Socioeconomic conditions as determining factors in the prevalence of systemic and ocular toxoplasmosis in Northeastern Brazil

Garcia, Carlos Alexandre de Amorim; Oréfice, Fernando; Lyra, Clélia de Oliveira; Gomes, Alexandre Bezerra; França, Mardone Cavalcante; Filho, Carlos Alexandre de Amorim Garcia

doi:10.1080/09286580490515170

Cited by 49 publications

(34 citation statements)

References 14 publications

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“…A high seroprevalence of infection with T. gondii in children (40%) and teenagers (60%) has been reported in Fortaleza and others parts of Brazil. 18,[25][26][27] The overall prevalence in pregnant women from our study was 69%, which was slightly higher than that observed in teenagers. The increase in prevalence with age is consistent with results of previous studies.…”

Section: Discussionmentioning

confidence: 79%

Prevalence and Risk Factors of Toxoplasmosis among Pregnant Women in Fortaleza, Northeastern Brazil

Sroka¹,

Bartelheimer²,

Winter³

et al. 2010

The American Society of Tropical Medicine and Hygiene

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Abstract. We determined the seroprevalence of Toxoplasma gondii and associated risk factors among 963 pregnant women attending an obstetric hospital in Fortaleza, Brazil. Seroprevalences of IgG and IgM against T. gondii were 68.6% (95% confidence interval [CI] = 65.6-71.6%) and 0.5% (95% CI = 0.06-1.0%), respectively. Seroprevalence of IgG was high in women less than 25 years of age (91.7%) and in low-income women (odds Ratio [OR] = 1.40, 95% CI = 1.02-1.90). Multivariate regression analysis showed that consumption of homemade water ice (adjusted OR = 1.49, 95% CI = 1.09-2.04), vegetables washed with untreated water (adjusted OR = 1.43, 95% CI = 1.05-1.94), consumption of chicken (adjusted OR = 1.49, 95% CI = 1.12-2.0), and dog ownership (adjusted OR= 1.46, 95% CI = 1.07-1.98) were factors associated with IgG seropositivity. Young women in northeastern Brazil living under poor socioeconomic conditions are at highest risk for acquiring infection with T. gondii . Oocyst contamination of water and soil must be addressed in future prevention strategies.

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Section: Discussionmentioning

confidence: 79%

Prevalence and Risk Factors of Toxoplasmosis among Pregnant Women in Fortaleza, Northeastern Brazil

Sroka¹,

Bartelheimer²,

Winter³

et al. 2010

The American Society of Tropical Medicine and Hygiene

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“…Poor socioeconomic conditions that are characterized by overcrowding and a lack of hand hygiene, and placing children in daycare facilities, promote CMV transmission 63. Low socioeconomic status is also associated with T. gondii infection,57,64–66 which may explain why persons with positive CMV serostatus were more likely to be seropositive for T. gondii IgG antibodies. The HSV-1 is an alpha-herpes virus that produces orolabial blisters or lesions.…”

Section: Discussionmentioning

confidence: 99%

Toxoplasma gondii Seropositivity and Co-Infection with TORCH Pathogens in High-Risk Patients from Qatar

Abu-Madi¹,

Behnke²,

Dabritz³

2010

The American Society of Tropical Medicine and Hygiene

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Testing of patients who are deemed to be at high risk for TORCH pathogens, e.g., pregnant women, their fetuses, neonates, and acquired immunodeficiency syndrome (AIDS) patients, is important so that specific treatment can be initiated. This study included 1,857 such patients between 2005 and 2008. Logistic regression was used to evaluate factors associated with Toxoplasma gondii seropositivity. Among 823 women of childbearing age, 35.1% and 5.2% tested positive for T. gondii IgG and IgM, respectively. Three infants ≤ 6 months of age (0.8% of 353) were congenitally infected. Factors associated with T. gondii IgG seropositivity included older age, East Mediterranean or African nationality, positive cytomegalovirus (CMV) and herpes simplex virus (HSV)-1 serostatus, and negative rubella IgG results. The decreasing prevalence of IgM antibodies between 2005 and 2008 suggested that exposure to T. gondii from food or environmental sources declined over this period in Qatar. Population-based studies of newborns would be helpful to accurately estimate incidence of congenital toxoplasmosis.

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“…It is a leading cause of blindness in Brazil[1] but not in Europe or North America [2],[3]. These differences are not adequately explained by high rates of postnatal or congenital infection in Brazil, as similar rates of infection have been observed in France and Eastern Europe [4]–[8]. Once infected, population-based studies of adolescents and adults, most of whom have postnatally acquired infection, report the risk of retinochoroiditis to vary from 2% in North Eastern Brazil to 25% in Southern Brazil [4], [9]–[11].…”

Section: Introductionmentioning

confidence: 99%

Ocular Sequelae of Congenital Toxoplasmosis in Brazil Compared with Europe

et al. 2008

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BackgroundToxoplasmic retinochoroiditis appears to be more severe in Brazil, where it is a leading cause of blindness, than in Europe, but direct comparisons are lacking. Evidence is accumulating that more virulent genotypes of Toxoplasma gondii predominate in South America.MethodsWe compared prospective cohorts of children with congenital toxoplasmosis identified by universal neonatal screening in Brazil and neonatal or prenatal screening in Europe between 1992 and 2003, using the same protocol in both continents.ResultsThree hundred and eleven (311) children had congenital toxoplasmosis: 30 in Brazil and 281 in Europe, where 71 were identified by neonatal screening. Median follow up was 4.1 years in Europe and 3.7 years in Brazil. Relatively more children had retinochoroiditis during the first year in Brazil than in Europe (15/30; 50% versus 29/281; 10%) and the risk of lesions by 4 years of age was much higher: the hazard ratio for Brazil versus Europe was 5.36 (95%CI: 3.17, 9.08). Children in Brazil had larger lesions, which were more likely to be multiple and to affect the posterior pole (p<0.0001). In Brazil, visual impairment (<6/12 Snellen) was predicted for most affected eyes (87%, 27/31), but not in Europe (29%; 20/69, p<0.0001). The size of newly detected lesions decreased with age (p = 0.0007).Conclusions T. gondii causes more severe ocular disease in congenitally infected children in Brazil compared with Europe. The marked differences in the frequency, size and multiplicity of retinochoroidal lesions may be due to infection with more virulent genotypes of the parasite that predominate in Brazil but are rarely found in Europe.

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Socioeconomic conditions as determining factors in the prevalence of systemic and ocular toxoplasmosis in Northeastern Brazil

Cited by 49 publications

References 14 publications

Prevalence and Risk Factors of Toxoplasmosis among Pregnant Women in Fortaleza, Northeastern Brazil

Prevalence and Risk Factors of Toxoplasmosis among Pregnant Women in Fortaleza, Northeastern Brazil

Toxoplasma gondii Seropositivity and Co-Infection with TORCH Pathogens in High-Risk Patients from Qatar

Ocular Sequelae of Congenital Toxoplasmosis in Brazil Compared with Europe

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