Authors:Cosme Alvarado-Esquivel, Ángel Osvaldo Alvarado-Félix, and Gustavo Alexis Alvarado-Félix
The epidemiology of Toxocara infection in rural Mexico is largely unknown. Therefore, we sought to determine the seroprevalence of Toxocara infection in rural people in a northern Mexican state. We performed a cross-sectional seroprevalence study of 641 people living in rural Durango State including 282 subjects of the general population, 214 subjects of Huichol ethnicity, and 145 subjects of Mennonite ethnicity. Sera of participants were analyzed for the presence of anti-Toxocara immunoglobulin G (IgG) antibodies using a commercially available enzyme immunoassay. Three (0.5%) of the 641 subjects tested were positive for anti-Toxocara IgG antibodies. Of the 3 Toxocara seropositive subjects, two were females, aged 19 and 39 years, and one was male, aged 59 years. They had contacted with dogs, cleaned cat excrement, consumed unwashed raw fruits, contacted soil, or lived in a house with soil floors. Seroprevalence of Toxocara infection was similar among the 3 groups of population studied: 0.4% for the general population, 0.9% for Huicholes, and 0.0% for Mennonites (P = 0.41). In conclusion, the Toxocara seroprevalence found in subjects in rural Durango is low as compared with those reported in people from rural areas in other countries.
Authors:Cosme Alvarado-Esquivel, Renata Vazquez-Morales, Edgar Colado-Romero, Ramiro Guzmán-Sánchez, Oliver Liesenfeld, and Jitender Dubey
We performed a cross-sectional study to determine the seroprevalence of Toxoplasma gondii infection in 308 domestic pigs slaughtered in La Paz, Baja California Sur State, Mexico using the modified agglutination test (MAT, cut off 1:25). Forty (13%) of the 308 pigs were seropositive with MAT titers of 1:25 in 16, 1:50 in 5, 1:100 in 4, 1:200 in 5, 1:400 in 3, 1:800 in 3, 1:1600 in 2, and 1:3200 in 2. Multivariate analysis of pigs’ characteristics showed that seropositivity to T. gondii was negatively associated with mixed breed (OR = 0.02; 95% CI: 0.003–0.26; P = 0.001). Other variables including sex, type of raising, and municipality did not show an association with T. gondii seropositivity by multivariate analysis. The frequency of high antibody titers (≥1:400) was significantly higher (P < 0.001) in Landrace pigs than mixed breed pigs. The seroprevalence of T. gondii infection in pigs for slaughter in Baja California Sur State is low compared with seroprevalences reported in pigs in other Mexican states. Landrace pigs demonstrated higher seroprevalence rates and antibody levels than mixed breed pigs. This is the first report of T. gondii infection in pigs raised in a desert climate.
Authors:Anabel Cruz-Romero, Cosme Alvarado-Esquivel, Dora Romero-Salas, Ángel Osvaldo Alvarado-Félix, Sokani Sánchez-Montes, Jesús Hernández-Tinoco, and Luis Francisco Sánchez-Anguiano
Purpose: This study aimed to determine the seroprevalence and correlates of Leptospira IgG antibodies in backyard pigs in the northern Mexican state of Durango. We performed a cross-sectional study of 305 backyard pigs. Anti-Leptospira IgG antibodies were detected using microscopic agglutination assay (MAT) with a panel of 12 Leptospira antigens.
Results: Overall, antibodies against Leptospira (any of the 12 Leptospira serovars examined) were found in 186 (61.0%) of the 305 pigs studied. Seropositive pigs were found on 80 (70.2%) of the 114 properties surveyed. The predominant serovar was Leptospira interrogans Pomona (n = 55); followed by Leptospira noguchii Lousiana and Leptospira santarosai Tarassovi (n = 53 each); L. interrogans Bataviae (n = 47); Leptospira biflexa Semaranga and L. interrogans Hebdomadis (n = 36 each); L. interrogans Pyrogenes (n = 30); L. interrogans Djasiman (n = 20); Leptospira borgpetersenii Ballum (n = 11); L. noguchii Panama and L. interrogans Canicola (n = 5 each); and L. borgpetersenii Mini (n = 2). Logistic regression showed that seropositivity was associated with low (<1000 m above sea level) altitude (odds ratio [OR] = 3.24; 95% confidence interval [CI]: 2.01–5.20; P < 0.001).
