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Toxoplasma gondii infection and liver disease: a case-control study in a northern Mexican population.
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PMID:  21569516     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Infection with the protozoan parasite Toxoplasma gondii may cause liver disease. However, the impact of the infection in patients suffering from liver disease is unknown. Therefore, through a case-control study design, 75 adult liver disease patients attending a public hospital in Durango City, Mexico, and 150 controls from the general population of the same region matched by gender, age, and residence were examined with enzyme-linked immunoassays for the presence of anti-Toxoplasma IgG and anti-Toxoplasma IgM antibodies. Socio-demographic, clinical and behavioral characteristics from the study subjects were obtained.
RESULTS: Seroprevalence of anti-Toxoplasma IgG antibodies and IgG titers did not differ significantly in patients (10/75; 13.3%) and controls (16/150; 10.7%). Two (2.7%) patients and 5 (3.3%) controls had anti-Toxoplasma IgM antibodies (P = 0.57). Seropositivity to Toxoplasma did not show any association with the diagnosis of liver disease. In contrast, seropositivity to Toxoplasma in patients was associated with consumption of venison and quail meat. Toxoplasma seropositivity was more frequent in patients with reflex impairment (27.8%) than in patients without this impairment (8.8%) (P = 0.05). Multivariate analysis showed that Toxoplasma seropositivity in patients was associated with consumption of sheep meat (OR = 8.69; 95% CI: 1.02-73.71; P = 0.04) and rabbit meat (OR = 4.61; 95% CI: 1.06-19.98; P = 0.04).
CONCLUSIONS: Seropositivity to Toxoplasma was comparable among liver disease patients and controls. Further studies with larger sample sizes are needed to elucidate the association of Toxoplasma with liver disease. Consumption of venison, and rabbit, sheep, and quail meats may warrant further investigation.
Authors:
Cosme Alvarado-Esquivel; José Luis Torres-Berumen; Sergio Estrada-Martínez; Oliver Liesenfeld; Miguel Francisco Mercado-Suarez
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2011-05-13
Journal Detail:
Title:  Parasites & vectors     Volume:  4     ISSN:  1756-3305     ISO Abbreviation:  Parasit Vectors     Publication Date:  2011  
Date Detail:
Created Date:  2011-06-02     Completed Date:  2011-10-25     Revised Date:  2013-06-30    
Medline Journal Info:
Nlm Unique ID:  101462774     Medline TA:  Parasit Vectors     Country:  England    
Other Details:
Languages:  eng     Pagination:  75     Citation Subset:  IM    
Affiliation:
Faculty of Medicine, Juárez University of Durango State, Durango, Dgo, Mexico. alvaradocosme@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Aged, 80 and over
Animals
Antibodies, Protozoan / blood*
Case-Control Studies
Enzyme-Linked Immunosorbent Assay
Female
Humans
Immunoglobulin G / blood
Immunoglobulin M / blood
Liver Diseases / epidemiology*,  parasitology*
Male
Mexico / epidemiology
Middle Aged
Seroepidemiologic Studies
Toxoplasma / immunology,  isolation & purification*
Toxoplasmosis / epidemiology*,  parasitology*
Chemical
Reg. No./Substance:
0/Antibodies, Protozoan; 0/Immunoglobulin G; 0/Immunoglobulin M
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Journal ID (nlm-ta): Parasit Vectors
ISSN: 1756-3305
Publisher: BioMed Central
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Copyright ©2011 Alvarado-Esquivel et al; licensee BioMed Central Ltd.
open-access:
Received Day: 14 Month: 4 Year: 2011
Accepted Day: 13 Month: 5 Year: 2011
collection publication date: Year: 2011
Electronic publication date: Day: 13 Month: 5 Year: 2011
Volume: 4First Page: 75 Last Page: 75
ID: 3105944
Publisher Id: 1756-3305-4-75
PubMed Id: 21569516
DOI: 10.1186/1756-3305-4-75

