Risk factors for Toxoplasma gondii seropositivity in the Old Order Amish.

Toxoplasma gondii (T. gondii) is an important human disease-causing parasite. In the USA, T. gondii infects >10% of the population, accrues economic losses of US$3.6 billion/year, and ranks as the second leading culprit of foodborne illness-related fatalities. We assessed toxoplasmosis risk among the Old Order Amish, a mostly homogenous population with a high prevalence of T. gondii seropositivity, using a questionnaire focusing on food consumption/preparation behaviours and environmental risk factors. Analyses were conducted using multiple logistic regression. Consuming raw meat, rare meat, or unpasteurised cow or goat milk products was associated with increased odds of seropositivity (unadjusted Odds Ratios: 2.192, 1.613, and 1.718 , respectively). In separate models by sex, consuming raw meat, or consuming unpasteurised cow or goat milk products, was associated with increased odds of seropositivity among women; washing hands after touching meat with decreased odds of seropositivity among women (adjusted OR (AOR): 0.462); and cleaning cat litterbox with increased odds of seropositivity among men (AOR: 5.241). This is the first study to assess associations between behavioural and environmental risk factors and T. gondii seropositivity in a US population with high seroprevalence for T. gondii. Our study emphasises the importance of proper food safety behaviours to avoid the risk of infection.

Persistent socioeconomic and racial and ethnic disparities in pathogen burden in the United States, 1999-2014.

The disproportionate burden of prevalent, persistent pathogens among disadvantaged groups may contribute to socioeconomic and racial/ethnic disparities in long-term health. We assessed if the social patterning of pathogen burden changed over 16 years in a U.S.-representative sample. Data came from 17 660 National Health and Nutrition Examination Survey participants. Pathogen burden was quantified by summing the number of positive serologies for cytomegalovirus, herpes simplex virus-1, HSV-2, human papillomavirus and Toxoplasma gondii and dividing by the number of pathogens tested, giving a percent-seropositive for each participant. We examined sex- and age-adjusted mean pathogen burdens from 1999-2014, stratified by race/ethnicity and SES (poverty-to-income ratio (PIR); educational attainment). Those with a PIR < 1.3 had a mean pathogen burden 1.4-1.8 times those with a PIR > 3.5, with no change over time. Educational disparities were even greater and showed some evidence of increasing over time, with the mean pathogen burden among those with less than a high school education approximately twice that of those who completed more than high school. Non-Hispanic Black, Mexican American and other Hispanic participants had a mean pathogen burden 1.3-1.9 times non-Hispanic Whites. We demonstrate that socioeconomic and racial/ethnic disparities in pathogen burden have persisted across 16 years, with little evidence that the gap is closing.

Exposure to Toxoplasma gondii in the Roma and Non-Roma Inhabitants of Slovakia: A Cross-Sectional Seroprevalence Study.

The lifestyle, health and social status of the Roma are generally below the standards characteristic for the non-Roma population. This study aimed to find out the seropositivity to Toxoplasma gondii (T. gondii) in the population of Roma living in segregated settlements and to compare it with the prevalence of antibodies in the non-Roma population from the catchment area of eastern Slovakia. The seroprevalence of antibodies to T. gondii was significantly higher in the Roma group (45.0%) than in non-Roma inhabitants (24.1%). A statistically significant difference was also recorded between the two non-Roma groups in the study, 30.4% of those from the catchment area and 19.7% from the non-catchment area were seropositive. Univariate logistic regression confirmed poverty and higher age to be significant risk factors influencing the seropositivity to T. gondii. Of the clinical symptoms analyzed in the study, only muscle and back pain were associated with seropositivity to T. gondii. The close contact of Roma with an environment contaminated by different infectious agents and the insufficient hygiene, lower level of education, poverty, lack of water and household equipment and high number of domestic animals increase the risk of infectious diseases in the Roma settlements and subsequently the spread of communicable diseases at the national or even international level.

