Abstract
Toxoplasmosis is a parasitic zoonotic disease caused by Toxoplasma gondii that afflicts humans worldwide and wild and domestic warm-blooded animals. In immunocompetent individuals, the acute phase of infection presents transient low or mild symptoms that remain unnoticed. In immunocompromised patients, T. gondii is a life-threatening opportunistic infection, which can result from the reactivation of latent infection or primary infection. Moreover, congenital toxoplasmosis, which results from the transplacental passage of tachyzoites into the fetus during a pregnant primary infection, can lead to miscarriage, stillbirth, or ocular and neurologic disease, and neurocognitive deficits in the newborns. Thus, the present review aims to address the current knowledge of T. gondii infection and toxoplasmosis in Africa and especially in Mozambique, stressing the importance of identifying risk factors and promote awareness among the health care providers and population, assessing the gaps in knowledge and define research priorities. In Mozambique, and in general in southern African countries, clinical disease and epidemiological data have not yet been entirely addressed in addition to the implications of T. gondii infection in immunocompetent individuals, in pregnant women, and its relation with neuropsychiatric disorders. The main gaps in knowledge in Mozambique include lack of awareness of the disease, lack of diagnostic methods in health facilities, lack of genetic data, and lack of control strategies.Graphical
Highlights
Toxoplasmosis is a zoonotic disease caused by the parasite Toxoplasma gondii, a cosmopolitan intracellular protozoan
Further advances in the understanding of Toxoplasma infection have found a link between this parasite, mental and mood disorders, and suicidal behavior. This parasitic infection should not be evaluated from a restricted anthroponotic perspective since wild and domestic animals are involved in parasite genetic recombination and transmission
It is of utmost importance to estimate the incidence of T. gondii infection and toxoplasmosis among the Mozambique population
Summary
Toxoplasmosis is a zoonotic disease caused by the parasite Toxoplasma gondii, a cosmopolitan intracellular protozoan. Toxoplasma gondii genotyping studies recognize three major subtypes identified as subtype I, subtype II, and subtype III They account for 95% of isolates from North America and Europe, each leading to differences in disease severity [2, 3]. In these regions, the majority of cases of congenital toxoplasmosis and toxoplasmosis infection in HIV immunosuppressed individuals are mainly caused by type II strains. Exotic, recombinant, or non-archetypal genotypes were found in other continents and the characterization of the strains by multilocus polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), using ten genetic markers revealed 18 different genotypes Together they account for 5% of infections, generating more virulent parasites due to its genetic diversity and the consequent increase of disease severity [3, 14, 20]. Despite the limited reports available on the relative importance of toxoplasmosis in Africa and in Mozambique, where the studies on human T. gondii infection are scarce, this review aims to: (i) summarize and critically examine the most relevant aspects of Toxoplasma infection and toxoplasmosis in Africa and, in Mozambique; (ii) identify gaps of knowledge; (iii) highlight the research opportunities and reflect on its implications for the population well-being and for the socio-economic development of Mozambique
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