children
Seroprevalence of Toxoplasma gondii infection in children with central nervous system disorders in Mansoura, Egypt: a case-control study
El-Beshbishi,S. N. , El-Tantawy,N. L, Elzeky, S. M., Abdalaziz , K. F. ,Atia, R. A.
Transactions of the Royal Society of Tropical Medicine and Hygiene 2018;112: 555-560
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Background: Toxoplasma gondii is a global infection with a crucial role in the development of neurological diseases. Data concerning the association between T. gondii and neurological illnesses in Egyptian children is scarce. Methods: A case-control study was conducted on 60 patients divided into children suffering from central nervous system manifestations without apparent chromosomal anomalies (n=30) and children with Down syndrome (n=30) recruited from Mansoura University Children's Hospital, Mansoura, Egypt. A total of 30 healthy children were included as controls. Demographics and clinical data were collected from all cases and Toxoplasma immunoglobulin (Ig) M and G antibodies were assessed by enzyme-linked immunosorbent assay. Results: Anti-T. gondii IgG was the most frequent antibody detected and the highest seropositivity rates were ranked for the neurologically disabled non-syndromic children, followed by Down syndrome, compared with controls (p <= 0.001). Statistically significant (p=0.05) associations were found between Toxoplasma IgG seropositivity and hydrocephalus and between Toxoplasma IgM and a history of contact with farm animals, soil and cats in children with Down syndrome. Conclusions: The association between Toxoplasma infection and neurological disorders in children should be kept in mind by paediatricians and assessment of T. gondii antibodies in early childhood is needed for timely management of afflicted patients.
Curiosity killed the cat: no evidence of an association between cat ownership and psychotic symptoms at ages 13 and 18 years in a UK general population cohort
Solmi, F., Hayes, J.F., Lewis, G., Kirkbride, J.B.
Psychological Medicine 2017; 47: 1659-1667
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Background. Congenital or early life infection with Toxoplasma gondii has been implicated in schizophrenia aetiology. Childhood cat ownership has been hypothesized as an intermediary marker of T. gondii infection and, by proxy, as a risk factor for later psychosis. Evidence supporting this hypothesis is, however, limited.
Method. We used birth cohort data from the Avon Longitudinal Study of Parents and Children (ALSPAC) to investigate whether cat ownership in pregnancy and childhood (ages 4 and 10 years) was associated with psychotic experiences (PEs) in early (age 13, N = 6705) and late (age 18, N = 4676) adolescence, rated from semi-structured interviews. We used logistic regression to examine associations between cat ownership and PEs, adjusting for several sociodemographic and socioeconomic factors, household characteristics and dog ownership. Missing data were handled via multiple imputation.
Results. Cat ownership during pregnancy was not associated with PEs at age 13 years [adjusted odds ratio (OR) 1.15, 95% confidence interval (CI) 0.97-1.35] or 18 years (OR 1.08, 95% CI 0.86-1.35). Initial univariable evidence that cat ownership at ages 4 and 10 years was associated with PEs at age 13 years did not persist after multivariable adjustment (4 years: OR 1.18, 95% CI 0.94-1.48; 10 years: OR 1.12, 95% CI 0.92-1.36). There was no evidence that childhood cat ownership was associated with PEs at age 18 years.
Conclusions. While pregnant women should continue to avoid handling soiled cat litter, given possible T. gondii exposure, our study strongly indicates that cat ownership in pregnancy or early childhood does not confer an increased risk of later adolescent PEs.
Is Toxoplasma gondii infection a risk factor for leukemia? An evidence-based meta-analysis
Huang, Y., Chang, A. S., Wang, J. S., Zeng, X. Q.,
Medical Science Monitor 2016; 22.
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Background: Possible associations of parasite infection with cancer risk have recently attracted much attention. Published studies concerning the association between Toxoplasma gondii (T. gondii) infection and leukemia risk have generated inconsistent results. In the present study, we aimed to address this topic by conducting a quantitative meta-analysis.
Material/Methods: Relevant publications were searched in electronic databases and eligible studies were rigorously screened and selected. Essential information was extracted and the data were pooled. Subgroup analysis on source of controls and detection target was also performed.
Results: A total of 6 studies that met the inclusion criteria were selected. The overall data show that T. gondii infection might have an association with increased leukemia risk (OR=3.05; 95% CI=1.83-5.08). Similar results were shown in the subgroups regarding source of controls and detection target.
Conclusions: Our results suggest that T. gondii infection might be a risk factor for leukemia, providing new insight into the etiology of leukemia. Future studies with large sample sizes in different geographic areas are needed to confirm this conclusion.
