Soroprevalência da infecção por Toxoplasma gondii em populações indígenas de Iauareté, São Gabriel da Cachoeira, Amazonas, Brasil

The goal of this survey was to estimate the seroprevalence of Toxoplasma gondii infection in Iauareté, a multiethnic Indian community in the upper Rio Negro basin. We carried out a cross-sectional survey (n = 260), in order to obtain serum samples and demographic data. The sample was randomly selected, by family conglomerate analysis. Serodiagnosis was performed by an enzyme-linked immunosorbent assay and indirect immunofluorescence. Prevalence of reactivity was 73.5% (191/260), being higher in the older-age groups, reaching 95.7% (44/46) in the group aged 50 years or more. The majority of seropositive subjects had titers equal to or less than 1:64. Seroprevalence was greater in Indians belonging to the Hupda ethnic group (p = 0.03). According to the present survey, Indian people living in Iauareté have a high prevalence of antibodies to T. gondii. Demographic concentration and urbanization within low sanitation and poor hygiene backgrounds, as well as unfiltered water consumption, may be related to the high frequency of T. gondii seroprevalence observed in the studied area.Este estudo objetivou estimar a soroprevalência da infecção por Toxoplasma gondii em Iauareté, uma comunidade indígena multiétnica situada na bacia do Alto Rio Negro. Foi realizado um estudo seccional (n = 260), obtendo-se amostras de soro e dados demográficos, através de amostragem sistemática por conglomerado. Os testes sorológicos foram realizados através de ensaio imunoenzimático e imunofluorescência indireta. A prevalência da reatividade foi de 73,5% (191/260), aumentando com a faixa etária e atingindo 95,7% (44/46) em maiores de 50 anos. A maioria das amostras reativas apresentou títulos iguais ou inferiores a 1:64. Observou-se maior freqüência de reatividade entre os índios da etnia Maku Hupda. De acordo com o presente estudo, a população indígena de Iauareté apresenta alta prevalência da presença de anticorpos contra T. gondii. A concentração demográfica e a urbanização, conduzidas sem infra-estrutura sanitária, levadas a cabo na região no ultimo século, podem estar relacionadas à alta freqüência de detecção de anticorpos contra T. gondii na área estudada

Knowledge of Toxoplasmosis among Doctors and Nurses Who Provide Prenatal Care in an Endemic Region

Congenital toxoplasmosis is a potentially severe infection and its prevention is most often based on serological screening in pregnant women. Many cases could be prevented by simple precautions during pregnancy. Aiming to assess the knowledge about toxoplasmosis among professionals working in antenatal care in a high prevalent region, a questionnaire was administered to 118 obstetric nurses and physicians attending at primary care units and hospitals. The questionnaire was self-completed and included questions on diagnosis, clinical issues, and prevention. Only 44% of total answers were corrected. Lower scores were observed among those with over 10 years of graduation, working in primary care units, and nurses. Errors were mainly observed in questions of prevention and diagnosis. As congenital toxoplasmosis is a mother-to-child (MTC) transmitted disease, early diagnosis and treatment can prevent serious and irreversible fetal damage. Thus, doctors and nurses who provide prenatal care must be appropriately trained on prophylactic, diagnostic, and clinical aspects of toxoplasmosis. The authors suggest that measures should be taken for continuing education regarding toxoplasmosis in pregnancy

Noninvasive Sampling: Monitoring of Wild Carnivores and Their Parasites

This chapter aims to present the importance, advantages, and disadvantages as well as the different types of noninvasive samples that can be used to monitor the carnivorous fauna and the parasitic agents that can infect these animals. This issue is extremely relevant, since noninvasive sampling has been increasingly used in different scientific researches that study animals with elusive habits, such as carnivores, and that claim animal welfare, once these animals do not need to be observed or captured. It is still important to highlight the scarcity of studies on parasitic diseases in free-living carnivores, being needed that parasitological surveys be done frequently by the conservation unit managers also to monitor the infectious agents that may be being introduced into the ecosystem of carnivores due to anthropization

Indirect immunofluorescence(IgG and IgM) tests for toxoplasmosis on 203 persons, with no symptomatology suggesting the disease, located in the city of Rio de Janeiro. Serological follow up one to two years later.