Toxoplasma gondii infection and liver disease: a case-control study in a Northern Mexican population
Cosme Alvarado-Esquivel1 Email: alvaradocosme@yahoo.com
José Luis Torres-Berumen2 Email: luis_5oldmobile@hotmail.com
Sergio Estrada-Martínez3 Email: semdurango@hotmail.com
Oliver Liesenfeld45 Email: olitoxo@yahoo.com
Miguel Francisco Mercado-Suarez2 Email: mime.su@hotmail.com
1Faculty of Medicine, Juárez University of Durango State. Avenida Universidad S/N. 34000 Durango, Dgo, Mexico
2Mexican Social Security Institute, Avenida Normal # 200, 34000, Durango City, Durango, Mexico
3Institute for Scientific Research, Juárez University of Durango State. Avenida Universidad S/N. 34000 Durango, Durango. Mexico
4Institute for Microbiology and Hygiene, Campus Benjamin Franklin, Charité Medical School, Hindenburgdamm 27. D-12203 Berlin, Germany
5Roche Molecular Diagnostics, Pleasanton, CA. USA

Background

Human infection with the protozoan parasite Toxoplasma gondii occurs worldwide [1,2]. Major routes of T. gondii infections include ingesting food or water that is contaminated with oocysts shed by cats or by eating undercooked or raw meat containing tissue cysts [2-4]. The clinical spectrum of T. gondii infection varies from an asymptomatic state to severe illness. The parasite can affect the host's lymph nodes, eyes, central nervous system, liver, and heart [3,5,6]. In liver, the parasite has been associated with a number of pathological changes including hepatomegaly, granuloma, hepatitis, and necrosis [7-14]. In addition, an epidemiological study has reported an association of T. gondii infection with liver cirrhosis [15]. However, epidemiological studies on the association of infection with T. gondii and liver disease are scarce, and have not been performed in Mexico. Therefore, we performed a case-control study in Northern Mexico to determine the seroprevalence of T. gondii infection and anti-T. gondii IgG levels in adult patients with liver disease attending the Department of Gastroenterology in a secondary-care public hospital in Durango City. Furthermore, we investigated socio-demographic, clinical, and behavioral characteristics associated with T. gondii seropositivity in these patients.


Methods
Study design and study populations

Through a case-control study design, we studied the association of liver disease with infection with T. gondii in adult patients and control subjects in Durango City, Mexico from January 2009 to December 2010.

Liver disease patients

Seventy five outpatients attended in the Gastroenterology Department of a public secondary-care hospital (Mexican Social Security Institute) in Durango City, Mexico were enrolled in the study. Forty seven patients were male and twenty eight were female. The mean age of the patients was 58.65 ± 14.41 years (range: 22-85 years). All patients resided in Durango State. Patients suffered from liver cirrhosis (n = 67), steatosis (n = 4), chronic hepatitis (n = 2), acute hepatitis (n = 1), and amoebic liver abscess (n = 1). The etiology of liver cirrhosis was alcohol consumption in 35 patients, hepatitis C virus in 4 patients, and unknown in 28 patients.

Control subjects

One hundred and fifty control subjects matched with patients by age, gender, and residence were included in the study. The mean age in controls was 58.68 ± 14.35 (range: 22-86) and comparable with that in patients (P = 0.99). Control subjects were obtained from the general population of Durango City, Mexico.

Ethical aspects

This study was approved by the Institutional Ethical Committee of the Mexican Social Security Institute. The purpose and procedures of the study were explained to all participants, and a written informed consent was obtained from all of them.

Socio-demographic, clinical and behavioral data

We explored socio-demographic, clinical and behavioral characteristics of the participants with the aid of a standardized questionnaire. Socio-demographic data including age, gender, birthplace, residence area, educational level, occupation, and socio-economic level were obtained from all participants. Clinical data explored in patients included type and duration of liver disease, clinical response to treatment, presence of concomitant diseases, presence or history of lymphadenopathy, frequent headache, impairments in memory, reflexes, hearing and vision, blood transfusion, transplant or surgery history. Behavioral data included animal contacts, contact with cat feces, foreign travel, kind of meat consumption (pork, beef, goat, sheep, boar, chicken, turkey, pigeon, rabbit, deer, squirrel, horse, opossum, or other), consumption of raw or undercooked meat, unpasteurized milk, dried or cured meat (chorizo, ham, sausages or salami), consumption of unwashed raw vegetables, fruits, or untreated water, frequency of eating away from home (in restaurants or fast food outlets), contact with soil (gardening or agriculture), and types of floors at home.

