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      Stillbirth history and Toxoplasma gondii infection in women attending public health centers in a northern Mexican City

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          Abstract

          Through a cross-sectional study design, 150 women attending public health centers with a history of stillbirths were examined for anti- Toxoplasma gondii IgG and IgM antibodies in Durango City, Mexico. Bivariate and multivariate analyses were used to assess the association of T. gondii seropositivity with the characteristics of the women with stillbirth history.

          Of the 150 women (mean age: 32.09 ± 9.16 years) studied, 14 (9.3%) had anti- T. gondii IgG antibodies and six (42.9%) of them were also positive for anti- T. gondii IgM antibodies. Multivariate analysis showed that T. gondii seropositivity was associated with high frequency (4–7 days a week) of eating meat (OR = 5.52; 95% CI: 1.48–20.59; P = 0.01), history of lymphadenopathy (OR = 4.52; 95% CI: 1.14–17.82; P = 0.03), and history of surgery (OR = 8.68; 95% CI: 1.04–72.15; P = 0.04).

          This is the first study on the seroepidemiology of T. gondii infection in women with a history of stillbirths in Mexico. The association of T. gondii exposure with a history of surgery warrants for further research. Risk factors for T. gondii infection found in the present survey may help to design optimal educational programs to avoid T. gondii infection.

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          Most cited references 29

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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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            The infectious origins of stillbirth.

            Our objective was to determine the relationship between various types of perinatal infections and stillbirths. By use of various textbooks on perinatal infections, multiple MEDLINE searches, and the reference list of all appropriate manuscripts, the appropriate English language literature was reviewed to define the relationship between various perinatal infections and stillbirths. Infection may cause stillbirth by a number of mechanisms, including direct infection, placental damage, and severe maternal illness. A large variety of organisms have been associated with stillbirth, including many bacteria, viruses, and protozoa. In developed countries, between 10% and 25% of stillbirths may be caused by an infection, whereas in developing countries, which often have much higher stillbirth rates, the contribution of infection is much greater. Ascending bacterial infection, both before and after membrane rupture, with organisms such as Escherichia coli, group B streptococci, and Ureaplasma urealyticum is usually the most common infectious cause of stillbirth. However, in areas where syphilis is very prevalent, up to half of all stillbirths may be caused by this infection alone. Malaria may be an important cause of stillbirth in women infected for the first time in pregnancy. The two most important viral causes of stillbirth are parvovirus and Coxsackie virus, although a number of other viral infections appear to be causal. Toxoplasma gondii, leptospirosis, Listeria monocytogenes, and the organisms that cause leptospirosis, Q fever, and Lyme disease have all been implicated as etiologic for stillbirth. Because infection-related stillbirth is relatively rare in developed countries, and those that do occur are caused by a wide variety of organisms, reducing this etiologic component of stillbirth much further will be difficult. However, in certain developing countries, the stillbirth rate is so high and the infection-related component so great that achieving a substantial reduction in stillbirth should be possible simply by reducing maternal infections.
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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
                18 June 2015
                June 2015
                : 5
                : 2
                : 164-171
                Affiliations
                [1 ] Biomedical Research Laboratory, Faculty of Medicine and Nutrition, Juárez University of Durango State , Avenida Universidad S/N, 34000 Durango, Mexico
                [2 ]Institute for Scientific Research “Dr. Roberto Rivera-Damm”, Juárez University of Durango State , Avenida Universidad S/N, 34000 Durango, Mexico
                [3 ]Mothers and Children’s Hospital, Secretary of Health , Durango, Mexico
                [4 ]Health Center 450, Secretary of Health , Toma de Zacatecas 129, 34000 Durango, Mexico
                [5 ] Clínica de Medicina Familiar, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado , Predio Canoas S/N, 34079 Durango, Mexico
                [6 ] Faculty of Nursing and Obstetrics, Juárez University of Durango State , Avenida Cuauhtémoc 223, 34000 Durango, Mexico
                [7 ]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; Phone/Fax: 0052-618-8130527; alvaradocosme@ 123456yahoo.com
                Article
                10.1556/1886.2015.00009
                4500068
                © 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.

                Page count
                Figures: 0, Tables: 3, Equations: 0, References: 23, Pages: 8
                Categories
                Original Article

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