Serosurvey of Toxoplasma gondii and Toxocara spp. co-infection in pregnant women in low-income areas of Brazil

IntroductionDespite human toxoplasmosis and toxocariasis having been listed among the top six most neglected parasitic zoonoses worldwide, presenting similar associated risk factors and transmission routes, few studies have been conducted in pregnant women and the consequences of concurrent infection remain to be fully established. Accordingly, the present study has serologically assessed the co-infection and associated risk factors for Toxoplasma gondii and Toxocara spp. in pregnant women, assisted by the public Unified National Health System (SUS) in southeastern Brazil.Materials and MethodsBlood samples were collected and tested for IgG antibodies against Toxoplasma gondii by chemiluminescence immunoassay and against Toxocara spp. by enzyme-linked immunosorbent assay (ELISA). An epidemiological questionnaire was applied to gather socioeconomic information to assess the risk factors associated with seropositivity to toxocariasis/toxoplasmosis by univariate analysis followed by logistic regression.ResultsOverall, seropositivity was 69/280 (24.6, 95% CI: 19.96–30.01) for T. gondii and 56/280 (20.0, 95% CI: 15.73–25.08) for Toxocara spp. Co-infection was observed in 25/280 (8.9, 95% CI: 6.12–12.85) pregnant women, with increased odds (OR: 3.3, CI 95%: 1.77–6.14, p = 0.0002). Logistic regression revealed that a higher educational level (high school or college) significantly reduced the likelihood of co-infection seropositivity, owning cats increased the odds of toxocariasis, and older pregnant women presented significantly higher T. gondii seropositivity.ConclusionCo-infection herein highlights the importance of educational programs in the prevention of toxocariasis and toxoplasmosis in pregnant women and other high-risk populations

Contaminação do solo por ovos de Toxocara spp. em balneários de água doce do interior do Estado de São Paulo, Brasil / Soil contamination by Toxocara spp. eggs in freshwater bathing sites in the interior of São Paulo State, Brazil

A toxocaríase é uma prevalente geozoonose de ocorrência mundial. A transmissão da doença ocorre principalmente pela ingestão acidental de solo contendo ovos de nematódeos do gênero Toxocara spp., que infectam cães e gatos. A pesquisa da contaminação de solo de balneários constitui uma lacuna na pesquisa científica sobre a transmissão da toxocaríase. O estudo teve como objetivo avaliar a contaminação por ovos de Toxocara spp. do solo de balneários (n=9) localizados em municípios no interior do Estado de São Paulo, Brasil. Foram coletadas amostras em 10 pontos da faixa de areia de cada balneário, em dois momentos diferentes (n= 20/balneário), totalizando 180 amostras. Alíquotas de 20 gramas de solo de cada ponto de coleta foram lavadas com Tween-80 a 5% e filtradas em peneiras metálicas (300 µm, 212 µm, 90 µm e 38µm). O filtrado foi submetido às técnicas de centrífugo-sedimentação e de centrífugo-flutuação (d=1.35 g/cm3) para recuperação de ovos de Toxocara spp. De acordo com os resultados obtidos, o solo de oito dos nove balneários (88,89%) visitados estavam contaminados com ovos de Toxocara spp., e a prevalência geral de contaminação nos pontos de coleta foi de 91,67%. A maioria dos ovos (92,59%) estava íntegra, porém apenas 1,53% em processo de embrionamento ou divisão celular, enquanto 5,34% apresentavam-se degenerados. A técnica de centrífugo-sedimentação mostrou-se superior (94,05% de recuperação) à técnica de centrífugo-flutuação (5,95%). Os resultados apresentados no estudo fornecem dados que suportam a necessidade de adoção de medidas educativas e de ações para redução da contaminação por ovos de Toxocara spp. e, consequentemente, dos riscos de transmissão de toxocaríase em balneários de água doce do Estado de São Paulo

One health approach to toxocariasis in Brazilian indigenous populations, their dogs, and soil contamination

IntroductionAlthough socioeconomic vulnerability and lifestyle factors may contribute to the transmission of Toxocara spp., no study has investigated indigenous populations in Brazil using the One Health approach.MethodsAccordingly, this study assessed anti-Toxocara spp. antibodies in Brazilian indigenous people and healthcare professionals by enzyme-linked immunosorbent assay. Presence of Toxocara spp. eggs (feces and hair) in dogs as definitive hosts and in soil samples of the indigenous communities were also recovered and molecularly investigated.ResultsOverall, 342/463 (73.9%) indigenous individuals and 46/147 (31.3%) non-indigenous healthcare professionals were seropositive for Toxocara spp. In addition, T. canis eggs were retrieved from 9/194 (4.6%) dog fecal samples and 4/204 (2.0%) dog hair samples, mainly from the Paraná State communities (3/42; 7.1%). Soil contamination was observed only in the Paraná State communities (36/90; 40.0%), with the molecular detection of T. canis. River water consumption was also associated with indigenous seropositivity (Odds ratio, 11.4).DiscussionIndigenous individuals in Paraná State communities were 2.72-fold more likely to be seropositive than those in São Paulo State, likely due to a lack of sanitary infrastructure. In this scenario, a primarily soil-transmitted disease may also have become waterborne, with embryonated eggs probably spread to water supplies by rain. Full-time healthcare professionals in daily contact with indigenous communities were 9.2-fold more likely to be seropositive than professionals who visited sporadically, suggesting exposure to Toxocara spp. during their work and raising health concerns. In addition, the findings herein showed a significantly higher seroprevalence in indigenous people than in healthcare workers (χ2 = 85.5; p < 0.0001), likely due to overtime exposure to Toxocara spp. In conclusion, Brazilian indigenous communities are highly exposed to toxocariasis, with poor infrastructure and contact with contaminated river water as associated risk factors and a higher risk of infection in healthcare professionals working full-time in these communities

Data_Sheet_1_Serosurvey of Toxoplasma gondii and Toxocara spp. co-infection in pregnant women in low-income areas of Brazil.docx

IntroductionDespite human toxoplasmosis and toxocariasis having been listed among the top six most neglected parasitic zoonoses worldwide, presenting similar associated risk factors and transmission routes, few studies have been conducted in pregnant women and the consequences of concurrent infection remain to be fully established. Accordingly, the present study has serologically assessed the co-infection and associated risk factors for Toxoplasma gondii and Toxocara spp. in pregnant women, assisted by the public Unified National Health System (SUS) in southeastern Brazil.Materials and MethodsBlood samples were collected and tested for IgG antibodies against Toxoplasma gondii by chemiluminescence immunoassay and against Toxocara spp. by enzyme-linked immunosorbent assay (ELISA). An epidemiological questionnaire was applied to gather socioeconomic information to assess the risk factors associated with seropositivity to toxocariasis/toxoplasmosis by univariate analysis followed by logistic regression.ResultsOverall, seropositivity was 69/280 (24.6, 95% CI: 19.96–30.01) for T. gondii and 56/280 (20.0, 95% CI: 15.73–25.08) for Toxocara spp. Co-infection was observed in 25/280 (8.9, 95% CI: 6.12–12.85) pregnant women, with increased odds (OR: 3.3, CI 95%: 1.77–6.14, p = 0.0002). Logistic regression revealed that a higher educational level (high school or college) significantly reduced the likelihood of co-infection seropositivity, owning cats increased the odds of toxocariasis, and older pregnant women presented significantly higher T. gondii seropositivity.ConclusionCo-infection herein highlights the importance of educational programs in the prevention of toxocariasis and toxoplasmosis in pregnant women and other high-risk populations.</p