Toxoplasmosis an Overlooked Disease: Seroprevalence in Cancer Patients

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Abstract

Background

Toxoplasmosis is one of the most important cosmopolitan life-threatening diseases in immune-compromised patients. It is caused by an intracellular protozoon: Toxoplasma gondii (T. gondii). The parasite can cause pneumonia, encephalitis or disseminated disease in immune-deficient patients and dangerous congenital anomalies in infants born to mothers infected during early pregnancies. The present study aims to evaluate the prevalence of toxoplasmosis in Egyptian cancer patients and to correlate the prevalence with type of malignancy and the different cancer treatment modalities.

Materials and Methods

Blood samples from 150 cancer patients and 50 control subjects have been examined for presence of anti- toxoplasma antibodies using a lateral flow chromatographic immunoassay.

Results

Among cancer patients included in this study, the prevalence of anti- T.gondii antibodies was 20% for IgG and 4% for IgM, while in the control group it was 8% and 2% in the same order. This difference was statistically significant for IgG (P =0.003) but not for IgM (P = 0.44). Patients with solid organ tumors treated with chemotherapy had the highest prevalence rate of toxoplasmosis (28%). It was also found higher in males (26%) than females (10%) and higher among urban (18%) than rural dwellers (16%).

Conclusion

Cancer patients showed a significantly higher rate of infection with T. gondii than their cross-matched control. For that reason, we recommend the inclusion of a screening test for toxoplasmosis in their routine workup.

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Most cited references 26

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Waterborne transmission of protozoan parasites: review of worldwide outbreaks - an update 2004-2010.

Selma Baldursson, Panagiotis Karanis (2011)

The present update gives a comprehensive review of worldwide waterborne parasitic protozoan outbreaks that occurred and were published globally between January 2004 and December 2010. At least one hundred and ninety-nine outbreaks of human diseases due to the waterborne transmission of parasitic protozoa occurred and were reported during the time period from 2004 to 2010. 46.7% of the documented outbreaks occurred on the Australian continent, 30.6% in North America and 16.5% in Europe. Cryptosporidium spp. was the etiological agent in 60.3% (120) of the outbreaks, Giardia lamblia in 35.2% (70) and other protozoa in 4.5% (9). Four outbreaks (2%) were caused by Toxoplasma gondii, three (1.5%) by Cyclospora cayetanensis. In two outbreaks (1%) Acanthamoeba spp. was identified as the causative agent. In one outbreak, G. lamblia (in 17.6% of stool samples) and Cryptosporidium parvum (in 2.7% of stool samples) as well as Entamoeba histolytica (in 9.4% of stool samples) and Blastocystis hominis (in 8.1% of stool samples) were detected. In those countries that are likely affected most a lack of surveillance systems is noticeable. However, countries that established surveillance systems did not establish an international standardization of reporting systems. Copyright © 2011 Elsevier Ltd. All rights reserved.

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Toxoplasma gondii seroprevalence in the United States 2009-2010 and comparison with the past two decades.

Jeffrey L. Jones, Deanna Kruszon-Moran, Hilda Rivera … (2014)

Toxoplasma gondii is a ubiquitous parasite that can cause neurologic and ocular disease. We tested sera from 7,072 people ≥ 6 years of age in the 2009-2010 National Health and Nutrition Examination Survey (NHANES) for immunoglobulin G antibodies and compared these results with two previous NHANES studies. The overall T. gondii antibody seroprevalence among persons ≥ 6 years of age in 2009-2010 was 13.2% (95% confidence limit [CL] 11.8%, 14.5%) and age-adjusted seroprevalence was 12.4% (95% CL 11.1%, 13.7%); age-adjusted seroprevalence among women 15-44 years of age was 9.1% (95% CL 7.2%, 11.1%). In U.S. born persons 12-49 years of age, the age-adjusted T. gondii seroprevalence decreased from 14.1% (95% CL 12.7%, 15.5%) in NHANES III (1988-1994) to 9.0% (95% CL 7.6%, 10.5%) in NHANES 1999-2004 to 6.7% (95% CL 5.3%, 8.2%) in NHANES 2009-2010 (P < 0.001 linear trend). Although T. gondii antibody presence is still relatively common, the prevalence in the United States has continued to decline.