Valoración de exposición y endemicidad de Toxoplasma gondii en donantes de sangre en la provincia de Holguín, Cuba / Assessment of exposure and endemicity of Toxoplasma gondii among blood donors from the province of Holguín, Cuba

INTRODUCCIÓN: la toxoplasmosis es la enfermedad parasitaria más difundida en el mundo que afecta al hombre, descrita hace poco más de 100 años y producida por Toxoplasma gondii. Una de las formas que el hombre adquiere la enfermedad es a través de la placenta, de órganos trasplantados y por transfusiones de sangre; la forma infectante del parásito denominada "taquizoitos" es la responsable de este tipo de infección y ocurre durante la fase hematógena del mismo en un individuo seropositivo a T gondii. En Cuba al igual que en otras partes del mundo se ha demostrado la presencia de este parásito; en la provincia de Holguín su circulación se ha confirmado en receptores de trasplante renal. OBJETIVOS: conocer la seroprevalencia en donantes de sangre que motivó el interés para la realización de este trabajo. MÉTODOS: se evaluaron 892 muestras de sueros de donantes de los 14 municipios de la provincia de Holguín, el comportamiento serológico se determinó por la Técnica de Inmunofluorescencia Indirecta. RESULTADOS: la seropositividad para Inmunoglobulina G, anti Toxoplasma gondii de un 38,2 %, CONCLUSIONES: los donantes de la provincia de Holguín, están expuesto al Toxoplasma gondii, donde existe endemicidad del parásito en todo sus municipios y queda demostrado que los individuos procedentes de áreas rurales, tienen mayor incidencia de seropositivos al Toxoplasma gondii que los de áreas urbanas.

INTRODUCTION: Toxoplasmosis is a parasitic disease caused by Toxoplasma gondii. First described a little over 100 years ago, it is the most widely distributed parasitic disease affecting humans. The disease may be acquired from the placenta, from transplanted organs or from blood transfusions. The infecting form of the parasite, known as "tachyzoite", is responsible for this type of infection, which occurs during the hematogenous stage in a T. gondii-seropositive individual. The presence of this parasite has been demonstrated both in Cuba and in other regions of the world. In the province of Holguín its circulation has been confirmed in renal transplant recipients. OBJECTIVES: The purpose of the present study was to determine the seroprevalence of toxoplasmosis among blood donors. METHODS: An evaluation was conducted of 892 serum samples from donors from the 14 municipalities in the province of Holguín. Serological behavior was determined by indirect immunofluorescence technique. RESULTS: Seropositivity for anti-Toxoplasma gondii Immunoglobulin G was found to be 38.2 %. CONCLUSIONS: Blood donors from the province of Holguín are exposed to Toxoplasma gondii. The parasite is endemic in all municipalities, and it has been shown that Toxoplasma gondii seropositivity is higher in rural areas than in urban areas.

Seroprevalence and correlates of Toxoplasma gondii infection in Yoremes (Mayos) in Mexico: a cross-sectional study.

