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1.
Article in Spanish | LILACS, COLNAL | ID: biblio-1363392

ABSTRACT

La toxoplasmosis es una infección parasitaria con distribución mundial, cuyo huésped definitivo son los felinos. Se presenta con un cuadro clínico sintomático difuso solo en el 20 % de los pacientes inmunocompetentes. Además del malestar general, fiebre y adinamia, el hallazgo más importante lo constituye la presencia de adenopatías a nivel cervical. Describimos un caso poco común de un paciente masculino con masa parotídea izquierda de crecimiento rápido, en quien se practicó parotidectomía, a fin de descartar la enfermedad linfoproliferativa. Se comprobó compromiso por Toxoplasma gondii luego de múltiples análisis.


Toxoplasmosis is a parasitic infection with worldwide distribution, whose definitive host is felines. It is only symptomatic in less than 20% of immunocompetent patients. Symptoms may vary from general malaise, fever, weakness and the presence of cervical lymphadenopathy. A description of an uncommon presentation of this disease in a male patient with progressively growing left-sided parotid mass, in whom a parotidectomy was performed to rule out lymphoproliferative disease. Infection by Toxoplasma gondii was diagnosed after a series of exams


Subject(s)
Humans , Toxoplasmosis , Parotid Gland
2.
Vaccimonitor (La Habana, Print) ; 30(3)2021. tab, graf
Article in English | LILACS, CUMED | ID: biblio-1341782

ABSTRACT

Toxoplasmosis is caused by infection with the protozoan parasite Toxoplasma gondii, that has the capacity to infect all warm-blooded animals worldwide. The purpose of this investigation was to determine the distribution of genotypes and alleles in miscarriages woman as a result of Toxoplasma gondii infection associated with interleukin-1β and interleukin-6 polymorphisms. A total of 125 miscarriage women suspected of toxoplasma infection and 50 healthy pregnant without previous miscarriage as control were enrolled in this study. The cases were screened for anti-toxoplasma IgM and IgG by ELISA test. Among the 125 miscarriage women, only 50 were positive to anti-Toxoplasma gondii IgG and IgM antibodies. The present study focused on assay the genotypes at IL-6 -174 G/C and IL-1β +3954 G>A to establish the associations between genetic polymorphisms and infection with Toxoplasma gondii. Results showed that the altered IL-1β GA, AA genotypes were high significant elevated in miscarriage women with toxoplasmosis (P=0.03), OR = 10 and 95 percent confidence intervals (1.32-81.48); (P=0.0007), OR = 0.07 and 95 percent confidence interval (0.01-0.32). The genotype GC at IL-6 (G/C) appears to be highly correlated with infection (P=0.01); OR = 3.18 and 95 percent confidence interval, (1.22- 8.30). In terms of allelic heterogeneity, C alleles were significantly more common in infected than uninfected cases for IL-6, while A allele is common in IL-1β single nucleotide polymorphisms (P =0.050). Furthermore, this study demonstrates that there is a strong and highly significant association between two forms of single nucleotide polymorphisms and the increased risk for toxoplasmosis. Genotypes of these polymorphism should be considered when evaluating genetic effects on toxoplasmosis incidence. However, to improve the prediction of this disease predisposition, a further study based on a larger cohort of patients is warranted(AU)


La toxoplasmosis es causada por la infección con el parásito protozoario Toxoplasma gondii, que tiene la capacidad de infectar a todos los animales de sangre caliente en todo el mundo. El propósito de esta investigación fue determinar la distribución de genotipos y alelos en mujeres con abortos espontáneos como resultado de la infección por Toxoplasma gondii asociada con polimorfismos de interleucina 1β e interleucina 6. Se inscribieron en este estudio un total de 125 mujeres con aborto espontáneo sospechosas de infección por toxoplasma y 50 embarazadas sanas, sin aborto espontáneo previo, como control. Los casos se examinaron para detectar IgM e IgG anti-toxoplasma mediante la prueba ELISA. Entre las 125 mujeres que sufrieron un aborto espontáneo, solo 50 fueron positivas a anticuerpos IgG e IgM anti-Toxoplasma gondii. El presente estudio se centró en analizar los genotipos de IL-6-174 G/C e IL-1β +3954 G>A para establecer las asociaciones entre polimorfismos genéticos e infección por Toxoplasma gondii. Los resultados mostraron que los genotipos alterados de IL-1β GA, AA fueron significativamente elevados en mujeres con aborto espontáneo con toxoplasmosis (P = 0,03), OR = 10 e intervalos de confianza del 95 por ciento (1,32-81,48); (P = 0,0007), OR = 0,07 e intervalo de confianza del 95 por ciento (0,01-0,32). El genotipo GC de IL-6 (G/C) parece estar altamente correlacionado con la infección (P = 0.01); OR = 3,18 e intervalo de confianza del 95%, (1,22- 8,30). En términos de heterogeneidad alélica, los alelos C fueron significativamente más comunes en los casos infectados que en los no infectados para la IL-6, mientras que el alelo A es común en los polimorfismos de nucleótido simple de IL-1β (P = 0.050). Además, este estudio demuestra que existe una asociación fuerte y altamente significativa entre dos formas de polimorfismos nucleótido simple y el mayor riesgo de toxoplasmosis. Se deben considerar los genotipos de estos polimorfismos al evaluar los efectos genéticos sobre la incidencia de la toxoplasmosis. Sin embargo, para mejorar la predicción de esta predisposición a la enfermedad, se justifica un estudio adicional basado en una cohorte más grande de pacientes(AU)


Subject(s)
Humans , Female , Pregnancy , Toxoplasmosis/epidemiology , Polymorphism, Single Nucleotide/genetics , Genotype
3.
Rev. bras. ciênc. vet ; 28(4): 206-210, out./dez. 2021. il.
Article in English | LILACS, VETINDEX | ID: biblio-1363766

ABSTRACT

Toxoplasma gondii is a protozoan parasite with worldwide distribution. Dogs are considered sentinel animals, useful for the detection of environmental infections and outbreaks of disease through serological surveys. Considering this, we aimed to assess the seroprevalence of toxoplasmosis in dogs from rural areas of the hinterland of the state of Sergipe, Northeastern Brazil. A total of 77 blood samples were collected from dogs and analyzed by the Indirect Hemagglutination test for the detection of anti-T. gondii antibodies Samples were considered positive when titers greater than or equal to 1:16 were observed. In addition, an epidemiological questionnaire designed to identify characteristics of the animal was performed to owners regarding sex, breed, age, sterilization, access to areas outside the house, environmental hygiene, contact with other animals and dog food. A total of 49.3% of dogs (n = 38) were positive for anti-T. gondii antibodies, most with high titers (44.7%). A higher relative frequency of seropositivity was observed in male dogs, not sterilized, mixed breed, which were fed exclusively on homemade food and had access to the street and contact with other animals. Taken together, our data reinforce the importance of developing health education actions within the scope of public health aimed at preventing this zoonosis.


