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      Seroprevalence of Toxoplasma gondii among healthy blood donors in two locations in Tunisia and associated risk factors Translated title: Séroprévalence de Toxoplasma gondii chez des donneurs de sang sains dans deux sites en Tunisie et facteurs de risque associés

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          Abstract

          Toxoplasma gondii is a protozoan parasite that can be transmitted to humans through a variety of routes including blood transfusion. This study aimed to investigate the seroprevalence of T. gondii infection and associated risk factors in healthy blood donors in Tunisia. A total of 800 healthy blood donors from two blood centers in south and coastal Tunisia were analyzed for anti- T. gondii IgG and IgM antibodies by indirect immunofluorescence assay (IFA) and enzyme-linked immunoassays (ELISA), respectively. Structured questionnaires were used to gather information on risk factors for T. gondii infection during collection. The overall seroprevalence was 44.4% of which 352 (44%) and 3 (0.4%) were positive for IgG and both IgG and IgM anti- T. gondii antibodies, respectively. Multivariate analysis showed that T. gondii seropositivity was significantly associated with the birth place (adjusted odds ratio [OR] = 2.72; 95% confidence interval [CI]: 1.49–4.94) and the age of the donors (adjusted OR = 4.98; 95% CI: 1.50–16.58) which are independent risk factors. In addition, the variables of hand washing before eating (adjusted OR = 0.52; 95% CI: 0.37–0.74) and living in an urban environment (adjusted OR = 0.30; 95% CI: 0.13–0.71) are two protective factors. This study provided the first data on the seroprevalence and epidemiology of T. gondii infection in healthy blood donors in Tunisia.

          Translated abstract

          Toxoplasma gondii est un parasite protozoaire qui peut être transmis à l’homme par diverses voies, dont la transfusion sanguine. Cette étude vise à étudier la séroprévalence de l’infection à T. gondii et les facteurs de risque associés chez les donneurs de sang sains en Tunisie. Au total, huit cents donneurs de sang sains de deux centres de transfusion sanguine du sud et de la côte tunisienne ont été analysés respectivement pour la recherche des anticorps IgG et IgM anti- T. gondii par immunofluorescence indirecte (IFA) et par dosage immuno-enzymatique (ELISA). Des questionnaires structurés ont été utilisés pour recueillir des informations sur les facteurs de risque d’infection à T. gondii pendant la collecte. La séroprévalence globale était de 44,4 % dont 352 (44 %) et 3 (0,4 %) étaient respectivement positifs pour les anticorps IgG et IgG/IgM anti- T. gondii. Une analyse multivariée a montré que la séropositivité à T. gondii était significativement associée au lieu de naissance (rapport de côtes ajusté [OR] = 2,72 ; intervalle de confiance à 95 % [IC] : 1,49–4,94) et à l’âge des donneurs (OR ajusté = 4,98 ; IC 95 % : 1,50–16,58) qui sont des facteurs de risque indépendants. De plus, le lavage des mains avant de manger (OR ajusté = 0,52 ; IC 95 % : 0,37–0,74) et vivre dans un milieu urbain (OR ajusté = 0,30 ; IC 95 % : 0,13–0,71) sont deux facteurs de protection. Cette étude a fourni les premières données sur la séroprévalence et l’épidémiologie de l’infection à T. gondii chez les donneurs de sang sains en Tunisie.

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          Most cited references 43

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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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            Unusual abundance of atypical strains associated with human ocular toxoplasmosis.

            To facilitate genotyping of Toxoplasma gondii in vitreous fluid of patients with severe or atypical ocular toxoplasmosis, polymerase chain reaction (PCR) restriction fragment length polymorphism (RFLP) assays were developed for SAG3 (p43) and SAG4 (p18), 2 single-copy surface antigen genes. Together with strategies for SAG1, SAG2, and B1, multilocus RFLP analyses were performed on PCR-amplified parasite DNA present in 12 clinical specimens. Most samples (8/12) were not infected by type II or type III mouse-avirulent strains. Only 1 type III and 3 type II strains were identified, all from immunosuppressed patients. In 6 otherwise healthy adults and in 1 immunosuppressed patient, the SAG1 allele associated with mouse virulence was amplified. Of 12 samples, 3 possessed true type I strains; 5 of 12 had new recombinant genotypes with alleles typical of type I or III strains at all loci examined. The unusual bias toward type I and/or recombinant genotypes bearing the SAG1 type I allele associated with mouse virulence in immunocompetent adults has important implications for the epidemiology and efficacious treatment of ocular toxoplasmosis.
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              Prevalence and risk factors for Toxoplasma gondii infection in meat animals and meat products destined for human consumption.

              Toxoplasma gondii is a protozoan parasite that is responsible for approximately 24% of all estimated deaths attributed to foodborne pathogens in the United States. Human infection results from accidental ingestion of oocysts from the environment, in water, or on insufficiently washed produce or from consumption of raw or undercooked meat products that contain T. gondii tissue cysts. This review focused on studies of T. gondii in meat because many human T. gondii infections are acquired through consumption of raw or undercooked meat. Prevalence of T. gondii is higher in conventionally reared pigs, sheep, and poultry than in cattle and is greater in meat products from organic than from conventionally reared meat animals because of outdoor access, which poses substantially greater opportunities for exposure to infected rodents, wildlife, and oocyst-contaminated feed, water, or environmental surfaces. Risk factors related to T. gondii exposure for livestock include farm type, feed source, presence of cats, methods of rodent and bird control, methods of carcass handling, and water quality. This review serves as a useful resource and information repository for informing quantitative risk assessment studies for T. gondii infection in humans through meat consumption.
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                Author and article information

                Journal
                Parasite
                Parasite
                parasite
                Parasite
                EDP Sciences
                1252-607X
                1776-1042
                2020
                21 September 2020
                : 27
                : ( publisher-idID: parasite/2020/01 )
                Affiliations
                [1 ] Laboratoire de Parasitologie–Mycologie Médicale et Moléculaire, Département de Biologie Clinique B, Faculté de Pharmacie de Monastir, Université de Monastir 5000 Monastir Tunisia
                [2 ] INSERM, Université Limoges, CHU Limoges, IRD, U1094 Neuroépidémiologie Tropicale, Institut d’Epidémiologie et de Neurologie Tropicale, GEIST 87000 Limoges France
                [3 ] Centre de Maternité et de Néonatologie de Monastir 5000 Monastir Tunisia
                [4 ] Hématologie – Banque du Sang de Monastir 5000 Monastir Tunisia
                [5 ] Centre de Transfusion Sanguine de Gafsa 2100 Gafsa Tunisia
                [6 ] Centre National de Référence (CNR) Toxoplasmose/Toxoplasma Biological Center (BRC), Centre Hospitalier-Universitaire Dupuytren 87000 Limoges France
                Author notes
                Article
                parasite200086 10.1051/parasite/2020049
                10.1051/parasite/2020049
                7504876
                © A. Lachkhem 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.

                Page count
                Figures: 1, Tables: 3, Equations: 0, References: 39, Pages: 9
                Categories
                Research Article

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