OBJECTIVES: We sought to determine the prevalence of anti-Toxoplasma gondii antibodies in Yoremes and to identify associations of T. gondii exposure with sociodemographic, clinical and behavioural characteristics of Yoremes. DESIGN: A cross-sectional survey. SETTING: Yoremes were enrolled in the locality of Tierra Blanca in the municipality of Navojoa in Sonora State, Mexico. PARTICIPANTS: We studied 200 Yoremes (Mayos); they are an indigenous ethnic group living in a coastal region in northwestern Mexico. PRIMARY AND SECONDARY OUTCOME MEASURES: We assessed the prevalence of anti-Toxoplasma IgG and IgM antibodies in participants using enzyme-linked immunoassays. We used a standardised questionnaire to obtain the characteristics of Yoremes. The association of T. gondii exposure and Yoremes' characteristics was assessed by bivariate and multivariate analyses. RESULTS: Of the 200 Yoremes studied (mean age: 31.50±18.43 years), 26 (13.0%) were positive for anti-T. gondii IgG antibodies and 19 (73.1%) of them were also positive for anti-T. gondii IgM antibodies. Seroprevalence of T. gondii infection did not vary with sex, educational level, occupation or socioeconomic status. In contrast, multivariate analysis of sociodemographic and behavioural characteristics showed that T. gondii exposure was associated with increasing age (OR=1.02; 95% CI 1.00 to 1.04; p=0.03) and consumption of squirrel meat (OR=4.99; 95% CI 1.07 to 23.31; p=0.04). Furthermore, seroprevalence of T. gondii infection was significantly higher in Yoremes with a history of lymphadenopathy (p=0.03) and those suffering from frequent abdominal pain (p=0.03). In women, T. gondii exposure was associated with a history of caesarean sections (p=0.03) and miscarriages (p=0.02). CONCLUSIONS: We demonstrate, for the first time, serological evidence of T. gondii exposure among Yoremes in Mexico. Results suggest that infection with T. gondii might be affecting the health of Yoremes. Results may be useful for an optimal design of preventive measures against T. gondii infection.

[Seroprevalance Differences of Toxoplasma Between Syrian Refugees Pregnants and Indigenous Turkish Pregnants in Kahramanmaras]. / Kahramanmaras Yöresindeki Yerlesik Türk Gebelerle Suriyeli Mülteci Gebeler Arasinda Toxoplasma Seroprevalans Farkliliklari.

OBJECTIVE: In this study, we aimed to compare the Syrian refugees and resident Turkish pregnant population in terms of Toxoplasma seroprevalence. METHODS: Data acquired from Kahramanmaras Necip Fazil City Hospital Department of Obstetrics and Gynecology between 2012 and 2013 were analyzed retrospectively. Results of 7201 Toxoplasma IgM tests and 4113 Toxoplasma IgG tests were evaluated. RESULTS: For 2012 and 2013 Toxoplasma IgM seropositivity was found in Syrian refugees 4.76% and 4.84% respectively in our study. In the same population Toxoplasma IgG seropositivity rates were 80% and 62.6%, respectively. Toxoplasma IgM seropositivity rates for the native peoples in Turkey in 2012 and 2013 was 1.96% and 2.34%, while in the same population Toxoplasma IgG seropositivity was detected 49.7% and 45.7% respectively. Toxoplasma IgM seropositivity was statistically higher in Syrian refugees for each year (p <0.001 and 0.019, respectively). Toxoplasma IgG seropositivity of Syrian refugees was statistically higher (p <0.001 and <0.001 respectively). CONCLUSION: Since it was found in our study that toxoplasma seropositivity rates of Syrian refugees living in the region of Kahramanmaras were statistically higher than the rates of local inhabitants, we consider that this condition should be taken into account in the follow-ups of Syrian pregnant refugees outnumbering in Kahramanmaras and its vicinity.

Seroepidemiology of Toxoplasma gondii infection in Bai and Han ethnic groups in southwestern China.

Eating raw pork and/or liver is a custom of the Bai ethnic group in China. Most people living in Dali Bai Autonomous Prefecture, Yunnan Province, southwestern China are of Bai ethnicity. Little is known of the seroprevalence of Toxoplasma gondii in Bai and Han ethnic populations in this region. In the present survey, a total of 555 and 595 blood samples were obtained from Bai and Han ethnic groups in Dali urban and rural areas, respectively. Enzyme-linked immunosorbent assay was performed to examine T. gondii IgG antibodies. Total positive rate of anti-T. gondii IgG in Bai and Han groups in this region was 21·6% (248/1150). The total seroprevalence of T. gondii was significantly higher in the Bai ethnic group (32·3%, 179/555) than in the Han ethnic group (11·6%, 69/595) (P < 0·01). The results of statistical analysis indicated that there was no significant difference between cat feeding/non-cat feeding groups in the Bai ethnic group, the most important risk factor was consumption of raw pork and/or liver for the Bai group, but feeding a cat may be the main route of T. gondii infection for the Han group. Therefore, it is essential to implement integrated strategies to prevent and control T. gondii infection in this unique region of the world.

