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      Factores de riesgo en mujeres embarazadas, infectadas por Toxoplasma gondii en Armenia-Colombia Translated title: Risk factors for Toxoplasma gondii infection in pregnant women in Armenia, Colombia

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          Abstract

          OBJETIVOS: Identificar los factores de riesgo para toxoplasmosis aguda en mujeres embarazadas del municipio de Armenia. MÉTODOS: Estudio de casos y controles en 14 casos y 34 controles (promedio de edad 23 ± 5,5 y 23 ± 5,1 respectivamente; p = 0,93). Participaron mujeres embarazadas con criterios diagnósticos para infección aguda o mujeres con hijos infectados por Toxoplasma gondii y mujeres embarazadas negativas para IgG específico para Toxoplasma. RESULTADOS: Los factores de riesgo más fuertemente asociados fueron carne poco cocida (OR: 13,2, IC95% 1,3-132, p = 0,01), tomar bebidas hechas con agua sin hervir (OR: 4,5, IC95% 1,1-17 p = 0,01) y el contacto con gatos menores de 6 meses (OR Indefinido, p = 0,01). Tomar agua embotellada fue un factor protector (OR: 0,24, IC95% 0,06-0,95, p = 0,02). CONCLUSIÓN: El 42% de las infecciones por Toxoplasma gondii en Armenia estuvieron asociadas al contacto con gatos y el consumo de carne poco cocida. Se sugiere también recomendar el consumo de agua de bolsa como una medida protectiva para toxoplasmosis en el embarazo.

          Translated abstract

          OBJECTIVES: To determine the risk factors associated with acute toxoplasmosis during pregnancy in Armenia. METHODS: Case-control study; 14 cases and 34 controls (mean ages 23±5.5 and 23±5.1 respectively; p = 0.93). Cases were pregnant women with serological criteria for acute toxoplasmosis and controls were seronegative pregnant women for Toxoplasma IgG. RESULTS: The risk factors more strongly predictive of acute toxoplasmosis in pregnant women were: eating undercooked meat (OR: 13.2; 95% CI: 1.3-132; p = 0.01), drinking beverages prepared with un-boiled water (OR: 4.5; 95% CI: 1.1-17; p = 0.01), and contact with cats aged less than 6 months (OR: undefined, p = 0.01). Drinking of bottled water was a protective factor (OR: 0.24; 95% CI: 0.06-0.95; p = 0.02). CONCLUSIONS: 42% of Toxoplasma gondii infections in pregnant women Armenia were associated to contact with young cats and to consumption of undercooked meat. Drinking of bottled water to prevent toxoplasma infection during pregnancy is also recommended.

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          Most cited references24

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          Highly Endemic, Waterborne Toxoplasmosis in North Rio de Janeiro State, Brazil

          In Campos dos Goytacazes, northern Rio de Janeiro state, Brazil, reports of uveitis consistent with toxoplasmosis led to a survey of the prevalence and risk factors for Toxoplasma gondii infection in 1997–1999. The survey population was selected randomly from schools, randomly chosen communities, and an army battalion. Serum samples from 1,436 persons were tested. With results adjusted for age, 84% of the population in the lower socioeconomic group was seropositive, compared with 62% and 23% of the middle and upper socioeconomic groups, respectively (p<0.001). When multivariate analysis was performed, drinking unfiltered water was found to increase the risk of seropositivity for the lower socioeconomic (odds ratio [OR]: 3.0, 95% confidence interval [CI] 1.3 to 6.9) and middle socioeconomic (OR: 1.7, 95% CI 1.2 to 2.3) populations. We also found a high T. gondii seroprevalence in this Brazilian community. Drinking unfiltered water increased the risk of T. gondii seropositivity, indicating the potential importance of oocyst transmission in water in this region.
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            Risk factors for Toxoplasma gondii infection in pregnancy. Results of a prospective case-control study in Norway.

