Serosurvey of Anti- Toxoplasma gondii  Antibodies in Homeless Persons of São Paulo City, Southeastern Brazil

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Abstract

Seroprevalence of Toxoplasma gondii has been extensively studied in a variety of different human populations. However, no study has focused on homeless populations. Accordingly, the present study aimed to assess the seroprevalence of anti- T. gondii antibodies and the risk factors associated in homeless persons from homeless shelter of São Paulo city, southeastern Brazil. In addition, anti-HIV antibodies and associated risk of T. gondii and HIV coinfection have been evaluated. Anti- T. gondii antibodies were detected by indirect fluorescent antibody test. In addition, anti-HIV levels were tested by chemiluminescence enzyme immunoassay, with positive samples confirmed by rapid immunoblot assay. Overall, IgG anti- T. gondii seropositivity was found in 43/120 (35.8%) homeless persons, with endpoint titers varying from 16 to 1,024. The only two pregnant women tested were negative for IgM by chemiluminescence enzyme immunoassay, with normal parturition and clinically healthy newborns in both cases. There were no statistical differences in the risk factors for anti- T. gondii serology ( p > 0.05). Anti-HIV seropositivity was found in 2/120 (1.7%) homeless persons, confirmed as HIV-1. One HIV seropositive individual was also sero-reactive to IgG anti- T. gondii, and both were negative to IgM anti- T. gondii. This is the first study that reports the serosurvey of T. gondii in homeless persons worldwide. Despite the limited sample size available in the present study, our findings have shown that the prevalence of anti- T. gondii antibodies in homeless persons herein was lower than the general population, probably due to homeless diet habit of eating mainly processed food intake. No statistical differences were found regarding risk factors for anti- T. gondii exposure in homeless persons. Future studies should be conducted to fully establish risk factors for anti- T. gondii exposure in homeless persons.

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Toxoplasmosis.

JG Montoya, O. Liesenfeld (2004)

Toxoplasma gondii is a protozoan parasite that infects up to a third of the world's population. Infection is mainly acquired by ingestion of food or water that is contaminated with oocysts shed by cats or by eating undercooked or raw meat containing tissue cysts. Primary infection is usually subclinical but in some patients cervical lymphadenopathy or ocular disease can be present. Infection acquired during pregnancy may cause severe damage to the fetus. In immunocompromised patients, reactivation of latent disease can cause life-threatening encephalitis. Diagnosis of toxoplasmosis can be established by direct detection of the parasite or by serological techniques. The most commonly used therapeutic regimen, and probably the most effective, is the combination of pyrimethamine with sulfadiazine and folinic acid. This Seminar provides an overview and update on management of patients with acute infection, pregnant women who acquire infection during gestation, fetuses or infants who are congenitally infected, those with ocular disease, and immunocompromised individuals. Controversy about the effectiveness of primary and secondary prevention in pregnant women is discussed. Important topics of current and future research are presented.

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Toxoplasmosis snapshots: global status of Toxoplasma gondii seroprevalence and implications for pregnancy and congenital toxoplasmosis.

Georgios Pappas, Nikos Roussos, Matthew E. Falagas (2009)

Toxoplasma gondii's importance for humans refers mainly to primary infection during pregnancy, resulting in abortion/stillbirth or congenital toxoplasmosis. The authors sought to evaluate the current global status of T. gondii seroprevalence and its correlations with risk factors, environmental and socioeconomic parameters. Literature published during the last decade on toxoplasmosis seroprevalence, in women who were pregnant or of childbearing age, was retrieved. A total of 99 studies were eligible; a further 36 studies offered seroprevalence data from regions/countries for which no data on pregnancy/childbearing age were available. Foci of high prevalence exist in Latin America, parts of Eastern/Central Europe, the Middle East, parts of south-east Asia and Africa. Regional seroprevalence variations relate to individual subpopulations' religious and socioeconomic practices. A trend towards lower seroprevalence is observed in many European countries and the United States of America (USA). There is no obvious climate-related gradient, excluding North and Latin America. Immigration has affected local prevalence in certain countries. We further sought to recognise specific risk factors related to seropositivity; however, such risk factors are not reported systematically. Population awareness may affect recognition of said risks. Global toxoplasmosis seroprevalence is continuingly evolving, subject to regional socioeconomic parameters and population habits. Awareness of these seroprevalence trends, particularly in the case of women of childbearing age, may allow proper public health policies to be enforced, targeting in particular seronegative women of childbearing age in high seroprevalence areas.

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The health of homeless people in high-income countries: descriptive epidemiology, health consequences, and clinical and policy recommendations.