Laboratory tests

Serum samples of participants were obtained and kept frozen at -20°C until analyzed. Sera were analyzed by qualitative and quantitative methods for anti-T. gondii IgG antibodies with the commercially available enzyme immunoassay kit "Toxoplasma IgG" (International Immuno-Diagnostics, Foster City, California). Anti-T. gondii IgG antibody levels were expressed as International Units (IU)/ml, and a result equal or greater than 8 IU/ml was considered positive. In addition, sera positive for anti-T. gondii IgG antibodies were further analyzed for anti-T. gondii IgM antibodies by the commercially available enzyme immunoassay "Toxoplasma IgM" kit (International Immuno-Diagnostics). All tests were performed following the instructions of the manufacturer.

Statistical Analysis

Results were analyzed with the aid of Epi Info version 3.5.1 and SPSS 15.0 (SPSS Inc. Chicago, Illinois). Age among the groups was compared by the student's t test. For comparison of the frequencies among groups, the Yates corrected or, when indicated, the Fisher exact test, were used. Bivariate and multivariate analyses were used to assess the association between subject's characteristics and T. gondii infection. Variables were included in the multivariate analysis if they had a P value equal or less than 0.25 in the bivariate analysis. Odd ratio (OR) and 95% confidence interval (CI) were calculated by multivariate analysis using multiple, unconditional, logistic regression. When a cell in the 2 × 2 contingency table had a value of zero, the odds ratio was calculated by adding 0.5 to all table cells [16]. A P value less than 0.05 was considered statistically significant.


Results

Anti-T. gondii IgG antibodies were found in 10 (13.3%) of 75 patients and in 16 (10.7%) of 150 controls (P = 0.71). Of the 10 anti-T. gondii IgG positive patients, 6 (8.0%) had IgG levels higher than 150 IU/ml, and 4 (5.3%) between 8 to 99 IU/ml. In comparison, of the 16 anti-T. gondii IgG positive controls, 9 (6.0%) had IgG levels higher than 150 IU/ml, 2 (1.3%) between 100 to 150 IU/ml, and 5 (3.3%) between 8 to 99 IU/ml. Anti-T. gondii IgG levels were comparable among patients and controls (P = 0.60). Anti-T. gondii IgM antibodies were found in 2 patients and in 5 controls (2.7% vs 3.3%, respectively; P = 0.57). The socio-demographic characteristics among seropositive and seronegative patients were not significantly different (Table 1). Seropositivity to T. gondii was significantly higher in patients with an occupation of truck driver than those with other occupations (3/3: 100% vs 8/65: 12.3%; P = 0.003). The type, duration and clinical response to treatment of liver disease did not show any association with the seroprevalence and levels of anti-T. gondii IgG (Table 2). The frequency of T. gondii seropositivity was higher in patients with reflex impairment (27.8%) than patients without this impairment (8.8%) (P = 0.05). Patients with a history of abdominal hernia repair had a significantly higher seroprevalence of T. gondii infection than those without this history (3/5: 60% vs 7/70: 10%, respectively; P = 0.01). In contrast, no statistically significant differences were observed among T. gondii positive and T. gondii negative patients in the frequencies of other clinical characteristics including concomitant diseases, frequent headaches, presence or history of lymphadenopathy, blood transfusion, or transplant, and impairments in memory, hearing or vision (Table 3).

Bivariate analysis showed a number of behavioral characteristics with a P value equal or less than 0.25 including cats at home, raising animals, traveling abroad, consumption of sheep, chicken, turkey, pigeon, rabbit, deer, squirrel, quail, skunk and armadillo meats, consumption of raw milk, ham, unwashed raw fruits, and untreated water, soil contact and soil floors at home. Multivariate analysis of these behavioral characteristics showed that consumption of sheep meat (OR = 8.69; 95% CI: 1.02-73.71; P = 0.04), rabbit meat (OR = 4.61; 95% CI: 1.06-19.98; P = 0.04), venison (OR = 40.46; 95% CI: 2.25-725.75; P < 0.01), and quail meat (OR = 38.50; 95% CI: 1.70-871.99; P < 0.01) were significantly associated with T. gondii infection in patients (Table 4). Other behavioral characteristics did not show an association with T. gondii infection. Raw data of patients and controls are included in additional files [additional file 1-cases and additional file 2-controls, respectively].