Toxoplasma gondii é um protozoário com distribuição mundial. Os cães são considerados animais sentinela, úteis para a detecção de infecções ambientais e surtos da doença por meio de levantamentos sorológicos. Portanto, o presente estudo teve como objetivo determinar a soroprevalência da toxoplasmose em cães da zona rural da região rural do Alto Sertão Sergipano, Brasil. Um total de 77 amostras de sangue de cães foram coletadas no município de Nossa Senhora da Glória, Sergipe e submetidas ao teste de Hemaglutinação Indireta para detecção de anticorpos anti-T. gondii, considerando títulos maiores ou iguais a 1:16 como positivos. Além disso, foi aplicado um questionário epidemiológico aos proprietários solicitando informações sobre sexo, raça, idade, esterilização, acesso às ruas, limpeza do ambiente, contato com outros animais e ração, além de dados do proprietário, como renda familiar e nível de educação. 49,3% dos cães (38/77) apresentaram anticorpos anti-T. gondii, a maioria com títulos elevados (44,7%). Foi observado maior frequência relativa de soropositividade em cães macho, não esterilizados, sem raça definida, que se alimentam exclusivamente de comida caseira e tem acesso a rua e contato com outros animais. Os dados obtidos reforçam a importância do desenvolvimento de ações de educação em saúde no âmbito da saúde pública voltadas à prevenção dessa zoonose.


Subject(s)
Animals , Dogs , Antibodies, Protozoan , Seroepidemiologic Studies , Toxoplasmosis , Dogs , Zoonoses/prevention & control , Rural Areas
4.
Rev. cuba. pediatr ; 93(2): e1255, fig
Article in Spanish | LILACS, CUMED | ID: biblio-1280373

ABSTRACT

Introducción: Las adenopatías, linfadenopatías o linfoadenomegalias constituyen causas frecuentes de consulta pediátrica. Estas entidades nosológicas pueden variar desde infecciones benignas transitorias hasta procesos malignos como linfoma, metástasis de tumores y otros. Objetivo: Describir un caso clínico con un síndrome adénico que por las características semiológicas sugería un proceso oncoproliferativo y los resultados de los estudios complementarios confirmaron un proceso infeccioso causado por Toxoplasma gondii. Presentación de caso: Adolescente femenina de 11 años de edad, eutrófica, con antecedentes personales de salud. Ingresó en el Hospital Pediátrico Universitario "William Soler " por presentar aumento de volumen en la región cérvico-lateral derecha. Al examen físico se palpó una adenopatía de aproximadamente 2 x 3 cm de diámetro, dura, inmóvil, no dolorosa, sin signos de inflamación, no adherida a planos profundos; evolutivamente, apareció otra adenopatía en posición cervical derecha baja, de iguales características. Se indicó hemograma, velocidad de sedimentación globular, proteína C reactiva, transaminasas, glicemia, proteínas totales, albúmina, triglicéridos, colesterol, marcadores tumorales, ecografía, rayos X de tórax, serología para detectar anticuerpos anti citomegalovirus, virus de inmunodeficiencia humana y Toxoplasma gondii. Se realizó, además, biopsia para estudio por anatomía patológica y biología molecular. Se concluyó el caso como un síndrome adénico de etiología toxoplásmica. Conclusiones: En pacientes adolescentes con adenopatías cervicales, independientemente de tamaño, tiempo de evolución y consistencia, se debe realizar diagnóstico diferencial por infección por Toxoplasma gondii, teniendo en cuenta que las adenopatías causadas por este parásito pueden tener algunas características similares a las ocasionadas por procesos oncoproliferativos que pueden presentarse a esta edad(AU)


Introduction: Adenopathies, lymphadenopathies or lymphadenomegalies are common causes of pediatric consultation. These nosological entities can range from transient benign infections to malignant processes such as lymphoma, tumor metastases, and others. Objective: Describe a clinical case with an adenic syndrome that from the semiological characteristics suggested an onco-proliferative process and the results of the complementary studies confirmed an infectious process caused by Toxoplasma gondii. Case presentation: 11-year-old female adolescent, eutrophic, with a personal health history. She was admitted at "William Soler" University Pediatric Hospital after presenting volume increase in the right lateral cervical region. An adenopathy of approximately 2 x 3 cm in diameter, hard, motionless, non-painful, with no signs of inflammation, not attached to deep planes was found at the physical examination; in the evolution, another adenopathy appeared in a lower right cervical position, with equal characteristics. Blood counts, globular sedimentation rate, C-reactive protein, transaminases, glycemia, total proteins, albumin, triglycerides, cholesterol, tumor markers, ultrasound, chest x-rays, serology for anti-cytomegalovirus antibodies, human immunodeficiency virus and Toxoplasma gondii tests were indicated. Biopsy was also performed for study by pathological anatomy and molecular biology. The case was concluded as an adenic toxoplasmic syndrome. Conclusions: In adolescent patients with cervical adenopathies, regardless of size, evolution time and consistency, differential diagnosis for Toxoplasma gondii infection should be made, taking into account that adenopathies caused by this parasite may have some characteristics similar to those caused by onco-proliferative processes that may occur at this age(AU)


Subject(s)
Humans , Child , Biopsy , Biomarkers, Tumor , Cytomegalovirus , Molecular Biology
5.
Rev. patol. trop ; 50(2): 1-15, jun. 2021. ilus
Article in English | LILACS | ID: biblio-1254525