Seena Fazel, John R Geddes, Margot Kushel (2014)

In the European Union, more than 400,000 individuals are homeless on any one night and more than 600,000 are homeless in the USA. The causes of homelessness are an interaction between individual and structural factors. Individual factors include poverty, family problems, and mental health and substance misuse problems. The availability of low-cost housing is thought to be the most important structural determinant for homelessness. Homeless people have higher rates of premature mortality than the rest of the population, especially from suicide and unintentional injuries, and an increased prevalence of a range of infectious diseases, mental disorders, and substance misuse. High rates of non-communicable diseases have also been described with evidence of accelerated ageing. Although engagement with health services and adherence to treatments is often compromised, homeless people typically attend the emergency department more often than non-homeless people. We discuss several recommendations to improve the surveillance of morbidity and mortality in homeless people. Programmes focused on high-risk groups, such as individuals leaving prisons, psychiatric hospitals, and the child welfare system, and the introduction of national and state-wide plans that target homeless people are likely to improve outcomes.

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Contributors

Laís Giuliani Felipetto: URI : http://loop.frontiersin.org/people/1087660/overview

Pedro Irineu Teider-Junior: URI : http://loop.frontiersin.org/people/1122611/overview

Felipe Fortino Verdan da Silva: URI : http://loop.frontiersin.org/people/1122638/overview

Ana Carolina Yamakawa: URI : http://loop.frontiersin.org/people/1017818/overview

Louise Bach Kmetiuk: URI : http://loop.frontiersin.org/people/1110505/overview

Anahi Chechia do Couto: URI : http://loop.frontiersin.org/people/1122659/overview

Camila Marinelli Martins: URI : http://loop.frontiersin.org/people/1122623/overview

Eduarda Stankiwich Vaz: URI : http://loop.frontiersin.org/people/1122630/overview

Leila Sabrina Ullmann: URI : http://loop.frontiersin.org/people/1122655/overview

Helio Langoni: URI : http://loop.frontiersin.org/people/1122618/overview

Jorge Timenetsky: URI : http://loop.frontiersin.org/people/1122652/overview

Andrea Pires dos Santos: URI : http://loop.frontiersin.org/people/968222/overview

Alexander Welker Biondo: URI : http://loop.frontiersin.org/people/1001028/overview

Journal

Journal ID (nlm-ta): Front Public Health

Journal ID (iso-abbrev): Front Public Health

Journal ID (publisher-id): Front. Public Health

Title: Frontiers in Public Health

Publisher: Frontiers Media S.A.

ISSN (Electronic): 2296-2565

Publication date (Electronic): 05 November 2020

Publication date Collection: 2020

Volume: 8

Electronic Location Identifier: 580637

Affiliations

[1] ¹Department of Veterinary Medicine, Graduate College of Veterinary Science, Federal University of Paraná , Curitiba, Brazil

[2] ²Clinical Analysis Laboratory Unit, Clinics Hospital, Federal University of Paraná , Curitiba, Brazil

[3] ³Department of Veterinary Hygiene and Public Health, São Paulo State University , Botucatu, Brazil

[4] ⁴Graduate College of Cellular and Molecular Biology, Federal University of Paraná , Curitiba, Brazil

[5] ⁵Department of Nursing and Public Health, State University of Ponta Grossa , Ponta Grossa, Brazil

[6] ⁶AAC&T Research Consulting LTDA , Curitiba, Brazil

[7] ⁷Institute of Biotechnology, São Paulo State University (UNESP) , Botucatu, Brazil

[8] ⁸Department of Medical Microbiology, University of São Paulo , São Paulo, Brazil

[9] ⁹Department of Comparative Pathobiology, Purdue University , West Lafayette, IN, United States

[10] ¹⁰Department of Veterinary Medicine, Federal University of Paraná , Curitiba, Brazil

Author notes

Edited by: Alexandre Morrot, Federal University of Rio de Janeiro, Brazil

Reviewed by: Phileno Pinge-Filho, State University of Londrina, Brazil; Xiaoping Huang, The First Affiliated Hospital of Soochow University, China

*Correspondence: Alexander Welker Biondo abiondo@ 123456ufpr.br

This article was submitted to Infectious Diseases - Surveillance, Prevention and Treatment, a section of the journal Frontiers in Public Health

Article

DOI: 10.3389/fpubh.2020.580637

PMC ID: 7674916

SO-VID: dcaaf4a1-3702-4e30-a0a4-3908ac1198c0

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This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

History

Date received : 15 July 2020

Date accepted : 13 October 2020

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Figures: 0, Tables: 2, Equations: 0, References: 59, Pages: 8, Words: 6306

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Serosurvey of Anti- Toxoplasma gondii Antibodies in Homeless Persons of São Paulo City, Southeastern Brazil

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Toxoplasmosis.

Toxoplasmosis snapshots: global status of Toxoplasma gondii seroprevalence and implications for pregnancy and congenital toxoplasmosis.

The health of homeless people in high-income countries: descriptive epidemiology, health consequences, and clinical and policy recommendations.

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