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1.
BMC Infect Dis ; 20(1): 734, 2020 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-33028245

RESUMO

BACKGROUND: HIV continues to be the main determinant morbidity with high mortality rates in Sub-Saharan Africa, with a high number of patients being late presenters with advanced HIV. Clinical management of advanced HIV patients is thus complex and requires strict adherence to updated, empirical and simplified guidelines. The current study investigated the impact of the implementation of a new clinical guideline on the management of advanced HIV in Kinshasa, Democratic Republic of Congo (DRC). METHODS: A retrospective analysis of routine clinical data of advanced HIV patients was conducted for the periods; February 2016 to March 2017, before implementation of new guidelines, and November 2017 to July 2018, after the implementation of new guidelines. Eligible patients were patients with CD4 < 200 cell/µl and presenting with at least 1 of 4 opportunistic infections. Patient files were reviewed by a medical doctor and a committee of 3 other doctors for congruence. Statistical significance was set at 0.05%. RESULTS: Two hundred four and Two hundred thirty-one patients were eligible for inclusion before and after the implementation of new guidelines respectively. Sex and age distributions were similar for both periods, and median CD4 were 36 & 52 cell/µl, before and after the new guidelines implementation, respectively. 40.7% of patients had at least 1 missed/incorrect diagnosis before the new guidelines compared to 30% after new guidelines, p < 0.05. Clinical diagnosis for TB and toxoplasmosis were also much improved after the implementation of new guidelines. In addition, only 63% of patients had CD4 count test results before the new guidelines compared to 99% of patients after new guidelines. Death odds after the implementation of new guidelines were significantly lower than before new guidelines in a multivariate regression model that included patients CD4 count and 10 other covariates, p < 0.05. CONCLUSIONS: Simplification and implementation of a new and improved HIV clinical guideline coupled with the installation of laboratory equipment and point of care tests potentially helped reduce incorrect diagnosis and improve clinical outcomes of patients with advanced HIV. Regulating authorities should consider developing simplified versions of guidelines followed by the provision of basic diagnostic equipment to health centers.


Assuntos
Antirretrovirais/uso terapêutico , Infecções por HIV/tratamento farmacológico , Adolescente , Adulto , Instituições de Assistência Ambulatorial , Contagem de Linfócito CD4 , República Democrática do Congo , Feminino , Guias como Assunto , Infecções por HIV/complicações , Infecções por HIV/mortalidade , Mortalidade Hospitalar , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Toxoplasmose/complicações , Toxoplasmose/diagnóstico , Tuberculose/complicações , Tuberculose/diagnóstico , Adulto Jovem
2.
Artigo em Inglês | MEDLINE | ID: mdl-32667393

RESUMO

Infection by the protozoan Toxoplasma gondii during pregnancy demands greater attention from the health authorities due to the risk of placental transmission, which can have devastating consequences to the foetus and newborn. This study was conducted in a high-risk prenatal care outpatient clinic of a university teaching hospital. Pregnant women screened for specific IgM and IgG anti -T. gondii, attended from January 2009 to August 2018 were included. From 530 suspected patients, 218 were followed up and they presented positive IgM and IgG anti- T. gondii. From these patients, 83 (38.0%) had low IgG avidity, 39 (18%) seroconverted in the second or third trimester of pregnancy, 19 (8.7%) had no avidity test, 69 (31.6%) had high IgG avidity after 16 weeks of gestation, five had recurrent chorioretinitis (2.2%) and three (1.3%) were seropositive to HIV. Complementary diagnoses were made in 30/48 (62.5%) of the patients revealing the presence of specific IgA antibodies raised to T. gondii; 3/63 (4.8%) peripheral blood samples and 1/57 (1.8%) amniotic fluid sample. There were eight foetal deaths, one case of neonatal hepatomegaly and one case of T. gondii DNA detected in a peripheral blood sample. Of the 139 newborn deliveries at the teaching hospital, there was a 38% loss of follow-up. The prevalence of congenital toxoplasmosis was 1.2 cases/1,000 live births in this study area, according to the retrospective survey of cases. Prenatal treatment may have helped to reduce the risk of vertical transmission.


