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      Concordance of Toxoplasma gondii Infection Markers Among Heterosexual Couples

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          Abstract

          Background

          Very little is known about concordance of Toxoplasma gondii ( T. gondii) infection markers among couples. Through a cross-sectional study, we sought to determine the correlation of T. gondii infection in a sample of 119 heterosexual couples in Durango State, Mexico.

          Methods

          Participants were examined for the presence of anti- T. gondii IgG and IgM antibodies using enzyme-linked immunoassays. IgG and IgM seropositive couples were further analyzed for the presence of T. gondii DNA by using polymerase chain reaction (PCR).

          Results

          Anti- T. gondii IgG antibodies were found in 71 (59.7%) men and in 63 (52.9%) women (odds ratio (OR) = 1.31; 95% confidence interval (CI): 0.78 - 2.19; P = 0.29). Of the 71 seropositive men, 40 (56.3%) had a seropositive couple; in contrast, of the 63 seropositive women, 40 (63.5%) had a seropositive couple (OR = 0.74; 95% CI: 0.37 - 1.48; P = 0.39). In total, 65 (54.6%) couples had concordant results (both IgG positive or both IgG negative), and 54 (45.4%) had discordant results (a seropositive man with a seronegative woman, or a seropositive woman with a seronegative man) (kappa index = 0.08; 95% CI: -0.09 - 0.26). With respect to high (> 150 IU/mL) levels of anti- T. gondii IgG antibodies, 79 (66.4%) of the 119 couples had concordant results and 40 (33.6%) had discordant results (kappa index = -0.15; 95% CI: -0.03 - 0.33). Forty couples were positive for anti- T. gondii IgM antibodies. Of them, 21 (52.5%) had concordant results, and 19 (47.5%) had discordant results (kappa index = -0.01; 95% CI: -0.39 - 0.28). Concerning PCR, eight (50%) of 16 couples were positive for T. gondii DNA. Of them, 11 (68.8%) had concordant results, and five (31.2%) had discordant results (kappa index = 0.31; 95% CI: -0.17 - 0.79).

          Conclusions

          Results suggest a poor concordance of serological and molecular markers of T. gondii infection among heterosexual couples. Further studies to confirm our results should be conducted.

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          Most cited references16

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          Toxoplasmosis in Blood Donors: A Systematic Review and Meta-Analysis.

          Masoud Foroutan-Rad, Hamidreza Majidiani, Sahar Dalvand … (2016)
          Transfusion-transmissible infections include pathogens that may cause severe and debilitating diseases. Toxoplasmosis is a cosmopolitan neglected parasitic infection that can lead to severe complications including death in immune-compromised patients or following infection in utero. Multiple studies have demonstrated the transmission of Toxoplasma gondii by blood transfusion. The objective of this review was to comprehensively assess the seroprevalence rate of Toxoplasma in blood donors from a worldwide perspective. Seven electronic databases (PubMed, Science Direct, Web of Science, Scopus, Cochrane, Ovid, and Google Scholar) were searched using medical subject headings terms. A total of 43 records met the inclusion criteria in which 20,964 donors were tested during the period from January 1980 to June 2015. The overall weighted prevalence of exposure to toxoplasmosis in blood donors was 33% (95% confidence interval [CI], 28%-39%). The seroprevalences of immunoglobulin (Ig)M and both IgG and IgM antibodies were 1.8% (95% CI, 1.1%-2.4%) and 1.1% (95% CI, 0.3%-1.8%), respectively. The highest and the lowest seroprevalences of toxoplasmosis were observed in Africa (46%; 95% CI, 14%-78%) and in Asia (29%; 95% CI, 23%-35%), respectively. Brazil (75%) and Ethiopia (73%) were identified as countries with high seroprevalence. Because positive serology does not imply infectiousness and because seroprevalence is high in some nations, a positive serology test result alone cannot be used as an effective method for donor screening. Future research for methods to prevent transfusion-transmitted toxoplasmosis may derive benefit from studies conducted in areas of high endemicity.
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            Investigating the Determinants of Toxoplasma gondii Prevalence in Meat: A Systematic Review and Meta-Regression

            Simone Belluco, Marzia Mancin, Daniele Conficoni … (2016)
            Background Toxoplasma gondii is one of the most widespread parasites in humans and can cause severe illness in immunocompromised individuals. However, its role in healthy people is probably under-appreciated. The complex epidemiology of this protozoan recognizes several infection routes but consumption of contaminated food is likely to be the predominant one. Among food, consumption of raw and undercooked meat is a relevant route of transmission, but the role of different meat producing animal species and meats thereof is controversial. Objectives The aim of the present work is to summarize and analyse literature data reporting prevalence estimates of T. gondii in meat animals/meats. Data Sources We searched Medline, Web of Science, Science Direct (last update 31/03/2015). Eligibility Criteria Relevant papers should report data from primary studies dealing with the prevalence of T. gondii in meat from livestock species as obtained through direct detection methods. Meta-analysis and meta-regression were performed. Results Of 1915 papers screened, 69 papers were included, dealing mainly with cattle, pigs and sheep. Pooled prevalences, based on random-effect models, were 2.6% (CI95 [0.5–5.8]) for cattle, 12.3% (CI95 [7.6–17.8]) for pigs and 14.7% (CI95 [8.9–21.5]) for sheep. Due to the high heterogeneity observed, univariable and multivariable meta-regression models were fitted showing that the geographic area for cattle (p = 0.032), the farming type for pigs (p = 0.0004) and the sample composition for sheep (p = 0.03) had significant effects on the prevalences of Toxoplasma detected/estimated. Moreover, the role of different animal species was dependent on the geographic location of animals’ origin. Limitations Limitations were due mainly to a possible publication bias. Conclusions and Implications The present work confirms the role of meat, including beef, as T. gondii sources, and highlights the need for a control system for this parasite to be implemented along the meat production chain. Moreover, consumer knowledge should be strengthened in order to reduce the impact of disease.
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              Seroepidemiology of Toxoplasma gondii infection in psychiatric inpatients in a northern Mexican city