            From 1992 to 1994, a prospective case-control study designed to identify preventable risk factors for Toxoplasma gondii infection in pregnancy was conducted in Norway. Case-patients were identified through a serologic screening program encompassing 37,000 pregnant women and through sporadic antenatal testing for Toxoplasma infection. A total of 63 pregnant women with serologic evidence of recent primary T. gondii infection and 128 seronegative control women matched by age, stage of pregnancy, expected date of delivery, and geographic area were enrolled. The following factors were found to be independently associated with an increased risk of maternal infection in conditional logistic regression analysis (in order of decreasing attributable fractions): 1) eating raw or undercooked minced meat products (odds ratio (OR) = 4.1, p = 0.007); 2) eating unwashed raw vegetables or fruits (OR = 2.4, p = 0.03); 3) eating raw or undercooked mutton (OR = 11.4, p = 0.005); 4) eating raw or undercooked pork (OR = 3.4, p = 0.03); 5) cleaning the cat litter box (OR = 5.5, p = 0.02); and 6) washing the kitchen knives infrequently after preparation of raw meat, prior to handling another food item (OR = 7.3, p = 0.04). In univariate analysis, travelling to countries outside of Scandinavia was identified as a significant risk factor, but this variable was not independently associated with infection after data were controlled for factors more directly related to the modes of infection.
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              Outbreak of toxoplasmosis associated with municipal drinking water. The BC Toxoplasma Investigation Team.

              Outbreaks of toxoplasmosis are recognised infrequently. In March, 1995, a sudden increase of serologically diagnosed cases of acute toxoplasmosis was noted in the Greater Victoria area of British Columbia, Canada. Concurrently, but independently, seven cases of acute toxoplasma retinitis were diagnosed against a background of no cases in the previous 5 years. Cases were defined by serological testing, clinical presentation, and residence in Greater Victoria. A screening programme for women who were or had been pregnant was started. Geographical mapping of cases, and case-control studies of symptomatic cases and of women enrolled in the screening programme were done. 100 individuals aged 6 to 83 years met the definition for an acute, outbreak-related case. 94 resided in Greater Victoria and six had visited it; 19 had retinitis, 51 had lymphadenopathy, four others had symptoms consistent with toxoplasmosis, seven had other symptoms, 18 were symptom-free, and one would not provide information. 36 (0.9%) of 3812 screened pregnant and postnatal women were cases. Excess cases were not detected outside Greater Victoria and no conventional source of toxoplasmosis was implicated. Mapping studies of cases and of the screened women, and both case-control studies showed significant associations between acute infection and residence in the distribution system of one reservoir supplying water to Greater Victoria (ORs or RRs: 3.53, 3.05, 8.27, and 5.42, respectively). The epidemic curve appeared bimodal, with peaks in December, 1994, and March, 1995, that were preceded by increased rainfall and turbidity in the implicated reservoir. A municipal water system that uses unfiltered, chloraminated surface water was the likely source of this large community-wide outbreak of toxoplasmosis.
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                Author and article information

                Journal
                rsap
                Revista de Salud Pública
                Rev. salud pública
                Instituto de Salud Publica, Facultad de Medicina - Universidad Nacional de Colombia (Bogotá, DF, Colombia )
                0124-0064
                July 2005
                : 7
                : 2
                : 180-190
                Affiliations
                [01] Armenia orgnameUniversidad del Quindío orgdiv1Centro de Investigaciones Biomédicas orgdiv2Grupo de Estudio en Parasitología Molecular (GEPAMOL) Colombia
                [02] Armenia orgnameUniversidad del Quindío orgdiv1Centro de Investigaciones Biomédicas orgdiv2Grupo de Estudio en Parasitología Molecular (GEPAMOL) Colombia gepamol2@ 123456uniquindio.edu.co
                Article
                S0124-00642005000200006 S0124-0064(05)00700206
                10.1590/s0124-00642005000200006
                4c14b49a-62ec-4571-8529-9ef95071c0b3

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 27 May 2005
                : 01 April 2005
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 24, Pages: 11
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                SciELO Public Health

                Self URI: Texto completo solamente en formato PDF (ES)
                Categories
                Artículos/Investigación

                Toxoplasma,toxoplasmosis,risk factors,epidemiology,pregnancy,Colombia,factores de riesgo,epidemiología,embarazadas

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