Assuntos
Complicações Parasitárias na Gravidez/diagnóstico , Toxoplasma/isolamento & purificação , Toxoplasmose/diagnóstico , Instituições de Assistência Ambulatorial , Anticorpos Antiprotozoários/sangue , Brasil , Feminino , Hospitais de Ensino , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Recém-Nascido , Gravidez , Complicações Parasitárias na Gravidez/tratamento farmacológico , Cuidado Pré-Natal , Estudos Prospectivos , Toxoplasma/genética , Toxoplasmose/sangue , Toxoplasmose/tratamento farmacológico
3.
Arch Microbiol ; 202(7): 1881-1888, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32448961

RESUMO

Due to defects and drawbacks of most conventional diagnostic methods including serology for the diagnosis of toxoplasmosis as a dangerous opportunistic infection in immunocompromised individuals, the accurate, rapid, and sensitive detection of infection in such patients is essential. In this study, the TaqMan probe-based real-time PCR and, a relatively new nucleic acid amplification method, the loop-mediated isothermal amplification (LAMP) technique was compared based on the repetitive elements (RE) sequence to detect Toxoplasma gondii (T. gondii) DNA in blood samples of immunocompromised individuals. During this study, 119 blood samples from immunocompromised cancer patients with renal failure, undergoing dialysis were studied. After DNA extraction from blood samples using the salt extraction method, the molecular techniques of TaqMan probe-based real-time PCR and LAMP were used to investigate the contamination of the samples with T. gondii, based on the 529 bp (RE) sequence of T. gondii. The analytical sensitivity of LAMP and real-time PCR was evaluated by duplicating the five-step serial dilutions of T. gondii tachyzoites from 0.25 to 5×105 spiked tachyzoites per milliliter of the Toxoplasma seronegative blood sample. The extracted DNA from other parasites and human chromosomal DNA were used to determine the specificity of the molecular methods. The obtained results were analyzed using Kappa statistical test and SPSS22 software. Out of 119 studied samples, 7 (5.8%) and 5 (4.2%) samples were positive for Toxoplasma by TaqMan probe-based real-time PCR and LAMP, respectively. The limits of detection of TaqMan probe-based real-time PCR and RE-LAMP in negative serum samples were one and five tachyzoites (CT 38), respectively. Both real-time PCR and LAMP methods were 100% specific for Toxoplasma detection. Positive results were obtained only with T. gondii DNA, while other DNA samples were negative. The TaqMan probe-based real-time PCR based on the RE sequence showed higher sensitivity to T. gondii DNA detection in blood samples of cancer patients and serial dilutions of parasitic tachyzoites. The results show that TaqMan probe-based real-time PRC is a sensitive and specific method for the detection of toxoplasmosis in immunocompromised individuals, as well as the LAMP assay, which can be used as a suitable alternative diagnostic method for the detection of toxoplasmosis in such patients, without need the for any expensive equipment.


Assuntos
DNA de Protozoário/genética , Técnicas de Amplificação de Ácido Nucleico , Infecções Oportunistas/diagnóstico , Parasitologia/métodos , Reação em Cadeia da Polimerase em Tempo Real , Toxoplasmose/diagnóstico , Animais , DNA de Protozoário/sangue , Humanos , Hospedeiro Imunocomprometido , Infecções Oportunistas/parasitologia , Sensibilidade e Especificidade , Toxoplasma/genética , Toxoplasmose/parasitologia
4.
Ann R Coll Surg Engl ; 102(7): e167-e169, 2020 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-32347740

RESUMO

Lymphadenopathy is a common presentation in surgical assessment units and has numerous differential diagnoses. In one-stop breast clinics, its discovery often raises concerns of malignancy. This case report focuses on the case of a 33-year-old pregnant woman presenting to the breast clinic with a right axillary lump, which was found to be the result of toxoplasmosis.


Assuntos
Linfadenopatia/etiologia , Complicações Parasitárias na Gravidez , Toxoplasmose/complicações , Adulto , Axila , Biópsia , Diagnóstico Diferencial , Feminino , Humanos , Linfonodos/patologia , Linfadenopatia/diagnóstico , Gravidez , Toxoplasmose/diagnóstico , Ultrassonografia Mamária/métodos
5.
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
7.
Parasite ; 27: 7, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32031519

RESUMO

BACKGROUND: Primary infection by Toxoplasma gondii in pregnant women can result in serious outcomes for the foetus. A false-positive IgG result during pregnancy can lead to a misdiagnosis of past infection and to stopping preventive measures. We collected 189 sera with positive Architect® Toxo IgG assay (Abbott Laboratories) and negative IgG results with at least two other serological tests, in order to find an explanation for the suspected false-positive IgG results. We used the recomLine Toxoplasma IgG® immunoblot (Mikrogen Diagnostik) to search for specific antigenic reactivities of the sera, and the LDBio Toxo II IgG® immunoblot (LDBio Diagnostics) as a confirmatory test. RESULTS: The bands GRA8 and/or GRA7 were positive for 148 samples (78.3%). GRA8 was the most frequent band, appearing in 133 patterns (70.4%), whereas GRA7 was present for 49 samples (25.9%). Of the 81 samples tested with LDBio®, 23 (28.4%) turned out to be positive. Of the 58 negative LDBio® tests (71.6%) (real false-positive Architect® IgG), 23 samples (39.6%) did not show either a GRA8 or p30 band by recomLine®. Their false positivity with Architect® remains unexplained since Abbott uses these two recombinant antigens for their assay. CONCLUSIONS: The Architect® IgG false positivity for T. gondii seems to be due to reactivity against GRA8 for the majority of the sera and GRA7 to a lesser extent. The hypothesis of past contact with parasites genetically close to T. gondii such as Hammondia hammondi or Neospora caninum seems promising and should be assessed further.