Clinical and serological follow up examinations were performed on 203 persons, from three to twenty years of age, from the otolaryngology department of a hospital in the city of Rio de Janeiro, with no symptomatology suggesting toxoplasmosis, but suffering from chronic tonsillitis. According to results obtained during the first indirect immunofluorescence tests, the patients were divided into following groups: Group I (non-reactive IgG and IgM), 98 persons (48.3%); Group II (1:16 &#8804; IgG &#8804; 1:256 and non-reactive IgM), 74 persons (36.5%); Group III (IgM &#8805; 1:1024 and non-reactive IgM), 18 persons (8.8%), and Group IV (IgG and IgM reactive), 13 persons (6.4%). One to two years later, 131 (64.5%) of the 203 persons were reexamined by a second indirect immunofluorescence test. In the case of 66 persons (Group I) whose serum was non-reactive in the IgG and IgM classes during the first indirect immunofluorescence test, serum conversion was observed in aproximately 21.2%. in 65 individuals (49.6%), (Groups II, III and IV),with reactive serum in the IgG classes during the first indirect immunofluorescence test, the second reaction showed an increase in titres in 20% of the cases, a decrease in 67.7% of the cases, or no alterations in 12.3 of the cases. In the IgM class, all 131 sera were non-reactive at 116 dilution the second immunofluorescence test, including the 13 cases that had previously been reactive in the immunoglobulin class, Symptomatology suggesting toxoplasmosis was only observed in one case during the second testing, this patient's principal physical sign being hypertrophied lymph nodes. during this period, the Toxoplasma antibodies showed titres of IgG 1:32000 and non-reactive IgM, whilst one year previously, during the first test, these titres were IgG 1:1024 and IgM 1:64. Differences in the age, sex and skin coloring of patients were not statistically significant as regards alterations in the indirect immunofluorescence test titres.<br>Foi feito o acompanhamento sorológico e clínico de 203 indivíduos de 3 a 20 anos de idade, provenientesde serviços de otorrinolaringologia na cidade do Rio de Janeiro, sem sintomatologia sugestiva de toxoplasmose, mas portadores de amigdalite crônica. Os pacientes, de acordo com os resultados da 1ª RIFi, foram divididos nos seguintesgrupos: Grupo I (IgG e IgM não reagente), 98 indivíduos (48.3%); Grupo II (1:16 IgG &#8804; 1:256 e IgM não reagente), 74 indivíduos (36,5%); Grupo III (IgG &#8805; 1:1024 e IgM não reagente), 18 indivíduos (8,8%) e Grupo IV (IgG e IgM reagentes), 13 indivíduos (6,4%). Um a dois anos após, 131 (64,5%) dos 203 indivíduos foram reexaminados para uma segunda RIFi. Dentre 66 deles (Grupo I), que eram soro não reagentes nas classes IgG e IgM na primeira, RIFI, observou-se soro conversão nas classes IgG em cerca de 21,2%. Em 65 (49,6%) indivíduos (Grupos II, III e IV),que eram soro reagentes nas classes IgG na primeira RIFI, observou-se que na segunda reação, os títulos variaram de modo ascendente em 20% dos casos, descendente em 67,7% dos casos ou não variaram em 12,3% dos casos. Na classe IgM todos os 131 soros apresentaram-se não reagentes à diluição de 1:16 na segunda RIFi, inclusive os 13 casos anteriormente reagentes nesta classe de imunoglobinas. Apenas em um caso observou-se sintomatologia sugestiva de toxoplasmose na ocasião da segunda coleta, sendo que o paciente apresentava, principalmente, gânglios hipertrofiados. Os títulos de anticorpos para toxoplasmose nesta época foram IgG 1:32000 e IgM não reagente enquanto que na primeira coleta um ano antes eram IgG 1:1024 e IgM 1:64. Quanto à idade, sexo e cor as diferenças nos títulos da RIFI foram estatisticamente não significantes