ABSTRACT

Toxoplasmosis is a zoonosis caused by Toxoplasma gondii, a protozoan that has a cosmopolitan geographic distribution and low specificity for intermediate hosts. Domestic chickens are among the most important hosts in toxoplasmosis epidemiology, since they are potential sources of infection for humans, in addition to indicating environmental contamination by protozoa. In this work, we studied the prevalence of T. gondii infection in chickens in different breeding systems from distinct mesoregions of Rio Grande do Norte and Paraiba States: broiler chickens from commercial farms and free-range chickens from small farms. Indirect fluorescent antibody test (IFAT) and ELISA techniques were used for detecting specific antibodies in blood samples from the birds. There were no seropositive samples among the broilers tested, indicating that intensive management limited the chances of infection for these animals. Among the free-range chickens, the frequency of IgG anti-T. gondii detected by IFAT and ELISA were 37.9% and 40.4% respectively. Among the seropositive samples by IFAT, 33 (27.1%) were positive at a dilution of 1:16; in 1:32, 31 (25.4%); in 1:64, 24 (19.7%); 15 (12.3%) in 1:128, and 19 presented titers greater than or equal to 1:256 (15.6%). The substantial concordance observed between IFAT and ELISA signifies these methods are effective methodologies for the diagnosis of avian toxoplasmosis. The high prevalence of specific antibodies among poultry in the studied region highlights the potential risk of T. gondii transmission to humans through consumption of infected meat.


Subject(s)
Humans , Animals , Seroepidemiologic Studies , Chickens , Toxoplasmosis , Infections
6.
Acta neurol. colomb ; 37(1,supl.1): 141-147, mayo 2021.
Article in Spanish | LILACS | ID: biblio-1248592

ABSTRACT

RESUMEN La toxoplasmosis es una de las infecciones más comunes en humanos. Debido a la prevalência de la coinfección con VIH, conlleva un alto impacto en los sistemas de salud. Los seres humanos pueden infectarse de toxoplasma al consumir carne mal cocinada de cordero o cerdo que contenga los quistes tisulares, o al consumir agua o alimentos contaminados con heces de gatos. Una vez presente en el humano, el T. gondii se multiplica en los enterocitos y se disemina por el torrente sanguíneo o linfático, parasitando las células musculares, de la retina y frecuentemente el sistema nervioso central. La técnica más usada para la detección de IgG o IgM contra toxoplasma es la técnica de Elisa. Los anticuerpos IgG pueden estar elevados sin tener una infección activa, por lo que el diagnóstico con IgM y posteriormente con test de avidez es fundamental. El líquido cefalorraquídeo muestra pleocitosis leve e hiperproteinorraquia. Las neuroimágenes son de alta utilidad, ya que usualmente la punción lumbar puede estar contraindicada por lesiones que producen efecto de masa. Idealmente, los pacientes deben ser valorados con resonancia magnética en la que típicamente se observan lesiones eccéntricas en ganglios basales con realce en anillo, posteriormente a la aplicación de contraste. Se debe considerar el linfoma del sistema nervioso central como diagnóstico diferencial. El tratamiento suele iniciarse de manera empírica con pirimetamina, sulfadiazina y ácido folínico, con evaluación de la mejoría imagenológica a los 10-14 días. Si no se encuentra disponible, es posible el tratamiento con trimetoprin-sulfametoxazol. El inicio temprano del tratamiento antibiótico es fundamental para el buen pronóstico; en cuatro meses se observa recuperación neurológica completa en menos del 20 % de los casos y a los tres años de seguimiento en aproximadamente el 30 % de los pacientes.


SUMMARY Toxoplasmosis is one of the most common infections in humans. Due to the prevalence of coinfection with HIV, it carries a high impact on health systems. Humans can become infected with toxoplasma by consuming undercooked lamb or pork meat that contains tissue cysts, or by consuming water or food contaminated with cat feces. Once present in humans, T. gondii multiplies in enterocytes and spreads through the blood or lymphatic stream, parasitizing muscle cells, the retina, and frequently the Central Nervous System. The most used technique for the detection of IgG or IgM against toxoplasma is the ELISA technique. IgG antibodies can be elevated without having an active infection, so diagnosis with IgM and later with avidity test is essential. Cerebrospinal fluid shows mild pleocytosis and hyperprotein spinal cord. Neuroimaging is highly useful, since lumbar puncture can usually be contraindicated due to lesions that produce a mass effect. Ideally, patients should be evaluated with magnetic resonance imaging, which typically shows eccentric lesions in the basal ganglia with ring enhancement after the application of contrast. Central Nervous System lymphoma should be considered as a differential diagnosis. Treatment is usually started empirically with pyrimethamine, sulfadiazine, and folinic acid, with evaluation of imaging improvement at 10-14 days. If not available, treatment with trimethoprine-sulfamethoxazole is possible. The early initiation of antibiotic treatment is essential for a good prognosis, in 4 months complete neurological recovery is observed in less than 20 % of cases and after 3 years of follow-up in approximately 30 % of patients.

7.
Ciênc. rural (Online) ; 51(5): e20200533, 2021. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1153892

ABSTRACT

ABSTRACT: Toxoplasmosis, neosporosis, and leishmaniasis are important diseases of worldwide distribution and can affect both pets and humans. Hunting dogs have been trained to hunt domestic and wild animals, which makes them more exposed to parasitic infections. The present study aimed to evaluate the seroprevalence of Toxoplasma gondii, Neospora caninum, and Leishmania spp. in hunting dogs from a rural area in Mato Grosso do Sul, Brazil. Serum samples were collected from 39 American Foxhound dogs, and the sex and age variables were recorded. Serum samples were subjected to an indirect fluorescent antibody test (IFAT) to detect antibodies. Seroprevalence was 35.9%, 15.4%, and 2.6% for Toxoplasma gondii, Neospora caninum e Leishmania spp., respectively. There was no statistical difference between genders for these diseases (P>0.05). Results demonstrated a circulation of these protozoa in hunting dogs in a rural area of ​​the state of Mato Grosso do Sul, which can contribute to the epidemiology of these diseases.


RESUMO: Toxoplasmose, neosporose e leishmaniose são importantes doenças de distribuição mundial e podem afetar tanto os animais de companhia quanto os humanos. Os cães de caça têm sido treinados para caçar animais domésticos e selvagens, o que torna esses animais mais expostos a infecções parasitárias. O presente estudo teve como objetivo avaliar a soroprevalência de Toxoplasma gondii, Neospora caninum e Leishmania spp. em cães de caça de área rural do Mato Grosso do Sul, Brasil. Foram coletadas amostras de soro de 39 cães da raça Foxhound-americano e as variáveis sexo e idade foram registradas. As amostras de soro foram submetidas a reação de imunofluorescência indireta (RIFI) para detecção dos anticorpos. A soroprevalência foi de 35,9%, 15,4% e 2,6% para Toxoplasma gondii, Neospora caninum e Leishmania spp., respectivamente. Não foi observado diferença estatística entre os sexos para todas as doenças (P>0.05). Os resultados demonstram circulação desses protozoários em cães de caça de uma área rural do estado do Mato Grosso do Sul, o que pode contribuir para a epidemiologia dessas doenças.

