High seroprevalence of Toxoplasma gondii infection in a subset of Mexican patients with work accidents and low socioeconomic status

<p>Abstract</p> <p>Background</p> <p><it>Toxoplasma gondii </it>has been associated with reflex impairment and traffic accidents. It is unknown whether <it>Toxoplasma </it>infection might be associated with work accidents. Therefore, using a case-control seroprevalence study design, 133 patients with a recent work accident and 266 control subjects of the general population from the same region were examined with enzyme-linked immunoassays for the presence and levels of anti-<it>Toxoplasma </it>IgG antibodies and anti-<it>Toxoplasma </it>IgM antibodies. Socio-demographic, work, clinical and behavioral characteristics from each worker were obtained.</p> <p>Results</p> <p>Eleven (8.3%) of 133 patients, and 14 (5.3%) of 266 controls had anti-<it>T. gondii </it>IgG antibodies. Anti-<it>T. gondii </it>IgG levels were higher than 150 IU/ml in 8 (6%) patients and 10 (3.8%) controls. Anti-<it>T. gondii </it>IgM antibodies were found in one (0.8%) of the workers, and in 6 (2.3%) of the controls. No statistically significant differences in the IgG seroprevalences, frequencies of high IgG levels, and IgM seroprevalences among patients and controls were found. In contrast, a low socio-economic level in patients with work accidents was associated with <it>Toxoplasma </it>seropositivity (<it>P </it>= 0.01). Patients with work accidents and low socioeconomic status showed a significantly (OR = 3.38; 95% CI: 0.84-16.06; <it>P </it>= 0.04) higher seroprevalence of <it>T. gondii </it>infection than controls of the same socioeconomic status (15.1% vs. 5%, respectively). Multivariate analysis showed a positive association of <it>T. gondii </it>infection with boar meat consumption (OR = 3.04; 95% CI: 1.03-8.94; <it>P </it>= 0.04). In contrast, a negative association between <it>T. gondii </it>infection and national trips (OR = 0.40; 95% CI: 0.17-0.96; <it>P </it>= 0.04), sausage consumption (OR = 0.20; 95% CI: 0.05-0.68; <it>P </it>= 0.01), and ham consumption (OR = 0.16; 95% CI: 0.05-0.51; <it>P </it>= 0.002) was found.</p> <p>Conclusions</p> <p>In the study described here seropositivity to <it>T. gondii </it>was associated to work accidents in a subset of patients with low socioeconomic status. This is the first report of an association of <it>T. gondii </it>infection and work accidents. Further studies to confirm our results are needed. Results may help in designing optimal prevention strategies to avoid <it>T. gondii </it>infection.</p

Seroprevalence of human Trypanosoma cruzi infection in diferent geografic zones of Chiapas, Mexico Soroprevalência da infecção humana pelo Trypanosoma cruzi em diferentes regiões de Chiapas, México

A serologic survey was carried out in four different geographic zones of Chiapas, Mexico. A total of 1,333 samples were collected from residents of thirteen communities located on the Coast, Central Mountain, Lacandon Forest and a zone called Mesochiapas. One hundred and fifty one seropositive individuals (11.3%) were identified. Human Trypanosoma cruzi infection was influenced by geography. In the Lacandon Forest and Central Mountains there was a higher seroprevalence 32.1 and 13.8% respectively, than on the coast (1.2%). In Mesochiapas there were no seropositive individuals among the 137 persons tested. An active transmission is probably continuing because seropositive cases (13.8%) were detected in children under 10 years of age. The vector recognized on the Coast was Triatoma dimidiata while in the Lacandon Forest it was Rhodnius prolixus.<br>Foi feito um estudo sorológico em quatro zonas geográficas do estado de Chiapas México. Foram colhidas 1333 amostras dos habitantes das 13 comunidades situadas na costa, na região central montanhosa, na floresta lacandona e na região chamada mesochiapas. Cento cinqüenta e uma pessoas (11,3%) foram identificadas como soropositivas. A infecção pelo Trypanosoma cruzi teve a influência da geografia local. Na floresta lacandona nas montanhas centrais, foi encontrada uma prevalência de 32,1 e 13,8% respectivamente, mais que na costa 1,2%. Na zona de mesochiapas não foi encontrada nenhuma pessoa com sorologia positiva entre 137 estudadas. Como encontramos sorologia positiva em crianças menores de 10 anos, pensamos que exista uma transmissão ativa contínua. Na costa foi reconhecido o vetor Triatoma dimidiata e na floresta Lacandona o Rhodnius prolixus

High prevalence anti-Trypanosoma cruzi antibodies, among blood donors in the State of Puebla, a non-endemic area of Mexico

Blood transfusion is the second most common transmission route of Chagas disease in many Latin American countries. In Mexico, the prevalence of Chagas disease and impact of transfusion of Trypanosoma cruzi-contaminated blood is not clear. We determined the seropositivity to T. cruzi in a representative random sample, of 2,140 blood donors (1,423 men and 647 women, aged 19-65 years), from a non-endemic state of almost 5 millions of inhabitants by the indirect hemagglutination (IHA) and enzyme linked immunosorbent assay (ELISA) tests using one autochthonous antigen from T. cruzi parasites, which were genetically characterized like TBAR/ME/1997/RyC-V1 (T. cruzi I) isolated from a Triatoma barberi specimen collected in the same locality. The seropositivity was up to 8.5% and 9% with IHA and ELISA tests, respectively, and up to 7.7% using both tests in common. We found high seroprevalence in a non-endemic area of Mexico, comparable to endemic countries where the disease occurs, e.g. Brazil (0.7%), Bolivia (13.7%) and Argentina (3.5%). The highest values observed in samples from urban areas, associated to continuous rural emigration and the absence of control in blood donors, suggest unsuspected high risk of transmission of T. cruzi, higher than those reported for infections by blood e.g. hepatitis (0.1%) and AIDS (0.1%) in the same region

Do Commercial Serologic Tests for Trypanosoma cruzi Infection Detect Mexican Strains in Women and Newborns?

We sought to determine the serological test that could be used for Trypanosoma cruzi seroprevalence studies in Mexico, where lineage I predominates. In a previous study among pregnant women and their newborns in the states of Yucatan and Guanajuato, we reported a 0.8–0.9% of prevalence for T. cruzi–specific antibodies by Stat-Pak and Wiener ELISA. We have expanded this study here by performing an additional non-commercial ELISA and confirming the seropositives with Western blot, using whole antigens of a local parasite strain. We found a seroprevalence of 0.6% (3/500) in Merida and 0.4% in Guanajuato (2/488). The 5 seropositive umbilical cord samples reacted to both non-commercial ELISA and Western blot tests, and only 1 of the maternal samples was not reactive to non-commercial ELISA. A follow-up of the newborns at 10 mo was performed in Yucatan to determine the presence of T. cruzi antibodies in children as evidence of congenital infection. None of the children was seropositive. One newborn from an infected mother died at 2 wk of age of cardiac arrest, but T. cruzi infection was not confirmed. The T. cruzi seroprevalence data obtained with both commercial tests (Stat-Pak and ELISA Wiener) are similar to those from non-commercial tests using a local Mexican strain of T. cruzi