ABSTRACT
Introduction: Toxoplasmosis is a zoonosis prevalent in one-third of the world's population, adversely affecting maternal-fetal health by causing varying degrees of damage to the fetus. Objective: To assess the seroprevalence of Toxoplasma gondii IgG and IgM antibodies and associated risk factors in first-trimester pregnant women in Cúcuta, Colombia, in 2018. Materials and Methods: Cross-sectional and correlational study in 111 women who voluntarily participated. Specific IgM and IgG antibodies were detected by luminescence immunoassay (LIA). Results: Total seropositivity for IgM and IgG was 19.8% and 35.1%, respectively, 11.7% was for IgM only, and 53.2% corresponded to the overall seronegativity rate for T. gondii. Risk factors (CI = 95%) such as undercooked meat consumption (54.1% of cases, OR = 1.8, p = 0.120), tap water consumption (48.6%, OR = 1.4, p = 0.421), and goat or cow raw milk consumption (39.6%, OR = 0.78, p = 0.553) were identified; in addition, living with cats (23.4%) was identified as a risk factor significantly associated with parasite seropositivity (OR = 2.8, p = 0.025). Discussion and Conclusions: Our findings showed a possible risk of primary infection in more than half of the pregnant population, given the seronegativity against the parasite. A considerable frequency of suspected cases of very recent infection was also found. In addition to being associated with a previously recognized risk factor, this fact suggests the presence of other dietary risks that should be addressed through prevention strategies during prenatal care and the need to strengthen event surveillance.
Introdução: A toxoplasmose é uma zoonose prevalente em um terço da população mundial, que afeta negativamente a saúde materno-fetal, causando diversos graus de danos ao feto. Objetivo: Propôs-se avaliar o estado sorológico IgG e IgM anti - Toxoplasma gondii e fatores de risco relacionados, em gestantes no primeiro trimestre em Cúcuta, Colômbia, no ano de 2018. Material e Métodos: Estudo transversal e correlacional em Participaram 111 mulheres voluntariamente, que foram testadas para IgM e IgG específicos pelo imunoensaio LIA. Resultados: 19,8% e 35,1% do total de soropositividade foram encontrados para IgM e IgG, respectivamente, 11,7% foi apenas para IgM e 53,2% corresponde à frequência de soronegatividade geral para T.gondii; Foram identificados fatores de risco (IC=95%) , como consumo de carne mal cozida (54,1% dos casos, OR= 1,8, p=0,120 ), água da torneira (48,6%, OR=1,4, p=0,421), cru leite de cabra ou vaca (39,6%, OR=0,78, p=0,553 ), além de conviver com gatos (23,4%), sendo este último significativamente associado à soropositividade ao parasita ( OR=2,8 , p =0,025 ). Discussão e conclusões: Nossos achados revelam um possível risco de infecção primária em mais da metade da população gestante dada a sua soronegatividade contra o parasita, mas também uma frequência considerável de casos com suspeita de infecção muito recente, que, além de estar associada a um fator de risco previamente reconhecido , sugere outros aspectos de risco em torno da alimentação que devem ser impactados por meio de estratégias de prevenção durante o pré-natal, sugerindo a necessidade de fortalecer a vigilância em torno do evento.
Subject(s)
Seroepidemiologic Studies , Toxoplasmosis , Risk Factors , Pregnant Women , ImmunityABSTRACT
ABSTRACT Objective. Isolate, identify and molecularly characterize pathogenic Cryptococcus isolates for humans from environmental and clinical samples from the city of Cúcuta. Materials and methods. A total of 1300 samples were collected from 446 trees of 10 different species in 10 public areas of Cúcuta. Concomitantly, clinical isolates of Cryptococcus neoformans were obtained (June 2016-June 2017). The samples were cultivated in Guizottia abysinica seed medium and were then biochemically identified and characterized by PCR fingerpinting and RFLP of the URA5 gene. Results. C. neoformans displayed an environmental prevalence of 4.3% (19 positive individuals), and that of C. gattii was 0.2% (1 positive individual); this yielded a total of 20 Cryptococcus-positive trees and 21 isolates (two from the same individual). Santander Park registered 47.6% of the global prevalence (10/21 isolates), followed by La Victoria Park with 23.8% (5/21 isolates), corresponding to C. neoformans. One C. gattii isolate was collected from a Ficus benjamina tree located in Mercedes Ábrego Park. Genotypic analysis revealed the presence of C. neoformans var. grubii VNI in 85.7% of environmental isolates as well as 100% of clinical isolates. VNII and VGII molecular types represented 9.5% and 4.8% of the environmental isolates, respectively. Conclusions. The longitudinal sampling of previously reported environmental niches of the fungus reveals its presence and suggests that permanent monitoring is required both in the environment and in patients, especially in endemic areas of the city.
RESUMEN Objetivo. Aislar, identificar y caracterizar molecularmente aislamientos de Cryptococcus patógenos para humanos a partir de muestras ambientales y clínicas de la ciudad de Cúcuta. Materiales y métodos. Se recolectaron 1300 muestras de 446 árboles de 10 especies diferentes, en 10 zonas públicas de Cúcuta. Concomitantemente, se obtuvieron aislados clínicos de Cryptococcus neoformans (junio de 2016-junio de 2017). Se realizó cultivo en agar semillas de Guizottia abysinica, posterior identificación bioquímica y caracterización genética mediante PCR-huella Digital y RFLP-URA5. Resultados. Se determinó prevalencia ambiental para C. neoformans de 4.3% (19 individuos positivos) y C. gattii de 0.2% (1 individuo positivo), para un total de 21 aislados y 20 árboles positivos. El parque Santander registró el 47.6% de la prevalencia global (10/21 aislados), seguido del parque La Victoria con 23.8% (5/21 aislados), correspondientes a C. neoformans. Se obtuvo un aislado de C. gattii en un individuo Ficus benjamina del parque Mercedes Ábrego. El análisis genotípico reveló presencia de C. neoformans var. grubii VNI en el 85.7% de los aislados ambientales, así como en el 100% de los clínicos, seguido de VNII y VGII en 9.5% y 4.8% de los aislados ambientales, respectivamente. Conclusiones. El muestreo longitudinal de los nichos ambientales previamente reportados del hongo revela su presencia y sugiere que se requiere una vigilancia permanente tanto en el medio ambiente como en los pacientes, especialmente en las zonas endémicas de la ciudad.