Seroprevalence of anti-Toxoplasma IgG and IgM among individuals who were referred to medical laboratories in Mazandaran province, northern Iran
Sharif, M., Daryani, A., Ebrahimnejad, Z., Gholami, S., Ahmadpour, E., Borhani, S., Lamsechi, N.
Journal of Infection and Public Health 2016; 9: 75-80
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Toxoplasma gondii (T. gondii) is a protozoan parasite that can cause toxoplasmosis in humans. However, there is no current data regarding Toxoplasma infection among individuals who were referred to medical laboratories in Mazandaran province (northern Iran). Therefore, we performed a population-based study of Toxoplasma seroprevalence in this region. A total of 1832 sera samples (from 654 men and 1178 women) were collected from people who were referred to medical laboratories in different cities throughout Mazandaran province between March and July 2012. The serum titers of anti-T. gondii IgG and IgM were measured using enzyme-linked immunosorbent assays. The seroprevalence of anti-Toxoplasma IgG was 55.5%; and 14.4% of the positive samples were seropositive for anti-Toxoplasma IgM. The highest seroprevalence was observed among people who were >50 years old (90.6%), and the lowest seroprevalence was observed among children who were 0-9 years old (9.4%; P < 0.001). There was no significant difference in the seroprevalences for each sex in the study population. However, a regional sex-specific difference in seroprevalence was observed between men (54.1%) and women (70.6%; P = 0.003) in the western cities of Mazandaran. As the seroprevalence of T. gondii in western and eastern Mazandaran was higher than that in the central cities, there is a need to evaluate the nature of the infection chain in these areas
Assessment of toxoplasma seropositivity in children suffering from attention deficit hyperactivity disorder
Afsharpaiman, S., Khosravi, M.H., Faridchehr, M., Komijani, M., Radfar, S., Amirsalari, S., Torkaman, M., Shirbazoo, S.
Galen Medical Journal 2016; 5: 188-193
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Background: Toxoplasmosis, a protozoan infection caused by Toxoplasma gondii, is suggested to be a risk factor for many psychological disorders such as schizophrenia and depression. Attention deficit hyperactivity disorder (ADHD) is one of the most common psychiatric disorders among children. Previous studies have assessed the correlation between ADHD and infectious diseases like toxoplasmosis. So we aimed to investigate the possible correlation between Toxoplasma seropositivity and ADHD in children. Materials and Methods: In this cross-sectional study children with signs of ADHD were regarded as patients and underwent clinical assessments. Diagnosis of these patients was based on DSM-IV-TR system which was performed by a pediatric psychiatrist. Forty-eight Children without signs of ADHD or other psychic disorders were considered as control, and 48 patients were considered as case group. Parents were asked to answer a questionnaire including demographic, pregnancy and habitual questions. Blood samples were taken from all individuals and assessed for anti-Toxoplasma IgM and IgG antibodies. Results: Ninety-six male and female patients with a mean age of 8.12 years underwent analysis. Seropositivity rate for anti-T.gondii IgG antibody was 4.2% in the case and 2.1% in control individuals (P=0.92). Anti-T.gondii IgM antibodies were not found in control individuals while it was found in 2.1% of case individuals (P=0.74). There was no statistically significant association between seroprevalence of IgM (P=0.74) and IgG (P=0.92) antibodies and ADHD in study individuals. Conclusion: Our findings showed that the toxoplasmosis seropositivity has no significant difference between children with and without ADHD. Further studies are needed with a larger amount of individuals.
Toxoplasmosis Titers and past Suicide Attempts Among Older Adolescents Initiating SSRI Treatment
Coryell, W., Yolken, R., Butcher, B., Burns, T., Dindo, L., Schlechte, J., Calarge, C.
Archives of Suicide Research 2016; 20: 605-613
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Latent infection with toxoplasmosis is a prevalent condition that has been linked in animal studies to high-risk behaviors, and in humans, to suicide and suicide attempts. This analysis investigated a relationship between suicide attempt history and toxoplasmosis titers in a group of older adolescents who had recently begun treatment with an SSRI. Of 108 participants, 17 (15.7%) had a lifetime history of at least one suicide attempt. All were given structured and unstructured diagnostic interviews and provided blood samples. Two individuals (11.9%) with a past suicide attempt, and two (2.1%) without this history, had toxoplasmosis titers >= 10 IU/ml (p = 0.166). Those with a past suicide attempt had mean toxoplasmosis titers that were significantly different (p = 0.018) from those of patients who lacked this history. An ROC analysis suggested a lower optimal threshold for distinguishing patients with and without suicide attempts (3.6 IU/ml) than that customarily used to identify seropositivity. Toxoplasmosis titers may quantify a proneness to suicidal behavior in younger individuals being treated with antidepressants.
