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      Seroepidemiology of Toxoplasma gondii infection in psychiatric inpatients in a northern Mexican city

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          Abstract

          Background

          Patients with psychiatric disorders were found to show a high seroprevalence of Toxoplasma gondii infection. There is scarce information about the epidemiology of T. gondii infection in psychiatric patients in Mexico. Therefore, we sought to determine the prevalence of T. gondii infection and associated socio-demographic, clinical and behavioural characteristics in a population of psychiatric patients in Durango City, Mexico. Seroprevalence in patients was compared with that obtained in a control population.

          Methods

          One hundred and thirty seven inpatients of a public psychiatric hospital and 180 controls were examined for the presence of IgG and IgM antibodies against T. gondii by enzyme-linked immunoassay (Diagnostic Automation Inc., Calabasas, CA, USA). The control population consisted of blood donors of a public blood bank and elderly persons attending a senior center in the same city. Age in controls (42 years +/- 20.2) was comparable with that of the psychiatric patients (43.7 years +/-13.8) (p = 0.42). Socio-demographic, clinical and behavioral characteristics from the patients were also obtained.

          Results

          Anti- T. gondii IgG antibodies indicating latent infection with T. gondii was found in 25 (18.2%) of 137 psychiatric inpatients and 16 (8.9%) of 180 controls (p = 0.02). Ten (26.3%) of 38 schizophrenic patients had latent infection and this prevalence was also significantly higher than that observed in controls (p = 0.005). Prevalence of anti- T. gondii IgM antibodies was comparable among patients and controls (4.4% vs 2.2%, respectively, p = 0.22). Multivariate analysis showed that T. gondii infection in inpatients was positively associated with sexual promiscuity (adjusted OR = 15.8; 95% CI: 3.8–64.8), unwashed raw fruit consumption (adjusted OR = 5.19; 95% CI: 2.3–11.3), and a history of surgery (adjusted OR = 6.5; 95% CI: 2.6–16), and negatively associated with lamb meat consumption (adjusted OR = 0.26; 95% CI: 0.10–0.63).

          Conclusion

          In the present study, psychiatric inpatients in Durango, Mexico, in general and schizophrenia inpatients in particular had a significantly higher prevalence of T. gondii infection than the control group. Results suggest that unwashed raw fruit consumption might be the most important route of T. gondii transmission in our psychiatric inpatients while lamb meat consumption the less important. Additional studies will have to elucidate the causative relation between infection with T. gondii and psychiatric disorders.

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          Most cited references 28

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          Clasificación Estadística Internacional de Enfermedades y Problemas Relacionados con la Salud

          (1995)
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            Toxoplasmosis - a waterborne zoonosis.

            Humans become infected with Toxoplasma gondii mainly by ingesting uncooked meat containing viable tissue cysts or by ingesting food or water contaminated with oocysts from the feces of infected cats. Circumstantial evidence suggests that oocyst-induced infections in humans are clinically more severe than tissue cyst-acquired infections. Until recently, water-borne transmission of T. gondii was considered uncommon but a large human outbreak linked to contamination of a municipal water reservoir in Canada by wild felids and the widespread infection by marine mammals in the USA provide reasons to question this view. The present paper reviews information on the biology of oocyst-induced infections of T. gondii in humans and animals and examines possible importance of transmission by water.
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              Waterborne Toxoplasmosis, Brazil, from Field to Gene

              Water was the suspected vehicle of Toxoplasma gondii dissemination in a toxoplasmosis outbreak in Brazil. A case-control study and geographic mapping of cases were performed. T. gondii was isolated directly from the implicated water and genotyped as SAG 2 type I.
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                Author and article information

                Journal
                BMC Infect Dis
                BMC Infectious Diseases
                BioMed Central (London )
                1471-2334
                2006
                19 December 2006
                : 6
                : 178
                Affiliations
                [1 ]Faculty of Medicine, Juárez University of Durango State (UJED). Durango, Mexico
                [2 ]Hospital of Mental Health "Dr. Miguel Vallebueno", Durango City, Secretary of Health. Durango, Mexico
                [3 ]State Center for Blood Transfusion. Durango City, Secretary of Health. Durango, Mexico
                [4 ]Institute for Scientific Research, UJED. Durango, Mexico
                [5 ]Institute for Microbiology and Hygiene, Campus Benjamin Franklin, Charité Medical School Berlin, Germany
                Article
                1471-2334-6-178
                10.1186/1471-2334-6-178
                1764421
                17178002
                Copyright © 2006 Alvarado-Esquivel et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Categories
                Research Article

                Infectious disease & Microbiology

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