Toxoplasma gondii is one of the world's most common parasites. Primary infection of the mother during pregnancy can lead to transmission to the fetus with risks of brain and eye lesions, which may ...cause lifelong disabilities. France instituted a national program based on monthly retesting of susceptible pregnant women to reduce the number of severe cases through prompt antenatal and postnatal treatment and follow-up. To evaluate the ability of the French prenatal retesting program to reduce the lifetime costs of congenital toxoplasmosis. We measured and then compared the costs and benefits of screening vs. not screening using decision-tree modelling. It included direct and indirect costs to society of treatment and care, and the lifetime lost earnings of children and caregivers. A probabilistic sensitivity analysis was carried out. Total lifetime costs per live born child identified as congenitally infected were estimated to be euro444 for those identified through prenatal screening vs euro656 for those who were not screened. Estimates were robust to changes in all costs of diagnosis, treatment, and sequelae.
Toxoplasma gondii is a zoonotic protozoan parasite that can cause morbidity and mortality in humans, domestic animals, and terrestrial and aquatic wildlife. The environmentally robust oocyst stage of ...T. gondii is fundamentally critical to the parasite's success, both in terms of its worldwide distribution as well as the extensive range of infected intermediate hosts. Despite the limited definitive host species (domestic and wild felids), infections have been reported on every continent, and in terrestrial as well as aquatic environments. The remarkable resistance of the oocyst wall enables dissemination of T. gondii through watersheds and ecosystems, and long-term persistence in diverse foods such as shellfish and fresh produce. Here, we review the key attributes of oocyst biophysical properties that confer their ability to disseminate and survive in the environment, as well as the epidemiological dynamics of oocyst sources including domestic and wild felids. This manuscript further provides a comprehensive review of the pathways by which T. gondii oocysts can infect animals and people through the environment, including in contaminated foods, water or soil. We conclude by identifying critical control points for reducing risk of exposure to oocysts as well as opportunities for future synergies and new directions for research aimed at reducing the burden of oocyst-borne toxoplasmosis in humans, domestic animals, and wildlife.
•Oocyst ingestion constitutes a significant proportion of T. gondii infections.•Oocyst attributes facilitate T. gondii transmission in terrestrial and aquatic habitats.•Oocysts are persistent and prevalent in water, soil and foods.•Mitigating oocyst-borne infections requires transdisciplinary international efforts.
Giardia duodenalis, Cryptosporidium spp. and Toxoplasma gondii are protozoan parasites that have been highlighted as emerging foodborne pathogens by the Food and Agriculture Organization of the ...United Nations and the World Health Organization. According to the European Food Safety Authority, 4786 foodborne and waterborne outbreaks were reported in Europe in 2016, of which 0.4% were attributed to parasites including Cryptosporidium, Giardia and Trichinella. Until 2016, no standardized methods were available to detect Giardia, Cryptosporidium and Toxoplasma (oo)cysts in food. Therefore, no regulation exists regarding these biohazards. Nevertheless, considering their low infective dose, ingestion of foodstuffs contaminated by low quantities of these three parasites can lead to human infection. To evaluate the risk of protozoan parasites in food, efforts must be made towards exposure assessment to estimate the contamination along the food chain, from raw products to consumers. This requires determining: (i) the occurrence of infective protozoan (oo)cysts in foods, and (ii) the efficacy of control measures to eliminate this contamination. In order to conduct such assessments, methods for identification of viable (i.e. live) and infective parasites are required. This review describes the methods currently available to evaluate infectivity and viability of G. duodenalis cysts, Cryptosporidium spp. and T. gondii oocysts, and their potential for application in exposure assessment to determine the presence of the infective protozoa and/or to characterize the efficacy of control measures. Advantages and limits of each method are highlighted and an analytical strategy is proposed to assess exposure to these protozoa.
is a cosmopolitan protozoan parasite which affects approximately 30% of the population worldwide. The drugs currently used against toxoplasmosis are few in number and show several limitations, such ...as drug intolerance, poor bioavailability, or drug resistance mechanism developed by the parasite. Thus, it is important to find new compounds able to inhibit parasite invasion or proliferation. In this study, the 400 compounds of the open-access Pathogen Box, provided by the Medicines for Malaria Venture (MMV) foundation, were screened for their anti-
activity. A preliminary
screening performed over 72 h by an enzyme-linked immunosorbent assay (ELISA) revealed 15 interesting compounds that were effective against
at 1 μM. Their cytotoxicity was estimated on Vero cells, and their 50% inhibitory concentrations (IC
) were further calculated. As a result, eight anti-
compounds with an IC
of less than 2 μM and a selectivity index (SI) value of greater than 4 were identified. The most active was MMV675968, showing an IC
of 0.02 μM and a selectivity index value equal to 275. Two other compounds, MMV689480 and MMV687807, also showed a good activity against
, with IC
s of 0.10 μM (SI of 86.6) and 0.15 μM (SI of 11.3), respectively. Structure-activity relationships for the eight selected compounds also were discussed on the basis of fingerprinting similarity measurements using the Tanimoto method. The anti-
compounds highlighted here represent potential candidates for the development of new drugs that could be used against toxoplasmosis.
