Abstract
Human toxoplasmosis, a protozoonosis caused by Toxoplasma gondii, has been described as a worldwide foodborne disease with important public health impact. Despite infection has reportedly varied due to differences in alimentary, cultural and hygienic habits and geographic region, social vulnerability influence on toxoplasmosis distribution remains to be fully established. Accordingly, the present study has aimed to assess T. gondii seroprevalence and factors associated to social vulnerability for infection in households of Ivaiporã, southern Brazil, with 33.6% population making half minimum wage or less, ranked 1,055th in population (31,816 habitants), 1,406th in per capita income (U$ 211.80 per month) and 1,021st in HDI (0.764) out of 5,570 Brazilian cities. Serum samples and epidemiological questionnaires were obtained from citizen volunteers with official City Secretary of Health assistance in 2015 and 2016. In overall, serosurvey has revealed 526/715 (73.57%) positive samples for anti-T. gondii antibodies by Indirect Fluorescent Antibody Test. Logistic regression has shown a significant increase associated to adults (p = 0.021) and elderly (p = 0.014) people, illiterates (p = 0.025), unemployment (p <0.001) and lack of household water tank (p = 0.039). On the other hand, sex (male or female), living area (urban or rural), yard hygiene, meat ingestion, sand or land contact, owning pets (dog, cat or both) were not significant variables of positivity for anti-T. gondii antibodies in the surveyed population. Although no significant spatial cluster was found, high intensity areas of seropositive individuals were located in the Kernel map where the suburban neighborhoods are located. In conclusion, socioeconomic vulnerability determinants may be associated to Toxoplasma gondii exposure. The increased risk due to illiteracy, adult or elderly age, unemployment and lack of household water tank were confirmed by multivariate analysis and the influence of low family income for seropositivity by the spatial analysis.
Highlights
Human toxoplasmosis, a protozoonosis caused by intracellular parasite Toxoplasma gondii, has been described as a worldwide foodborne disease with important public health impact [1,2]
The present study has aimed to assess T. gondii seroprevalence and factors associated to social vulnerability for infection in households of Ivaiporã, southern Brazil, 33.6% of its population, ranked 1,055th in population (31,816 habitants), 1,406th in per capita income (U$ 211.80 per month) and 1,021st in human development index (HDI) (0.764) out of 5,570 Brazilian cities
The present study has been approved by the Ethics Committee of Research Involving Human Beings at the Londrina State University and conducted as part of the official activities coordinated by the City Secretary of Health
Summary
A protozoonosis caused by intracellular parasite Toxoplasma gondii, has been described as a worldwide foodborne disease with important public health impact [1,2]. The foodborne transmission may occur by intake of shedding oocysts from felid feces and contaminate water, infecting a wide range of intermediate hosts including dogs and human beings [3]. Cases of toxoplasmosis in immunocompetent patients has been mostly asymptomatic; in immunocompromised individuals, shown a tendency of more severe clinical manifestations. Prevalence of T. gondii seropositivity may vary worldwide from 10% to 90%, mainly due to regional variations [1], with lifetime persistence of infection, typically asymptomatic, potentially latent and associated to psychiatric disorders [10,11,12] or including death in immunocompromised patients [13,14,15]. Associated factors for toxoplasmosis have been shown relevance on T. gondii seroprevalence, including school level [16,17] and low family income in latent toxoplasmosis related to cognitive deficit [18]
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