Seroprevalence of Toxoplasma gondii infection in patients with Alzheimer’s disease
Rashno, M. M., Fallahi, S., Kheirandish, F., Bagheri, S., Kayedi, M. H., Birjandi, M.
Archives of Clinical Infectious Diseases 2016, 11: ARTN e37205 10.5812/archcid.37205
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Background: Toxoplasmosis is one of the most important diseases in humans and animals. Almost one-third of the human population around the world is infected with toxoplasmosis. The agent of this parasitic disease is a protozoan called Toxoplasma gondii (T. gondii) that causes encephalitis in people with suppressed immune systems and abortion, mental retardation and chorioretinitis in the fetus. Alzheimer's disease (AD) is the most important neurodegenerative disease.
Objectives: Due to the high prevalence of toxoplasmosis in Iran and evidence on its impact on neurodegenerative diseases, this study was performed to evaluate the T. gondii infection in patients with AD.
Patients and Methods: In this case-control study, after selection of alzheimer's patients (APs) referred to Imam Reza psychiatric hospital of Khorramabad, west of Iran, and healthy controls (each group consisted of 87 individuals), using the convenience sampling method and under the supervision of a neurologist, blood samples were taken during July 2014 and January 2015. The collected samples were transferred to the research laboratory of parasitology under cold chain storage and then, the serum samples were separated by centrifugation and were frozen at -20 degrees C until use. The T. gondii IgM and IgG specific antibodies were assessed in serum samples using commercial Enzyme Linked Immunosorbent Assay (ELISA) kits.
Results: The overall prevalence of T. gondii infection in patients with AD and the control group, using ELISA assay, was obtained as 66.6% (58/87) and 56.32% (49/87), respectively (P = 0.99). In this study, there was no significant association between T. gondii infection and AD. On the other hand, no statistically significant difference was observed between the two groups in terms of infection with T. gondii (P = 0.99).
Conclusions: Higher prevalence of T. gondii in patients with AD compared to controls showed the possible impact of this parasite in AD, which may exacerbate symptoms, and this requires special attention of specialists and patient families.
Maternal infection during pregnancy and risk of autism spectrum disorders: A systematic review and meta-analysis
Jiang, H. Y., Xu, L. L., Shao, L., Xia, R. M., Yu, Z. H., Ling, Z. X., Yang, F., Deng, M., Ruan, B.
Brain Behavior and Immunity 2016; 58: 165-172
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Conflicting evidence exists with regard to the relationship between maternal infection during pregnancy and the risk of autism spectrum disorder (ASD) in offspring. The aim of this meta-analysis was to systematically assess this relationship. To identify relevant studies, we conducted systematic searches in PubMed and Embase of scientific articles published through March 2016. Random-effects models were adopted to estimate overall relative risk. A total of 15 studies (2 cohort and 13 case-control studies) involving more than 40,000 ASD cases were included in our meta-analysis. Our results showed that maternal infection during pregnancy was associated with an increased risk of ASD in offspring (OR = 1.13, 95% confidence interval (CI): 1.03-1.23), particularly among those requiring hospitalization (OR = 1.30, 95% CI: 1.14-1.50). Subgroup analyses suggested that risk may be modulated by the type of infectious agent, time of infectious exposure, and site of infection. These findings indicate that maternal infection during pregnancy increases the risk of ASD in offspring. Possible mechanisms may include direct effects of pathogens and, more indirectly, the effects of inflammatory responses on the developing brain. (C) 2016 Elsevier Inc. All rights reserved.
Assessment of Toxoplasma sweropositivity in children suffering from attention deficit hyperactivity disorder
Afsharpaiman, S., Khosravi, M. H., Faridchehr, M., Komijani, M., Radfar, S., Amirsalari, S., Torkaman, M., Shirbazoo, S.