Assuntos
Anticorpos Antiprotozoários/sangue , Imunoglobulina G/sangue , Testes Sorológicos/normas , Toxoplasmose/diagnóstico , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Reações Cruzadas , Reações Falso-Positivas , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Kit de Reagentes para Diagnóstico/normas , Toxoplasma , Toxoplasmose/imunologia , Adulto Jovem
8.
J Nerv Ment Dis ; 208(2): 118-126, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31985560

RESUMO

This study investigated the seroprevalence of Toxoplasma gondii in a cohort of 101 Italian inpatients affected by mood or schizophrenia-spectrum disorders and compared clinical features between seronegative and seropositive subjects. Patients diagnosed according to DSM-5 criteria underwent clinical assessments and blood collection to test parasite-specific IgG/IgM serum levels. Twenty-eight patients (27.7%) had IgG anti-T. gondii, and none had IgM antibodies. We found higher prevalence rate in patients aged 40 years or older, as compared with younger. No significant association was detected between T. gondii and a specific diagnostic category; however, bipolar disorder (BD)-II showed the highest positivity rate (40.9%). The seropositive status was significantly associated with a lower presence of psychotic symptoms, higher number of total episodes of predominant excitatory polarity, longer illness duration, and lower severity of current episode, particularly anxiety, depressive, and withdrawal/retardation symptoms. These preliminary results seem to point out an association between chronic toxoplasmosis and a specific subtype of BD.


Assuntos
Transtorno Bipolar/diagnóstico , Esquizofrenia/diagnóstico , Psicologia do Esquizofrênico , Toxoplasmose/diagnóstico , Toxoplasmose/psicologia , Adulto , Idoso , Transtorno Bipolar/epidemiologia , Transtorno Bipolar/psicologia , Doença Crônica , Estudos de Coortes , Comorbidade , Correlação de Dados , Feminino , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Esquizofrenia/epidemiologia , Estudos Soroepidemiológicos , Toxoplasmose/epidemiologia , Adulto Jovem
9.
Aust N Z J Public Health ; 44(1): 49-52, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31825558

RESUMO

OBJECTIVE: Toxoplasmosis may follow consumption of undercooked meat containing Toxoplasma gondii cysts. Lamb is considered to pose the highest risk for contamination across meats. Red meat is often served undercooked, yet there are no current data on T. gondii contamination of Australian sourced and retailed lamb. We sought to address this gap in public health knowledge. METHODS: Lamb mincemeat was purchased at the supermarket counter three times weekly for six months. T. gondii was detected by real-time polymerase chain reaction (PCR) of DNA extracted from the meat following homogenisation. Purchases were also tested for common foodborne bacterial pathogens. RESULTS: Conservative interpretation of PCR testing (i.e. parasite DNA detected in three of four tests) gave a probability of 43% (95% confidence interval, 32%-54%) that lamb mincemeat was contaminated with T. gondii. None of the purchases were contaminated with Campylobacter jejuni, Salmonella species or S. enterica serovar Typhimurium, indicating sanitary meat processing. CONCLUSIONS: Australian lamb is commonly contaminated with T. gondii. Future studies should be directed at testing a range of red meats and meat cuts. Implications for public health: Consuming undercooked Australian lamb has potential to result in toxoplasmosis. There may be value in health education around this risk.


Assuntos
Carne/parasitologia , Toxoplasma/isolamento & purificação , Toxoplasmose Animal/parasitologia , Toxoplasmose/diagnóstico , Animais , Austrália/epidemiologia , Humanos , Produtos da Carne/parasitologia , Reação em Cadeia da Polimerase em Tempo Real , Ovinos/parasitologia , Toxoplasma/genética , Toxoplasmose/epidemiologia , Toxoplasmose/parasitologia
10.
Rev Soc Bras Med Trop ; 52: e20190250, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31800920