Seroepidemiology of Toxoplasma gondii infection in the Israeli population.

Toxoplasmosis seroprevalence varies considerably between countries. We studied the seroprevalence of Toxoplasma gondii IgG antibodies in a national sample of the Israeli population; 2794 sera were tested. The highest age-adjusted seroprevalence rate was in Arabs (non-Bedouins) (60.4%), significantly higher compared to the rate in Jews (19.9%) and Bedouins (27.5%) (P < 0.01). There were no significant gender differences. Seropositivity increased with age in all population groups. For Jews, seropositivity was associated with place of birth and socioeconomic status. A finding of low seroprevalence rate in Bedouins despite their poor living conditions and close contact with livestock is surprising, and might be attributed to the dry and hot climate conditions in their area of residence. In women of reproductive age the seroprevalence was 15.1% in Jews, 25.4% in Bedouins and 72.3% in Arabs (non-Bedouins). Thus, the majority of pregnant women are susceptible to primary infection with T. gondii, and the risk for congenital toxoplasmosis remains high.

Seroprevalence and risk factors for toxoplasmosis among antenatal women in London: a re-examination of risk in an ethnically diverse population.

BACKGROUND: Primary infection with Toxoplasma gondii in pregnancy can result in miscarriage, hydrocephalus, cerebral calcification and chorioretinitis in the newborn. The objective of our study was to evaluate seroprevalence of and analyse risk factors for toxoplasmosis in antenatal women from 2006 to 2008 in an ethnically diverse population of Central London to re-examine the need for a screening policy. METHODS: We performed serum IgG estimations to T. gondii using a commercial kit, and analysed risk factors for acquisition using a questionnaire. RESULTS: Seroprevalence for T. gondii was 17.32% in 2610 samples tested. In all, 67.7% were of UK origin (seroprevalence: 11.9%) and were significantly non-immune to T. gondii (OR: 0.38, 95% CI: 0.31-0.47; P < 0.0001). Risk factors for seroprevalence included African/Afro-Caribbean (OR: 2.67, 95% CI: 1.83-3.88; P < 0.001; seroprevalence: 31.5%), Middle eastern (OR: 3.12, 95% CI: 1.62-5.99; P ≤ 0.001; seroprevalence: 34.8%) and mixed (OR: 1.75, 95% CI: 1.16-2.63; P = 0.007; seroprevalence: 23.3%) ethnic groups; eating undercooked meat (OR: 1.64, 95% CI: 1.29-2.08; P ≤ 0.001; seroprevalence: 20.2%) and drinking unpasteurised milk (OR: 1.38, 95% CI: 1.01-1.88; P = 0.05; seroprevalence: 23.1%). There was no association with pet cats or eating unpasteurised cheeses and antibody responses. CONCLUSION: Low national prevalence of toxoplasma seroconversion and congenital disease would likely not justify screening in the UK. Individual risk assessment is recommended in ethnically diverse urban areas where populations with relatively high seroprevalence and parasite-associated risk factors exist together with an indigenous population with low prevalence. One universal screening policy based on the indigenous prevalence and risk factors may not be suitable for all.

An age-adjusted seroprevalence study of Toxoplasma antibody in a Malaysian ophthalmology unit.