Galen Medical Journal 2016; 5: 188-193
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Background: Toxoplasmosis, a protozoan infection caused by Toxoplasma gondii, is suggested to be a risk factor for many psychological disorders such as schizophrenia and depression. Attention deficit hyperactivity disorder (ADHD) is one of the most common psychiatric disorders among children. Previous studies have assessed the correlation between ADHD and infectious diseases like toxoplasmosis. So we aimed to investigate the possible correlation between Toxoplasma seropositivity and ADHD in children. Materials and Methods: In this cross-sectional study children with signs of ADHD were regarded as patients and underwent clinical assessments. Diagnosis of these patients was based on DSM-IV-TR system which was performed by a pediatric psychiatrist. Forty-eight Children without signs of ADHD or other psychic disorders were considered as control, and 48 patients were considered as case group. Parents were asked to answer a questionnaire including demographic, pregnancy and habitual questions. Blood samples were taken from all individuals and assessed for anti-Toxoplasma IgM and IgG antibodies. Results: Ninety-six male and female patients with a mean age of 8.12 years underwent analysis. Seropositivity rate for anti-T.gondii IgG antibody was 4.2% in the case and 2.1% in control individuals (P=0.92). Anti-T.gondii IgM antibodies were not found in control individuals while it was found in 2.1% of case individuals (P=0.74). There was no statistically significant association between seroprevalence of IgM (P=0.74) and IgG (P=0.92) antibodies and ADHD in study individuals. Conclusion: Our findings showed that the toxoplasmosis seropositivity has no significant difference between children with and without ADHD. Further studies are needed with a larger amount of individuals.
The relationship between pediatric obsessive compulsive disorder and Toxoplasma gondii
Memik, N. C., Tamer, G. S., Unver, H., Gundogdu, O. Y.
Journal of Obsessive-Compulsive and Related Disorders 2015; 7: 24-28
Seroprevalence of Toxoplasma gondii infection among patients with hand, foot and mouth disease in Henan, China: a hospital-based study
Wang, S., Lan, C. W., Zhang, L. W., Zhang, H. Z., Yao, Z. J., Wang, D., Ma, J. B., Deng, J. R., Liu, S. G.
Infectious Diseases of Poverty 2015; 4.
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Background: The prevalence of infection with Toxoplasma gondii (T. gondii) in humans has been increasing in China due to the growing number of cats in the country. Hand, foot and mouth disease (HFMD) is a serious public health issue in China and still one of the leading causes of child mortality. However, little is known about the epidemiology of T. gondii infection among HFMD patients.
Methods: A case-control study of 281 HFMD patients from the First People's Hospital of Pingdingshan in Pingdingshan city, Henan province, central China, and 222 controls from Pingdingshan city was conducted. Anti-T. gondii antibodies were serologically detected using the enzyme-linked immunosorbent assay.
Results: We found that the overall anti-T. gondii immunoglobulin G (IgG) antibody prevalence among HFMD patients was 12.46 %, which was significantly higher than that in clinically healthy children (1.80 %). The highest T. gondii seroprevalence was detected in critical cases (22.58 %), followed by severe cases (11.50 %), and the lowest was detected in mild cases (8.33 %).
Conclusion: The present study is the first survey of T. gondii seroprevalence among HFMD patients in China; 12.46 % were defined as seropositive. It is imperative that improved integrated measures are taken to prevent and control T. gondii infection among HFMD patients.
Recurrent headaches may be caused by cerebral toxoplasmosis
Prandota, J., Gryglas, A., Fuglewicz, A., Zeslawska-Falenczyk, A., Ujma-Czapska, B., Szenborn, L., Mierzwa, J.
World Journal of Clinical Pediatrics 2014; 3: 59-68
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AIM: To establish seroprevalence and provide characteristics of Toxoplasma gondii (TG) infection in children with recurrent headaches. METHODS: The study was performed in 178 children aged 7-17 years admitted consecutively to the Department of Pediatric Neurology from November 2009 to July 2011. The children were surveyed with a questionnaire with the help and assistance of their parents and blood samples taken on admission were studied for the presence of specific anti-TG IgM, IgG antibodies and IgG avidity using enzyme immunoassay Platelia Toxo IgM, IgG. RESULTS: The study showed that 19 children (8 boys, 11 girls; 8-17 years old, mean age 14.36 years) had high serum anti-TG IgG antibody levels (range: 32.2 > 240 UI/mL, mean 120.18 UI/mL; positive value for IgG was >/= 9 UI/mL). The avidity index (AI) ranged from 0.202 to 0.925 (scale: >/= 0.5 high AI). The results for IgM antibodies were all negative and the obtained results ranged from 0.113 to 0.25 U/mL (mean = 0.191 IU/mL) and all values below 0.8 IU/mL were considered negative. The most frequent complaints found in the seropositive patients were headaches that affected the frontal (13 children), occipital (4) and parietal areas (5). Headaches usually had a pulsating (in 7 patients) and squeezing (6) character and rarely were piercing, dull or expanding. Interestingly, 8 children did not feel discomfort during the headaches, probably because they did not have sufficiently increased intracranial pressure yet. The headaches usually appeared 1-2 times/mo, lasted for 2-6 h, and had a mean intensity of 5.5 points in a 10 point subjective scale. The comorbidities included epilepsy (5 patients), various infections in 3 children (chronic eustachitis, chronic rhinitis, chronic purulent tonsillitis, streptococcal pharyngitis, meningitis, allergic diseases), disturbances of behavior, deficits of attention, and ocular and motor concentration disorders in 1 child. The electroencephalographic and neuroimaging studies performed in our patients had a very limited value in establishing cerebral toxoplasmosis. CONCLUSION: Ten point six seven percent of the studied children had markedly increased serum anti-TG IgG antibodies and high AI indicated chronic infestation. It is suggested that tests for TG infection should be introduced to routine diagnostics in patients with recurrent headaches.