8.
Rev. bras. parasitol. vet ; 30(1): e028520, 2021. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1156222

ABSTRACT

Abstract This study aimed to identify members of the Sarcocystidae family in naturally infected wild birds at a rescue center in the state of Minas Gerais, southeastern Brazil. The heart and brain of 44 wild birds were evaluated by bioassay in mice to detect T. gondii, and extracted DNA was used for nested PCR of the 18S ribosomal DNA gene to detect members of the Sarcocystidae family. The positive samples were sequenced, assembled, edited and compared with sequences deposited in GenBank. Toxoplasma gondii was isolated from six (13.6%) out of 44 birds. Toxoplasma gondii DNA was identified in 10/44 (22.7%) of the birds. The amplified sequences exhibited 100% similarity with the DNA of the ME49 strain of T. gondii. Sarcocystis DNA (99% similarity) was identified in 5/44 (11.4%) of the birds. T. gondii and Sarcocystis spp. are common in wild birds in Minas Gerais, Brazil.


Resumo O objetivo deste estudo foi identificar membros da família Sarcocystidae em aves silvestres de vida livre naturalmente infectadas e resgatadas no estado de Minas Gerais, Brasil. Coração e cérebro de 44 aves silvestres foram avaliados por bioensaio em camundongos para detecção de T. gondii e extração de DNA para Nested-PCR do gene 18S do DNA ribossomal de membros da família Sarcocystidae. As amostras positivas foram sequenciadas, analisadas, editadas e comparadas com sequências depositadas no GenBank. Toxoplasma gondii foi isolado de seis (13,6%) das 44 aves. DNA de T. gondii foi identificado em 10/44 (22,7%) das 44 aves. As sequências amplificadas exibiram 100% de similaridade com o DNA da cepa ME49 de T. gondii. DNA de Sarcocystis (99% de similaridade) foi identificado em 5/44 (11,4%) das 44 aves. T. gondii e Sarcocystis spp. são encontrados, comumente, em aves silvestres no estado de Minas Gerais, Brasil.

9.
Rev. bras. parasitol. vet ; 30(1): e017520, 2021. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1156223

ABSTRACT

Abstract We investigated the occurrence of Toxoplasma gondii and Neospora caninum antibodies in pigs raised in the Northeast of Pará, Brazil. At Study I, convenience sampled 151 pigs at two slaughterhouses, with and without state inspection; and Study II, which assessed 159 pigs with probabilistic sampling from nine pig farms. Serological analysis was performed using indirect fluorescent antibody test for T. gondii and N. caninum with a cutoff of 64 and 50, respectively. Overall, 6.77% pigs were seropositive for T. gondii and 5.16% for N. caninum. In Study I, pigs slaughtered with and without state inspection presented similar occurrence for both coccidia (p>0.05). Study II found an association between N. caninum seropositivity and sludge discarded into the soil, feeding pigs with animal-based protein, subsistence system, and absence of nipple drinkers. No association was found for T. gondii. Pigs from Pará are a potential source of T. gondii infection to humans. To our best knowledge, this is the first study to report anti-N. caninum antibodies in the serum of pigs in Pará State, Brazilian Amazon.


Resumo Foi investigada a ocorrência de anticorpos contra Toxoplasma gondii e Neospora caninum em suínos criados no nordeste do Pará, Brasil. No Estudo I, foram amostrados 151 porcos em dois matadouros, com e sem inspeção estadual. O Estudo II avaliou 159 suínos com amostragem probabilística de nove granjas de suínos. Para sorologia, utilizou-se o teste de imunofluorescência indireta para T. gondii e N. caninum com ponto de corte de 1:64 e 1:50, respectivamente. No geral, 6,77% dos suínos foram soropositivos para T. gondii e 5,16% para N. caninum. No Estudo I, suínos abatidos em matadouros com e sem inspeção estadual apresentaram ocorrência semelhante para ambos os coccídios (p> 0,05). Os animais amostrados de Belém, Benevides, Marituba, Bujaru, Castanhal e Igarapé-Miri foram positivos para T. gondii, enquanto os soropositivos para N. caninum foram encontrados em Belém, Bujaru, Castanhal e Santo Antônio do Tauá. O Estudo II encontrou associação entre soropositividade de N. caninum e esterco descartado no solo, alimentação dos suínos com proteína de origem animal, criação de subsistência e ausência de bebedores tipo "nipple". Não foi encontrada associação para T. gondii. A carne suína apresenta potencial risco de transmissão de T. gondii para os habitantes da região. De acordo com nosso conhecimento, este é o primeiro relato de anticorpos anti-N. caninum em suínos no estado do Pará, Amazônia brasileira.

10.
Article in Chinese | WPRIM | ID: wpr-913074

ABSTRACT

Objective To evaluate the impact of Toxoplasma gondii human infections on blood lipid levels. Methods A total of 1 000 healthy volunteers that were randomly sampled from a tertiary hospital during the period from December 2017 through December 2019 were enrolled, and assigned into the infection group and the control group according to the detection of serum anti-T. gondii antibody using enzyme-linked immunosorbent assay (ELISA). The serum levels of total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL) and triglyceride (TG) were detected and compared between the two groups. Results The seroprevalence of anti-T. gondii antibody was 8.40% in the study subjects, and there were no significant differences between the infection and control groups in terms of gender (χ2 = 1.29, P > 0.05) or age (χ2 = 1.41, P > 0.05). The mean serum LDL (t = 3.89, P < 0.05) and TC levels (t = 3.81, P < 0.05) were significantly higher in the infection group than in the control group, while no significant differences were seen between the two groups in terms of mean serum TG (t = 0.97, P > 0.05) or HDL levels (t = 0.75, P > 0.05). In addition, the proportions of abnormal LDL (χ2 = 9.69, P < 0.01) and TC levels (χ2 = 10.39, P < 0.01) were significantly greater in the infection group than in the control group, while no significant differences were found in the proportion of abnormal TG (χ2 = 0.02, P > 0.05) or HDL level (χ2 = 0.11, P > 0.05) between the two groups. Conclusion T. gondii human infections affect blood lipid levels, and the individuals sero-positive for anti-T. gondii antibody have higher mean serum LDL and TC, as well as higher proportions of abnormal TC and LDL than sero-negative individuals.

