High frequency of ocular toxoplasmosis in Quindio, Colombia and risk factors related to the infection.
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ABSTRACT: Objectives
To determine the frequency of retinochoroidal lesions by ocular toxoplasmosis and their relationships with risk factors, in residents of two districts with high exposure to Toxoplasma, in Armenia-Quindío, Colombia.Methods
Cross-sectional analyses of fundoscopy screening, serological tests, and questionnaires were performed to determine risk factors associated with ocular toxoplasmosis retinochoroidal lesions. Differences in proportions were analyzed using the chi-squared test.Results
Of 161 individuals examined, 17 (10.5%) exhibited retinochoroidal scars suggestive of old inactive Toxoplasma gondii infection. All 17 individuals were seropositive for T. gondii antibodies. Consumption of bottled water was protective against T. gondii infection among individuals in this study. There were no specific epidemiological risk factors associated with ocular toxoplasmosis retinochoroidal lesions.Conclusion
Ocular toxoplasmosis is an important cause of visual impairment in Armenia-Quindío, Colombia. The consumption of boiled or bottled water is a major preventive public health measure to reduce infection by T. gondii and the subsequent onset of OT.
SUBMITTER: Gomez-Marin JE
PROVIDER: S-EPMC8056222 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundPrevious studies suggest a relationship between precipitation and ocular toxoplasmosis (OT) reactivation and congenital toxoplasmosis infection. We aimed to investigate the relationship between precipitation and the frequency of new OT cases in Colombia from 2015 to 2019.MethodologyThis retrospective cohort study analyzed data obtained from a claims-based database created by the Colombian Ministry of Health and national registries of precipitation of the Institute of Hydrology, Meteorology, and Environmental Studies. We estimated the daily number of OT cases, interpolating data from the average number of annual cases from 2015 to 2019. Then, we compared exposures (mean daily precipitation) in the case period in which the events (interpolated OT new cases) occurred by a quasi-Poisson regression, combined with a distributed lag non-linear model to estimate the non-linear and lag-response curve.Principal findingsIn the 5-year analysis, there were 1,741 new OT cases. Most of the cases occurred in 2019, followed by 2015 and 2018. New OT cases among departments were significantly different (P< 0.01). The cumulative exposure-response curve was decreasing for most departments. Nevertheless, in Chocó, Bogotá, Cesar, Cauca, and Guajira, when a certain amount of precipitation accumulates, the relative risk (RR) increases, which was contrary to the pattern observed in the other regions. The response curves to the one-day lag showed that precipitation influences the RR; however, the trends vary by department. Finally, an increasing trend in the number of cases was directly proportional to precipitation in Guajira, Atlántico, Norte de Santander, Santander, Caquetá and Quindío (r = 0.84; P< 0.05).ConclusionsPrecipitation influenced the RR for new OT cases. However, varying trends among geographical regions (departments) lead us to hypothesize that other sociodemographic, behavioral, and environmental variables, such as wind and water contamination, could influence the RR.
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Project description:BACKGROUND:Several Zika virus (ZIKV) outbreaks have occurred since October 2015. Because there is no effective treatment for ZIKV infection, developing an effective surveillance and warning system is currently a high priority to prevent ZIKV infection. Despite Aedes mosquitos having been known to spread ZIKV, the calculation approach is diverse, and only applied to local areas. This study used meteorological measurements to monitor ZIKV infection due to the high correlation between climate change and Aedes mosquitos and the convenience to obtain meteorological data from weather monitoring stations. METHODS:This study applied the Bayesian structured additive regression modeling approach to include spatial interactive terms with meteorological factors and a geospatial function in a zero-inflated Poisson model. The study area contained 32 administrative departments in Colombia from October 2015 to December 2017. Weekly ZIKV infection cases and daily meteorological measurements were collected. Mapping techniques were adopted to visualize spatial findings. A series of model selections determined the best combinations of meteorological factors in the same model. RESULTS:When multiple meteorological factors are considered in the same model, both total rainfall and average temperature can best assess the geographic disparities of ZIKV infection. Meanwhile, a 1-in. increase in rainfall is associated with an increase in the logarithm of relative risk (logRR) of ZIKV infection of at most 1.66 (95% credible interval [CI]?=?1.09, 2.15) as well as a 1?°F increase in average temperature is significantly associated with at most 0.79 (95% CI?=?0.12, 1.22) increase in the logRR of ZIKV. Moreover, after controlling rainfall and average temperature, an independent geospatial function in the model results in two departments with an excessive ZIKV risk which may be explained by unobserved factors other than total rainfall and average temperature. CONCLUSION:Our study found that meteorological factors are significantly associated with ZIKV infection across departments. The study determined both total rainfall and average temperature as the best meteorological factors to identify high risk departments of ZIKV infection. These findings can help governmental agencies monitor at risk areas according to meteorological measurements, and develop preventions in those at risk areas in priority.
