An Epidemic of Toxoplasmosis

Holland, Gary N.

doi:10.1001/archophthalmol.2008.538

Cited by 9 publications

(2 citation statements)

References 26 publications

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“…In acquired toxoplasmosis, TRC will develop in 1–3% of infected individuals in the USA and Europe [ 5 , 6 , 7 ]. In some populations and geographical locations these rates may be much higher [ 8 , 9 , 10 ]. When the eye is affected, toxoplasmosis follows a remitting-relapsing course.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Short-Term, Intensive Antifolate Treatment (with Pyrimethamine and Sulfadoxine) and Antibiotics Followed by Long-Term, Secondary Antifolate Prophylaxis on the Rate of Toxoplasmic Retinochoroiditis Recurrence

et al. 2016

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PurposeTo assess the impact of intensive antifolate treatment, followed by secondary antifolate prophylaxis (A-SP) on the recurrence rate of toxoplasmic retinochoroiditis (TRC). To investigate whether there are any other factors potentially predisposing for recurrence.Material and MethodsA total of 637 medical records of TRC patients, who had been treated in the years 1994–2013 were reviewed. All patients were treated with pyrimethamine /sulfadoxine one 25mg/500mg tablet daily (P/S 25/500mg) for 21 days with a double loading dose for the first two days. From Day 2 the patients also received prednisone at a starting dose of 40mg and spiramycine 3 million IU three times daily, given for 10 days followed by azithromycin 500mg once daily for another 6 days. The analysis of the recurrence rate involved 352 patients who had completed 6-month secondary prophylaxis (P/S one 25 mg/500mg tablet twice a week).ResultsWhen secondary antifolate prophylaxis (A-SP) was instituted immediately after the treatment for TRC, the probability of 3-year recurrence–free survival after the first course of A-SP was 90.9%. A recurrence was most likely approximately 3.5 years after the first treatment. A univariate Cox regression model demonstrated that a risk for recurrence was 2.82 times higher (p = 0.02) in patients with retinal scars. In the multivariate analysis, the risk for recurrence was 2.41 higher (p = 0.06). In patients with haemorrhagic lesions the risk for recurrence was lower, aRR = 0.17 (approaching borderline statistical significance p = 0.08).ConclusionsWith the institution of A-SP of immediately after the intensive treatment for TRC, i.e. when a reactivation was most likely, there was no recurrence during A-SP. Following A-SP the recurrence rates were low and recurrence-free periods tended to be longer. The treatment regimen employed had a beneficial effect on the recurrence interval as it reduced and delayed the highest probability of recurrence.

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Section: Introductionmentioning

confidence: 99%

The Impact of Short-Term, Intensive Antifolate Treatment (with Pyrimethamine and Sulfadoxine) and Antibiotics Followed by Long-Term, Secondary Antifolate Prophylaxis on the Rate of Toxoplasmic Retinochoroiditis Recurrence

et al. 2016

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“…Long known as a cause of congenital infection 6 , recent studies highlight toxoplasmosis as a cause of ocular disease due to newly acquired infections in otherwise healthy adults 7 . Frequent and severe outbreaks of ocular toxoplasmosis have been described in South America 8 and India 9, 10 , and may occur in other localities. Notably, infection of healthy individuals in South America often leads to severe, recurrent ocular toxoplasmosis 11 , with an estimated disease burden of 30 million individuals requiring treatment annually in Brazil alone 12 .…”

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confidence: 99%

High Throughput Repurposing Screen Reveals Compounds with Activity Against Toxoplasma gondii Bradyzoites

Uddin,

Xia,

et al. 2024

Preprint

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Toxoplasma gondiicauses widespread chronic infections that are not cured by current treatments due to inability to affect semi-dormant bradyzoite stages within tissue cysts. To identify compounds to eliminate chronic infection, we developed a HTS using a recently characterized strain ofT. gondiithat undergoes efficient conversion to bradyzoites in intro. Stage-specific expression of luciferase was used to selectively monitor growth inhibition of bradyzoites by the Library of Pharmacological Active Compounds, consisting of 1280 drug-like compounds. We identified 44 compounds with >50% inhibitory effects against bradyzoites, including several new highly potent compounds several of which have precedent for antimicrobial activity. Subsequent characterization of the compound Sanguinarine sulfate revealed potent and rapid killing against in vitro produced bradyzoites and bradyzoites harvested from chronically infected mice. These findings provide a platform for expanded screening and identify promising compounds for further preclinical development againstT. gondiibradyzoites responsible for chronic infection.

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