Is there any role of Toxoplasma gondii in the etiology of obsessive-compulsive disorder?
Miman, O., Mutlu, E. A., Ozcan, O., Atambay, M., Karlidag, R., Unal, S.
Psychiatry Research 2010; 177: 263-265
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Obsessive-compulsive disorder (OCD) is a common psychiatric illness. Although the aetiology of OCD is still unknown, the family-genetic data show that familial forms of OCD may be associated with a specific genetic susceptibility. Recent investigations have associated development of OCD with infectious illness. Toxoplasmic encephalitis (TE) is a common presentation of Toxoplasma gondii infection of the central nervous system (CNS). The most commonly affected CNS region in TE is the cerebral hemisphere, followed by the basal ganglia, cerebellum and brain stem. The basal ganglia has been implicated in the development of OCD. Therefore, in this study, it was aimed to investigate a possible association between Toxoplasma infection and OCD. We selected 42 patients with OCD and 100 healthy volunteers, and investigated the sero-positivity rate for anti-Toxoplasma IgG antibodies by Enzyme Linked Immunosorbent Assay (ELISA). The sero-positivity rate for anti-T. gondii IgG antibodies among OCD patients (47.62%) was found to be significantly higher than the rate in healthy volunteers (19%). This is the first report to examine a potential association between Toxoplasma infection and OCD. The main finding of the present study is an increased level of IgG antibodies to T. gondii in OCD patients when compared with the level in healthy controls. There might be a causal relationship between chronic toxoplasmosis and the aetiology of OCD. (C) 2010 Elsevier Ireland Ltd. All rights reserved.
Epilepsy and seropositivity rates of Toxocara canis and Toxoplasma gondii
Akyol, A., Bicerol, B., Ertug, S., Ertabaklar, H., Kiylioglu, N.
Seizure-European Journal of Epilepsy 2007; 16: 233-237.
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Purpose: Increased seropositivity for Toxoplasma gondii and Toxocara canis have been observed in epileptic patients. Our aim is to determine whether there is any relationship between these agents and epilepsy in our cryptogenic epilepsy group.
Material and methods: We studied specific IgG antibodies against T gondii and T canis in 100 cryptogenic epileptic patients and 50 healthy volunteers that had no history of epilepsy in their first degree relatives. We studied T gondii and T canis-specific IgG antibody serum levels and compared the values of these two groups.
Result: We found similar T gondii and T canis serum IgG antibodies in patients with cryptogenic epilepsy and in the control group, even though the control group included more animal owners.
Conclusion: We did not show any relationships between epilepsy and positive T gondii and T canis serology in our epileptic patients. (c) 2006 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.
Toxoplasmosis and mental-retardation -report of a case-control study
Caiaffa, W. T., Chiari, C. A., Figueiredo, A. R. P., Orefice, F., Antunes, C. M. F.
Memorias Do Instituto Oswaldo Cruz 1993; 88: 253-261
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A case-control study evaluating the association between mental retardation and toxoplasmosis was conducted among 845 school children in Belo Horizonte, MG, Brazil. Cases (450) were mentally retarded children attending a Public school for special education. Controls (395) were children from the regular public school system. Clinical and anthropometric examinations and interviews were carried out to determine risk factors for toxoplasmosis and mental retardation. Diagnosis of Toxoplasma gondii infection was based upon an indirect immunofluorescent test (IFA); 55% of cases and 29% of controls were positive. The Relative Odds of mental retardation in children with positive serology was 3.0 (95% CI 2.2-4.0). Maternal exposure to cats and contact with soil were associated with an increased risk of mental retardation. Retinochoroiditis was fourfold more prevalent among cases than controls and was only diagnosed in T. gondii IFA positive participants. Congenital toxoplasmosis, in its subclinical form, appears to be an important component in the etiology of mental retardation, especially in high risk (lower socioeconomic) groups. The population attributable risk was estimated as 6.0-9.0%, suggesting the amount of mental retardation associated with this infection.