Toxoplasma gondii is a public health risk in developing countries, especially those located in the tropics. Widespread infection may inflict a substantial burden on state resources, as patients can develop severe neurological defects and ocular diseases that result in lifelong loss of economic independence. We tested sera for IgG antibody from 493 eye patients in Malaysia. Overall age-adjusted seroprevalence was estimated to be 25% (95% CI: [21%, 29%]). We found approximately equal age-adjusted seroprevalence in Chinese (31%; 95% CI: [25%, 38%]) and Malays (29%; 95% CI: [21%, 36%]), followed by Indians (19%; 95% CI: [13%, 25%]). A logistic regression of the odds for T. gondii seroprevalence against age, gender, ethnicity and the occurrence of six types of ocular diseases showed that only age and ethnicity were significant predictors. The odds for T. gondii seroprevalence were 2.7 (95% CI for OR: [1.9, 4.0]) times higher for a patient twice as old as the other, with ethnicity held constant. In Malays, we estimated the odds for T. gondii seroprevalence to be 2.9 (95% CI for OR: [1.8, 4.5]) times higher compared to non-Malays, with age held constant. Previous studies of T. gondii seroprevalence in Malaysia did not explicitly adjust for age, rendering comparisons difficult. Our study highlights the need to adopt a more rigorous epidemiological approach in monitoring T. gondii seroprevalence in Malaysia.

Seroprevalence and sources of toxoplasmosis among Orang Asli (indigenous) communities in Peninsular Malaysia.

This study aims to evaluate the current seroprevalence of toxoplasmosis among indigenous communities in Peninsular Malaysia and relate its association with epidemiological data. Overall seroprevalence of Toxoplasma gondii was 37.0% with 31.0% immunoglobulin (Ig) G, 1.8% IgM, and 4.2% seropositivity for both anti-Toxoplasma antibodies. Multivariate analysis showed that age above 12 years (odds ratio [OR] = 2.70, 95% confidence interval [CI] = 1.75-4.04, P < 0.001), using untreated river and mountain water supplies (OR = 1.50, 95% CI = 1.01-2.40, P = 0.050), and close proximity with cats (OR = 1.40, 95% CI = 1.10-1.76, P = 0.010) were factors associated with toxoplasmosis. Given the high seroprevalence of toxoplasmosis among these communities who live in poor socioeconomic conditions, a comprehensive health surveillance program and screening should be initiated among women of childbearing age and pregnant women during the antenatal period for early diagnosis and treatment. The role of domestic cats and environmental contamination with oocyst in soil and water has to be highlighted and addressed in future prevention strategies for these communities.

[Serological markers in immigrant and Spanish pregnant women in Granada]. / Marcadores serológicos en gestantes inmigrantes y autóctonas en Granada.

INTRODUCTION: Female immigration from less developed countries into Spain has grown in number over the years, and could contribute to changing the prevalence of routine serological markers in pregnant women. MATERIAL AND METHODS: From April 2007 until May 2008 we studied the prevalence of serum antibodies against Treponema pallidum, Toxoplasma gondii, rubella virus, human immunodeficiency virus (HIV 1/2), and hepatitis B virus (HBV) in samples from 4,171 immigrant and Spanish pregnant women in Granada. RESULTS: The seroprevalence of toxoplasmosis in pregnant immigrants was higher than in non-immigrants (44% vs. 14.4%). The overall prevalence against rubella was 97.3%. Sub-Saharan and North African women showed the lowest prevalence (88% and 89%). The prevalence of HBsAg was higher in immigrants than in Spanish women (2.6% vs. 0.4%), and especially high among the Eastern European (6.9%) and Asian (8.1%) pregnant women. The seroprevalences of HIV (0.9% vs. 0.1%) and syphilis (TPHA) (3.5% vs. 0.07%), were higher in immigrants. Seroprevalence against T. pallidum was higher among Eastern European (11.5%) and Latin-American (3.5%) women, whereas sub-Saharan (11.8%) and North African (1%) women showed the highest anti-HIV prevalence. CONCLUSION: Hepatitis B, anti-HIV, syphilis, and antibodies against T. gondii are found more frequently in immigrants than in Spanish pregnant women, whereas rubella protection in Spanish women is higher than immigrant pregnant women.

