Building Programs to Eradicate Toxoplasmosis Part I: Introduction and Overview.

Purpose of Review: Review building of programs to eliminate Toxoplasma infections. Recent Findings: Morbidity and mortality from toxoplasmosis led to programs in USA, Panama, and Colombia to facilitate understanding, treatment, prevention, and regional resources, incorporating student work. Summary: Studies foundational for building recent, regional approaches/programs are reviewed. Introduction provides an overview/review of programs in Panamá, the United States, and other countries. High prevalence/risk of exposure led to laws mandating testing in gestation, reporting, and development of broad-based teaching materials about Toxoplasma. These were tested for efficacy as learning tools for high-school students, pregnant women, medical students, physicians, scientists, public health officials and general public. Digitized, free, smart phone application effectively taught pregnant women about toxoplasmosis prevention. Perinatal infection care programs, identifying true regional risk factors, and point-of-care gestational screening facilitate prevention and care. When implemented fully across all demographics, such programs present opportunities to save lives, sight, and cognition with considerable spillover benefits for individuals and societies. Supplementary Information: The online version contains supplementary material available at 10.1007/s40124-022-00269-w.

Building Programs to Eradicate Toxoplasmosis Part IV: Understanding and Development of Public Health Strategies and Advances "Take a Village".

Purpose of Review: Review international efforts to build a global public health initiative focused on toxoplasmosis with spillover benefits to save lives, sight, cognition and motor function benefiting maternal and child health. Recent Findings: Multiple countries' efforts to eliminate toxoplasmosis demonstrate progress and context for this review and new work. Summary: Problems with potential solutions proposed include accessibility of accurate, inexpensive diagnostic testing, pre-natal screening and facilitating tools, missed and delayed neonatal diagnosis, restricted access, high costs, delays in obtaining medicines emergently, delayed insurance pre-approvals and high medicare copays taking considerable physician time and effort, harmful shortcuts being taken in methods to prepare medicines in settings where access is restricted, reluctance to perform ventriculoperitoneal shunts promptly when needed without recognition of potential benefit, access to resources for care, especially for marginalized populations, and limited use of recent advances in management of neurologic and retinal disease which can lead to good outcomes. Supplementary Information: The online version contains supplementary material available at 10.1007/s40124-022-00268-x.

Building Programs to Eradicate Toxoplasmosis Part II: Education.

Purpose of Review: Review work to create and evaluate educational materials that could serve as a primary prevention strategy to help both providers and patients in Panama, Colombia, and the USA reduce disease burden of Toxoplasma infections. Recent Findings: Educational programs had not been evaluated for efficacy in Panama, USA, or Colombia. Summary: Educational programs for high school students, pregnant women, medical students and professionals, scientists, and lay personnel were created. In most settings, short-term effects were evaluated. In Panama, Colombia, and USA, all materials showed short-term utility in transmitting information to learners. These educational materials can serve as a component of larger public health programs to lower disease burden from congenital toxoplasmosis. Future priorities include conducting robust longitudinal studies of whether education correlates with reduced adverse disease outcomes, modifying educational materials as new information regarding region-specific risk factors is discovered, and ensuring materials are widely accessible.

Building Programs to Eradicate Toxoplasmosis Part III: Epidemiology and Risk Factors.

Purpose of Review: Review comprehensive data on rates of toxoplasmosis in Panama and Colombia. Recent Findings: Samples and data sets from Panama and Colombia, that facilitated estimates regarding seroprevalence of antibodies to Toxoplasma and risk factors, were reviewed. Summary: Screening maps, seroprevalence maps, and risk factor mathematical models were devised based on these data. Studies in Ciudad de Panamá estimated seroprevalence at between 22 and 44%. Consistent relationships were found between higher prevalence rates and factors such as poverty and proximity to water sources. Prenatal screening rates for anti-Toxoplasma antibodies were variable, despite existence of a screening law. Heat maps showed a correlation between proximity to bodies of water and overall Toxoplasma seroprevalence. Spatial epidemiological maps and mathematical models identify specific regions that could most benefit from comprehensive, preventive healthcare campaigns related to congenital toxoplasmosis and Toxoplasma infection.

Multilocus analysis reveals further genetic differences between Tritrichomonas foetus from cats and cattle.