11.
Article in Chinese | WPRIM | ID: wpr-913068

ABSTRACT

Objective To investigate the expression and possible role of hypoxia-inducible factor-1 (HIF-1) at the maternal-fetal interface following Toxoplasma gondii infection during early pregnancy. Methods Twenty pregnant C57BL/6 mice, each weighing 16 to 20 g, were randomly divided into 4 groups, including the 12-d control group, 12-d infection group, 18-d control group and 18-d infection group. Mice in the 12-d and 18-d infection groups were injected intraperitoneally with 150 tachyzoites of the T. gondii PRU strain on day 6 of pregnancy, while mice in the 12-d control and 18-d control groups were injected with the same volume of phosphate buffered saline (PBS). Mice in the control and infection groups were sacrificed on days 12 and 18 of pregnancy, and the placental and uterine specimens of the pregnant mice in each group were sampled for pathological examinations. The mRNA expression of HIF-1α, HIF-1β and vascular endothelial growth factor (VEGF) was quantified using quantitative fluorescent real-time PCR (qPCR) assay in the placental and uterine specimens, and the correlation between HIF-1α and VEGF mRNA expression was examined. In addition, and the HIF-1α expression was detected using immunohistochemical staining in the placental and uterine specimens of pregnant mice. Results Compared with the 12-d and 18-d control groups, adverse pregnant outcomes were observed in mice in 12-d and 18-d infection groups, such as teratism and placental dysplasia. HE staining showed swelling and blood stasis of cells, sinusoid reduction and inflammatory cell infiltration in the labyrinth area of the placenta specimens of mice in 12-d and 18-d infection groups relative to 12-d and 18-d control groups, and columnar epithelial cell injury and inflammatory cell infiltration were seen in the mouse uterine specimens in both infection groups. qPCR assay detected significantly higher HIF-1α (F = 132.6, P < 0.05) and HIF-1β mRNA expression (F = 286.9, P < 0.05) in the placental specimens and lower HIF-1α (F = 111.5, P < 0.05) and HIF-1β mRNA expression (F = 55.2, P < 0.05) in the uterine specimens in the 12-d infection group than in the 12-day control group, and significantly lower HIF-1α and HIF-1β mRNA expression was detected in the placental and uterine specimens in the 18-d infection group than in the 18-day control group (F = 215.8, 418.9, 156.8 and 200.1; all P values < 0.05). Significantly lower VEGF-A (F = 426.2, P < 0.05), VEGF-B (F = 104.6, P < 0.05) and VEGF-C mRNA expression (F = 566.9, P < 0.05) in the placental specimens and higher VEGF-A (F = 426.2, P < 0.05), VEGF-B (F = 104.6, P < 0.05) and VEGF-C mRNA expression (F = 566.9, P < 0.05) in the uterine specimens were detected in the 12-d infection group than in the 12-d control group, and higher VEGF-A, VEGF-B and VEGF-C mRNA expression was found in the placental and uterine specimens in the 18-d infection group than in the 18-d control group (F = 521.9, 100.6, 275.9, 224.6, 108.2 and 333.4; all P values < 0.05). Immunohistochemical staining showed strongly and mildly positive HIF-1α expression in the mouse placental labyrinth area in the 12-d and 18-d infection groups relative to 12-d and 18-d control groups, while no HIF-1α expression was detected in mouse uterine specimens. Conclusions HIF-1α expression appears a tendency towards a rise in the second trimester and a reduction in the third trimester in mice following T. gondii infection during early pregnancy, which is contrary to the changing tendency of VEGF-A, VEGF-B, and VEGF-C expression. It is hypothesized that HIF-1α inhibits placental angiogenesis in mice during pregnancy through suppressing VEGF expression, resulting in adverse pregnant outcomes.

12.
Article in Chinese | WPRIM | ID: wpr-908226

ABSTRACT

Objective:To explore the infection of Toxoplasma gondii in patients with common gynecological malignancies and to explore the correlation between gynecological malignancies and Toxoplasma gondii infection, so as to provide basis for the prevention and control of Toxoplasma gondii infection in such population in the future. Methods:Patients with gynecological malignancies (114 cases of ovarian cancer, 107 cases of cervical cancer and 110 cases of endometrial cancer) treated in Shengjing Hospital of China Medical University from January 2018 to January 2020 were selected as the study group, and 200 women with normal physical examination during the same period were selected as the control group.Enzyme linked immunosorbent assay was used to detect serum anti Toxoplasma gondii IgM and IgG antibodies in the two groups. Results:The overall Toxoplasma gondii infection rate and the overall serum anti- Toxoplasma gondii IgG antibody positive rate in the study group were 26.89%(89/331) and 26.28%(87/331), respectively, which were higher than 5.00%(10/200) of the control group, and the results were significantly different( χ2 values were 39.32, 37.73, P<0.01). The positive rates of anti- Toxoplasma gondii IgG antibody in patients with ovarian cancer, cervical cancer and endometrial cancer of the study group were 28.07%(32/114), 25.23%(27/107) and 25.45%(28/110), respectively, which were higher than those in the control group (5.00%,10/200)( χ2 values were 32.26, 27.32, 28.00, all P<0.01). Conclusions:The positive rate of Toxoplasma gondii infection in gynecological malignant tumor patients with low immune function is high, which should be paid enough attention by medical staff to strengthen the prevention and control of infection.