RESUMO

INTRODUCTION: Toxoplasmosis is an asymptomatic disease that can lead to systemic disease in the fetus of pregnant women with primary infection. This study aimed to determine the prevalence of toxoplasmosis, associated factors, and correlation between the serology of pregnant women and their pets, in the municipality of Ilhéus, Bahia, Brazil. METHODS: This cross-sectional study was conducted in 196 pregnant women and their cats or dogs (n=89). Semi-structured interviews were conducted and serum samples from the pregnant women were tested to detect IgM and IgG antibodies against Toxoplasma gondii, and avidity tests were performed for IgM-positive samples. The serum collected from pets were tested for IgG antibodies, and IgM antibodies in cats. A non-conditional logistic regression analysis was performed to identify infection-associated factors. RESULTS: IgG and IgM antibodies were detected in 67.9% (133/196) and 1.5% (3/196) samples, respectively, for women with an avidity of over 60%. Age ≥ 25 and the presence of cats in the vicinity were found to be associated with infection, while the level of education and previous orientation toward prevention of toxoplasmosis were protective factors in pregnant women. IgG antibodies were detected in 46.1% (41/89) of the animals, and cats were found to be negative for IgM. For the animals, age ≥ 1 year was a factor associated with infection. There was no correlation between serology of the pregnant women and the animals (p=0.15). CONCLUSIONS: An elevated prevalence of toxoplasmosis was detected in the region. Therefore, the adoption of preventive measures by public healthcare bodies is recommended.


Assuntos
Anticorpos Antiprotozoários/sangue , Complicações Parasitárias na Gravidez/epidemiologia , Toxoplasma/imunologia , Toxoplasmose/epidemiologia , Adulto , Animais , Brasil/epidemiologia , Gatos , Estudos Transversais , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Imunoglobulina G/sangue , Imunoglobulina M/sangue , Gravidez , Complicações Parasitárias na Gravidez/diagnóstico , Complicações Parasitárias na Gravidez/etiologia , Prevalência , Fatores de Risco , Toxoplasmose/diagnóstico , Toxoplasmose/etiologia
11.
BMC Infect Dis ; 19(1): 1042, 2019 Dec 10.
Artigo em Inglês | MEDLINE | ID: mdl-31823777

RESUMO

BACKGROUND: Toxoplasma gondii is an opportunistic protozoan parasite that can infect all warm-blooded animals including humans and cause serious clinical manifestations. Toxoplasmosis can be diagnosed using histological, serological, and molecular methods. In this study, we aimed to detect T. gondii RE gene in various human samples by in house and commercial real time polymerase chain reactions. METHODS: A total of 38 suspected cases of toxoplasmosis [peripheral blood (n:12), amnion fluid (n:11), tissue (n:9), cerebrospinal fluid (n:5), and intraocular fluid (n:1)] were included to the study. An in house and a commercial RT-PCR were applied to investigate the T. gondii RE gene in these samples. RESULTS: The compatibility rate of the two tests was 94.7% (37/38). When the commercial RT-PCR kit was taken as reference, the sensitivity and specificity of in house RT-PCR test was 87.5 and 100%. When the in house RT-PCR test was taken as reference, the commercial RT-PCR kit has 100% sensitivity and 96.8% specificity. Incompatibility was detected in only in a buffy coat sample with high protein content. CONCLUSIONS: Both the commercial and in house RT-PCR tests can be used to investigate T. gondii RE gene in various clinical specimens with their high sensitivity and specificity. In house RT-PCR assay can be favorable due to cost savings compared to using the commercial test.


Assuntos
DNA de Protozoário/metabolismo , Reação em Cadeia da Polimerase em Tempo Real/métodos , Toxoplasma/genética , Líquido Amniótico/microbiologia , Animais , Buffy Coat/microbiologia , DNA de Protozoário/isolamento & purificação , Humanos , Masculino , Kit de Reagentes para Diagnóstico , Toxoplasma/isolamento & purificação , Toxoplasmose/diagnóstico , Toxoplasmose/microbiologia , Turquia
12.
BMC Pregnancy Childbirth ; 19(1): 484, 2019 Dec 09.
Artigo em Inglês | MEDLINE | ID: mdl-31818265

RESUMO

OBJECTIVES: TORCH infections caused by Toxoplasma gondii (TOX), rubella virus (RV), cytomegalovirus (CMV) and herpes simplex virus 1,2 (HSV-1,2) are associated with congenital anomalies. The study aimed to analyze the characteristics of TORCH screening in reproductive age women. METHODS: A total of 18,104 women (2015-2017) from a teaching hospital in Xi'an, China, were enrolled in the study. The characteristics of TORCH screening, i.e., the application of TORCH test, the seroprevalence, the impact of age, periods of gestation and woman with bad obstetric history (BOH) on the serological data were investigated. RESULTS: In the study, 319 women (1.76%) performed dynamic TORCH test. 51.66, 20.44 and 3.83% of the population did the test in the pre-gestation period, the first and third trimester, respectively. Quite a few pre-gestation women (29.74%) ignored screening of IgG antibodies. The overall IgG/IgM seropositvity of TOX, RV, CMV, HSV-1 and HSV-2 was 4.35%/0.35, 90%/0.63, 96.79%/0.97, 81.11%/0.14 and 6.1%/0.19%, respectively. The age-specific distributions and periods of gestation had no significant effect on the seroprevalence of TORCH agents, p>0.05. However, BOH was significantly associated with higher seropositvity of IgM (RV, CMV, HSV-1 and HSV-2) and IgG (CMV and HSV-1) antibodies, p < 0.05. CONCLUSION: In Xi'an region, more attentions should be paid to TOX, CMV, HSV-2 and the women with BOH for TORCH screening. Meanwhile, a greater emphasis needs to be placed on TORCH test used inappropriately in China.