Tritrichomonas foetus isolates from feline and bovine origin has been previously shown to carry a certain degree of genetic heterogeneity. Here, novel candidate molecular markers were developed by means of multilocus sequence typing of the gap2 gene (encoding for T. foetus glyceraldehyde-3-phosphate dehydrogenase), ITS region, the TR7/TR8 variable-length repeat and microsatellite genotyping. These markers were used to characterize T. foetus field isolates from bulls and domestic cats and to compare phylogenetically with the following ATCC isolates: T. foetus isolated from cattle and pig (syn. Tritrichomonas suis), Tritrichomonas mobilensis, Tetratrichomonas gallinarum and Pentatrichomonas hominis. Among them, TFMS10 and TFMS7 were found to be the most polymorphic markers. Moreover, an 809 bp fragment of the gap2 gene was successfully amplified from all the trichomonads included in this study and the sequence analysis revealed differences between T. foetus porcine and feline genotypes and T. mobilensis in comparison to the bovine T. foetus ATCC isolate. The TR7/TR8 repeat pattern was not reproducible, being only consistent the fragments of approximately 110 and 217 bp. Sequence analysis of the latter revealed the existence of 3 SNPs resulting in 98.6 % homology between bovine and feline isolates. A search for similar sequences was carried out to develop a Restriction Length Fragment Polymorphism analysis. A 503 bp region, named TF1, revealed the existence of two BbvI restriction enzyme sites that were able to generate different length fragments for T. foetus feline and bovine isolates. Finally, the neighbour-joining analyses showed that T. foetus porcine genotype clusters together with bovine genotype, whereas T. mobilensis and the feline genotype form a separate cluster.

Accesibilidad al agua como alternativa para promover su consumo en la Universidad de Panamá / Accessibility to drinking water as an alternative to promote its consumption at the Universidad de Panamá

RESUMEN Objetivo Identificar la capacidad de brindar un buen acceso a instalaciones y equipos que propicien el consumo de agua dentro de la Universidad de Panamá, como parte de su compromiso de promover comportamientos que beneficien la salud en esta comunidad. Metodología Se realizó un estudio estadístico descriptivo y análisis multivariado, utilizando la técnica de análisis de correspondencia entre las variables "Estamentos Universitarios" (estudiantes, docentes y administrativos) vs "Acceso a fuentes de agua" y el "Acceso a fuentes de agua" vs "Insumos para facilitar el consumo de agua". Resultados El 66,3% de los encuestados reconocieron al agua como la bebida más accesible para consumo, proveniente principalmente de las fuentes de agua, seguido del agua embotellada. Conclusiones Este trabajo pone de manifiesto el reconocimiento de la importancia del consumo de agua en la población universitaria, sugiriendo que la Universidad de Panamá provee de condiciones en infraestructura para que haya accesibilidad a ella, promoviendo así hábitos de consumo saludables, cumpliendo con su compromiso con la salud de la población.(AU)

ABSTRACT Objective To identify the capacity to provide appropriate access to facilities and equipment that encourage drinking water consumption at the Universidad de Panamá, as part of its commitment to promote behaviors that benefit the health of this community. Materials and Methods A descriptive statistical study and a multivariate analysis were carried out using the correspondence analysis technique to explore relationships among the variables "University Group" (students, teachers and administrative staff) vs. "Access to water sources" and "Access to water sources" vs. "Inputs to facilitate water consumption". Results 66.3% of the population surveyed recognized drinking water as the most accessible drink for consumption, mainly from water sources, followed by bottled water. Conclusions This work highlights the importance of promoting water consumption in the university population, suggesting that the Universidad de Panamá has infrastructure conditions that allow water intake, thus promoting healthy habits and fulfilling its commitment to the health of the population.(AU)

[Accessibility to drinking water as an alternative to promote its consumption at the Universidad de Panamá]. / Accesibilidad al agua como alternativa para promover su consumo en la Universidad de Panamá.