13.
Article in Chinese | WPRIM | ID: wpr-886768

ABSTRACT

Objective To investigate the seroprevalence of Toxoplasma gondii infections among patients with diabetes mellitus in Hangzhou City. Methods A total of 337 patients with type 1 diabetes mellitus, 624 patients with type 2 diabetes mellitus and 384 patients with gestational diabetes mellitus living in Hangzhou City during the period from March 2017 through May 2020 were recruited as the study subjects, while age- and gender-matched healthy volunteers and pregnant women without gestational diabetes mellitus served as controls. Enzyme-linked immunosorbent assay (ELISA) was employed to detect serum IgG and IgM antibodies against T. gondii in patients with diabetes mellitus and controls, and the seroprevalence of anti-T. gondii antibody was compared between diabetes mellitus patients and controls. Results The overall seroprevalence of anti-T. gondii antibody (18.10% vs. 4.45%, χ2 = 31.38, P < 0.01) and the seroprevalence of anti-T. gondii IgG antibody (14.54% vs. 2.97%, χ2 = 28.28, P < 0.01) were both significantly higher in patients with type 1 diabetes mellitus than in healthy controls, while no significant difference was seen in the seroprevalence of anti-T. gondii IgM antibody between patients and controls (3.56% vs. 1.48%, χ2 = 2.96, P > 0.05). The seroprevalence rates of serum anti-T. gondii (23.56% vs. 6.57%, χ2 = 70.37, P < 0.01) and anti-T. gondii IgG antibodies (21.15% vs. 5.45%, χ2 = 66.73, P < 0.01) were significantly higher in patients with type 2 diabetes mellitus than in healthy controls, while no significant difference was seen in the seroprevalence of anti-T. gondii IgM antibody between patients and controls (2.40% vs. 1.12%, χ2 = 2.96, P > 0.05). In addition, the overall seroprevalence of serum anti-T. gondii antibody (26.30% vs. 19.53%, χ2 = 4.98, P < 0.05) and the seroprevalence of anti-T. gondii IgG antibody (23.70% vs. 17.71%, χ2 = 4.20, P < 0.05) were both significantly higher in patients with gestational diabetes mellitus than in pregnant women without gestational diabetes mellitus, while no significant difference was seen in the seroprevalence of anti-T. gondii IgM antibody between pregnant women with and without gestational diabetes mellitus (2.60% vs. 1.82%, χ2 = 0.54, P > 0.05). Conclusions The patients with diabetes mellitus present a higher seroprevalence rate of anti-T. gondii antibody than controls in Hangzhou City. Screening of T. gondii infections and health education pertaining to toxoplasmosis prevention and control knowledge should be reinforced in patients with diabetes mellitus.

14.
Tropical Biomedicine ; : 135-141, 2021.
Article in English | WPRIM | ID: wpr-886305

ABSTRACT

@#Leishmaniasis and toxoplasmosis are parasitic protozoal diseases that pose serious health concerns, especially for immunocompromised people. Leishmania major and Toxoplasma gondii are endemic in Saudi Arabia and are particularly common in the Qassim Region. The present work was conducted to evaluate the in vitro antileishmanial and antitoxoplasmal activity of methanolic extracts and phytochemical fractions from two plants, Euphorbia retusa and Pulicaria undulata, which are ethnobotanical agents used to treat parasitic infection. Whole E. retusa and P. undulata plants were extracted with methanol and fractionated using petroleum ether, chloroform, ethyl acetate, n-butanol, and water and then were tested in vitro against L. major promastigote and the amastigote stages of T. gondii; the cytotoxicity of the extracts was tested against Vero cell line. The methanolic extracts of E. retusa and P. undulata exhibited promising antitoxoplasmal activity against T. gondii with EC50 values 5.6 and 12.7 μg mL-1 , respectively. The chloroform fraction of P. undulata was the most potent, exhibiting an EC50 of 1.4 μg mL-1 and SI value of 12.1. It was also the most active fraction against both L. major promastigotes and amastigotes, exhibiting an EC50 of 3.9 and 3.8 μg mL-1 and SI values 4.4 and 4.5, respectively. The chloroform fraction from P. undulata is a very good candidate for the isolation of active antitoxoplasmal and antileishmanial ingredients; therefore, further phytochemical analysis for active compound isolation is highly recommended.

15.
Chinese Journal of Biotechnology ; (12): 290-300, 2021.
Article in Chinese | WPRIM | ID: wpr-878562

ABSTRACT

For improving epitope immunogenicity and achieving the co-immunization, late protein 1 (L1) of HPV type 16 (HPV16L1) was selected as the vector to carry the dominant epitope of Toxoplasma gondii because of the shared common population between Toxoplasma gondii and human papillomavirus (HPV). RSepitope-HPV16L1 (RSepitope fused at the "N-terminus" of HPV16L1) and HPV16L1-RSepitope (RSepitope fused at the "C-terminus" of HPV16L1) chimeras were constructed. After transfection of COS-7 cells with the recombinants, Western blot, RT-PCR, and immunofluorescence experiments confirmed that RSepitope-HPV16L1 could successfully express the corresponding mRNA and protein of RSepitope and HPV16L1, but the HPV16L1-RSepitope construct could not. A "prime-boost" immunization program was applied in mice to further evaluate the immune response elicited by the constructs, and the RSepitope-HPV16L1 immunization group produced the most significantly increased humoral and cellular immune responses (the highest RSepitope-specific IgG antibody level and the highest IFN-γ production, respectively), in which both elevated Th1 and Th2 immune responses were obtained. Moreover, the advantage of HPV16L1 as an epitope carrier was remarkable for RSepitope-HPV16L1, which induced a more prominent immunological response than RSepitope alone (without fusion with HPV16L1). Our research indicated that the N-terminus of HPV16L1 could be a better insertion site for enhancing target epitope immunogenicity, and our study offers a design for epitope vaccine of reasonable combination.


Subject(s)
Animals , Antibody Formation , Epitopes , Immunization , Mice , Mice, Inbred BALB C , Toxoplasma , Vaccination , Vaccines, DNA
16.
Article in Chinese | WPRIM | ID: wpr-876710