Assuntos
Infecções por Citomegalovirus/epidemiologia , Programas de Rastreamento/estatística & dados numéricos , Complicações Infecciosas na Gravidez/epidemiologia , Reprodução , Rubéola (Sarampo Alemão)/epidemiologia , Toxoplasmose/epidemiologia , Adolescente , Adulto , Anticorpos/sangue , China/epidemiologia , Citomegalovirus , Infecções por Citomegalovirus/diagnóstico , Feminino , Herpes Simples , Herpesvirus Humano 2 , Hospitais de Ensino , Humanos , Programas de Rastreamento/métodos , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/microbiologia , Rubéola (Sarampo Alemão)/diagnóstico , Vírus da Rubéola , Estudos Soroepidemiológicos , Toxoplasma , Toxoplasmose/diagnóstico , Adulto Jovem
13.
Artigo em Inglês | MEDLINE | ID: mdl-31850240

RESUMO

The intracellular parasite Toxoplasma gondii can cause chronic infections in most warm-blooded animals, including humans. In the USA, strains belonging to four different Toxoplasma clonal lineages (types 1, 2, 3, and 12) are commonly isolated, whereas strains not belonging to these lineages are predominant in other continents such as South America. Strain type plays a pivotal role in determining the severity of Toxoplasma infection. Therefore, it is epidemiologically relevant to develop a non-invasive and inexpensive method for determining the strain type in Toxoplasma infections and to correlate the genotype with disease outcome. Serological typing is based on the fact that many host antibodies are raised against immunodominant parasite proteins that are highly polymorphic between strains. However, current serological assays can only reliably distinguish type 2 from non-type 2 infections. To improve these assays, mouse, rabbit, and human infection serum were reacted against 950 peptides from 62 different polymorphic Toxoplasma proteins by using cellulose membrane peptide arrays. This allowed us to identify the most antigenic peptides and to pinpoint the most relevant polymorphisms that determine strain specificity. Our results confirm the utility of previously described peptides and identify novel peptides that improve and increase the specificity of the assay. In addition, a large number of novel proteins showed potential to be used for Toxoplasma diagnosis. Among these, peptides derived from several rhoptry, dense granule, and surface proteins represented promising candidates that may be used in future experiments to improve Toxoplasma serotyping. Moreover, a redesigned version of the published GRA7 typing peptide performed better and specifically distinguished type 3 from non-type 3 infections in sera from mice, rabbits, and humans.


Assuntos
Peptídeos , Análise Serial de Proteínas/métodos , Proteínas de Protozoários , Sorotipagem/métodos , Toxoplasma/classificação , Toxoplasmose/diagnóstico , Toxoplasmose/parasitologia , Sequência de Aminoácidos , Epitopos/química , Epitopos/imunologia , Genoma de Protozoário , Genótipo , Humanos , Peptídeos/química , Peptídeos/imunologia , Proteínas de Protozoários/imunologia , Sensibilidade e Especificidade , Toxoplasma/genética , Toxoplasma/imunologia , Toxoplasmose/imunologia , Sequenciamento Completo do Genoma
14.
Epidemiol Infect ; 147: e305, 2019 11 26.
Artigo em Inglês | MEDLINE | ID: mdl-31767044

RESUMO

Epidemiological data for Toxoplasma gondii regarding malignancy have gained increasing attention; however, the information about T. gondii infection among children with malignant lymphoma (ML) in China is unclear. Therefore, 314 children with lymphoma and 314 healthy children, age- and gender-matched, were recruited to estimate the seroprevalence of T. gondii in the participants and identify the risk factors of infection. Blood samples from all participants were collected and examined for T. gondii IgG and IgM antibodies using ELISA. The results showed that the overall seroprevalence of T. gondii antibodies (including IgG and/or IgM) in ML patients and healthy controls was 19.8% and 9.9%, respectively. Contact with the cats, consumption of oysters and history of chemotherapy were estimated to be the risk factors for T. gondii infection in children with lymphoma by multivariable logistic regression analysis, whereas in healthy children, contact with cats and consumption of oysters were the risk factors. Moreover, among various histological types of lymphoma, individuals with NK/T-cell lymphoma, B-small lymphocytic lymphoma, marginal zone B-lymphoma and Hodgkin's lymphoma had a higher seroprevalence than healthy controls (P < 0.05). These findings indicated the high prevalence of T. gondii infection in children with lymphoma, and hence, efforts should be performed to evaluate the effect of the infection further in lymphoma patients.


