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.
Dubey JP (2010): Toxoplasmosis of Animals and Humans. Second Edition. CRC Press, Boca Raton, Florida
Sepúlveda-Arias JC , Gómez-Marin JE, Bobic B, Naranjo-Galvis CA, Djurkovic-Djakovic O. Toxoplasmosis as a travel risk. Travel Med Infect Dis 12, 592–601 (2014)
Montoya JG , Liesenfeld O: Toxoplasmosis. Lancet 363, 1965–1976 (2004)
Weiss LM , Dubey JP: Toxoplasmosis: a history of clinical observations. Int J Parasitol 39, 895–901 (2009)
Flegr J , Havlícek J, Kodym P, Malý M, Smahel Z: Increased risk of traffic accidents in subjects with latent toxoplasmosis: a retrospective case-control study. BMC Infect Dis 2, 11 (2002)
Flegr J , Klose J, Novotná M, Berenreitterová M, Havlícek J: Increased incidence of traffic accidents in Toxoplasma-infected military drivers and protective effect RhD molecule revealed by a large-scale prospective cohort study. BMC Infect Dis 9, 72 (2009)
Alvarado-Esquivel C , Torres-Castorena A, Liesenfeld O, Estrada-Martínez S, Urbina-Álvarez JD: High seroprevalence of Toxoplasma gondii infection in a subset of Mexican patients with work accidents and low socioeconomic status. Parasit Vectors 5, 13 (2012)
Flegr J : Schizophrenia and Toxoplasma gondii: an undervalued association? Expert Rev Anti Infect Ther 13, 817–820 (2015)
Alvarado-Esquivel C , Urbina-Álvarez JD, Estrada-Martínez S, Torres-Castorena A, Molotla-de-León G, Liesenfeld O, Dubey JP: Toxoplasma gondii infection and schizophrenia: a case control study in a low Toxoplasma seroprevalence Mexican population. Parasitol Int 60, 151–155 (2011)
Okusaga O , Langenberg P, Sleemi A, Vaswani D, Giegling I, Hartmann AM, Konte B, Friedl M, Groer MW, Yolken RH, Rujescu D, Postolache TT: Toxoplasma gondii antibody titers and history of suicide attempts in patients with schizophrenia. Schizophr Res 133, 150–155 (2011)
Alvarado-Esquivel C , Sánchez-Anguiano LF, Arnaud-Gil CA, López-Longoria JC, Molina-Espinoza LF, Estrada-Martínez S, Liesenfeld O, Hernández-Tinoco J, SifuentesÁlvarez A, Salas-Martínez C: Toxoplasma gondii infection and suicide attempts: a case-control study in psychiatric outpatients. J Nerv Ment Dis 201, 948–952 (2013)
Flegr J , Klapilová K, Kanková S: Toxoplasmosis can be a sexually transmitted infection with serious clinical consequences. Not all routes of infection are created equal. Med Hypotheses 83, 286–289 (2014)
Lopes WD , Rodriguez JD, Souza FA, dos Santos TR, dos Santos RS, Rosanese WM, Lopes WR, Sakamoto CA, da Costa AJ: Sexual transmission of Toxoplasma gondii in sheep. Vet Parasitol 195, 47–56 (2013)
Arantes TP , Lopes WD, Ferreira RM, Pieroni JS, Pinto VM, Sakamoto CA, Costa AJ: Toxoplasma gondii: evidence for the transmission by semen in dogs. Exp Parasitol 123, 190–194 (2009)
Alvarado-Esquivel C , Alanis-Quiñones OP, Arreola-Valenzuela MA, Rodríguez-Briones A, Piedra-Nevarez LJ, Duran-Morales E, Estrada-Martínez S, Martínez-García SA, Liesenfeld O: Seroepidemiology of Toxoplasma gondii infection in psychiatric inpatients in a northern Mexican city. BMC Infect Dis 19, 178 (2006)
De Paepe ME , Guerrieri C, Waxman M: Opportunistic infections of the testis in the acquired immunodeficiency syndrome. Mt Sinai J Med 57, 25–29 (1990)