Discussion

In this seroprevalence case-control study, we found a comparable frequency of anti-T. gondii IgG and IgM antibodies in liver disease patients and controls. Similarly, levels of anti-T. gondii IgG antibodies were comparable among these groups indicating that T. gondii infection is not likely to substantially contribute to the etiology of liver disease in our patient population. We are not aware of previous reports about the association of T. gondii infection in liver disease patients in Mexico, and reports in other countries are scarce. Our results conflict with those reported in a Turkish study where researchers found an association of T. gondii infection with liver cirrhosis [15]. Most of our patients suffered from liver cirrhosis but we did not find any association between seropositivity to T. gondii and cirrhosis. Similarly, the comparable seroprevalence of T. gondii infection in patients and controls differs from those reported in an Egyptian study where researchers found a 65.5% seroprevalence of T. gondii antibodies in patients with acute and chronic hepatic diseases against a 27% seroprevalence found in controls [17]. Certainly, differences in the characteristics of the studies might explain the differences in the seroprevalences including the use of different laboratory methods and matching procedures, difference in ages of participants and proportions of controls and patients.

None of the socio-demographic characteristics and diagnosis of liver disease associated with T. gondii seropositivity in our patients. Concerning behavioral characteristics, it was noteworthy that there was an association between T. gondii seropositivity and sheep meat consumption (OR = 8.69; 95% CI: 1.02-73.71; P = 0.04). Infections with T. gondii have been reported in sheep [18]. In addition, viable T. gondii has been found in lambs destined for meat consumption in the USA [19], and ovine meat consumed in France [20]. It will therefore be of interest to examine the seroprevalence of T. gondii infection in sheep in Durango. In a recent study in the USA, elevated risk of recent T. gondii infection was associated with eating rare lamb [21]. Even frozen lamb meat has been associated with acute T. gondii infection in Brazil [22]. The association of T. gondii infection and consumption of sheep meat in our patients was unexpected since lamb meat consumption was negatively associated with T. gondii infection in a previous study in psychiatric patients in Durango [23]. We are not aware of any previous report about a positive association of T. gondii infection and consumption of sheep meat in Mexico. Remarkably, consumption of rabbit meat was also associated with T. gondii infection in patients (OR = 4.61; 95% CI: 1.06-19.98; P = 0.04). Infections with T. gondii in rabbits have been reported in several countries [24-26]. Antibodies against T. gondii were found in 77 (26.9%) of 286 domestic rabbits from three rabbit farms in Mexico [25]. However, the seroprevalence of T. gondii infection in rabbits in Durango is unknown. To the best of our knowledge there is not any previous report about the association of T. gondii infection and consumption of rabbit meat. In the present study, we also found an association between T. gondii seropositivity and consumption of quail meat (P < 0.01). Experimental infections with T. gondii in bobwhite [27] and Japanese quail [28] have been reported. We are not aware of any previous epidemiological report about the association of T. gondii infection and consumption of quail meat. More expectedly, we observed an association between T. gondii seropositivity and consumption of venison (P = < 0.01). Infections with T. gondii have been reported in deer [29,30]. Consumption of undercooked or uncooked venison has been linked to ocular toxoplasmosis in deer hunters [31]. Interestingly, toxoplasmosis with liver involvement has been reported in deer hunters who had eaten undercooked venison [32].

The frequency of T. gondii seropositivity was higher in patients with reflex impairment (27.8%) than patients without this impairment (8.8%), and this difference showed a borderline significance (P = 0.05). In a previous study in patients with visual impairment in Durango, we found that patients with reflex impairment had a significantly higher frequency of T. gondii infection than those with normal reflexes [33]. Reflex impairment might contribute to reducing the quality of life in T. gondii infected patients.


Conclusions

Seropositivity to T. gondii was comparable among liver disease patients and controls. Further studies with larger sample sizes are needed to elucidate the association of T. gondii with liver disease. Consumption of venison, and rabbit, sheep, and quail meats may warrant further investigation.


Competing interests

The authors declare that they have no competing interests.


Authors' contributions

CAE conceived and designed the study protocol, participated in the coordination and management of the study, applied the questionnaires, performed the laboratory tests and data analysis, and wrote the manuscript. JLTB and MFMS obtained clinical data, applied the questionnaires and performed the data analysis. SEM performed the statistical analysis. OL performed the data analysis, and wrote the manuscript. All authors read and approved the final manuscript.


Funding

This study was supported by Fondos Mixtos Durango-Consejo Nacional de Ciencia y Tecnología, Mexico. Grant No. 66718.