Assuntos
Linfoma/parasitologia , Toxoplasmose/complicações , Adolescente , Anticorpos Antiprotozoários/sangue , Biomarcadores/sangue , Estudos de Casos e Controles , Criança , Pré-Escolar , China/epidemiologia , Feminino , Humanos , Lactente , Recém-Nascido , Modelos Logísticos , Masculino , Fatores de Risco , Estudos Soroepidemiológicos , Toxoplasma/imunologia , Toxoplasmose/sangue , Toxoplasmose/diagnóstico , Toxoplasmose/epidemiologia
15.
Mikrobiyol Bul ; 53(4): 442-450, 2019 Oct.
Artigo em Turco | MEDLINE | ID: mdl-31709941

RESUMO

Toxoplasmosis is one of the most common parasitic infection in humans. Serological and molecular methods are used for diagnosis. Molecular methods are becoming increasingly preferred, since they lead to shortening of diagnostic time. In our study, it was aimed to determine Toxoplasma gondii by a cost-effective, quantitative, fast and reliable method without using a commercial kit, and apply method verification. T.gondii strain which was continued by mouse inoculation in our laboratory was used for method verification study. For this purpose DNA extraction was performed using a commercial kit. The limit of detection and, high and low positivity rates were determined by serial dilutions of DNA sample. Accuracy and certainty studies were performed using with TG-F, TG-R primers and TaqMan TG probe for method verification of the test. In the study with serial dilutions of DNA sample, detection limit was determined as 10-3 dilutions (0.028 copies/reaction). Furthermore 10-1 dilution (2.8 copies/reaction) was considered as high positive, 10-2 dilution (0.28 copies/reaction) was considered as low positive and method verification studies were performed. The accuracy of test was determined as 0.62 for high positive samples and 0.14 for low positive samples. CV value of intra-assay certainty was 0.62 for high positive samples and 0.14 for low positive samples, whereas, CV value of inter-assay certainty was calculated as 1.03 for high positive samples and 2.34 for low positive samples. Correlation coefficient was determined as 0.99. The coefficient of variation of inhouse realtime PCR method used in our study was found to be below 15%, and it was decided to be suitable for routine laboratory studies.


Assuntos
Reação em Cadeia da Polimerase em Tempo Real , Toxoplasma , Toxoplasmose , Animais , Primers do DNA , DNA de Protozoário , Humanos , Camundongos , Parasitologia/métodos , Reação em Cadeia da Polimerase em Tempo Real/normas , Sensibilidade e Especificidade , Toxoplasma/genética , Toxoplasmose/diagnóstico
16.
J Nerv Ment Dis ; 207(12): 1025-1030, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31688493

RESUMO

In this study, we aimed to explore the potential pathophysiological relationship between suicide attempts and Toxoplasma gondii infection. Fifty patients aged between 12 and 18 years who attempted suicide and 50 healthy adolescents were included in this study. All adolescents were evaluated by a child psychiatrist using a semistructured interview and Rosenberg Self-Esteem Scale (RSES), Children's Depression Inventory (CDI), and Inventory of Parent and Peer Attachment. T. gondii IgM and IgG antibodies of patients and control subjects were analyzed from blood samples by enzyme-linked immunosorbent assay. Psychiatric disorders particularly mood disorders were more common in adolescents in the patient group. Adolescents attempting suicide were found to have worse relationships with their parents; their CDI scores were higher, and their RSES scores were lower than their healthy peers. There were no significant differences between the patient and the control groups in terms of Toxoplasma IgG antibody positivity. Although the seropositivity of Toxoplasma IgG antibody was higher in the patient group than that in the control group, the difference between the two groups was not statistically significant.