Jautzke G , Sell M, Thalmann U, Janitschke K, Gottschalk J, Schürmann D, Ruf B: Extracerebral toxoplasmosis in AIDS. Histological and immunohistological findings based on 80 autopsy cases. Pathol Res Pract 189, 428–436 (1993)
Alvarado-Esquivel C , Estrada-Martínez S, Pizarro-Villalobos H, Arce-Quiñones M, Liesenfeld O, Dubey JP: Seroepidemiology of Toxoplasma gondii infection in general population in a northern Mexican city. J Parasitol 97, 40–43 (2011)
Janitschke K , Nürnberger F: Studies on the significance of sexual intercourse for the transmission of Toxoplasma gondii (author’s transl). Zentralbl Bakteriol Orig A 231, 323–332 (1975)
Blewett DA , Teale AJ, Miller JK, Scott GR, Buxton D: Toxoplasmosis in rams: possible significance of venereal transmission. Vet Rec 111, 73–75 (1982)
Asgari Q , Keshavarz Valian H, Rezaeian M, Shojaee S, Mehrabani D: Toxoplasma gondii: sexual transmission in mice. J Parasit Dis 39, 253–257 (2015)
Prasetyo AA , Ariapramuda R, Kindi EA, Dirgahayu P, Sari Y, Dharmawan R, Kageyama S: Men having sex with men in Surakarta, Indonesia: demographics, behavioral characteristics and prevalence of blood borne pathogens. Southeast Asian J Trop Med Public Health 45, 1032–1047 (2014)
Alvarado-Esquivel C , Hernández-Tinoco J, Sánchez-Anguiano LF, Ramos-Nevárez A, Cerrillo-Soto SM, Sáenz-Soto L, Liesenfeld O: High seroprevalence of Toxoplasma gondii infection in inmates: a case control study in Durango City, Mexico. Eur J Microbiol Immunol (Bp) 4, 76–82 (2014)
Alvarado-Esquivel C , Liesenfeld O, Torres-Castorena A, Estrada-Martínez S, Urbina-Alvarez JD, Ramos-de la Rocha M, Márquez-Conde JA, Dubey JP: Seroepidemiology of Toxoplasma gondii infection in patients with vision and hearing impairments, cancer, HIV, or undergoing hemodialysis in Durango, Mexico. J Parasitol 96, 505–508 (2010)
Alvarado-Esquivel C , Estrada-Martínez S, Pizarro-Villalobos H, Arce-Quiñones M, Liesenfeld O, Dubey JP: Seroepidemiology of Toxoplasma gondii infection in general population in a northern Mexican city. J Parasitol 97, 40–43 (2011)
Alvarado-Esquivel C , Pacheco-Vega SJ, Hernández-Tinoco J, Salcedo-Jáquez M, Sánchez-Anguiano LF, Berumen-Segovia LO, Rábago-Sánchez E, Liesenfeld O: Toxoplasma gondii infection in interstate truck drivers: a case-control seroprevalence study. Parasit Vectors 8, 77 (2015)
Alvarado-Esquivel C , Liesenfeld O, Márquez-Conde JA, Estrada-Martínez S, Dubey JP: Seroepidemiology of infection with Toxoplasma gondii in workers occupationally exposed to water, sewage, and soil in Durango, Mexico. J Parasitol 96, 847–850 (2010)
Jones JL , Dubey JP: Foodborne toxoplasmosis. Clin Infect Dis 55, 845–851 (2012)
Alvarado-Esquivel C , Liesenfeld O, Herrera-Flores RG, Ramírez-Sánchez BE, González-Herrera A, Martínez-García SA, Dubey JP: Seroprevalence of Toxoplasma gondii antibodies in cats from Durango City, Mexico. J Parasitol 93, 1214–1216 (2007)
Dubey JP , Velmurugan GV, Alvarado-Esquivel C, Alvarado-Esquivel D, Rodríguez-Peña S, Martínez-García S, González-Herrera A, Ferreira LR, Kwok OC, Su C: Isolation of Toxoplasma gondii from animals in Durango, Mexico. J Parasitol 95, 319–322 (2009)
Liesenfeld O , Press C, Montoya JG, Gill R, Isaac-Renton JL, Hedman K, Remington JS: False-positive results in immunoglobulin M (IgM) Toxoplasma antibody tests and importance of confirmatory testing: the Platelia Toxo IgM test. J Clin Microbiol 35, 174–178 (1997)