Supplementary Material Additional file 1

Patients. Raw data of patients suffering from liver diseases.


Click here for additional data file (1756-3305-4-75-S1.XLS)

Additional file 2

Controls. Raw data of controls of patients suffering from liver diseases.


Click here for additional data file (1756-3305-4-75-S2.XLS)


References
Hill DE,Chirukandoth S,Dubey JP,Biology and epidemiology of Toxoplasma gondii in man and animalsAnim Health Res RevYear: 20056416110.1079/AHR200510016164008
Dubey JP,Toxoplasmosis of animals and humansYear: 2009SecondBoca Raton, Florida CRC Press
Montoya JG,Liesenfeld O,ToxoplasmosisLancetYear: 20043631965197610.1016/S0140-6736(04)16412-X15194258
Dawson D,Foodborne protozoan parasitesInt J Food MicrobiolYear: 200510320722710.1016/j.ijfoodmicro.2004.12.03216083823
Walker M,Zunt JR,Parasitic central nervous system infections in immunocompromised hostsClin Infect DisYear: 2005401005101510.1086/42862115824993
Balasundaram MB,Andavar R,Palaniswamy M,Venkatapathy N,Outbreak of acquired ocular toxoplasmosis involving 248 patientsArch of OphthalYear: 2010128283210.1001/archophthalmol.2009.354
Karasawa T,Shikata T,Takizawa I,Morita K,Komukai M,Localized hepatic necrosis related to cytomegalovirus and Toxoplasma gondiiActa Pathol JpnYear: 1981315275346267876
Ortego TJ,Robey B,Morrison D,Chan C,Toxoplasmic chorioretinitis and hepatic granulomasAm J GastroenterolYear: 199085141814202220741
Bonacini M,Kanel G,Alamy M,Duodenal and hepatic toxoplasmosis in a patient with HIV infection: review of the literatureAm J GastroenterolYear: 199691183818408792710
Hassan MM,Farghaly AM,Gaber NS,Nageeb HF,Hegab MH,Galal N,Parasitic causes of hepatomegaly in childrenJ Egypt Soc ParasitolYear: 1996261771898721239
Mastroianni A,Coronado O,Scarani P,Manfredi R,Chiodo F,Liver toxoplasmosis and acquired immunodeficiency syndromeRecenti Prog MedYear: 1996873533558831254
Doğan N,Kabukçuoğlu S,Vardareli E,Toxoplasmic hepatitis in an immunocompetent patientTurkiye Parazitol DergYear: 20073126026318224612
Neves ES,Bicudo LN,Curi AL,Carregal E,Bueno WF,Ferreira RG,Amendoeira MR,Benchimol E,Fernandes O,Acute acquired toxoplasmosis: clinical-laboratorial aspects and ophthalmologic evaluation in a cohort of immunocompetent patientsMem Inst Oswaldo CruzYear: 200910439339610.1590/S0074-0276200900020003919430671
Nunura J,Vásquez T,Endo S,Salazar D,Rodriguez A,Pereyra S,Solis H,Disseminated toxoplasmosis in an immunocompetent patient from Peruvian AmazonRev Inst Med Trop Sao PauloYear: 20105210711020464132
Ustun S,Aksoy U,Dagci H,Ersoz G,Incidence of toxoplasmosis in patients with cirrhosisWorld J GastroenterolYear: 20041045245414760779
Fleiss JL,Statistical methods for rates and proportionsYear: 1981SecondNew York: John Wiley & Sons
Ghanam ME,Shataat MA,Monib Mel-S,Hassan AA,Younis AI,Evaluation of the role of some parasitic infections as a cause of acute and chronic hepatic diseasesJ Egypt Soc ParasitolYear: 200131374212557927
Dubey JP,Toxoplasmosis in sheep--the last 20 yearsVet ParasitolYear: 200916311410.1016/j.vetpar.2009.02.02619395175
Dubey JP,Sundar N,Hill D,Velmurugan GV,Bandini LA,Kwok OC,Majumdar D,Su C,High prevalence and abundant atypical genotypes of Toxoplasma gondii isolated from lambs destined for human consumption in the USAInt J ParasitolYear: 200838999100610.1016/j.ijpara.2007.11.01218191859
Halos L,Thébault A,Aubert D,Thomas M,Perret C,Geers R,Alliot A,Escotte-Binet S,Ajzenberg D,Dardé ML,Durand B,Boireau P,Villena I,An innovative survey underlining the significant level of contamination by Toxoplasma gondii of ovine meat consumed in FranceInt J ParasitolYear: 20104019320010.1016/j.ijpara.2009.06.00919631651
Jones JL,Dargelas V,Roberts J,Press C,Remington JS,Montoya JG,Risk factors for Toxoplasma gondii infection in the United StatesClin Infect DisYear: 20094987888410.1086/60543319663709
Jones JL,Muccioli C,Belfort R Jr,Holland GN,Roberts JM,Silveira C,Recently acquired Toxoplasma gondii infection, BrazilEmerg Infect DisYear: 20061258258716704805
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 cityBMC Infect DisYear: 2006617810.1186/1471-2334-6-17817178002
Almería S,Calvete C,Pagés A,Gauss C,Dubey JP,Factors affecting the seroprevalence of Toxoplasma gondii infection in wild rabbits (Oryctolagus cuniculus) from SpainVet ParasitolYear: 200412326527010.1016/j.vetpar.2004.06.01015325052
Figueroa-Castillo JA,Duarte-Rosas V,Juárez-Acevedo M,Luna-Pastén H,Correa D,Prevalence of Toxoplasma gondii antibodies in rabbits (Oryctolagus cuniculus) from MexicoJ ParasitolYear: 20069239439510.1645/GE-663R.116729701
Harfoush M,Tahoon Ael-N,Seroprevalence of Toxoplasma gondii antibodies in domestic ducks, free-range chickens, turkeys and rabbits in Kafr El-Sheikh Governorate EgyptJ Egypt Soc ParasitolYear: 20104029530221246937
Dubey JP,Ruff MD,Kwok OC,Shen SK,Wilkins GC,Thulliez P,Experimental toxoplasmosis in bobwhite quail (Colinus virginianus)J ParasitolYear: 19937993593910.2307/32837338277387
Dubey JP,Goodwin MA,Ruff MD,Kwok OC,Shen SK,Wilkins GC,Thulliez P,Experimental toxoplasmosis in Japanese quailJ Vet Diagn InvestYear: 1994621622110.1177/1040638794006002138068754
Vanek JA,Dubey JP,Thulliez P,Riggs MR,Stromberg BE,Prevalence of Toxoplasma gondii antibodies in hunter-killed white-tailed deer (Odocoileus virginianus) in four regions of MinnesotaJ ParasitolYear: 199682414410.2307/32841138627499
Gamarra JA,Cabezón O,Pabón M,Arnal MC,Luco DF,Dubey JP,Gortázar C,Almeria S,Prevalence of antibodies against Toxoplasma gondii in roe deer from SpainVet ParasitolYear: 200815315215610.1016/j.vetpar.2008.01.02818316161
Ross RD,Stec LA,Werner JC,Blumenkranz MS,Glazer L,Williams GA,Presumed acquired ocular toxoplasmosis in deer huntersRetinaYear: 20012122622910.1097/00006982-200106000-0000511421011
Sacks JJ,Delgado DG,Lobel HO,Parker RL,Toxoplasmosis infection associated with eating undercooked venisonAm J EpidemiolYear: 19831188328386650484
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, MexicoJ ParasitolYear: 20109650550810.1645/GE-2378.120557194

