Toxoplasmosis screening and risk factors amongst pregnant females in Natal, northeastern Brazil

Abstract

Toxoplasmosis results in systemic disease, and if the mother is infected for the first time during gestation, the fetus may suffer substantial damage. Relatively little is known about the epidemiology of toxoplasmosis in pregnancy in most states of northeastern Brazil. Seroprevalence of toxoplasmosis among pregnant woman was studied in Natal, capital of Rio Grande do Norte State, in northeastern Brazil, from March to December 2007. The sera were tested for IgM and avidity of IgG antibodies to Toxoplasma by a microparticle enzyme immunoassay. The overall seroprevalence was high [126/190 (66.3%)]; prevalence increased with age indicating that in this setting most infections occur in adulthood (third decade of life). Only one pregnant woman was IgM positive and had high-avidity antibodies. The high percentage of pregnant women who are vulnerable to this parasite (33.1%) favors primary infection during pregnancy. Our studies show that direct contact with cats or dogs was highly associated with toxoplasmosis (odds ratio 2.72, P<0.001, 95% CI 1.46-5.02). The number of years in school (P<0.001), precarious socioeconomic status and limited knowledge about the disease (P<or=0.05 for both) were also associated with toxoplasmosis infection. The pattern of risk factors for infection corroborate other studies in Brazil.

Factors associated to infection by Toxoplasma gondii in pregnant women attended in Basic Health Units in the city of Rolândia, Paraná, Brazil

“…It occurs due to the contamination of the soil by felid oocytes deposition in the feces of infected felines, that under ideal moisture and temperature conditions and in a favorable shady location can remain infected for 12 to 24 months 22 . On the other hand, BARBOSA et al (2009) 8 assessed pregnant women in Natal, Rio Grande do Norte, northeast of Brazil, and did not find an association between toxoplasmosis and gardening probably because of the climate of the region, which is dry and hot throughout the year.…”

Prevalência de toxoplasmose em gestantes atendidas em dois centros de referência em uma cidade do Nordeste, Brasil

“…Esse dado também foi descrito em outros países, como relatado no Japão 24 . Em um estudo multicêntrico na Europa, realizado em 6 países europeus, o consumo de carne foi estimado ser responsável por 30 Referências a 63% dos casos de infecção por T. gondii, atribuídas ao consumo de carne crua ou mal cozida, o que representou o principal fator de risco para a infecção em todos os centros estudados 37 . Não foi encontrada associação entre a infecção por T. gondii e os diversos hábitos de comportamento, presença de horta em casa, presença de gatos em casa e contato com gatos durante a fase adulta, ingestão de vegetais crus, ingestão de linguiça caseira e leite in natura e manipulação de terra ou areia pelas gestantes.…”

“…Valores semelhantes de prevalência de susceptibilidade foram encontrados Rio Grande do Sul (25,5%) 22 e em Recife (22,5%) 13 . A prevalência de infecção ativa para o T. gondii nas mulheres grávidas foi de 0,9%, achados similares foram evidenciados em Fortaleza, Ceará (0,5%) 15 e em Natal, Rio Grande do Norte (0,52%) 30 , que também estão no Nordeste do Brasil, e em Goiânia, Goiás (0,7%) 31 . Considerando que o número de gestantes que tiveram IgM regente contra T. gondii neste estudo foi relativamente baixo para realizar análises estatísticas, todas as mulheres com infecção ativa tinham entre 19 e 27 anos de idade, estavam na primeira gravidez e não tinham gata ou cão em casa.…”

Risk factors for Toxoplasma gondii infection among pregnant women from the State of Tocantins, Northern Brazil

“…For example, it has been demonstrated that contact with the soil constitutes the most important risk factor associated with T. gondii infection in the Southern region of Brazil (15) . In contrast, the direct contact with cats was shown to be highly associated with T. gondii infection in humans residing in the northeast region (10) . Considering the importance of this zoonotic infection and the lack of data in some regions, the aim of this study was to assess the seroprevalence and the risk factors associated with T. gondii infection in pregnant women living in the State of Tocantins, Northern Brazil.…”

“…In general, the lowest prevalence has been reported in North America, whereas in Latin America, and particularly in countries such as Brazil, Colombia, and Cuba the prevalence of infection might reach 70% (10) (11) . The wide prevalence range is due to the different risk factors, which might infl uence the likelihood of infection by T. gondii in a given population (e.g., ingestion of undercooked meat, unpasteurized milk, or educational level) (5) (12) .…”