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Project description:ProposeTo report two cases of severe acute multi-systemic failure with bilateral ocular toxoplasmosis in immunocompetent patients from urban settings in Colombia.ObservationsWe report two immunocompetent male patients aged 44- and 67-years-old who, despite not having visited the Amazonian region in Colombia, had severe bilateral posterior uveitis and extensive-bilateral macular lesions and multiple organ failure that required admission to an intensive care unit. Toxoplasma gondii was positive by PCR assay in vitreous humor samples. Patients were treated with intravitreal clindamycin and dexamethasone in addition to systemic treatment with trimethoprim-sulfamethoxazole. In both patients, infection by atypical strains was confirmed; in one case by serotyping and in another one by genotyping (ROP 18 virulent allele). After 2 and 4 months of treatment respectively, the patients showed improvement of the posterior uveitis and its systemic manifestations. However, there was no significant visual acuity improvement due to bilateral extensive macular involvement.Conclusions and importanceClinicians should be aware that toxoplasmosis originating from South America could be associated with severe acute multisystemic and intraocular bilateral involvement, even in patients with no history of exposure to jungle environments.
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Project description:ObjectivesToxoplasma gondii is an opportunistic parasite that causes a clinical manifestation known as toxoplasmosis. We investigated the prevalence and potential risk factors of T. gondii infection among women in Khartoum, Sudan. A sero-parasitological cross-sectional study included 100 women aging between 15 and 50 years old was conducted between January and November 2018. Serum samples were collected and investigated for the presence of anti-T. gondii immunoglobulins.ResultsMean age of the women population included was 26.75?±?8.25 with a range between 15 and 50 years. Sero-prevalence of T. gondii antibodies was 27% (27/100) with a 95% confidence interval (CI) of 18.6-36.8%. Among seropositive population 81% (22/27), 15% (4/27) and 4% (1/27) were seropositive for IgG antibodies, IgM antibodies and both antibodies respectively. Age group 21-30 years old had the highest frequency of detected IgG (10/45) and IgM (3/45). Married women had the highest frequency of detected IgG or IgM, 18/79 and 3/79, respectively. Risk factors analysis showed a total of 37/100 participants were having direct contact with cats and 66/100 have a frequent raw meat consumption, neither direct cats contact nor raw meat consumption had a statistically significant association with seropositivity to T. gondii (P value?=?0.052 and 0.565, respectively).
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Project description:PurposeTo compare the intraocular cytokine and chemokine profiles in patients with acute primary acquired ocular toxoplasmosis (pOT) or recurrent ocular toxoplasmosis (rOT) and to correlate them with their clinical characteristics.MethodsAqueous humor samples were collected from 62 consecutive patients (21 pOT, 30 rOT, and 11 noninfected controls) and analyzed by multiplex assay. Correlations were assessed between cytokine/chemokine levels, type of inflammatory response (Th1, Th2, and Th17), and clinical characteristics. In all OT patients, the clinical diagnosis of either pOT or rOT was confirmed by positive intraocular Goldmann/Witmer-Desmonts coefficient. Correlations were assessed between a preselected panel of immune mediators and the clinical characteristics of OT.ResultsIn pOT patients, increased levels of IL-2, IFN-γ, TNF-α, IL-15, IL-4, IL-5, IL-9, IL-13, IL-17, IL-1Rα, IL-6, IL-1β, and chemokines MIP-1α, MIP-1β, IP-10, Eotaxin, IL-8, RANTES, PDGF-bb, GM-CSF, G-CSF, and MCP-1 were found in comparison to those in controls (p < 0.05). Patients with rOT showed elevated levels of IL-2, IFN-γ, TNF-α, IL-15, IL-4, IL-5, IL-9, IL-17, IL-1Rα, IL-6, IL-1β, and chemokines MIP-1α, IP-10, Eotaxin, IL-8, RANTES, PDGF-bb, G-CSF, and MCP-1 compared to controls (p < 0.05). In addition, IL-7 (p = 0.028) differed between pOT and rOT; IL-9 (p = 0.054) and IL-13 (p = 0.051) showed a tendency of higher concentration in pOT than in rOT. A negative correlation was found between IL-7 (p = 0.017) as well as IL-9 (p = 0.008) and the number of recurrences. Cytokine ratios showed no difference between pOT and rOT, indicating a dominant Th1-type response in both infectious groups. Moreover, a positive correlation was detected between IL-7, VEGF, IL-13 and age at aqueous humor sampling (p < 0.05).ConclusionsThis study for the first time shows subtle differences between the intraocular cytokine profiles in patients with either acute pOT or rOT.
