Seroepidemiological map of <i>Toxoplasma gondii</i> infection and associated risk factors in preconception period in China: A nationwide cross‐sectional study

Zhou, Qiongjie; Wang, Qiaomei; Shen, Haiping; Zhang, Yiping; Zhang, Shikun; Li, Xiaotian; Acharya, Ganesh

doi:10.1111/jog.13638

Cited by 14 publications

(7 citation statements)

References 20 publications

(19 reference statements)

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“…Surprisingly, migrant women showed a lower risk of past TOX infection as compared with native women, which could be explained by several mechanisms connected to the healthy migrant effect (HME). Previous studies observed signi cant regional variations in the prevalence of human TOX infection with the trends increasing from West China to East China, which coincided with the incidence of TOX infection in food animals [24,25]. As an economically developed province, Guangdong has attracted a huge number of migrant populations from the less developed central and western regions.…”

Section: Migrant Status and Torch Infectionsmentioning

confidence: 96%

The impact of migration-related characteristics on the risk of TORCH infections among women of childbearing age: A population-based study in southern China

Han²,

Xiong

et al. 2022

Preprint

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Background TORCH infections are the most common prenatal infections causing congenital malformation and infant mortality, especially in developing countries. Migrant women might be vulnerable to TORCH infections, but little is known about the association between migration-related characteristics and TORCH infection risk. This study aimed to investigate the impact of migrant status, migration distance, and the spouse’s migrant status on the TORCH epidemic among women of childbearing age. Methods Based on the National Free Preconception Health Examination Project, we analyzed a representative dataset of TORCH infections among women of childbearing age (15–49 years old) in Guangdong Province of China (2014–2019, n = 2,451,297). The past and/or recent infection status of TORCH infections (Toxoplasma gondii [TOX], Cytomegalovirus [CMV], and Rubella virus [RV]) were identified. Demographic and migration-related characteristics were collected. We thoroughly assessed the prevalence of TORCH infections in both migrant and native women and estimated adjusted odd ratios (aOR) for migration-related characteristics using multivariable logistic regression after adjusting the other sociodemographic factors. Results Among all 2,451,297 participants, 443,725 (18.1%) were migrant women. Migrant women presented a lower risk of past TOX infection (aOR: 0.89, 0.88–0.91) suggesting a healthy migrant effect (HME), but a higher risk of recent TOX infection (aOR: 1.88, 1.77–1.99), past CMV infection (aOR: 1.26, 1.25–1.28) and RV infection in natural ways (aOR: 1.05, 1.04–1.06). Compared with intra-provincial migrants, inter-provincial migrants had a lower past TOX infection (aOR: 0.88, 0.85–0.91), but a higher risk of recent TOX infection (aOR: 1.16, 1.05–1.27) and RV infection (aOR: 1.33, 1.31–1.36). In addition, having a migrant spouse was associated with a higher risk for all types of infection. Conclusions This study reported the association of migrant status and migration distance with TORCH infections, although the significance and directionality of these associations varied between pathogens. The spouse’s migrant status further amplified the infection risk for all types of pathogens. Our findings suggested interventions for preventing the spread of CMV and RV infection and new acquisition of TOX infection for migrants in southern China, to narrow the native-migrant health inequity and decrease the incidence of prenatal infections and related adverse outcomes.

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Section: Migrant Status and Torch Infectionsmentioning

confidence: 96%

The impact of migration-related characteristics on the risk of TORCH infections among women of childbearing age: A population-based study in southern China

Han²,

Xiong

et al. 2022

Preprint

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“…Toxoplasmosis in China is a consistent problem, despite being lower 43 than the commonly accepted world average 1,44 ; according to nationwide studies involving several thousands of examined humans, the national prevalence of toxoplasmosis fluctuated from 5.9% in the early ‘90 s 45 to 7.9% in the ‘00 s 46 . A more recent nationwide study involving 2,008,561 women before pregnancy reported even lower prevalence (2.6%) 47 , depicting a decreasing trend in younger generations in rural areas. Similar trend has been identified in the nationwide survey as well 46 , where the highest prevalence regards citizens over 80 years old.…”

Section: Introductionmentioning

confidence: 91%

First molecular detection of Toxoplasma gondii in vegetable samples in China using qualitative, quantitative real-time PCR and multilocus genotyping

