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      Seroprevalence and risk factors of Toxoplasma gondii infection in primary school children in Henan province, central China Translated title: Séroprévalence et facteurs de risque de Toxoplasma gondii chez les enfants des écoles primaires de la province du Henan, en Chine centrale

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          Toxoplasma gondii is an obligate intracellular protozoan parasite with global distribution. However, data on T. gondii infection among children in primary school in Henan province, central China were lacking. In this study, 2451 serum samples of primary school children in this province were collected from September 2015 to October 2018 and evaluated for T. gondii antibodies using an enzyme-linked immunosorbent assay (ELISA). The overall seroprevalence was 9.51% (233/2451), of which 7.59% (186/2451) showed IgG positivity, 0.73% (18/2451) IgM and 1.18% (29/2451) both. The main risk factors related to T. gondii infections were the age of children, residence area, contact with cats, and exposure to soil. Moreover, hand washing before eating was considered a protective factor. Seroprevalence of T. gondii infection among the study population was common, emphasizing the need to prevent and control this infection. This is the first report of T. gondii seroprevalence in primary school children in Henan province, central China.

          Translated abstract

          Toxoplasma gondii est un parasite protozoaire intracellulaire obligatoire à distribution mondiale. Cependant, des informations concernant l’infection à T. gondii chez les enfants des écoles primaires n’étaient pas disponibles dans la province du Henan, en Chine centrale. Dans cette étude, 2451 échantillons de sérum d’élèves du primaire de cette province ont été collectés de septembre 2015 à octobre 2018 et évalués pour les anticorps contre T. gondii à l’aide d’un dosage immuno-enzymatique (ELISA). La séroprévalence globale était de 9,51 % (233/2451), dont 7,59 % (186/2451) représentaient la positivité des IgG, 0,73 % (18/2451) représentaient les IgM et 1,18 % (29/2451) représentaient les deux. Les principaux facteurs de risque liés aux infections à T. gondii étaient l’âge des enfants, la zone de résidence des enfants, les contacts avec les chats et l’exposition au sol. De plus, le lavage des mains avant de manger est considéré comme un facteur protecteur. La séroprévalence contre T. gondii dans la population étudiée était courante, ce qui souligne la nécessité de prévenir et de contrôler cette infection. Il s’agit du premier signalement de la séroprévalence contre T. gondii chez les enfants des écoles primaires de la province du Henan.

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          Seroepidemiology of human Toxoplasma gondii infection in China

          Background Toxoplasmosis is an important zoonotic parasitic disease worldwide. In immune competent individuals, Toxoplasma gondii preferentially infects tissues of central nervous systems, which might be an adding factor of certain psychiatric disorders. Congenital transmission of T. gondii during pregnancy has been regarded as a risk factor for the health of newborn infants. While in immune-compromised individuals, the parasite can cause life-threatening infections. This study aims to investigate the prevalence of T. gondii infection among clinically healthy individuals and patients with psychiatric disorders in China and to identify the potential risk factors related to the vulnerability of infection in the population. Methods Serum samples from 2634 healthy individuals and 547 patients with certain psychiatric disorders in Changchun and Daqing in the northeast, and in Shanghai in the south of China were examined respectively for the levels of anti-T. gondii IgG by indirect ELISA and a direct agglutination assay. Prevalence of T. gondii infection in the Chinese population in respect of gender, age, residence and health status was systematically analyzed. Results The overall anti-T. gondii IgG prevalence in the study population was 12.3%. In the clinically healthy population 12.5% was sero-positive and in the group with psychiatric disorders 11.3% of these patients were positive with anti-T. gondii IgG. A significant difference (P = 0.004) was found between male and female in the healthy population, the seroprevalence was 10.5% in men versus 14.3% in women. Furthermore, the difference of T. gondii infection rate between male and female in the 20-19 year's group was more obvious, with 6.4% in male population and 14.6% in female population. Conclusion A significant higher prevalence of T. gondii infection was observed in female in the clinically healthy population. No correlation was found between T. gondii infection and psychiatric disorders in this study. Results suggest that women are more exposed to T. gondii infection than men in China. The data argue for deeper investigations for the potential risk factors that threat the female populations.
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            Congenital toxoplasmosis: An overview of the neurological and ocular manifestations

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              [A national survey on current status of the important parasitic diseases in human population].