Assuntos
Transtornos Mentais/sangue , Transtornos Mentais/psicologia , Tentativa de Suicídio/psicologia , Toxoplasma/metabolismo , Toxoplasmose/sangue , Toxoplasmose/psicologia , Adolescente , Criança , Feminino , Humanos , Masculino , Transtornos Mentais/diagnóstico , Estudos Soroepidemiológicos , Toxoplasmose/diagnóstico
17.
Parasitol Res ; 118(12): 3449-3457, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31659453

RESUMO

We assessed the risk for toxoplasmosis in 10 school restaurants in Armenia (Quindio, Colombia). We analyzed the presence of Toxoplasma gondii DNA in the food, water, and living and inert surfaces of school restaurants, and we correlated these findings with the results of food safety inspection scores and with the prevalence of specific anti-T. gondii antibodies in children who ate at these restaurants. Of the 213 samples, 6.1% were positive using PCR to test for T. gondii DNA. Positive samples were found in meat, water, cucumber, guava juice, inert surfaces, and living surfaces. In 60% (6/10) of the public school restaurants, there was at least one PCR T. gondii-positive sample. In 311 serum samples from children who attended the restaurants, 101 (33%) were positive for IgG and 12 (3.9%) for IgM anti-T. gondii. The median of the compound score for the fulfillment of inspection for food safety conditions was of 60.7% (range 50-72). Higher T. gondii PCR positivity in surfaces, food, or water at each restaurant was correlated with lower inspection scores for water supply and water storage conditions. Lower scores in physical infrastructure and disinfection procedures and higher scores in furniture were correlated with a higher prevalence of IgG anti-T. gondii in children who ate at those restaurants. Inspection scores can identify restaurants with a higher risk for the presence of T. gondii.


Assuntos
Contaminação de Alimentos/análise , Parasitologia de Alimentos , Toxoplasma/isolamento & purificação , Toxoplasmose/epidemiologia , Animais , Anticorpos Anti-Idiotípicos/sangue , Anticorpos Antiprotozoários/sangue , Armênia/epidemiologia , Criança , Colômbia/epidemiologia , Feminino , Inocuidade dos Alimentos , Humanos , Masculino , Carne/parasitologia , Prevalência , Restaurantes/estatística & dados numéricos , Fatores de Risco , Instituições Acadêmicas/estatística & dados numéricos , Toxoplasma/classificação , Toxoplasma/genética , Toxoplasmose/sangue , Toxoplasmose/diagnóstico , Toxoplasmose/parasitologia
18.
Microb Pathog ; 137: 103788, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31605758

RESUMO

Toxoplasmosis caused by an obligatory intracellular protozoan parasite of Toxoplasma gondii threats a wide spectrum of human and animal hosts. It has been shown that the intensity of the disease in humans depends on the host's immune responses. Immunological investigations on whole protein molecules of T. gondii have shown that these antigens are not fully responsible for the immune response, which leads to a decrease in specificity and affinity of the antigen (epitope)-antibody (paratope) binding. Currently, epitopes have shown promising entities to stimulate B, T, cytotoxic T lymphocyte, and NK cells resulting in enhancement of protective immunity against toxoplasmosis patients. Thus, the accurate designing, prediction, and conducting of antigenic epitopes of T. gondii (with linear and/or spatial structures (can augment our understanding about development of new serological diagnostic kits and vaccines. The current review provides an update on the latest advances of current epitopes described against toxoplasmosis including B cell/T cell epitopes, antigen types, parasite strains, epitope sequences, assay settings (in vitro and/or in vivo), and target strategy. Present results disclosed that the designing of effective multiepitopes of T. gondii by in silico modeling and immunoinformatics tools can strengthen our knowledge about triggering of epitope-based vaccine/diagnosis strategies in future perspectives.


Assuntos
Antígenos de Protozoários/administração & dosagem , Toxoplasma/imunologia , Toxoplasmose/diagnóstico , Toxoplasmose/prevenção & controle , Animais , Antígenos de Protozoários/genética , Antígenos de Protozoários/imunologia , Humanos , Proteínas de Protozoários/administração & dosagem , Proteínas de Protozoários/genética , Proteínas de Protozoários/imunologia , Toxoplasma/genética , Toxoplasmose/imunologia , Toxoplasmose/parasitologia , Vacinação , Vacinas/administração & dosagem , Vacinas/genética , Vacinas/imunologia
19.
BMC Infect Dis ; 19(1): 826, 2019 Sep 18.
Artigo em Inglês | MEDLINE | ID: mdl-31533667

RESUMO

BACKGROUND: The association between Toxoplasma gondii infection and thyroid disease has been poorly studied. Therefore, we sought to determine the association between T. gondii seropositivity and thyroid dysfunction. METHODS: We performed an age- and gender-matched case-control study of 176 patients suffering from hypothyroidism (n = 161) or hyperthyroidism (n = 15) and 528 control subjects without these diseases in a public hospital in Durango City, Mexico. Anti-Toxoplasma IgG antibodies were determined in sera from cases and controls using a commercially available enzyme-linked immunoassay. RESULTS: Anti-T. gondii IgG antibodies were found in 11 (6.3%) of 176 patients suffering from thyroid dysfunction and in 48 (9.1%) of 528 control subjects (OR = 0.66; 95% CI: 0.33-1.31; P = 0.23). Stratification by two groups of age (50 years and younger, and 51 year and older) showed that the youngest group of patients with thyroid dysfunction had a significantly lower seroprevalence of T. gondii infection than its age- and gender-matched control group (1/83: 1.2% vs 23/257: 8.6%; OR = 0.12; 95% CI: 0.01-0.93; P = 0.01). This stratification also showed that the youngest group of patients with hypothyroidism had a significantly lower seroprevalence of T. gondii infection than its age- and gender matched control group (0/75: 0% vs 21/233: 9.0%; P = 0.003). CONCLUSIONS: Our results suggest that thyroid dysfunction is not associated with seropositivity to T. gondii in general; however, in young (50 years or less) patients, a negative association between infection and thyroid dysfunction and hypothyroidism was found. Further research to confirm this negative association is needed.