Conclusions: This is the first report of Leptospira exposure in backyard pigs in Mexico and of an association between Leptospira exposure in pigs and altitude. Backyard pigs represent a high-risk group for Leptospira exposure.
Authors:Dr. Cosme Alvarado-Esquivel, J. Hernández-Tinoco, L. F. Sánchez-Anguiano, A. Ramos-Nevárez, S. M. Cerrillo-Soto, L. Sáenz-Soto, and O. Liesenfeld
The seroprevalence of infection with the parasite Toxoplasma gondii and the association with risk factors has not been determined in inmates. Through a case-control study, 166 inmates from a state correctional facility in Durango City, Mexico and 166 age- and gender-matched non-incarcerated subjects were examined for the presence of anti-T. gondii IgG and IgM antibodies using enzyme-linked immunoassays.
Seroprevalence of anti-T. gondii IgG antibodies was higher in inmates (35, 21.1%) than in controls (14, 8.4%) (OR = 2.90; 95% CI: 1.43–5.94; P = 0.001). Anti-T. gondii IgM antibodies were detected in two (1.2%) inmates and in seven (4.2%) controls (P = 0.17). Multivariate analysis of socio-demographic, incarceration, and behavioral characteristics of inmates revealed that T. gondii seropositivity was associated with being born out of Durango State (OR = 3.91; 95% CI: 1.29–11.79; P = 0.01). In addition, T. gondii seroprevalence was higher (P = 0.03) in inmates that had suffered from injuries (17/56: 30.4%) than those without such history (18/110: 16.4%).
The seroprevalence of T. gondii infection in inmates in Durango City is higher than the seroprevalences found in the general population in the same city, indicating that inmates may represent a new risk group for T. gondii infection. Further research on T. gondii infection in inmates is needed.
Authors:Cosme Alvarado-Esquivel, Luis Francisco Sánchez-Anguiano, Alejandra Mendoza-Larios, Jesús Hernández-Tinoco, José Francisco Pérez-Ochoa, Elizabeth Irasema Antuna-Salcido, Elizabeth Rábago-Sánchez, and Oliver Liesenfeld
The presence of tissue cysts of Toxoplasma gondii has only poorly been investigated in autopsy series. We determined the presence of T. gondii cysts in a series of 51 autopsies in a public hospital using immunohistochemistry of brain and heart tissues. The association of tissue cysts with the general characteristics of the autopsy cases was also investigated.
Of the 51 cases studied, five (9.8%) were positive by immunohistochemistry for T. gondii cysts in the brain. None of the heart specimens was positive for T. gondii cysts. The presence of T. gondii cysts in brains did not vary with age, sex, birthplace, residence, education, occupation, or the presence of pathology in the brain. In contrast, multivariate analysis showed that the presence of T. gondii cysts was associated with undernourishment (OR = 33.90; 95% CI: 2.82–406.32; P = 0.005).
We demonstrated cerebral T. gondii cysts in an autopsy series in Durango City, Mexico. Results suggest that T. gondii can be more readily found in brain than in heart of infected individuals. This is the first report of an association between the presence of T. gondii in brains and undernourishment.
Authors:Cosme Alvarado-Esquivel, Ada A. Sandoval-Carrillo, Fernando Vazquez-Alaniz, José M. Salas-Pacheco, Jesús Hernández-Tinoco, Luis Francisco Sánchez-Anguiano, and Elizabeth Irasema Antuna-Salcido
It is not clear whether infection with cytomegalovirus (CMV) is associated with hypertensive disorders in pregnant women. Through a case-control study design, 146 women suffering from hypertensive disorders in pregnancy (cases) and 146 age-matched normotensive pregnant women (controls) were examined for the presence of anti-CMV IgG and IgM antibodies with enzyme-linked immunoassays. IgM seropositive samples were further assayed by enzyme-linked fluorescent assay (ELFA).