Seroepidemiology of Toxoplasma gondii infection in a Mennonite community in Durango State, Mexico.

There is a lack of information concerning the epidemiology of Toxoplasma gondii infection in Mennonites (an ethnic group of Mexican citizens of German descent living in rural communities). The prevalence of anti- T. gondii immunoglobulin (Ig) G and IgM antibodies was examined in 152 Mennonites in Durango State, Mexico, using enzyme-linked immunoassays. In total, 46 (30.3%) of 152 participants (mean age 38.4 ± 15.5 yr) had IgG T. gondii antibodies; 5 (3.3%) also had IgM T. gondii antibodies. Toxoplasma gondii infection was significantly associated with the presence of cats at home (adjusted OR  =  3.93; 95% CI: 1.40-11.05), raising cattle (adjusted OR  =  3.88; 95% CI: 1.24-12.11), consumption of pigeon meat (adjusted OR  =  3.0; 95% CI: 1.36-6.63), and consumption of untreated water (adjusted OR  =  2.42; 95% CI: 1.09-5.40). This is the first report of seroprevalence and contributing factors for T. gondii infection in Mennonites and of an association of the consumption of pigeon meat with T. gondii infection. Results of this study should be useful in the design of optimal preventive measures against T. gondii infection.

Racial and ethnic differences in the seroprevalence of 6 infectious diseases in the United States: data from NHANES III, 1988-1994.

OBJECTIVES: We examined racial/ethnic differences in the seroprevalence of selected infectious agents in analyses stratified according to risk categories to identify patterns and to determine whether demographic, socioeconomic, and behavioral characteristics explain these differences. METHODS: We analyzed data from the third National Health and Nutrition Examination Survey, comparing differences among groups in regard to the prevalence of infection with hepatitis A, B, and C viruses, Toxoplasma gondii, Helicobacter pylori, and herpes simplex virus type 2. RESULTS: Racial/ethnic differences were greater among those in the low-risk category. In the case of most infectious agents, odds associated with race/ethnicity were almost 2 times greater in that category than in the high-risk category. CONCLUSIONS: Stratification and adjustment for socioeconomic factors reduced or eliminated racial/ethnic differences in the prevalence of infection in the high-risk but not the low-risk group, wherein race/ethnicity remained significant and might have been a surrogate for unmeasured risk factors.

[Evaluation of toxoplasmosis seroprevalence among 2416 women of childbearing age followed at the Pasteur Institute of New Caledonia]. / Estimation de la séroprevalence de la toxoplasmose chez 2 416 femmes en âge de procréer suivies à l'Institut Pasteur de Nouvelle-Calédonie.

Evaluation of Toxoplasmosis seroprevalence was conducted in 2416 women of childbearing age by Pasteur Institute of New-Caledonia. The estimated seroprevalence was 56.7%, significantly higher in the North-East part of the territory (79.1%), area characterized by strong precipitations, and in the Melanesian ethnic group (62.1%). The habits of this population could enhance contamination by ingestion of oocysts during childhood or adolescence, particularly in the North-East territory. Melanesian women living in the North-East and being not immunized against toxoplasmosis represent the population with the highest risk for Toxoplasma gondii infection.

Toxoplasmosis: prevalence and risk factors.

A total of 200 pregnant women were recruited in this cross-sectional study. The overall seroprevalence of toxoplasmosis in pregnant women was found to be 49%, in which 39%, 4% and 6% for anti-Toxoplasma IgG, IgM and both anti-Toxoplasma IgG and IgM antibodies, respectively. We found the differences in Toxoplasma seroprevalence rates among the races were significant: the highest rate was in the Malays (55.7%), followed by the Indian (55.3%) and the Chinese (19.4%) (P<0.05) populations. An increase in Toxoplasma seroprevalence with increasing parity was detected (P<0.05). Women with no children had a prevalence of 39.7%, while women with one or more than two children had a prevalence of 44.2% and 62.9%, respectively. In this study, there was no significant association between Toxoplasma seroprevalence and various possible risk factors in pregnant women (P>0.05). When multivariate analysis was performed, no significant association between Toxoplasma seroprevalence and history of contact with cats, consumption of undercooked meat and blood transfusion was found (P>0.05). We did not find any newly diagnosed cases of acute acquired toxoplasmosis in pregnancy during the study period.