Lass

Kontogeorgos

et al. 2019

Sci Rep

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Toxoplasma gondii infection is becoming increasing problem in China but there is no data concerning contamination of vegetables intended for consumption with this parasite. The aim of the present study was to investigate fresh vegetables originated from open markets located in the Xining City, the Qinghai-Tibet Plateau (QTP), P.R. China for their contamination with T. gondii. A total of 279 fresh vegetable samples were collected and analysed using real-time PCR assay targeting B1 gene and multilocus genotyping. T. gondii DNA was found in 10 (3.6%) samples tested; eight of them represented T. gondii type I and remaining two T. gondii type II. The approximate level of contamination of positive vegetables samples, estimated based on quantitative real-time PCR (qPCR), ranged between less than one and 27000 T. gondii oocysts per sample, with majority not exceeding several oocysts per sample. The results of the study confirmed that T. gondii is present in vegetables offered in open markets in the Qinghai province, P.R. China; eating them unwashed and raw may therefore pose a threat to consumers. This is the first investigation describing T. gondii detection in fresh vegetables intended for consumption collected from the territory of P.R. China using sensitive molecular tools.

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“…Although there is no evidence of increased risk of Toxoplasma infection for plumbers who are frequently exposed to sewage water [87], oocysts are persistent and prevalent in water, soil, and foods [88]. Also, vegetarians and certain occupations such as farmers are significantly more associated with Toxoplasma IgM seropositivity [89].…”

Section: Interpretation Of Toxoplasma Serologymentioning

confidence: 99%

Tubulointerstitial nephritis and uveitis syndrome following meningitis and systemic lymphadenopathy with persistent Toxoplasma immunoglobulin M: a case report

et al. 2021

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Background Tubulointerstitial nephritis and uveitis syndrome is a rare lymphocyte-related oculorenal inflammatory disease presumed to be associated with drug use and infectious agents. Toxoplasma gondii is one of such pathogens that could exhibit encephalitis, meningitis, and uveitis in immunocompromised or in some immunocompetent individuals. If the immunoglobulin M of Toxoplasma is positive on screening, the interpretation of the result is not simple, especially when immunoglobulin M stays positive persistently. Case presentation A 34-year-old Asian male developed fever, headache, and lymphadenopathy with tenderness, which was initially diagnosed as meningitis. Antibiotics were started, and diclofenac sodium was used for the fever. Although his symptoms were alleviated in a week by the treatment, gradual decline in renal function was noted, prompting a renal biopsy that indicated acute granulomatous interstitial nephritis. A week later, tenderness in both eyes with blurred vision appeared and revealed iritis and keratic precipitations in both eyes; hence, the diagnosis of acute tubulointerstitial nephritis and bilateral uveitis syndrome was made. Toxoplasma gondii-specific immunoglobulin G and immunoglobulin M titers were both positive. Although we could not rule out recent infection of Toxoplasma gondii, which may cause uveitis initially, Toxoplasma immunoglobulin G avidity test indicated a distant infection, which allowed us to rule out meningitis and uveitis as responsible for the complication of recent Toxoplasma gondii infection. Drug-induced lymphocyte stimulation test, or lymphocyte transformation test of diclofenac sodium, was solely positive among the tested drugs. Uveitis was alleviated only with ophthalmic steroid, and renal function returned to normal without administration of systemic steroid. Conclusions We experienced a case of diclofenac-induced tubulointerstitial nephritis and uveitis syndrome. In ruling out infections, Toxoplasma immunoglobulin M was persistently positive, and Toxoplasma immunoglobulin G avidity test indicated a “distant” infection. From these two results, we ruled out recent infection. However, it should be noted that “distant” infection indicated by commercial immunoglobulin G avidity is still a multiplex profile consisting of reinfection, reactivation, and latent infection. Narrowing down the infection profile of Toxoplasma is challenging in some cases. Therefore, careful diagnosis and extended follow-up of such patients are needed.

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Seroepidemiological map of Toxoplasma gondii infection and associated risk factors in preconception period in China: A nationwide cross‐sectional study

Cited by 14 publications

References 20 publications

The impact of migration-related characteristics on the risk of TORCH infections among women of childbearing age: A population-based study in southern China

The impact of migration-related characteristics on the risk of TORCH infections among women of childbearing age: A population-based study in southern China

First molecular detection of Toxoplasma gondii in vegetable samples in China using qualitative, quantitative real-time PCR and multilocus genotyping

Tubulointerstitial nephritis and uveitis syndrome following meningitis and systemic lymphadenopathy with persistent Toxoplasma immunoglobulin M: a case report

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