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Seroprevalence and risk factors for Toxoplasmosis in HIV infected and non-infected individuals in Bahir Dar, Northwest Ethiopia

Fisseha Walle, Nigatu Kebede, Aster Tsegaye … (2013)

Background Toxoplasmosis, a zoonotic disease distributed worldwide, is an infection caused by the ubiquitous obligatory intracellular coccidian protozoan organism, Toxoplasma gondii. It is a major public health concern because the disease is serious in terms of mortality or physical and /or psychological sequellae in patients with HIV disease. The aim of the study was to assess the seroprevalence of Toxoplasma gondii IgG and IgM antibodies and associated risk factors in HIV infected and non-infected individuals attending Felege Hiwot referral hospital, Bahir Dar, Northwest Ethiopia. Methods A cross sectional study was conducted at Felege Hiwot referral hospital, Bahir Dar, Amhara National Regional State. Venous blood samples were collected from 103 HIV infected pre anti-retroviral therapy patients at Felege Hiwot referral hospital and 101 HIV negative apparently healthy voluntary blood donors at the blood bank. Serum samples were analyzed for anti-Toxoplasma gondii IgG and IgM antibodies using a commercially available ELISA kit. Socio-demographic and associated risk factors for Toxoplasmosis from each individual were also obtained and the data was analyzed using SPSS version 18. Results Of the examined HIV seropositive individuals, 87.4% (90/103) and 10.7% (11/103) were positive for anti-T. gondii IgG and IgM antibodies, respectively. Multivariate analysis using logistic regression showed that anti-T. gondii seropositivity was independently significantly associated with undercooked or raw meat consumption (adjusted OR=5.73, 95% CI=1.35-24.39; P=0.02) and having contact with cat (adjusted OR= 4.29, 95% CI=1.08-16.94; P=0.04) in HIV positive individuals. In HIV negative apparently healthy blood donors, prevalence of anti-T. gondii antibodies were 70.29% and 2.97% for IgG and IgM, respectively. Multivariate analysis showed that undercooked or raw meat consumption (adjusted OR=6.45, 95% CI=2.16-19.28; p=0.001) and sex (OR=6.79, 95% CI=2.14-21.60; p=0.001) were independently significantly associated with anti-T. gondii IgG seropositivity, with a significantly higher number of males affected than females. Conclusion The present findings showed a high sero-prevalence of anti-T. gondii antibodies in HIV infected pre-ART and HIV non-infected apparently healthy blood donors in Bahir Dar. Consumption of undercooked or raw meat might greatly contribute towards acquiring T. gondii infection in HIV infected pre-ART and HIV non-infected apparently healthy blood donors. It may be appropriate to include routine serological screening test for determination of anti-T. gondii antibodies in HIV infected pre-ART individuals and HIV negative apparently healthy blood donors. In addition, health education towards avoiding eating undercooked and raw meat, and avoiding contact with cats were recommended.

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Author and article information

Journal

Journal ID (nlm-ta): Asian Pac J Cancer Prev

Journal ID (iso-abbrev): Asian Pac. J. Cancer Prev

Title: Asian Pacific Journal of Cancer Prevention : APJCP

Publisher: West Asia Organization for Cancer Prevention (Iran )

ISSN (Print): 1513-7368

ISSN (Electronic): 2476-762X

Publication date (Print): 2018

Volume: 19

Issue: 7

Pages: 1987-1991

Affiliations

[1 ] Department of Clinical Oncology, Kasr Al-Ainy Faculty of Medicine, Cairo University, Egypt

[3 ] Department of Medical Parasitology, Kasr Al-Ainy Faculty of Medicine, Cairo University, Egypt

[2 ] Department of Medical Parasitology, Faculty of Medicine, Helwan University, Egypt

[4 ] Department of Medical Parasitology, Theodor Bilharz Research Institute, Egypt

Author notes

[* ] For Correspondence: Raafat.malek@ 123456kasralainy.edu.eg

Article

Publisher ID: APJCP-19-1987

DOI: 10.22034/APJCP.2018.19.7.1987

PMC ID: 6165665

PubMed ID: 30051689

SO-VID: 6e727aec-7f2d-4a6e-a6fa-f240b1536000

License:

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License

Toxoplasmosis an Overlooked Disease: Seroprevalence in Cancer Patients

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Abstract

Background

Materials and Methods

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Conclusion

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Karger: Oncology

Most cited references 26

Waterborne transmission of protozoan parasites: review of worldwide outbreaks - an update 2004-2010.

Toxoplasma gondii seroprevalence in the United States 2009-2010 and comparison with the past two decades.

Seroprevalence and risk factors for Toxoplasmosis in HIV infected and non-infected individuals in Bahir Dar, Northwest Ethiopia

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