Anti-CMV IgG antibodies were found in 138 (94.5%) controls and in 136 (93.2%) cases (odds ratio [OR] = 0.78; 95% confidence interval [CI]: 0.30–2.05; P = 0.62). High (>18 IU/ml) levels of anti-CMV IgG antibodies were found in 37.7% of the 138 seropositive controls and in 34.6% of the 136 seropositive cases (OR = 0.87; 95% CI: 0.53–1.43; P = 0.59). Anti-CMV IgM antibodies were found in 1 (0.7%) of the controls but in none of the cases using ELFA (P = 1.0). Seropositivity to CMV was not associated with a previous preeclampsia and was similar among cases regardless their mean systolic and diastolic blood pressures, and mean arterial blood pressure.
No serological evidence of an association between CMV infection and hypertensive disorders of pregnancy was found. Further research to elucidate the role of CMV in hypertensive disorders in pregnancy should be conducted.
Authors:Cosme Alvarado-Esquivel, Yazmin del Rosario Rico-Almochantaf, Jesús Hernández-Tinoco, Gerardo Quiñones-Canales, Luis Francisco Sánchez-Anguiano, Jorge Torres-González, Björn Schott, Oliver Liesenfeld, and Ildiko Rita Dunay
Little is known about the association of Toxoplasma gondii infection and neurological disorders. We performed a case-control study with 344 patients with neurological diseases and 344 neurologically healthy age- and gender-matched subjects. Sera of participants were analyzed for anti-T. gondii IgG and IgM antibodies using commercially available immunoassays. Anti-T. gondii IgG antibodies were detected in 25 (7.3%) cases and in 35 (10.2%) controls (odds ratio [OR] = 0.69; 95% confidence interval [CI]: 0.40–1.18; P = 0.17). Anti-T. gondii IgM antibodies were found in 5 (14.3%) of the 25 IgG seropositive cases and in 13 (37.1%) of the 35 IgG seropositive controls (P = 0.15). Anti-T. gondii IgG antibodies were found in 8 (3.8%) of 213 female cases and in 23 (10.8%) of 213 female controls (OR = 0.32; 95% CI: 0.14–0.73; P = 0.005); and in 17 (13.0%) of 131 male cases and in 12 (9.2%) of 131 male controls (P = 0.32). No direct association between IgG seropositivity and specific neurological disorders was detected. We found no support for a role of latent T. gondii infection in the risk for neurological disorders in this setting. With respect to specific neurological disorders, further studies using larger patient cohorts will be required.
Authors:Cosme Alvarado-Esquivel, Sandy Pacheco-Vega, Jesús Hernández-Tinoco, Diana Saldaña-Simental, Luis Sánchez-Anguiano, Misael Salcedo-Jáquez, Agar Ramos-Nevárez, Oliver Liesenfeld, José Márquez-Conde, Sandra Cerrillo-Soto, Lucio Martínez-Ramírez, and Carlos Guido-Arreola
The association of infection with Toxoplasma gondii and occupational exposure to animals has been scantly determined. We performed a case-control study with 200 subjects from Durango Province, Mexico, occupationally exposed to animals and 200 age- and gender-matched subjects without this occupation. Sera from all participants were analyzed for anti-T. gondii IgG and IgM antibodies using enzyme-linked immunoassays. The association of seroprevalence with sociodemographic, work, clinical, and behavioral characteristics in cases was determined.Cases and controls had similar frequencies of anti-T. gondii IgG antibodies (12/200: 6.0% and 11/200: 5.5%, respectively) (OR = 3.0; 95% CI: 0.12–73.64; P = 1.0). The frequency of sera with high (>150 IU/ml) levels of anti-T. gondii IgG antibodies was comparable among cases and controls (P = 0.61). Seroprevalence of anti-T. gondii IgM antibodies was similar in cases (4, 2.0%) than in controls (4, 2.0%) (P = 1.0). Multivariate analysis showed that seropositivity was associated with eating while working (OR = 7.14; 95% CI: 1.91–26.72; P = 0.003) and consumption of duck meat (OR = 5.43; 95% CI: 1.43–20.54; P = 0.01).No association between seropositivity to T. gondii and occupational exposure to animals was found. However, risk factors for infection found should be taken into account to reduce the exposure to T. gondii.
