Limits...
HUMAN TOXOPLASMOSIS OUTBREAKS AND THE AGENT INFECTING FORM. FINDINGS FROM A SYSTEMATIC REVIEW.

Meireles LR, Ekman CC, Andrade jR HF, Luna EJ - Rev. Inst. Med. Trop. Sao Paulo (2015 Sep-Oct)

Bottom Line: There was no gender or age group selection in the outbreaks, which were described more often in the Americas.A large number of individuals were affected when oocysts, associated with soil and water contaminated with cat feces, were considered the transmission source.Such information may be useful in the design and implementation of control strategies.

View Article: PubMed Central - PubMed

Affiliation: Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, SP, Brasil.

ABSTRACT
Toxoplasmosis, a worldwide highly prevalent zoonotic infection, is transmitted either by the oocysts, from water and soil, or the tissue cysts, in raw or undercooked infected meat, of Toxoplasma gondii. An ongoing debate is whether there are differences between the clinical and epidemiological characteristics of the outbreaks due to one or the other infective form of the agent. We performed a systematic review, recovering 437 reported outbreaks of which 38 were selected. They were complete reports containing ascribed Toxoplasma infecting form, and clinical and demographic data. There was no gender or age group selection in the outbreaks, which were described more often in the Americas. A large number of individuals were affected when oocysts, associated with soil and water contaminated with cat feces, were considered the transmission source. Onset of symptoms occurred early when the infection was ascribed to meat tissue cysts (11.4 ± 6.7 days) with sharpened temporal distribution of cases, while a broader and prolonged appearance of new cases was observed when oocysts in water were the source of the infection (20 ± 7 days, p < 0.001). Such information may be useful in the design and implementation of control strategies.

Show MeSH

Related in: MedlinePlus

- Systematic review flowchart.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4660444&req=5

f01: - Systematic review flowchart.

Mentions: Research and selection of outbreak reports: We performed the research of human toxoplasmosis outbreak reports, in the above mentioned databases, recovering 431. We also checked citations from complete articles and found another six, resulting in 437 reports. We selected 269 (62.4%) outbreak reports after the exclusion of 162 that were duplicated. The next step was data quality; we excluded 214 incomplete, partial, limited or merely descriptive reports, especially those found in Food Sciences & Tech Abstracts database. We selected 55 (20.40%) available reports that fulfilled all the inclusion criteria for the study, as described in the Materials and Methods section, but 13 had incomplete data from affected patients, six focused only on the differential diagnosis with other food or waterborne diseases, six were incomplete regarding the parasitological data and four were only related to the characterization of the agent and laboratorial data, resulting in 38 outbreaks reports available for systematic review (Table 1). The algorithm of this process is shown in Figure 1.


HUMAN TOXOPLASMOSIS OUTBREAKS AND THE AGENT INFECTING FORM. FINDINGS FROM A SYSTEMATIC REVIEW.

Meireles LR, Ekman CC, Andrade jR HF, Luna EJ - Rev. Inst. Med. Trop. Sao Paulo (2015 Sep-Oct)

- Systematic review flowchart.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4660444&req=5

f01: - Systematic review flowchart.
Mentions: Research and selection of outbreak reports: We performed the research of human toxoplasmosis outbreak reports, in the above mentioned databases, recovering 431. We also checked citations from complete articles and found another six, resulting in 437 reports. We selected 269 (62.4%) outbreak reports after the exclusion of 162 that were duplicated. The next step was data quality; we excluded 214 incomplete, partial, limited or merely descriptive reports, especially those found in Food Sciences & Tech Abstracts database. We selected 55 (20.40%) available reports that fulfilled all the inclusion criteria for the study, as described in the Materials and Methods section, but 13 had incomplete data from affected patients, six focused only on the differential diagnosis with other food or waterborne diseases, six were incomplete regarding the parasitological data and four were only related to the characterization of the agent and laboratorial data, resulting in 38 outbreaks reports available for systematic review (Table 1). The algorithm of this process is shown in Figure 1.

Bottom Line: There was no gender or age group selection in the outbreaks, which were described more often in the Americas.A large number of individuals were affected when oocysts, associated with soil and water contaminated with cat feces, were considered the transmission source.Such information may be useful in the design and implementation of control strategies.

View Article: PubMed Central - PubMed

Affiliation: Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, SP, Brasil.

ABSTRACT
Toxoplasmosis, a worldwide highly prevalent zoonotic infection, is transmitted either by the oocysts, from water and soil, or the tissue cysts, in raw or undercooked infected meat, of Toxoplasma gondii. An ongoing debate is whether there are differences between the clinical and epidemiological characteristics of the outbreaks due to one or the other infective form of the agent. We performed a systematic review, recovering 437 reported outbreaks of which 38 were selected. They were complete reports containing ascribed Toxoplasma infecting form, and clinical and demographic data. There was no gender or age group selection in the outbreaks, which were described more often in the Americas. A large number of individuals were affected when oocysts, associated with soil and water contaminated with cat feces, were considered the transmission source. Onset of symptoms occurred early when the infection was ascribed to meat tissue cysts (11.4 ± 6.7 days) with sharpened temporal distribution of cases, while a broader and prolonged appearance of new cases was observed when oocysts in water were the source of the infection (20 ± 7 days, p < 0.001). Such information may be useful in the design and implementation of control strategies.

Show MeSH
Related in: MedlinePlus