Tables
[TableWrap ID: T1] Table 1 

Socio-demographic characteristics of the patients and seropositivity to T. gondii.


Prevalence of T. gondii infection

Characteristic No. % No. % P value
Gender
 Male 47 62.7 8 17.0 0.19
 Female 28 37.3 2 7.1
Age groups (years)
 30 or less 3 4.0 0 0.0
 31-50 17 22.7 2 11.8 0.56
 51-70 41 54.7 6 14.6
 >70 14 18.7 2 14.3
Residence place
 Durango City 75 100.0 10 13.3
Birth place
 Durango State 67 89.3 9 13.4 0.71
 Other Mexican State 8 10.7 1 12.5
Residence area
 Urban 49 65.3 5 10.2 0.2
 Suburban 1 1.3 0 0.0
 Rural 25 33.3 5 20.0
Socio-economic level
 Low 50 72.5 8 16.0 0.44
 Medium 19 27.5 2 10.5
Educational level
 No education 6 8.0 1 16.7 0.58
 Up to 6 years 63 84.0 8 12.7
 7-12 years 6 8.0 1 16.7
Occupation
 No laborerb 26 34.7 1 3.8 0.07
 Laborerc 49 65.3 9 18.4

bNon laborer = none occupation, student or housewife.

cLaborer = Employee, business, agriculture, construction worker, driver or other.