              In order to understand the current status and trends of the important parasitic diseases in human population, to evaluate the effect of control activities in the past decade and provide scientific base for further developing control strategies, a national survey was carried out in the country (Taiwan, Hongkong and Macau not included) from June, 2001 to 2004 under the sponsorship of the Ministry of Health. The sample sizes of the nationwide survey and of the survey in each province (autonomous region and municipality, P/A/M) were determined following a calculating formula based on an estimation of the sample size of random sampling to the rate of population. A procedure of stratified cluster random sampling was conducted in each province based on geographical location and economical condition with three strata: county/city, township/town, and spot, each spot covered a sample of 500 people. Parasitological examinations were conducted for the infections of soil-transmitted nematodes, Taenia spp, and Clonorchis sinensis, including Kato-Katz thick smear method, scotch cellulose adhesive tape technique and test tube-filter paper culture (for larvae). At the same time, another sampled investigation for Clonorchis sinensis infection was carried out in the known endemic areas in 27 provinces. Serological tests combined with questionnaire and/or clinical diagnosis were applied for hydatid disease, cysticercosis, paragonimiasis, trichinosis, and toxoplasmosis. A total sampled population of 356 629 from the 31 P/A/M was examined by parasitological methods and 26 species of helminth were recorded. Among these helminth, human infections of Metorchis orientalis and Echinostoma aegypti were detected in Fujian Province which seemed to be the first report in the world, and Haplorchis taichui infection in Guangxi Region was the first human infection record in the country. The overall prevalence of helminth infections was 21.74%. The prevalence of soil-transmitted nematodes was 19.56% (including hookworm infection 6.12%, Ascaris infection 12.72% and Trichuris infection 4.63%), and the estimated number of population infected with soil-transmitted nematodes was 129 million (with 39.3, 85.93 and 29.09 million for hookworm, Ascaris and Trichuris infections respectively). The prevalence of Taenia infection was 0.28% with an infected population of 550 000. The prevalence of Clonorchis sinensis in the national survey was 0.58%. From the survey in the known Clonorchis endemic areas with a sample of 217 829, terobius vermicularis infection in children under 12 years old was 10.28%. The positive rate of serological tests for hydatid disease, cysticercosis, paragonimiasis, trichinosis, and toxoplasmosis was 12.04% (4 796/39 826), 0.58% (553/96 008), 1.71% (1 163/68 209), 3.38% (3 149/93 239) and 7.88% (3 737/47 444) respectively. In comparison to the last national survey in 1990, the prevalence of hookworm, Ascaris lumbricoides and Trichuris trichiura infections has been reduced by 60.72%, 71.29% and 73.60% respectively, and the number of infected people by soil-transmitted nematodes has declined remarkably. However, the prevalence of Clonorchis infection significantly increased in the provinces of Guangdong, Guangxi and Jilin by 182%, 164% and 630% respectively. A remarkable increase of the prevalence of Taenia infection was found in Sichuan and Tibet, by 98% and 97% respectively. Echinococcosis is important in the Western part of China. Many parasitic diseases are still highly prevalent in the rural and pastoral areas with higher prevalence, morbidity and certain case fatality in farmers and herdsmen, especially in women and children.

                Author and article information

                EDP Sciences
                07 April 2020
                : 27
                : ( publisher-idID: parasite/2020/01 )
                [1 ] Xinxiang Key Laboratory of Pathogenic Biology, School of Basic Medical Sciences, Xinxiang Medical University Xinxiang 453003 Henan PR China
                [2 ] MOE Joint International Research Laboratory of Animal Health and Food Safety, College of Veterinary Medicine, Nanjing Agricultural University Nanjing 210095 Jiangsu PR China
                Author notes

                These authors contributed equally to this paper.

                parasite190169 10.1051/parasite/2020018
                © S. Wang 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.

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                Figures: 1, Tables: 3, Equations: 0, References: 31, Pages: 6
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