ABSTRACT

Objective To explore the dynamic expression of programmed cell death-1 (PD-1) and its ligand PD-L1 at the maternal-fetal interface of mice post-infection with Toxoplasma gondii at early pregnancy and examine its interaction with interferon-γ (IFN-γ). Methods A total of 20 mice at day 0 of pregnancy were randomly assigned into 4 groups, including the 12-day pregnancy control group (12 dpn group), 12-day pregnancy and infection group (12 dpi group), 18-day pregnancy control group (18 dpn group) and 18-day pregnancy and infection group (18 dpi group), respectively. On the 6th day of the pregnancy, mice in the 12 dpi and 18 dpi groups were injected intraperitoneally with 150 tachyzoites of the T. gondii PRU strain, while mice in the 12 dpn and 18 dpn groups were injected with the same volume of PBS. All mice in the four groups were sacrificed on 12th and 18th day of the pregnancy, and the number of placenta and fetus was counted and the weight of placenta and fetus was measured. Then, the placental and uterine tissues of the pregnant mice in each group were sampled for pathological examinations. The mRNA expression of PD-1, PD-L1, T. gondii surface antigen SAG-1 and IFN-γ genes was quantified using a quantitative real-time PCR (qPCR) assay, and the correlation between PD-1 and IFN-γ expression was examined. In addition, the 12 dpn group, 12 dpi group, 18 dpn group, 18 dpi group, PBS negative control of the 12 pdi group and PBS negative control of the 18 dpi group were assigned, and the PD-1 expression was determined in the uterine and placenta tissues of the pregnant mice. Results Adverse pregnant outcomes were seen in mice in the 12 dpi and 18 dpi groups, including placental dysplasia and fetal maldevelopment, and the placental weights and fetal body weights were significantly lower in mice in the 12 dpi and 18 dpi groups than those in the 12 dpn and 18 dpn groups (t = 5.52, 11.44, 12.63 and 11.67, all P < 0.01). The histopathological examinations showed that the decidua and junctional regions of the placental tissues were loosely connected in the 12 dpi and 18 dpi groups, and a large number of inflammatory cells infiltration and congestion were seen in the placental and uterine tissues. qPCR assay detected significant differences in PD-1, PD-L1, IFN-γ and SAG-1 expression in the placental and uterine tissues among the 12 dpn, 12 dpi, 18 dpn and 18 dpi groups (F = 22.48, 51.23, 9.61, 47.49, 16.08, 21.52, 28.66 and 238.90, all P < 0.05), and the PD-1, PD - L1, IFN - γ and SAG - 1 expression was all significantly higher in the placental and uterine tissues of mice in the 12 dpi group than in the 12 dpn group (all P values < 0.05). The PD-1 and PD-L1 expression was significantly lower in the placental tissues of mice in the 18 dpi group than in the 18 dpn group (all P values < 0.05), and the IFN-γ and SAG-1 expression was significantly higher in the placental and uterine tissues of mice in the 18 dpi group than in the 18 dpn group (all P values < 0.05), while the PD-1 and PD-L1 expression was significantly lower in the placental and uterine tissues of mice in the 18 dpi group than in the 12 dpi group (all P values < 0.05). Immunohistochemical staining showed PD-1 expression in the inflammatory cells of the placental tissues of mice in the 12 dpi group, and no apparent PD-1 expression in the 18 dpi group, while strongly positive PD-1 expression was found in the uterine epithelium of mice in the 12 dpi group, and mildly strong expression was in the 18 dpi group. In addition, the IFN-γ mRNA expression was positively correlated with the PD-1 mRNA expression in placental (rs = 0.99, P < 0.01) and uterine tissues of mice in the 12 dpi group (rs = 0.97, P < 0.01) and in placental (rs = 0.82, P < 0.01) and uterine tissues of mice in the 18 dpi group (rs = 0.81, P < 0.01). Conclusions Following T. gondii infection at early pregnancy, the PD-1 and PD-L1 expression shows a remarkable rise at middle pregnancy and a reduction at late pregnancy in placental and uterine tissues of mice, which appears the same tendency with IFN-γ expression during the same time period, and PD-1 expression positively correlates with IFN-γ expression. The dynamic expression of PD-1 and PD-L1 on the maternal-fetal interface of mice may be mutually mediated by IFN-γ induced by T. gondii infection.

17.
Rev. bras. parasitol. vet ; 30(1): e023220, 2021. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1251362

ABSTRACT

Abstract The aim of this study was to evaluate the seroprevalence and factors associated with the presence of anti-Toxoplasma gondii and anti-Neospora caninum antibodies in sheep from Paraná state. The detection of antibodies for T. gondii and N. caninum was performed by homemade and commercial indirect ELISA, respectively. Multiple logistic regression analysis was used to verify the factors associated with the seroprevalence. Antibodies anti-T. gondii and anti-N. caninum were observed in 42.7% and in 17.6% of the animals, respectively. The protective factors associated to seropositive were "some level of confinement" (full or semi-extensive confinement) (OR=0.53) for T. gondii and "use of skilled labor" (OR=0.64) for N. caninum. The risk factors were "presence of cats" (OR=1.75) for T. gondii and "feeding of dogs with sheep placental remains" (OR=1.79) for N. caninum. In addition, to presenting a significant and simultaneous seroprevalence for both agents (9.9% of the animals), the results also indicate that deficiencies in management and environmental sanitation, the presence of reservoirs, and types of exploitation enhance the seropositivity. Thus, studies like this might support sanitary programs and public policies for the prevention of T. gondii and N. caninum in the sheep herds of Paraná state.


Resumo O objetivo deste estudo foi avaliar a soroprevalência e os fatores de risco associados à presença de anticorpos contra Toxoplasma gondii e Neospora caninum em ovinos do Paraná. A detecção dos anticorpos para T. gondii e N. caninum foi realizada, usando-se testes de ELISA indireto caseiro e comercial, respectivamente. A análise de regressão logística múltipla foi usada para verificar os fatores de risco associados à soroprevalência. Anticorpos anti-T. gondii e anti-N. caninum foram observados em 42,7% e em 17,6% dos animais, respectivamente. Os fatores de proteção associados à soropositividade foram "algum nível de confinamento (confinamento ou semiextensivo)" (OR=0,53) para T. gondii e "presença de mão de obra especializada" para N. caminum (OR=0,64). Os fatores de risco foram "presença de gatos" para T. gondii (OR=1,75) e "alimentação de cães com resíduos placentários" (OR=1,79) para N. caninum. Além de apresentar uma significante e simultânea soroprevalência para ambos os agentes (9,9% dos animais), os resultados também indicam que as deficiências em gestão e saneamento ambiental, a presença de reservatórios e os tipos de exploração favorecem a soropositividade. Dessa forma, estudos como estes podem auxiliar em programas sanitários e políticas públicas para a prevenção de T. gondii e N. caninum nos rebanhos ovinos do Paraná.

