Rural residence remains a risk factor for Toxoplasma infection among pregnant women in a highly urbanized Brazilian area: a robust cross-sectional study.

BACKGROUND: Despite high seroprevalence of asymptomatic infection in humans, toxoplasmosis can manifest as a severe systemic disease, as occurs in the congenital infection. Here we evaluate the seroprevalence of Toxoplasma infection among pregnant women in a highly urbanized area of Brazil. METHODS: A robust seroepidemiological study was conducted using laboratory databases of anti-Toxoplasma gondii serological results together with information on age, month/year of diagnosis and place of residence of pregnant women in the public health system of the city of Juiz de Fora, Brazil. RESULTS: Of 5895 pregnant women analysed, 54.7% showed seronegativity and 44.4% showed seropositivity for immunoglobulin G (IgG) antibodies against Toxoplasma gondii. This seropositivity rate increased to 68.3% when only considering participants from rural areas. Multivariate analysis revealed higher odds of being seropositive associated with age (odds ratio [OR] 1.06 [confidence interval {CI} 1.05 to 1.07]) and with living in rural areas (OR 2.96 [CI 1.64 to 5.36]). The spatial distribution of IgG seropositivity indicated a higher prevalence concentrated in rural and peripheral neighbourhoods. CONCLUSIONS: This is the first report to use spatial analysis to show a cluster of Toxoplasma infection in rural and peripheral neighbourhoods of a highly urbanized municipality, which highlights the need for adequate healthcare actions to be implemented for women living in these areas.

Prevalência de resultados positivos de VDRL (Venereal Disease Research Laboratory) e análise das variáveis epidemiológicas em pacientes atendidos no serviço de saúde pública / Prevalence of VDRL (Venereal Disease Research Laboratory) positive results and epidemiological variables analysis in patients assessed on a public health service

Syphilis is an infection caused by Treponema pallidum of sexual, blood and vertical transmission. Despite being easy to diagnose and treat, its incidence has been increasing in Brazil in recent years, and it is being considered a public health problem in the country and worldwide. The aim of this study was to describe the prevalence of positive results for VDRL (Venereal Diseases Research Laboratory) in the city of Juiz de Fora / MG between 2014 and 2016, as well its epidemiological characteristics. 25,735 VDRL results were analyzed from the database of the Central Laboratory (LACEN) of the city hall of Juiz de Fora. The results were then related to the variables year, gender, age, pregnant or not and the region of the city where the test was performed. The prevalence of positive results was 5.55%, with the highest number of cases recorded in 2015. Reactive cases were more prevalent in the central region, in men and a higher prevalence was obtained for the age group of 12 to 18 years. Among women, it was observed higher VDRL positivity in non-pregnant women from August 2015 to December 2016. The data obtained in this study indicates an increase in prevalence of syphilis from 2014 to 2015, followed by a reduction in the following year, among the population served by SUS, where young men represent the population at greater risk.