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      Seroprevalence and risk factors of Toxoplasma gondii infection in primary school children in Henan province, central China Translated title: Séroprévalence et facteurs de risque de Toxoplasma gondii chez les enfants des écoles primaires de la province du Henan, en Chine centrale

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          Abstract

          Toxoplasma gondii is an obligate intracellular protozoan parasite with global distribution. However, data on T. gondii infection among children in primary school in Henan province, central China were lacking. In this study, 2451 serum samples of primary school children in this province were collected from September 2015 to October 2018 and evaluated for T. gondii antibodies using an enzyme-linked immunosorbent assay (ELISA). The overall seroprevalence was 9.51% (233/2451), of which 7.59% (186/2451) showed IgG positivity, 0.73% (18/2451) IgM and 1.18% (29/2451) both. The main risk factors related to T. gondii infections were the age of children, residence area, contact with cats, and exposure to soil. Moreover, hand washing before eating was considered a protective factor. Seroprevalence of T. gondii infection among the study population was common, emphasizing the need to prevent and control this infection. This is the first report of T. gondii seroprevalence in primary school children in Henan province, central China.

          Translated abstract

          Toxoplasma gondii est un parasite protozoaire intracellulaire obligatoire à distribution mondiale. Cependant, des informations concernant l’infection à T. gondii chez les enfants des écoles primaires n’étaient pas disponibles dans la province du Henan, en Chine centrale. Dans cette étude, 2451 échantillons de sérum d’élèves du primaire de cette province ont été collectés de septembre 2015 à octobre 2018 et évalués pour les anticorps contre T. gondii à l’aide d’un dosage immuno-enzymatique (ELISA). La séroprévalence globale était de 9,51 % (233/2451), dont 7,59 % (186/2451) représentaient la positivité des IgG, 0,73 % (18/2451) représentaient les IgM et 1,18 % (29/2451) représentaient les deux. Les principaux facteurs de risque liés aux infections à T. gondii étaient l’âge des enfants, la zone de résidence des enfants, les contacts avec les chats et l’exposition au sol. De plus, le lavage des mains avant de manger est considéré comme un facteur protecteur. La séroprévalence contre T. gondii dans la population étudiée était courante, ce qui souligne la nécessité de prévenir et de contrôler cette infection. Il s’agit du premier signalement de la séroprévalence contre T. gondii chez les enfants des écoles primaires de la province du Henan.

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          Most cited references32

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          Congenital toxoplasmosis: An overview of the neurological and ocular manifestations

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            A systematic review and meta-analysis of the seroprevalence of Toxoplasma gondii in cats in mainland China

            Background Toxoplasmosis is caused by Toxoplasma gondii which can infect all warm-blooded animals. As the most common feline definitive host, cats play a vital role in the transmission of T. gondii. However, national estimates of the seroprevalence of T. gondii in cats in mainland China are lacking, and therefore a systematic review and meta-analysis were performed to provide insight into national environmental transmission levels and potential transmission to humans. Methods Studies published up until July 1, 2016, on T. gondii seroprevalence in cats within mainland China were searched for in CNKI, WanFang, CBM, PubMed, Embase and through the reference lists of resulting articles. The seroprevalence with its 95% confidence interval (CI) for each individual study was presented, and then point estimates and their 95% confidence intervals (CIs) of pooled seroprevalence were calculated. Subgroup analyses were performed according to potential risk factors. Results A total of 38 eligible studies, published between 1995 to 2016, covering fifteen provinces and municipalities, and involving 7,285 cats, were included. The seroprevalence in cats per study ranged from 3.9 to 79.4% with a median of 20.3%. As substantial heterogeneity existed among studies, a random-effects model was used to estimate the pooled seroprevalence. The value of the point estimate seroprevalence was 24.5% (95% CI: 20.1–29.0). Seroprevalence in stray cats was significantly higher than in pet cats (OR = 3.00, 95% CI: 1.60–5.64). The seroprevalence increased significantly with cat age (P = 0.018) with 17.4% (95% CI: 7.6–27.2) in the group of ≤ 1 year old, 19.5% (95% CI: 12.7–26.3) in the group of ≤ 3 year-old and 31.6% (95% CI: 22.9–40.3) in the group of > 3 year-old. Conclusions The seroprevalence of T. gondii in cats in mainland China was moderate and was associated with cat ownership and age. Due to the increasing prevalence of pet cats in China and the intimate relationship between these cats and humans, this might present a significant exposure risk, particularly for China’s large susceptible population. Therefore, further research is needed into the links between cat ownership and human T. gondii infection and how to reduce T. gondii exposure in humans via cat contacts and the environmental contamination with T. gondii oocysts by cats. Electronic supplementary material The online version of this article (doi:10.1186/s13071-017-1970-6) contains supplementary material, which is available to authorized users.
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              Seroepidemiology of human Toxoplasma gondii infection in China