The same study reported that when PCR on amniotic fluid was routinely introduced in 1995 (i.e., infected fetuses were treated earlier with pyrimethamine/sulfadiazine), the risk of developing clinical ...signs in children followed for 3 years dropped significantly (odds ratio OR 0.59; 95% CI 0.4 to 0.89; p = 0.012), and the odds of severe neurologic sequelae or death in infants with congenital toxoplasmosis was also significantly lower (OR 0.24; 95% CI 0.07-0.71) 2. Prusa-Romana et al. recently reported that antenatal treatment reduces the risk of mother-to-child transmission when compared with those without treatment 18. ...it is possible that the greater disease severity observed at birth in the US is in part due to the lack of antenatal screening and treatment in these children. Here we propose that, whatever the approach chosen (French-like versus USA-like), there are three underlying issues that need to be addressed by each country or region: parents should be informed about the disease and how to prevent it; health care providers should have access to state-of-the art information and guidelines, and counseling should be available at reference centers; and studies should be performed to address the issue of whether antenatal screening programs are cost-effective.
Toxoplasmosis is a life-threatening infection in immunocompromised patients (ICPs). The definitive diagnosis relies on parasite DNA detection, but little is known about the incidence and burden of ...disease in HIV-negative patients. A 3-year retrospective study was conducted in 15 reference laboratories from the network of the French National Reference Center for Toxoplasmosis, in order to record the frequency of Toxoplasma gondii DNA detection in ICPs and to review the molecular methods used for diagnosis and the prevention measures implemented in transplant patients. During the study period, of 31,640 PCRs performed on samples from ICPs, 610 were positive (323 patients). Blood (n = 337 samples), cerebrospinal fluid (n = 101 samples), and aqueous humor (n = 100 samples) were more frequently positive. Chemoprophylaxis schemes in transplant patients differed between centers. PCR follow-up of allogeneic hematopoietic stem cell transplant (allo-HSCT) patients was implemented in 8/15 centers. Data from 180 patients (13 centers) were further analyzed regarding clinical setting and outcome. Only 68/180 (38%) patients were HIV(+); the remaining 62% consisted of 72 HSCT, 14 solid organ transplant, and 26 miscellaneous immunodeficiency patients. Cerebral toxoplasmosis and disseminated toxoplasmosis were most frequently observed in HIV and transplant patients, respectively. Of 72 allo-HSCT patients with a positive PCR result, 23 were asymptomatic; all were diagnosed in centers performing systematic blood PCR follow-up, and they received specific treatment. Overall survival of allo-HSCT patients at 2 months was better in centers with PCR follow-up than in other centers (P < 0.01). This study provides updated data on the frequency of toxoplasmosis in HIV-negative ICPs and suggests that regular PCR follow-up of allo-HSCT patients could guide preemptive treatment and improve outcome.
•A method based on membrane filtration and molecular detection was used to detect parasites in water.•This is the first study on the presence of protozoan parasites in drinking water in Morocco.•The ...overall parasitic contamination rate of drinking waters in the region of Marrakech was 67.3%.
The association between the parasitic illnesses and the consumption of contaminated water has been largely reported. However, there is still a lack of studies investigating the extent of parasitic contamination in water in Morocco. This is the first study in Morocco that aimed at assessing the presence of protozoan parasites, namely Cryptosporidium spp., Giardia duodenalis, and Toxoplasma gondii, in drinking water consumed in the region of Marrakech.
Samples processing was performed by membrane filtration and qPCR detection. A total of 104 drinking water samples (tap water, well, and spring waters) was collected between 2016 and 2020.
The analysis revealed an overall protozoa contamination rate of 67.3% (70/104), of which 35 samples were positive for Giardia duodenalis, 18 for Toxoplasma gondii, and 17 for both parasites, whereas no sample was positive for Cryptosporidium spp.
This first study showed that drinking water in the region of Marrakech contained parasites which could represent a risk for consumers. For a better understanding and estimation of the risk encountered by local inhabitants, further studies concerned with (oo)cyst viability, infectivity, and genotype identification need to be performed.