[TableWrap ID: T2] Table 2 

Bivariate analysis of liver disease characteristics in patients and seropositivity to T. gondii infection.


No. of subjects tested Prevalence of T. gondii infection P value Anti-T. gondii IgG levels >150 IU/ml


Characteristic No. % No. %
Diagnosis
 Acute hepatitis 1 0 0.0 -
 Chronic hepatitis 2 0 0.0 -
 Cirrhosis 67 9 13.4 0.89 5 55.6
 Steatosis 4 1 25.0 1 100
 Amoebic abscess 1 0 0.0 -
Alcohol related disease
 Yes 35 6 17.1 0.28 3 50
 No 40 4 10.0 3 75
Duration of disease
 Less than 1 year 30 5 16.7 0.35 3 60
 1 to 5 years 34 4 11.8 3 75
 More than 5 years 11 1 9.1 1 100
Treatment response
 Good 50 8 16.0 4 50
 Regular 4 1 25.0 1 100
 Bad 3 1 33.3 0.44 1 100

[TableWrap ID: T3] Table 3 

Bivariate analysis of clinical data and infection with T. gondii in patients.


No. of subjects tested Prevalence of T. gondii infection P value
Characteristic No. %
Concomitant disease
 Yes 49 5 10.2 0.22
 No 26 5 19.2
Lymphadenopathy ever
 Yes 11 1 9.1 0.54
 No 64 9 14.1
Headache frequently
 Yes 25 3 12 0.55
 No 50 7 14
Blood transfusión
 Yes 50 6 12 0.44
 No 25 4 16
Transplantation
 Yes 4 0 0 0.55
 No 71 10 14.1
Surgery ever
 Yes 42 7 16.7 0.27
 No 33 3 9.1
Memory impairment
 Yes 32 4 12.5 0.56
 No 43 6 14
Reflex impairment
 Yes 18 5 27.8 0.05
 No 57 5 8.8
Hearing impairment
 Yes 48 6 12.5 0.51
 No 27 4 14.8
Visual impairment
 Yes 27 3 11.1 0.48
 No 48 7 14.6

[TableWrap ID: T4] Table 4 

Multivariate analysis of selected characteristics of patients and their association with T. gondii infection.


Raw numbers

Characteristic Yes No Odds ratio 95% Confidence interval P value
Cats at home 7/41 3/34 1.99 0.45 - 8.81 0.36
Raising animals 8/48 2/27 2.53 0.48 - 13.37 0.27
Traveling abroad 6/34 4/41 2.24 0.54 - 9.23 0.26
Sheep meat consumption 9/43 1/32 8.69 1.02 - 73.71 0.04
Chicken meat consumptiona 9/74 1/1 0.04 0.001-1.27 0.01
Turkey meat consumption 9/51 1/24 5.97 0.68 - 51.93 0.10
Pigeon meat consumption 3/12 7/63 2.42 0.46 - 12.69 0.29
Rabbit meat consumption 7/31 3/44 4.61 1.06 - 19.98 0.04
Venison consumptiona 10/36 0/39 40.46 2.25-725.75 <0.01
Squirrel meat consumption 5/24 5/51 2.46 0.59 - 10.29 0.21
Quail meat consumptiona 2/2 8/73 38.50 1.70-871.99 <0.01
Skunk meat consumption 2/5 8/70 3.11 0.43 - 22.39 0.25
Armadillo meat consumption 1/2 9/73 7.11 0.08-566.52 0.05
Raw milk consumption 6/31 4/44 2.26 0.56 - 8.99 0.24
Ham consumption 7/63 3/12 0.46 0.09 - 2.21 0.33
Unwashed raw fruits 5/24 5/51 2.4 0.60 - 9.58 0.21
Untreated water 9/47 1/28 6.73 0.75 - 60.49 0.08
Soil contact 9/53 1/22 3.86 0.45 - 33.17 0.21
Soil floor at home 4/16 6/59 2.35 0.51 - 10.72 0.26

aOdd ratios for these characteristics were calculated by adding 0.5 to each cell of the 2 × 2 table.



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