Authors:Cosme Alvarado-Esquivel, Luis Francisco Sánchez-Anguiano, Jesús Hernández-Tinoco, Emilio Arreola-Cháidez, Juan López, Karla Itzel Salcido-Meraz, Sergio Estrada-Martínez, José Antonio Navarrete-Flores, Alma Rosa Pérez-Álamos, Marcia Hernández-Ochoa, Elizabeth Rábago-Sánchez, and Oliver Liesenfeld
Through an age- and sex-matched case-control study, we sought to determine whether female sex workers have an increased risk of Toxoplasma gondii exposure and to determine the sociodemographic, work, clinical, and behavioral characteristics of these workers associated with T. gondii exposure. Female workers (n = 136) and controls (n = 272) were examined with enzyme-linked immunoassays (EIA) for the presence of anti-Toxoplasma IgG and IgM antibodies. IgM positive sera were additionally tested with enzyme linked-fluorescence immunoassay (ELFA). Anti-T. gondii IgG antibodies were found in 21 (15.44%) of 136 cases and in 10 (3.67%) of 272 controls (OR = 4.05; 95% CI: 1.84–8.89; P = 0.0001). Anti-T. gondii IgG levels higher than 150 IU/ml were found in 13 (9.6%) of 136 cases and in 8 (2.9%) of 272 controls (P = 0.007). Anti-T. gondii IgM antibodies were found in two cases and in six controls by EIA, but all were negative by ELFA. T. gondii seropositivity was associated with being born out of Durango State (OR = 10.47; 95% CI: 2.9–36.8; P < 0.01), injuries during sex work (OR = 6.30; 95% CI: 1.1–33.7; P = 0.03), and soil contact (OR = 4.11; 95% CI: 1.2–14.0; P = 0.02). This is the first report of an association of T. gondii infection and female sex workers.
Authors:Cosme Alvarado-Esquivel, Luis Francisco Sánchez-Anguiano, Jesús Hernández-Tinoco, Agar Ramos-Nevarez, Sergio Estrada-Martínez, Sandra Margarita Cerrillo-Soto, Miriam Alejandra Mijarez-Hernández, Carlos Alberto Guido-Arreola, Alma Rosa Pérez-Álamos, Isabel Beristain-Garcia, and Elizabeth Rábago-Sánchez
We determined the association between having a history of surgery and the seroreactivity to T. gondii. An age- and gender-matched case-control study of 391 subjects with a history of surgery and 391 subjects without this history was performed. Sera of subjects were analyzed for detection of anti-T. gondii immunoglobulin G (IgG) and M (IgM) antibodies using enzyme-linked immunoassays. Anti-T. gondii IgG antibodies were found in 25 (6.4%) of the 391 cases and in 21 (5.4%) of the 391 controls (odds ratio [OR] = 1.29; 95% confidence interval [CI]: 0.66–2.18; P = 0.54). The frequency of cases with high IgG antibody levels (10/25: 40.0%) was equal to that found in controls (8/21: 38.1%) (OR = 1.08; 95% CI: 0.32–3.56; P = 0.89). Of the 25 anti-T. gondii IgG antibody seropositive cases, 5 (16.0%) were also positive for anti-T. gondii IgM antibodies. Meanwhile, of the 21 anti-T. gondii IgG antibody seropositive controls, 4 (19.0%) were also positive for anti-T. gondii IgM antibodies (OR = 0.81; 95% CI: 0.17–3.72; P = 0.80). Logistic regression showed that only the variable “hysterectomy” was associated with T. gondii seropositivity (OR = 4.6; 95% CI: 1.6–13.4; P = 0.005). Results suggest that having a history of surgery is not an important risk factor for infection with T. gondii. However, the link between T. gondii infection and hysterectomy should be further investigated.