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      High Seroprevalence of Toxoplasma Gondii Infection in Female Sex Workers: A Case-Control Study

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          Abstract

          Through an age- and sex-matched case-control study, we sought to determine whether female sex workers have an increased risk of Toxoplasma gondii exposure and to determine the sociodemographic, work, clinical, and behavioral characteristics of these workers associated with T. gondii exposure. Female workers ( n = 136) and controls ( n = 272) were examined with enzyme-linked immunoassays (EIA) for the presence of anti- Toxoplasma IgG and IgM antibodies. IgM positive sera were additionally tested with enzyme linked-fluorescence immunoassay (ELFA). Anti- T. gondii IgG antibodies were found in 21 (15.44%) of 136 cases and in 10 (3.67%) of 272 controls (OR = 4.05; 95% CI: 1.84–8.89; P = 0.0001). Anti- T. gondii IgG levels higher than 150 IU/ml were found in 13 (9.6%) of 136 cases and in 8 (2.9%) of 272 controls ( P = 0.007). Anti- T. gondii IgM antibodies were found in two cases and in six controls by EIA, but all were negative by ELFA. T. gondii seropositivity was associated with being born out of Durango State (OR = 10.47; 95% CI: 2.9–36.8; P < 0.01), injuries during sex work (OR = 6.30; 95% CI: 1.1–33.7; P = 0.03), and soil contact (OR = 4.11; 95% CI: 1.2–14.0; P = 0.02). This is the first report of an association of T. gondii infection and female sex workers.

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          Most cited references29

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          Toxoplasmosis: A history of clinical observations.

          It has been 100 years since Toxoplasma gondii was initially described in Tunis by Nicolle and Manceaux (1908) in the tissues of the gundi (Ctenodoactylus gundi) and in Brazil by Splendore (1908) in the tissues of a rabbit. Toxoplasma gondii is a ubiquitous, Apicomplexan parasite of warm-blooded animals that can cause several clinical syndromes including encephalitis, chorioretinitis, congenital infection and neonatal mortality. Fifteen years after the description of T. gondii by Nicolle and Manceaux a fatal case of toxoplasmosis in a child was reported by Janků. In 1939 Wolf, Cowen and Paige were the first to conclusively identify T. gondii as a cause of human disease. This review examines the clinical manifestations of infection with T. gondii and the history of the discovery of these manifestations.
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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
                Eur J Microbiol Immunol (Bp)
                Eur J Microbiol Immunol (Bp)
                EUJMI
                European Journal of Microbiology & Immunology
                Akadémiai Kiadó (Budapest )
                2062-509X
                2062-8633
                4 November 2015
                December 2015
                : 5
                : 4
                : 285-292
                Affiliations
                [1 ]Faculty of Medicine and Nutrition, Juárez University of Durango State, Avenida Universidad S/N , 34000 Durango, Durango, Mexico
                [2 ]Institute for Scientific Research “Dr. Roberto Rivera Damm”, Juárez University of Durango State, Avenida Universidad S/N , 34000 Durango, Durango, Mexico
                [3 ]Clinic for Sanitary Inspection , Durango, Mexico
                [4 ]General Hospital, Secretary of Health, Avenida 5 de febrero 220 , 34000 Durango, Mexico
                [5 ]Institute for Microbiology and Hygiene, Campus Benjamin Franklin, Charité Medical School , Hindenburgdamm 27, D-12203 Berlin, Germany
                Author notes
                * Laboratorio de Investigación Biomédica, Facultad de Medicina y Nutrición, Avenida Universidad S/N, 34000 Durango, Dgo, México. 0052-618-8130527; alvaradocosme@ 123456yahoo.com
                # Current address: Chief Medical Officer, Medical and Scientific Affairs, Roche Molecular Systems, Pleasanton, CA 94588, USA

                Competing interests

                The authors declare that they have no competing interests.

                Article
                10.1556/1886.2015.00039
                4681356
                26716017
                5739e365-0932-472e-b439-3c14f96ee4c3
                © 2015, The Author(s)

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 01 October 2015
                : 13 October 2015
                Page count
                Figures: 0, Tables: 4, Equations: 0, References: 31, Pages: 8
                Categories
                Original Article

                toxoplasma gondii,seroprevalence,female sex workers,case-control study,risk factors

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