Toxoplasma gondii is a zoonotic intracellular parasite of particular concern in the conservation of wildlife due to its ability to infect all homeotherms and potentially cause acute fatal disease in ...naive species. In the Galapagos (Ecuador), an archipelago composed of more than a hundred islets and islands, the presence of T. gondii can be attributed to human-introduced domestic cats, but little is known about its transmission in wildlife populations. We compared the prevalence of antibodies against T. gondii in sympatric Galapagos wild bird species that differ in diet and contact with oocyst-contaminated soil to determine the relative importance of trophic habits as an exposure factor. Plasma samples were obtained from 163 land birds inhabiting Santa Cruz, one of the cat-inhabited islands, and from 187 seabirds breeding in cat-free surrounding islands (Daphne Major, North Seymour, and South Plaza). These samples were tested for the presence of T. gondii antibodies using the modified agglutination test (MAT ≥ 1:10). All seven species of land birds and 4/6 species of seabirds presented seropositive results. All great frigatebirds (Fregata minor) (N = 25) and swallow-tailed gulls (Creagrus furcatus) (N = 23) were seronegative. Prevalence ranged from 13% in Nazca boobies (Sula granti) to 100% in Galapagos mockingbirds (Mimus parvulus). It decreased from occasional carnivores (63.43%) to granivores-insectivores (26.22%), and strict piscivores (14.62%). These results indicate that the consumption of tissue cysts poses the highest risk of exposure to T. gondii for Galapagos birds, followed by the ingestion of plants and insects contaminated by oocysts as important transmission pathways.
Toxoplasma gondii is a protozoan parasite that uses felids as definitive hosts and warm-blooded animals as intermediate hosts. While the dispersal of T. gondii infectious oocysts from land to coastal ...waters has been well documented, transmission routes to pelagic species remain puzzling. We used the modified agglutination test (MAT titre ≥ 10) to detect antibodies against T. gondii in sera collected from 1014 pelagic seabirds belonging to 10 species. Sampling was carried out on eight islands of the Western Indian Ocean: Reunion and Juan de Nova (colonized by cats), Cousin, Cousine, Aride, Bird, Europa and Tromelin islands (cat-free). Antibodies against T. gondii were found in all islands and all species but the great frigatebird. The overall seroprevalence was 16.8% 95% CI: 14.5%-19.1% but significantly varied according to species, islands and age-classes. The low antibody levels (MAT titres = 10 or 25) detected in one shearwater and three red-footed booby chicks most likely resulted from maternal antibody transfer. In adults, exposure to soils contaminated by locally deposited oocysts may explain the detection of antibodies in both wedge-tailed shearwaters on Reunion Island and sooty terns on Juan de Nova. However, 144 adults breeding on cat-free islands also tested positive. In the Seychelles, there was a significant decrease in T. gondii prevalence associated with greater distances to cat populations for species that sometimes rest on the shore, i.e. terns and noddies. This suggests that oocysts carried by marine currents could be deposited on shore tens of kilometres from their initial deposition point and that the number of deposited oocysts decreases with distance from the nearest cat population. The consumption of fishes from the families Mullidae, Carangidae, Clupeidae and Engraulidae, previously described as T. gondii oocyst-carriers (i.e. paratenic hosts), could also explain the exposure of terns, noddies, boobies and tropicbirds to T. gondii. Our detection of antibodies against T. gondii in seabirds that fish in the high sea, have no contact with locally contaminated soils but frequent the shores and/or consume paratenic hosts supports the hypothesis of an open-sea dispersal of T. gondii oocysts by oceanic currents and/or fish.
Identification of cercariae was long based on morphological and morphometric features, but these approaches remain difficult to implement and require skills that have now become rare. Molecular tools ...have become the reference even though they remain relatively time-consuming and expensive. We propose a new approach for the identification of cercariae using MALDI-TOF mass spectrometry. Snails of different genera (Radix, Lymnaea, Stagnicola, Planorbis, and Anisus) were collected in the field to perform emitting tests in the laboratory. The cercariae they emitted (Trichobilharzia anseri, Diplostomum pseudospathaceum, Alaria alata, Echinostoma revolutum, Petasiger phalacrocoracis, Tylodelphys sp., Australapatemon sp., Cotylurus sp., Posthodiplostomum sp., Parastrigea sp., Echinoparyphium sp. and Plagiorchis sp.) were characterized by sequencing the D2, ITS2 and ITS1 domains of rDNA, and by amplification using specific Alaria alata primers. A sample of each specimen, either fresh or stored in ethanol, was subjected to a simple preparation protocol for MALDI-TOF analysis. The main spectral profiles were analyzed by Hierarchical Clustering Analysis. Likewise, the haplotypes were analyzed using the maximum likelihood method. Analytical performance and the log-score value (LSV) cut-off for species identification were then assessed by blind testing. The clusters obtained by both techniques were congruent, allowing identification at a species level. MALDI-TOF enables identification at an LSV cut-off of 1.7 without false-positives; however, it requires more data on closely related species. The development of a "high throughput" identification system for all types of cercariae would be of considerable interest in epidemiological surveys of trematode infections.
PDF