18.
Rev. bras. parasitol. vet ; 30(2): e000621, 2021. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1251368

ABSTRACT

Abstract Molecular methods such as Copro-PCR stand out in the diagnosis of T. gondii, because they are highly sensitive and specific, and can distinguish T. gondii from other morphologically similar coccids. The purpose was the detection of Toxoplasma gondii copro-prevalence by polymerase chain reaction in 149 fecal samples from stray and domiciled cats, using three distinct markers (B5-B6, 18S and 529bp RE). Oocysts of T. gondii/H. hammondi were detected in 15.4% by parasitology fecal tests (PFT), and 4% of these oocysts were positively identified as T. gondii by Copro-PCR. The presence of T. gondii genetic material was detected in 16.1%, but 12% of the samples that tested positive by Copro-PCR were negative in PFT. Samples with discordant results were subjected to a new Copro-PCR with 18S marker and a 529, and of the 17 samples, 9 contained T. gondii genetic material. A comparison of the PFT and the molecular methods showed the latter was more sensitive, since it detected 22.1% while the PFT detected 15.4%. Demonstrating the high sensitivity and specificity of the Copro-PCR, particularly with the association of primers (k=0.809), but also confirms the importance of using molecular techniques in laboratories, since Copro-PCR was able to detect samples considered negative by PFT.


Resumo Métodos moleculares como a Copro-PCR se destacam no diagnóstico de T. gondii por serem altamente sensíveis e específicos, podendo distinguir T. gondii de outros coccídeos morfologicamente semelhantes. O objetivo foi a detecção da coproprevalência de Toxoplasma gondii por reação em cadeia da polimerase, em 149 amostras fecais de gatos errantes e domiciliados, utilizando-se três marcadores distintos (B5-B6, 18S e 529pb RE). Oocistos de T. gondii/H. hammondi foram detectados em 15,4% pelos exames parasitológicos de fezes (EPF), e 4% desses oocistos foram identificados positivamente como T. gondii pela Copro-PCR. A presença de material genético de T. gondii foi detectada em 16,1%, mas 12% das amostras positivas pelo Copro-PCR foram negativas no EPF. As amostras com resultados discordantes foram submetidas a uma nova Copro-PCR com os marcadores 18S e 529 e, das 17 amostras, 9 continham material genético de T. gondii. A comparação do EPF com os métodos moleculares mostrou que esse último foi mais sensível, pois detectou 22,1%, enquanto o EPF detectou 15,4%. Isso demonstra a alta sensibilidade e especificidade da Copro-PCR, principalmente com a associação de marcadores (k = 0,809); mas também confirma a importância do uso de técnicas moleculares em laboratórios, uma vez que a Copro-PCR foi capaz de detectar amostras consideradas negativas pelo EPF.

19.
Rev. bras. parasitol. vet ; 30(2): e000321, 2021. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1251382

ABSTRACT

Abstract The aim of this study was to evaluate the genotypic characteristics of Toxoplasma gondii isolated from free-range chickens in the metropolitan area of Goiânia, Goiás, in Brazil's central-west region. The seroprevalence rate was found to be 96%, according to an indirect hemagglutination assay. Brain and heart samples were processed by peptic digestion for a mice bioassay. The tissues were homogenized and the resulting samples were subjected to polymerase chain reaction (PCR), which revealed that 64% of them contained the parasite's DNA. The mice bioassay revealed 15 isolates, 8 of them tachyzoites isolates from the peritoneal lavage and 7 from brain cysts. T. gondii genotypes were determined through PCR-RFLP, using the following markers: SAG1, SAG2, SAG3, BTUB, GRA6, c22-8, c29-2, L358, PK1, alt. SAG2, Apico and CS3. Three genotypes were identified, inclued ToxoDB #65, and the other two are not yet described in the literature. Hence, we conclude that the isolates obtained from the metropolitan area of Goiânia showed relatively low genetic diversity.


Resumo O objetivo deste estudo foi avaliar as características genotípicas de Toxoplasma gondii isolados de galinhas caipiras da Região Metropolitana de Goiânia, Goiás, Região Centro Oeste do Brasil. A soroprevalência foi de 96% dos animais, determinada por hemaglutinação indireta. As amostras de cérebro e coração foram processadas através da digestão péptica para o bioensaio em camundongos. Os tecidos foram homogeneizados, e as amostras resultantes foram analisadas por reação em cadeia da polimerase (PCR), que possibilitou a detecção do DNA do parasito em 64% deles. Por meio do bioensaio em camundongos, foi possível detectar 15 isolados, 8 deles apresentando taquizoítos na lavagem peritoneal e 7 apresentando cistos cerebrais. A determinação dos genótipos de T. gondii foi realizada por PCR-RFLP com os seguintes marcadores: SAG1, SAG2, SAG3, BTUB, GRA6, c22-8, c29-2, L358, PK1, alt. SAG2, Apico e CS3. Foi possível definir 3 genótipos, incluindo o ToxoDB # 65 e dois deles ainda não foram descritos na literatura. Portanto, conclui-se que os isolados obtidos na região metropolitana de Goiânia apresentaram diversidade genética relativamente baixa.

20.
Article | IMSEAR | ID: sea-209627

ABSTRACT

Toxoplasmosis is a worldwide zoonosis caused by the ubiquitous, Apicomplexan parasite, Toxoplasmagondii. This disease remains a significant aetiologic factor in pregnant women and HIV patients. In Sub-Saharan African countries like Ghana, the low antiviral therapy coverage exacerbates the risk of HIV-related mortality resulting from concurrent infections like toxoplasmosis. This paper reviews published data on toxoplasmosis in both humans and animals in Ghana. Serological surveys in humans indicate high prevalence of toxoplasmosis (up to 92.5%) in a cross-section of Ghanaians, including pregnant women and their neonates, blood donors, as well as HIV and eye patients. Limited data from epidemiological surveys also show Toxoplasmainfections in four food animals, with the prevalence ranging from 7.5% to as high as 64%. Molecular analyses in animals have also revealed three novel genotypes, TgCkGh1, TgCkGh2 and TgCtGh1. There are, however, no reports in other food animals like dogs, cattle and grasscutters in Ghana. The role of environmental matrices in the epidemiology of the disease also needs to be investigated. There is paucity of data in the Northern part of Ghana, with most reports concentrated on Southern Ghana, thus necessitating nationwide surveysunder a ‘One-Health’ concept to inform management of the disease. Policies which mandate screening of expectant mothers and blood donors are recommended to limit disease transmission in Ghana.ReviewArticle.

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