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Project description:Staphylococcus aureusbacteremia (SAB) often leads to ocular infections, including endophthalmitis and chorioretinitis. However, the incidence, risk factors, and outcomes of ocular infections complicated by SAB are largely unknown. We retrospectively analyzed the incidence and risk factors of ocular involvement in a prospective cohort of patients with SAB at a tertiary-care hospital. Ophthalmologists reviewed the fundoscopic findings and classified the ocular infections as endophthalmitis or chorioretinitis. During the 5-year study period, 1,109 patients had SAB, and data for 612 (55%) who underwent ophthalmic examinations within 14 days after SAB onset were analyzed. Of those 612 patients, 56 (9% [95% confidence interval [CI], 7 to 12%]) had ocular involvement, including 15 (2.5%) with endophthalmitis and 41 (6.7%) with chorioretinitis. In a multivariate analysis, infective endocarditis (adjusted odds ratio [aOR], 5.74 [95% CI, 2.25 to 14.64]) and metastatic infection (aOR, 2.38 [95% CI, 1.29 to 4.39]) were independent risk factors for ocular involvement. Of the 47 patients with ocular involvement who could communicate, only 17 (36%) had visual disturbances. Two-thirds of the patients with endophthalmitis (10/15 patients) were treated with intravitreal antibiotics combined with parenteral antibiotics, whereas all of the patients with chorioretinitis were treated only with systemic antibiotics. No patients became blind. Among 42 patients for whom follow-up assessments were available, the ocular lesions improved in 29 (69%) but remained the same in the others. Ocular involvement was independently associated with death within 30 days after SAB onset. Ocular involvement is not uncommon among patients with SAB. Routine ophthalmic examinations should be considered for patients with infective endocarditis or metastatic infections caused by SAB.
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Project description:BackgroundHIV-prevalence, as well as incidence of zoonotic parasitic diseases like cystic echinococcosis, has increased in the Kyrgyz Republic due to fundamental socio-economic changes after the breakdown of the Soviet Union. The possible impact on morbidity and mortality caused by Toxoplasma gondii infection in congenital toxoplasmosis or as an opportunistic infection in the emerging AIDS pandemic has not been reported from Kyrgyzstan.Methodology/principal findingsWe screened 1,061 rural and 899 urban people to determine the seroprevalence of T. gondii infection in 2 representative but epidemiologically distinct populations in Kyrgyzstan. The rural population was from a typical agricultural district where sheep husbandry is a major occupation. The urban population was selected in collaboration with several diagnostic laboratories in Bishkek, the largest city in Kyrgyzstan. We designed a questionnaire that was used on all rural subjects so a risk-factor analysis could be undertaken. The samples from the urban population were anonymous and only data with regard to age and gender was available. Estimates of putative cases of congenital and AIDS-related toxoplasmosis in the whole country were made from the results of the serology. Specific antibodies (IgG) against Triton X-100 extracted antigens of T. gondii tachyzoites from in vitro cultures were determined by ELISA. Overall seroprevalence of infection with T. gondii in people living in rural vs. urban areas was 6.2% (95%CI: 4.8-7.8) (adjusted seroprevalence based on census figures 5.1%, 95% CI 3.9-6.5), and 19.0% (95%CI: 16.5-21.7) (adjusted 16.4%, 95% CI 14.1-19.3), respectively, without significant gender-specific differences. The seroprevalence increased with age. Independently low social status increased the risk of Toxoplasma seropositivity while increasing numbers of sheep owned decreased the risk of seropositivity. Water supply, consumption of unpasteurized milk products or undercooked meat, as well as cat ownership, had no significant influence on the risk for seropositivity.ConclusionsWe present a first seroprevalence analysis for human T. gondii infection in the Kyrgyz Republic. Based on these data we estimate that 173 (95% CI 136-216) Kyrgyz children will be born annually to mothers who seroconverted to toxoplasmosis during pregnancy. In addition, between 350 and 1,000 HIV-infected persons are currently estimated to be seropositive for toxoplasmosis. Taken together, this suggests a substantial impact of congenital and AIDS-related symptomatic toxoplasmosis on morbidity and mortality in Kyrgyzstan.
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Project description:Worldwide, ocular toxoplasmosis (OT) is the principal cause of posterior uveitis, a severe, life-altering disease. A Toxoplasma gondii enzyme-linked immunoassay that detects strain-specific antibodies present in serum was used to correlate serotype with disease.Toxoplasma serotypes in consecutive serum samples from German uveitis patients with OT were compared with non-OT seropositive patients with noninfectious autoimmune posterior uveitis. OT patients were tested for association of parasite serotype with age, gender, location, clinical onset, size, visual acuity, or number of lesions (mean follow-up, 3.8 years) to determine association with recurrences.A novel, nonreactive (NR) serotype was detected more frequently in serum samples of OT patients (50/114, 44%) than in non-OT patients (4/56, 7%) (odds ratio, 10.0; 95% confidence interval 3.4-40.8; P < .0001). Non-OT patients were predominantly infected with Type II strains (39/56; 70%), consistent with expected frequencies in Central Europe. Among OT patients, those with NR serotypes experienced more frequent recurrences (P = .037). Polymerase chain reaction detected parasite DNA in 8/60 OT aqueous humor specimens but failed to identify Type II strain alleles.Toxoplasma NR and Type II serotypes predominate in German OT patients. The NR serotype is associated with OT recurrences, underscoring the value of screening for management of disease.
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