              Background Toxoplasmosis is an important zoonotic parasitic disease worldwide. In immune competent individuals, Toxoplasma gondii preferentially infects tissues of central nervous systems, which might be an adding factor of certain psychiatric disorders. Congenital transmission of T. gondii during pregnancy has been regarded as a risk factor for the health of newborn infants. While in immune-compromised individuals, the parasite can cause life-threatening infections. This study aims to investigate the prevalence of T. gondii infection among clinically healthy individuals and patients with psychiatric disorders in China and to identify the potential risk factors related to the vulnerability of infection in the population. Methods Serum samples from 2634 healthy individuals and 547 patients with certain psychiatric disorders in Changchun and Daqing in the northeast, and in Shanghai in the south of China were examined respectively for the levels of anti-T. gondii IgG by indirect ELISA and a direct agglutination assay. Prevalence of T. gondii infection in the Chinese population in respect of gender, age, residence and health status was systematically analyzed. Results The overall anti-T. gondii IgG prevalence in the study population was 12.3%. In the clinically healthy population 12.5% was sero-positive and in the group with psychiatric disorders 11.3% of these patients were positive with anti-T. gondii IgG. A significant difference (P = 0.004) was found between male and female in the healthy population, the seroprevalence was 10.5% in men versus 14.3% in women. Furthermore, the difference of T. gondii infection rate between male and female in the 20-19 year's group was more obvious, with 6.4% in male population and 14.6% in female population. Conclusion A significant higher prevalence of T. gondii infection was observed in female in the clinically healthy population. No correlation was found between T. gondii infection and psychiatric disorders in this study. Results suggest that women are more exposed to T. gondii infection than men in China. The data argue for deeper investigations for the potential risk factors that threat the female populations.
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                Author and article information

                Journal
                parasite
                https://www.parasite-journal.org
                Parasite
                Parasite
                EDP Sciences
                1776-1042
                07 April 2020
                2020
                07 April 2020
                07 April 2020
                : 27
                : ( publisher-idID: parasite/2020/01 )
                : 23
                Affiliations
                [1 ] Xinxiang Key Laboratory of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University, , Xinxiang, 453003 Henan, PR China,
                [2 ] MOE Joint International Research Laboratory of Animal Health and Food Safety, College of Veterinary Medicine, Nanjing Agricultural University, , Nanjing, 210095 Jiangsu, PR China,
                Author notes
                [a]

                These authors contributed equally to this paper.

                Article
                parasite190169
                10.1051/parasite/2020018
                c23ad306-4c60-4045-a819-b05ba2a41ca8
                © S. Wang et al., published by EDP Sciences, 2020

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 20 December 2019
                : 21 March 2020
                Page count
                Figures: 1, Tables: 3, Equations: 0, References: 31, Pages: 6
                Categories
                Research Article
                Custom metadata
                Parasite 27, 23 (2020)
                2020
                2020
                2020

                Parasitology,Life sciences
                Toxoplasma gondii,Seroprevalence,Central China,Risk factors,Primary school children

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