              Cosme Alvarado-Esquivel, Olga-Patricia Alanis-Quiñones, Miguel-Ángel Arreola-Valenzuela … (2006)
              Background Patients with psychiatric disorders were found to show a high seroprevalence of Toxoplasma gondii infection. There is scarce information about the epidemiology of T. gondii infection in psychiatric patients in Mexico. Therefore, we sought to determine the prevalence of T. gondii infection and associated socio-demographic, clinical and behavioural characteristics in a population of psychiatric patients in Durango City, Mexico. Seroprevalence in patients was compared with that obtained in a control population. Methods One hundred and thirty seven inpatients of a public psychiatric hospital and 180 controls were examined for the presence of IgG and IgM antibodies against T. gondii by enzyme-linked immunoassay (Diagnostic Automation Inc., Calabasas, CA, USA). The control population consisted of blood donors of a public blood bank and elderly persons attending a senior center in the same city. Age in controls (42 years +/- 20.2) was comparable with that of the psychiatric patients (43.7 years +/-13.8) (p = 0.42). Socio-demographic, clinical and behavioral characteristics from the patients were also obtained. Results Anti-T. gondii IgG antibodies indicating latent infection with T. gondii was found in 25 (18.2%) of 137 psychiatric inpatients and 16 (8.9%) of 180 controls (p = 0.02). Ten (26.3%) of 38 schizophrenic patients had latent infection and this prevalence was also significantly higher than that observed in controls (p = 0.005). Prevalence of anti-T. gondii IgM antibodies was comparable among patients and controls (4.4% vs 2.2%, respectively, p = 0.22). Multivariate analysis showed that T. gondii infection in inpatients was positively associated with sexual promiscuity (adjusted OR = 15.8; 95% CI: 3.8–64.8), unwashed raw fruit consumption (adjusted OR = 5.19; 95% CI: 2.3–11.3), and a history of surgery (adjusted OR = 6.5; 95% CI: 2.6–16), and negatively associated with lamb meat consumption (adjusted OR = 0.26; 95% CI: 0.10–0.63). Conclusion In the present study, psychiatric inpatients in Durango, Mexico, in general and schizophrenia inpatients in particular had a significantly higher prevalence of T. gondii infection than the control group. Results suggest that unwashed raw fruit consumption might be the most important route of T. gondii transmission in our psychiatric inpatients while lamb meat consumption the less important. Additional studies will have to elucidate the causative relation between infection with T. gondii and psychiatric disorders.
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                Author and article information

                Journal
                Journal ID (nlm-ta): J Clin Med Res
                Journal ID (iso-abbrev): J Clin Med Res
                Journal ID (publisher-id): Elmer Press
                Title: Journal of Clinical Medicine Research
                Publisher: Elmer Press
                ISSN (Print): 1918-3003
                ISSN (Electronic): 1918-3011
                Publication date (Print): September 2017
                Publication date (Electronic): 27 July 2017
                Volume: 9
                Issue: 9
                Pages: 788-792
                Affiliations
                [a ]Biomedical Research Laboratory, Faculty of Medicine and Nutrition, Juarez University of Durango State, Avenida Universidad S/N, 34000 Durango, Mexico
                [b ]Secretaria de Salud, Avenida Cuauhtemoc 225 norte, 34000 Durango, Mexico
                [c ]Institute for Scientific Research “Dr. Roberto Rivera-Damm”, Juarez University of Durango State, Avenida Universidad S/N, 34000 Durango, Mexico
                Author notes
                [d ]Corresponding Author: Cosme Alvarado-Esquivel, Laboratorio de Investigacion Biomedica, Facultad de Medicina y Nutricion, Avenida Universidad S/N, 34000 Durango, Dgo, Mexico. Email: alvaradocosme@ 123456yahoo.com
                Article
                DOI: 10.14740/jocmr3117w
                PMC ID: 5544485
                SO-VID: c88e7b00-d265-4bac-acc0-38ecd501447a
                Copyright © Copyright 2017, Alvarado-Esquivel et al.
                License:

                This article is distributed under the terms of the Creative Commons Attribution Non-Commercial 4.0 International License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Date received : 25 June 2017
                Date accepted : 17 July 2017
                Categories
                Subject: Original Article

                ScienceOpen disciplines: Medicine
                Keywords: toxoplasma gondii,infection markers,seroprevalence,couples,concordance,epidemiology,mexico
                Data availability:
                ScienceOpen disciplines: Medicine
                Keywords: toxoplasma gondii, infection markers, seroprevalence, couples, concordance, epidemiology, mexico

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