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      Seroprevalence of Toxoplasma gondii infection among women of childbearing age in an endemic region of Romania, 2016–2018 Translated title: Séroprévalence de l’infection à Toxoplasma gondii chez les femmes en âge de procréer dans une région endémique de la Roumanie, 2016-2018

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          Abstract

          Toxoplasmosis is an important worldwide zoonosis caused by the protozoan parasite Toxoplasma gondii. This parasitic infection is often asymptomatic in immunocompetent people. However, if the infection occurs in pregnant women, it can have serious consequences for the foetus. In this study, we evaluated the seroprevalence of T. gondii in women of childbearing age in Arad County, Western Romania. Serum samples from 2626 women were analysed using a Siemens ADVIA Centaur XP Immunoassay System. Toxoplasma gondii IgG antibodies were demonstrated in 1081 women (41%) and prevalence tended to increase with age, from 32% in women aged 15–19 years to 62% in women aged 40–45 years. There was a higher prevalence in rural areas (46%) than in urban areas (36%). This study provides new data on T. gondii seroprevalence in women of childbearing age from Western Romania.

          Translated abstract

          La toxoplasmose est une zoonose mondiale importante causée par le parasite protozoaire Toxoplasma gondii. Cette infection parasitaire est souvent asymptomatique chez les sujets immunocompétents. Cependant, si l’infection survient chez la femme enceinte, elle peut avoir de graves conséquences pour le fœtus. Dans cette étude, nous avons évalué la séroprévalence de T. gondii chez les femmes en âge de procréer dans le comté d’Arad, dans l’ouest de la Roumanie. Des échantillons de sérum de 2626 femmes ont été analysés avec le Siemens ADVIA Centaur XP. Des anticorps IgG contre T. gondii ont été mis en évidence chez 1081 femmes (41 %) et la prévalence avait tendance à augmenter avec l’âge, passant de 32 % chez les femmes âgées de 15 à 19 ans à 62 % chez les femmes âgées de 40 à 45 ans. La prévalence était plus élevée dans les zones rurales (46 %) que dans les zones urbaines (36 %). Cette étude fournit de nouvelles données sur la séroprévalence de T. gondii chez les femmes en âge de procréer de l’ouest de la Roumanie.

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          Most cited references 29

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          Toxoplasmosis snapshots: global status of Toxoplasma gondii seroprevalence and implications for pregnancy and congenital toxoplasmosis.

          Toxoplasma gondii's importance for humans refers mainly to primary infection during pregnancy, resulting in abortion/stillbirth or congenital toxoplasmosis. The authors sought to evaluate the current global status of T. gondii seroprevalence and its correlations with risk factors, environmental and socioeconomic parameters. Literature published during the last decade on toxoplasmosis seroprevalence, in women who were pregnant or of childbearing age, was retrieved. A total of 99 studies were eligible; a further 36 studies offered seroprevalence data from regions/countries for which no data on pregnancy/childbearing age were available. Foci of high prevalence exist in Latin America, parts of Eastern/Central Europe, the Middle East, parts of south-east Asia and Africa. Regional seroprevalence variations relate to individual subpopulations' religious and socioeconomic practices. A trend towards lower seroprevalence is observed in many European countries and the United States of America (USA). There is no obvious climate-related gradient, excluding North and Latin America. Immigration has affected local prevalence in certain countries. We further sought to recognise specific risk factors related to seropositivity; however, such risk factors are not reported systematically. Population awareness may affect recognition of said risks. Global toxoplasmosis seroprevalence is continuingly evolving, subject to regional socioeconomic parameters and population habits. Awareness of these seroprevalence trends, particularly in the case of women of childbearing age, may allow proper public health policies to be enforced, targeting in particular seronegative women of childbearing age in high seroprevalence areas.
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            Toxoplasma gondii seroprevalence in the United States 2009-2010 and comparison with the past two decades.

            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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              Severe congenital toxoplasmosis in the United States: clinical and serologic findings in untreated infants.

              Congenital toxoplasmosis can cause significant neurologic manifestations and other untoward sequelae. The Palo Alto Medical Foundation Toxoplasma Serology Laboratory database was searched for data on infants 0 to 180 days old, in whom congenital toxoplasmosis had been confirmed and who had been tested for Toxoplasma gondii-specific immunoglobulin G (IgG), IgM, and IgA antibodies, between 1991 and 2005. Their clinical findings were confirmed at the National Collaborative Chicago-based Congenital Toxoplasmosis Study center. We reviewed available clinical data and laboratory profiles of 164 infants with congenital toxoplasmosis whose mothers had not been treated for the parasite during gestation. One or more severe clinical manifestations of congenital toxoplasmosis were reported in 84% of the infants and included eye disease (92.2%), brain calcifications (79.6%), and hydrocephalus (67.7%). In 61.6% of the infants, eye disease, brain calcifications, and hydrocephalus were present concurrently. T. gondii-specific IgM, IgA, and IgE antibodies were demonstrable in 86.6%, 77.4%, and 40.2% of the infants, respectively. Testing for IgM and IgA antibodies increased the sensitivity of making the diagnosis of congenital toxoplasmosis to 93% compared with testing for IgM or IgA individually. IgM and IgA antibodies were still present in 43.9% of infants diagnosed between 1 and 6 months of life. Our study reveals that severe clinical signs of congenital toxoplasmosis including hydrocephalus, eye disease, or intracranial calcifications occurred in 85% infants whose sera were referred to our reference Toxoplasma Serology Laboratory during a period of 15 years. Laboratory tests, including serologic and polymerase chain reaction tests, were critical for diagnosis in the infants. Our results contrast remarkably with those of European investigators who rarely observe severe clinical signs in infants with congenital toxoplasmosis.
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                Author and article information

                Journal
                Parasite
                Parasite
                parasite
                Parasite
                EDP Sciences
                1252-607X
                1776-1042
                2020
                16 November 2020
                : 27
                : ( publisher-idID: parasite/2020/01 )
                Affiliations
                [1 ] Discipline of Parasitology, Victor Babes University of Medicine and Pharmacy Piata Eftimie Murgu, No. 1 300041 Timisoara Romania
                [2 ] Bioclinica Dreptatii Street, No. 23, Bl. 707 310300 Arad Romania
                [3 ] Vasile Goldis Western University Liviu Rebreanu Street, No. 86 310048 Arad Romania
                [4 ] Clinical Laboratory, Municipal Clinical Emergency Hospital Strada Gheorghe Dima Nr. 5 300254 Timisoara Romania
                [5 ] Clinical Laboratory, Institute of Cardiovascular Diseases Strada Gheorghe Adam Numarul 13A 300310 Timisoara Romania
                [6 ] Center for Diagnosis and Study of Parasitic Diseases, Victor Babes University of Medicine and Pharmacy Piata Eftimie Murgu, No. 1 300041 Timisoara Romania
                Author notes
                Article
                parasite200112 10.1051/parasite/2020057
                10.1051/parasite/2020057
                7669453
                33198884
                © A.G. Mihu 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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