OBJECTIVE: To identify the capacity to provide appropriate access to facilities and equipment that encourage drinking water consumption at the Universidad de Panamá, as part of its commitment to promote behaviors that benefit the health of this community. MATERIALS AND METHODS: A descriptive statistical study and a multivariate analysis were carried out using the correspondence analysis technique to explore relationships among the variables "University Group" (students, teachers and administrative staff) vs. "Access to water sources" and "Access to water sources" vs. "Inputs to facilitate water consumption". RESULTS: 66.3% of the population surveyed recognized drinking water as the most accessible drink for consumption, mainly from water sources, followed by bottled water. CONCLUSIONS: This work highlights the importance of promoting water consumption in the university population, suggesting that the Universidad de Panamá has infrastructure conditions that allow water intake, thus promoting healthy habits and fulfilling its commitment to the health of the population.

OBJETIVO: Identificar la capacidad de brindar un buen acceso a instalaciones y equipos que propicien el consumo de agua dentro de la Universidad de Panamá, como parte de su compromiso de promover comportamientos que beneficien la salud en esta comunidad. METODOLOGÍA: Se realizó un estudio estadístico descriptivo y análisis multivariado, utilizando la técnica de análisis de correspondencia entre las variables "Estamentos Universitarios" (estudiantes, docentes y administrativos) vs "Acceso a fuentes de agua" y el "Acceso a fuentes de agua" vs "Insumos para facilitar el consumo de agua". RESULTADOS: El 66,3% de los encuestados reconocieron al agua como la bebida más accesible para consumo, proveniente principalmente de las fuentes de agua, seguido del agua embotellada. CONCLUSIONES: Este trabajo pone de manifiesto el reconocimiento de la importancia del consumo de agua en la población universitaria, sugiriendo que la Universidad de Panamá provee de condiciones en infraestructura para que haya accesibilidad a ella, promoviendo así hábitos de consumo saludables, cumpliendo con su compromiso con la salud de la población.

Seroprevalence of Toxoplasma gondii in domestic pets from metropolitan regions of Panama.

Toxoplasmosis is a worldwide zoonotic disease but information regarding domestic animals in Central America is scarce and fragmented. The aim of this study was to determine the seroprevalence of Toxoplasma gondii in domestic cats and dogs in different metropolitan regions of Panama. A total of 576 samples were collected; sera from 120 cats and 456 dogs were tested using a commercial indirect enzyme-linked immunosorbent assay (ELISA). The overall seroprevalence of IgG antibodies was 30.73%. There is high seroprevalence of T. gondii in cats and dogs in the metropolitan regions around the Panama Canal; however, differences between these species were not significant. Statistical analysis indicated that there are relevant variables, such as the age of animals, with a direct positive relationship with seroprevalence. None of the variables related to animal welfare (veterinary attention provided, type of dwelling, and access to green areas and drinking water) were associated with seropositivity.

Consumo de agua como hábito saludable en la población universitaria / Consumption of water as healthy habit in the university population

Objetivo: Caracterizar el perfil de hábitos y prácticas de salud de los universitarios en cuanto al consumo deagua en la Universidad de Panamá.El agua es uno de los grandes componentes del cuerpo humano. Constituye el medio en que se llevan a cabola mayor parte de las reacciones químicas en el cuerpo y juega un papel importante en la transformación deenergía, la excreción de desechos y la regulación de la temperatura (Brown 2006).Metodología: Se utilizó el muestreo aleatorio estratificado proporcional, utilizando un error máximo de 3%y un 95% de confianza. Además se le probó la homogeneidad estructural del instrumento. Con los resultadosobtenidos, se procedió a desarrollar un análisis descriptivo con diferentes variables de tipo general ademásde las preguntas sobre el consumo de agua. Por otro lado se realizó un análisis multivariante aplicando elmétodo HJ-Biplot el cual permitirá identificar patrones con respecto a las respuestas manifestadas en lasfacultades examinadas.Resultados: La muestra estaba distribuida 15% administrativos, 68% estudiantes 17% docentes. Dondemanifiestanqueeltipodelíquidoconelqueacompañanlascomidastienecomopreferenciaconsumiragua. Y delgrupo de los encuestados los estudiantes universitarios son aquellos con los menores niveles de consumo deagua argumentados por la falta de tiempo.Conclusión: La población está anuente que el consumo del agua genera beneficios en la salud física y en elbienestar general, sin embargo los hábitos generales de la misma no reflejan dicho conocimiento.

