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      Lack of Association Between Toxoplasma gondii Infection and Diabetes Mellitus: A Matched Case-Control Study in a Mexican Population

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          Abstract

          Background

          Very little is known about the association between infection with Toxoplasma gondii ( T. gondii) and diabetes mellitus. We perform an age- and gender-matched case-control study to determine the association of T. gondii infection and diabetes mellitus.

          Methods

          Cases included 156 patients with diabetes mellitus and 156 controls without diabetes mellitus who attended in two public clinics in Durango City, Mexico. Sera of cases and controls were tested for the presence of anti- Toxoplasma IgG and IgM antibodies using commercially available enzyme-linked fluorescence assays (ELFA).

          Results

          Anti- T. gondii IgG antibodies were found in 10 (6.4%) of the 156 cases and in five (3.2%) of the 156 controls (odds ratio (OR): 2.06; 95% confidence interval (CI): 0.69 - 6.19; P = 0.18). The frequency of high (> 150 IU/mL) anti- T. gondii IgG levels in seropositive cases (1/10: 10.0%) was comparable to the one (1/5: 20%) in seropositive controls (OR: 0.44; 95% CI: 0.02 - 9.03; P = 1.00). None of the 10 cases and five controls with seropositivity to anti- T. gondii IgG antibodies were positive for anti- T. gondii IgM antibodies. Stratification by gender showed similar frequencies of T. gondii infection in female cases (7/107: 6.5%) and female controls (4/107: 3.7%) (OR: 1.80; 95% CI: 0.51 - 6.34; P = 0.53), and in male cases (3/49: 6.1%) and male controls (1/49: 2.0%) (OR: 3.13; 95% CI: 0.31 - 31.19; P = 0.61).

          Conclusions

          We conclude that there is not serological evidence of an association between T. gondii infection and diabetes mellitus in the studied subjects in Durango City, Mexico. Further studies to elucidate the role of T. gondii in diabetes should be conducted.

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          Most cited references19

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          A review on human toxoplasmosis.

          Toxoplasmosis is a worldwide infection caused by the intracellular parasite Toxoplasma gondii. At least a third of the world human population are infected with the parasite, making it one of the most successful parasitic infections. Primary maternal infection may cause health-threatening sequelae for the foetus, or even cause death in uterus. Reactivation of a latent infection in immune deficiency conditions such as AIDS and organ transplantation can cause fatal toxoplasmic encephalitis. Toxoplasmosis is a major cause of retinochoroiditis, especially in individuals with an impaired immune system. Despite the usually 'asymptomatic' nature of the infection, a significant burden imposed by the parasite necessitates the implementation of effective means for the prevention, diagnosis, and management of this disease. Laboratory diagnosis, i.e. PCR and serologic assays, plays the main role in the diagnosis of congenital infection and assists in the confirmatory diagnosis of toxoplasmic encephalitis and ocular toxoplasmosis. Here, we briefly review general aspects of Toxoplasma infection and focus on the diagnostic methods currently used in medical laboratories for the diagnosis of Toxoplasma infection.
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            Foodborne toxoplasmosis.

            Toxoplasmosis can be due to congenital infection or acquired infection after birth and is one of the leading illnesses associated with foodborne hospitalizations and deaths. Undercooked meat, especially pork, lamb, and wild game meat, and soil contaminated with cat feces on raw fruits and vegetables are the major sources of foodborne transmission for humans. The new trend in the production of free-range organically raised meat could increase the risk of Toxoplasma gondii contamination of meat. Foodborne transmission can be prevented by production practices that reduce T. gondii in meat, adequate cooking of meat, washing of raw fruits and vegetables, prevention of cross contamination in the kitchen, and measures that decrease spread of viable oocysts into the environment.
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              Seroepidemiology of Toxoplasma gondii infection in general population in a northern Mexican city.

              There is a lack of information about the seroepidemiology of T. gondii infection in the general population of Durango City, Mexico. Anti- Toxoplasma gondii IgG and IgM antibodies were sought in 974 inhabitants in Durango City, Mexico with the use of enzyme-linked immunoassays. in total, 59 (6.1%) of 974 participants (mean age 37 ± 16.1 yr) had IgG anti- T. gondii antibodies. Twenty (2.1%) of them also had IgM anti- T. gondii antibodies. IgG levels of 13-99, 100-150, and >150 International Units (IU)/ml were found in 14 (23.7%), 3 (5.1%), and 42 (71.2%) anti- T. gondii IgG-positive participants, respectively. Prevalence of infection increased with age (P < 0.05), and was significantly lower in participants born in Durango State than those born in other Mexican states (P < 0.01). Toxoplasma gondii infection was significantly associated with consumption of boar meat (adjusted odds ratio [OR]  =  3.02; 95% confidence interval [CI]: 1.49-6.13), and squirrel meat (adjusted OR  =  2.18; 95% CI: 1.17-4.09). in addition, infection was negatively associated with travel abroad (adjusted OR  =  0.42; 95% CI: 0.23-0.77), and salami consumption (adjusted OR  =  0.57; 95% CI: 0.32-0.99). This is the first report of seroprevalence and contributing factors for T. gondii infection in general population in Durango City, and of an association of the consumption of boar meat with T. gondii infection. This study provides a basis for the design of successful preventive measures against T. gondii infection.
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                Author and article information

                Journal
                J Clin Med Res
                J Clin Med Res
                Elmer Press
                Journal of Clinical Medicine Research
                Elmer Press
                1918-3003
                1918-3011
                June 2017
                26 April 2017
                : 9
                : 6
                : 508-511
                Affiliations
                [a ]Faculty of Medicine and Nutrition, Juarez University of Durango State, Avenida Universidad S/N, 34000 Durango, Dgo, Mexico
                [b ]Institute for Scientific Research “Dr. Roberto Rivera Damm”, Juarez University of Durango State, Avenida Universidad S/N, 34000 Durango, Durango, Mexico
                [c ]Clinica de Diabetes, Secretaria de Salud, Predio Canoas S/N, 34000 Durango, Dgo, Mexico
                [d ]Hospital General de Durango, Secretaria de Salud, Avenida 5 de febrero y Norman Fuentes, 34000 Durango, Dgo, Mexico
                [e ]Centro de Salud de Servicios Ampliados 450, Toma de Zacatecas 129, 34000 Durango, Dgo, Mexico
                Author notes
                [f ]Corresponding Author: Cosme Alvarado-Esquivel, Laboratorio de Investigacion Biomedica, Facultad de Medicina y Nutricion, Avenida Universidad S/N, 34000 Durango, Dgo, Mexico. Email: alvaradocosme@ 123456yahoo.com
                Article
                10.14740/jocmr3029w
                5412524
                28496551
                1d34c020-610a-4870-8763-5e8e514deff2
                Copyright 2017, Alvarado-Esquivel et al.

                This article is distributed under the terms of the Creative Commons Attribution Non-Commercial 4.0 International License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 05 April 2017
                Categories
                Original Article

                Medicine
                toxoplasma gondii,seroprevalence,diabetes mellitus,case-control study
                Medicine
                toxoplasma gondii, seroprevalence, diabetes mellitus, case-control study

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