Triagem sorológica e fatores de risco para toxoplasmose em gestantes no Sul do Brasil

Screening sorológico e avaliação de fatores de risco para a transmissão de Toxoplasma gondii foi conduzido em 2.126 gestantes no sul do Brasil. Entre as gestantes avaliadas, 74,5% (n=1.583) mostraram anticorpos específicos contra Toxoplasma gondii. O contato com o solo foi o maior fator associado à infecção.Serological screening and evaluation of exposure factors for Toxoplasma gondii transmission were conducted in 2126 pregnant women from southern Brazil. Specific antibodies against Toxoplasma gondii were presented by 74.5% (n=1583) of the pregnant women evaluated. Contact with soil was found to be the major factor for infection

Uma breve revisão sobre toxoplasmose na gestação

AIMS: This is a brief guide on toxoplasmosis in pregnancy and on congenital toxoplasmosis for public health students and professionals. Its aims are to present key points of the transmission and diagnosis of Toxoplasma gondii infection, and to summarize the evidences about management of pregnant women and infants with suspected or proven toxoplasmosis. SOURCE OF DATA: Studies were identified from PubMed (1990-2009), and through contact with experts in the field, including our Congenital Toxoplasmosis Research Group. SUMMARY OF FINDINGS: Review of studies shows that preventive measures reduce the risk of congenital Toxoplasma gondii infection and improve the perinatal outcomes and the prognosis of children. Being usually asymptomatic, or having inespecific clinical manifestations, acute primary toxoplasmic infection almost always goes unnoticed. Therefore, its detection is based on routine serology. Serological screening for toxoplasmosis during pregnancy should start at the first prenatal visit, to detect cases of acute infection (and to start treatment as soon as possible) and cases of seronegative pregnant women (who must be monitored throughout pregnancy and receive education about primary prevention measures). CONCLUSIONS: This review highlights the importance of prevention and diagnosis of toxoplasmosis during pregnancy, as well as of monitoring neonates born to mothers with serological tests compatible with acute infection, even in the absence of signs and symptoms of toxoplasmosis.OBJETIVOS: este é um breve guia sobre toxoplasmose na gestação e toxoplasmose congênita, para estudantes e profissionais de saúde pública. Depois de apresentar os pontos principais de transmissão e diagnóstico da infecção pelo Toxoplasma gondii, busca-se resumir as evidências sobre o manejo de gestantes e de neonatos com toxoplasmose suspeita ou confirmada. FONTE DE DADOS: os estudos foram identificados no PubMed (1990-2009) e por meio do contato com especialistas no assunto, incluindo pesquisas realizadas pelo nosso Grupo de Pesquisa em Toxoplasmose Congênita. SÍNTESE DOS DADOS: a revisão dos estudos mostra que as medidas de prevenção reduzem o risco de infecção congênita pelo Toxoplasma gondii e melhoram os desfechos perinatais e o prognóstico das crianças. Sendo na maioria das vezes assintomática, ou apresentando um quadro clínico inespecífico, a infecção toxoplásmica aguda primária passa quase sempre despercebida. Por isso, sua detecção é baseada na sorologia de rotina. A triagem sorológica para toxoplasmose durante a gravidez deve começar na primeira visita pré-natal, para que sejam detectados os casos de infecção aguda (e iniciar o tratamento o mais brevemente possível) e os casos de gestantes soronegativas (que devem ser monitoradas durante toda a gestação e instruídas sobre medidas de prevenção primária). CONCLUSÕES: esta revisão ressalta a importância da prevenção e do diagnóstico da toxoplasmose na gestação, assim como do acompanhamento de neonatos de mães com sorologia compatível com infecção aguda, mesmo na ausência de sinais e sintomas sugestivos de toxoplasmose