp-DP4w (coef 0.72, 95% CI 0.57-0.91, p = 0.006). There were no significant sex-specific differences in PQ levels among children whose mothers were randomized to IPTp-SP8w or IPTp-DP8w. The main limitations were small sample size and childhood provision of DP every 12 weeks in infancy. CONCLUSIONS: Contrary to our hypothesis, preventing malaria in pregnancy with IPTp-DP in the context of chemoprevention with DP during infancy does not lead to a reduced incidence of malaria in childhood; in this setting, it may be associated with an increased incidence of malaria in females. Future studies are needed to better understand the biological mechanisms of in utero drug exposure on drug metabolism and how this may affect the dosing of antimalarial drugs for treatment and prevention during infancy. TRIAL REGISTRATION: ClinicalTrials.gov number NCT02163447.


Assuntos
Antimaláricos/administração & dosagem , Artemisininas/administração & dosagem , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Malária Falciparum/prevenção & controle , Complicações Parasitárias na Gravidez/prevenção & controle , Pirimetamina/administração & dosagem , Quinolinas/administração & dosagem , Sulfadoxina/administração & dosagem , Adolescente , Adulto , Antimaláricos/efeitos adversos , Artemisininas/efeitos adversos , Pré-Escolar , Método Duplo-Cego , Esquema de Medicação , Combinação de Medicamentos , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Malária Falciparum/epidemiologia , Malária Falciparum/parasitologia , Malária Falciparum/transmissão , Gravidez , Complicações Parasitárias na Gravidez/epidemiologia , Complicações Parasitárias na Gravidez/parasitologia , Pirimetamina/efeitos adversos , Quinolinas/efeitos adversos , Sulfadoxina/efeitos adversos , Fatores de Tempo , Resultado do Tratamento , Uganda/epidemiologia , Adulto Jovem
20.
Parasite Immunol ; 40(9): e12570, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29971806

RESUMO

Congenital toxoplasmosis is caused by the vertical transmission of infection from mother to foetus through the placenta when a pregnant woman is infected with Toxoplasma gondii (T. gondii). Congenital infection can have serious consequences, such as intrauterine abortion, foetal death and severe neurological, ocular or other organ damage in the foetus. In this review, we focus on recent publications investigating vertical transmission of T. gondii infection, cellular immunopathogenesis and protective immunity in primary toxoplasmosis during pregnancy.


Assuntos
Complicações Parasitárias na Gravidez/parasitologia , Toxoplasma/fisiologia , Toxoplasmose/imunologia , Animais , Feminino , Humanos , Transmissão Vertical de Doença Infecciosa , Masculino , Placenta/imunologia , Placenta/parasitologia , Gravidez , Complicações Parasitárias na Gravidez/imunologia , Complicações Parasitárias na Gravidez/patologia , Toxoplasma/genética , Toxoplasmose/parasitologia , Toxoplasmose/patologia , Toxoplasmose/transmissão
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