Objective: Characterize the habit profile and health practices of university students, administrative personneland faculty members, in regards to water consumption in the University of Panama.Water is one of the major components of human body. It constitutes the mean for body’s main chemicalreactions and plays an important role in the transformation of energy, waste excretion and temperatureregulation (Brown, 2006).Methodology: Proportional stratified random sampling was used, using a maximum error of 3% and 95%confidence. Also, the structural homogéneity of the instrument was tested. With the results, we proceeded todevelop a descriptive analysis with different general variables in addition to questions about drinking water.Furthermore, a multivariate analysis using the HJ- Biplot method was run for identifying patterns related tothe responses expressed by the students from different schools.Results: The sample was distributed among 15% staff, 68% students and 17% faculty. They expressed theirpreference of drinking water during meals instead of any other kind of beverage. The students interviewedare the group drinking the less amount of water due to lack of time.Conclusion: The population is aware of the benefits of drinking water for physical health and well-being;however, the general habits do not reflect this knowledge.

Objetivo: Caraterizar o perfil de hábitos e práticas de saúde dos universitários enquanto ao consumo de águana Universidade de Panamá.A água é um dos grandes componentes do corpo humano. Constitui o meio em que se dão a maior partereações químicas no corpo e têm um papel importante na transformação de energia, a excreção dos detritose a regulação da temperatura (Brown 2006). Metodologia: Se utilizou a amostragem aleatória estratificadaproporcional com um erro máximo de 3% e um 95% de confiança. Além disso, se provou a homogeneidadeestrutural do instrumento. Com os resultados obtidos se procedeu a desenvolver uma análise descritiva comdiferentes variáveis de tipo geral, além das perguntas sobre o consumo de água. Por outro lado, se realizouuma análise múlti variante aplicando o método HJ-Biplot, que permitirá identificar padrões com respeito àsrespostas manifestadas nas faculdades testadas.Resultados: A amostra foi distribuída em 15% administrativos, 68% estudantes e 17% docentes. Osresultados indicam que o tipo de líquido preferido para acompanhar as comidas é a água, e do grupo derespondentes, os estudantes universitários foram aqueles com os menores níveis de consumo de água,argumentando a falta de tempo.Conclusão: A população sabe que o consumo de água gera benefícios na saúde física e o bem-estar integral,porém, os hábitos gerais no refletem esse conhecimento.

Detection of a novel genotype of Cryptosporidium in Antarctic pinnipeds.

A study was conducted to investigate the presence of Cryptosporidium and Giardia in Antarctic marine mammals. A total of 270 faecal samples from different species of pinnipeds from different locations in the South Shetland Islands and Antarctic Peninsula were analysed by immunofluorescence microscopy and PCR. Cryptosporidium was detected by PCR in three samples from Southern elephant seals (Mirounga leonina) and 2 Weddell seals (Leptonychotes weddellii). However, no oocysts were observed in any of the samples by immunofluorescence microscopy. Molecular characterisation of the isolates, using the 18S rDNA, the HSP70 and the COWP loci, revealed the presence of a Cryptosporidium sp., previously reported from an Antarctic Southern elephant seal, in the elephant seals and a novel genotype in Weddell seals. Giardia could not be detected in any of the samples analysed.

Detection of Toxoplasma gondii antibodies in Antarctic pinnipeds.

The presence of Toxoplasma gondii antibodies was investigated in Antarctic marine mammals. Two hundred and eleven sera from different species of pinnipeds collected in years 2007, 2010 and 2011 from different locations in the South Shetland Islands and Antarctic Peninsula were analysed using a commercially available agglutination test kit. The presence of antibodies (titres ≥ 1:25) against T. gondii was detected in a total of 28 animals (13.3%). Amongst animal species, percentages of detection were higher in Southern elephant seals (Mirounga leonina) (76.9%; 10/13) followed by Weddell seals (Leptonychotes weddellii) (41.9%; 13/31). Antibodies were also found in 4 of 165 (2.4%) Antarctic fur seals (Arctocephalus gazella) and 1 of 2 Crabeater seals (Lobodon carcinophaga). Highest titres (1:100-1:800) were also observed in Southern elephant seals and Weddell seals. To the best of our knowledge this is the first report on the detection of antibodies against T. gondii in Antarctic marine mammals.