Epidemiological Aspects of Maternal and Congenital Toxoplasmosis in Panama.

Carlos Flores,Ximena Norero,Jovanna Borace,Carlos M Restrepo,Mariangela Soberon,Digna Wong,Alejandro Llanes,Mario Quijada R,Zuleima Caballero E,María F Lucero,Anabel García,Mayrene Ladrón De Guevara,German Guzmán,Lorena Fábrega,Delba Villalobos-Cerrud,María Teresa Moreno,Valli De La Guardia,Rima Mcleod,X Sáez-Llorens

doi:10.3390/pathogens10060764

Abstract

In Panama, epidemiological data on congenital toxoplasmosis are limited, making it difficult to understand the scope of clinical manifestations in the population and factors that may increase the risk of infection. This study provides insight into the epidemiological situation of maternal and congenital toxoplasmosis in Panama and contributing information on the burden of this disease in Central America. Blood samples were collected from 2326 pregnant women and used for the detection of anti-T. gondii antibodies. A high seroprevalence (44.41%) was observed for T. gondii infection in pregnant women from different regions of Panama, with an estimated incidence rate of congenital toxoplasmosis of 3.8 cases per 1000 live births. The main risk factors associated with T. gondii infection using bivariate statistical analysis were an elementary level education and maternal age range of 34-45 years. Multivariate statistical analyses revealed that in some regions (San Miguelito, North and West regions), the number of positive cases correlated with the presence of pets, stray dogs and the consumption of poultry. In other regions (East and Metropolitan regions), the absence of pets was considered a protective factor associated with negative cases, while the presence of stray cats and the age range of 25–34 years did not represent any risk in these regions.

Highlights

Toxoplasmosis is one of the most common and widespread human parasitic infections worldwide, caused by the Apicomplexan parasite Toxoplasma gondii
The avidity test was not conclusive for diagnosis in most of the suspected cases of congenital toxoplasmosis (CT) identified in this study
Our results indicated a lower seroprevalence for T. gondii infection and a higher incidence rate of CT than those reported in Panama in 2014 [31]

Summary

Introduction

Toxoplasmosis is one of the most common and widespread human parasitic infections worldwide, caused by the Apicomplexan parasite Toxoplasma gondii. CT has not traditionally been considered an important global public health concern, and remains a neglected disease with serious congenital, neurological and ocular sequelae [1] These facts, together with its high prevalence reported in vulnerable populations with a low socioeconomic level, contribute to perpetuate poverty, mainly in underdeveloped countries [2,3]. The consumption of contaminated food is possibly the main risk factor in Latin American countries, contributing greatly to the burden of CT in the region, with 1.8 to 3.4 cases per 1000 live newborns [1,10,12] This incidence may be underestimated, due to the inadequate interpretation of serological tests and the lack of follow-up of at-risk patients. Some cities of Mexico have shown relatively low percentages of seropositivity, with maximum values around 6% [7,22]

Methods

Results

Conclusion