Seroepidemiology of Toxoplasma gondii infection among Chinese aboriginal and Han people residing in mountainous areas of northern Thailand.

A seroepidemiological survey of Toxoplasma gondii infection among Chinese refugees, including Akka and Yau aborigines and Han people living in mountainous areas at elevations of 1,100-1,400 m in Chiang-Rai Province of northern Thailand, was conducted during January 2003 using the latex agglutination test. The overall seroprevalence of T. gondii infection was 9.1% for Akka aborigines, 37.9% for Yau aborigines, and 7.9% for Han people, respectively. No significant gender difference in seroprevalence was found among any of the groups (P > 0.05). The results of a multiple logistic regression analysis for Yau aborigines and Han people showed that the older the age, the higher the odds ratios (OR) of being seropositive (OR = 3.0, 95% confidence interval [CI] = 0.5 to 16.9, P < 0.001 and OR = 1.5, 95% CI = 0.3 to 8.0, P = 0.06 for the elderly group vs. the child group for the Yau aborigines and Han people, respectively). In contrast, the OR was lower among older Akka aboriginal populations (OR = 0.1, 95% CI = 0.0 to 0.4, P < 0.001). Ethnically, Yau aboriginal populations had a significantly higher seroprevalence than did the Akka aborigines and Han people (P < 0.001).

Toxoplasma gondii infection in the United States: seroprevalence and risk factors.

Infection with Toxoplasma gondii can cause severe illness when the organism is contracted congenitally or when it is reactivated in immune-suppressed persons. To determine the prevalence of T. gondii infection in a representative sample of the US population, the authors tested sera from participants in the Third National Health and Nutrition Examination Survey (1988-1994) for immunoglobulin G antibodies to T. gondii. Of 27,145 persons aged > or =12 years, 17,658 (65%) had sera tested. The overall age-adjusted seroprevalence was 22.5% (95% confidence interval (CI): 21.1, 23.9); among women aged 15-44 years, seroprevalence was 15.0% (95% CI: 13.2, 17.0). Age-adjusted seroprevalence was higher in the Northeast (29.2%) than in the South (22.8%), Midwest (20.5%), or West (17.5%) (p < 0.05). In multivariate analysis, risk for T. gondii infection increased with age and was higher among persons who were foreign-born, persons with a lower educational level, those who lived in crowded conditions, and those who worked in soil-related occupations, although in subset analyses risk categories varied by race/ethnicity. Nearly one quarter of adults and adolescents in the United States have been infected with T. gondii. Most women of childbearing age in the United States are susceptible to acute infection and should be educated about ways to minimize exposure to T. gondii.

Seroprevalence of antibodies against Toxoplasma gondii among two rural populations in northern Israel.

The prevalence of antibodies against Toxoplasma gondii was measured in two rural populations in northern Israel--Jewish kibbutz members and Arab villagers. The respective prevalences in these two populations were 22.2% and 55.8% (P < 0.001). No correlation was found between the presence of antibodies and sex, occupation, contact with cats, a history of fever and/or lymphadenopathy, eye disease, abortions or delivery of children with congenital malformations. In contrast to Jewish children who were not found to have antibodies in the first decade of life, 20.5% of Arab children tested positive. A gradual increase in the prevalence of antibodies with age was seen in both groups, with the Jews reaching a prevalence of 42.6% at age 60+ and the Arabs reaching 74% at age 40. The difference between the two groups probably stems from different eating habits, namely ingestion of raw meat and unpasteurized milk and milk products.