Assuntos
Hipotireoidismo/diagnóstico , Toxoplasmose/diagnóstico , Adulto , Anticorpos Antiprotozoários/sangue , Estudos de Casos e Controles , Ensaio de Imunoadsorção Enzimática , Feminino , Hospitais Públicos , Humanos , Hipotireoidismo/complicações , Hipotireoidismo/epidemiologia , Imunoglobulina G/sangue , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Estudos Soroepidemiológicos , Toxoplasma/imunologia , Toxoplasma/isolamento & purificação , Toxoplasmose/complicações , Toxoplasmose/epidemiologia
20.
Rev Bras Ginecol Obstet ; 41(9): 539-547, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31546277

RESUMO

OBJECTIVE: To describe a population of pregnant women diagnosed with toxoplasmosis and their respective newborns, describing the hospital protocol for treatment and follow-up. METHODS: Retrospective cohort of pregnant women with acute toxoplasmosis infection and risk of transplacental transmission who were sent to the Fetal Medicine Group of Hospital de Clínicas de Porto Alegre (HCPA) between - January 1, 2006 and December 31, 2016. All patients with confirmed disease were included. The diagnostic protocol and treatment were applied; a polymerase chain reaction (PCR) analysis of the amniotic fluid was used to diagnose toxoplasmosis and determine the treatment. The newborns were followed up at the pediatric outpatient clinic specializing in congenital infection. The patients who were not followed up or were not born in the HCPA were excluded. RESULTS: A total of 65 patients were confirmed to have gestational toxoplasmosis; 40 performed amniocentesis, and 6 (15%) were identified as having positive PCR in the amniotic fluid. In five of those cases, this result associated with the gestational age defined the triple therapy during pregnancy, and in one case, it defined the monotherapy (advanced gestational age). A total of 4 of these newborns were treated from birth with triple therapy for 10 months, 1 was not treated (due to maternal refusal), and 1 progressed to death within the first 54 hours of life due to complications of congenital toxoplasmosis. Of the 34 remaining cases with a negative PCR, 33 were treated with monotherapy and 1 was treated with triple therapy (ultrasound findings); of these children, 9 (26.5%) presented negative immunoglobulin G (IgG), 24 (70.6%) presented positive IgG (but none presented positive immunoglobulin M [IgM]), and 1 (2,9%) presented alterations compatible with congenital disease and started treatment with the triple therapy soon after birth. Out of the total sample of 60 patients, among the 25 who did not perform amniotic fluid PCR, 5 were treated with triple therapy (ultrasound findings/prior treatment) and 20 patients were submitted to monotherapy; only two newborns underwent treatment for congenital toxoplasmosis. Among the 65 cases of gestational toxoplasmosis, 6 (9,2%) children had a diagnosis of congenital toxoplasmosis, and 2 patients with triple therapy felt severe adverse effects of the medications. CONCLUSIONS: The present study suggests that research on PCR screening of the amniotic fluid may be useful to identify patients with a higher potential for fetal complications, who may benefit from the poly-antimicrobial treatment. Patients with negative PCR results must continue to prevent fetal infection with monotherapy, without risk of fetal or maternal impairment.


Assuntos
Complicações Infecciosas na Gravidez , Toxoplasmose , Amniocentese/estatística & dados numéricos , Antiprotozoários/administração & dosagem , Antiprotozoários/uso terapêutico , Brasil , Criança , Pré-Escolar , Feminino , Seguimentos , Hospitais Universitários , Humanos , Lactente , Recém-Nascido , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/tratamento farmacológico , Complicações Infecciosas na Gravidez/epidemiologia , Estudos Retrospectivos , Toxoplasmose/diagnóstico , Toxoplasmose/tratamento farmacológico , Toxoplasmose/epidemiologia , Toxoplasmose Congênita/diagnóstico , Toxoplasmose Congênita/tratamento farmacológico , Toxoplasmose Congênita/epidemiologia , Ultrassonografia Pré-Natal
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