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Using Multivariate Statistics

Evidence on foodborne disease (FBD) in low and middle income countries (LMICs) is still limited, but important studies in recent years have broadened our understanding. These suggest that developing country consumers are concerned about FBD; that most of the known burden of FBD disease comes from biological hazards; and, that most FBD is the result of consumption of fresh, perishable foods sold in informal markets. FBD is likely to increase in LMICs as the result of massive increases in the consumption of risky foods (livestock and fish products and produce) and lengthening and broadening value chains. Although intensification of agricultural production is a strong trend, so far agro-industrial production and modern retail have not demonstrated clear advantages in food safety and disease control. There is limited evidence on effective, sustainable and scalable interventions to improve food safety in domestic markets. Training farmers on input use and good practices often benefits those farmers trained, but has not been scalable or sustainable, except where good practices are linked to eligibility for export. Training informal value chain actors who receive business benefits from being trained has been more successful. New technologies, growing public concern and increased emphasis on food system governance can also improve food safety.

Food Safety in Low and Middle Income Countries

One Health is a collaborative, interdisciplinary effort that seeks optimal health for people, animals, plants, and the environment. Toxoplasmosis, caused by Toxoplasma gondii, is an intracellular protozoan infection distributed worldwide, with a heteroxenous life cycle that practically affects all homeotherms and in which felines act as definitive reservoirs. Herein, we review the natural history of T. gondii, its transmission and impacts in humans, domestic animals, wildlife both terrestrial and aquatic, and ecosystems. The epidemiology, prevention, and control strategies are reviewed, with the objective of facilitating awareness of this disease and promoting transdisciplinary collaborations, integrative research, and capacity building among universities, government agencies, NGOs, policy makers, practicing physicians, veterinarians, and the general public.

/pdf/the-one-health-approach-to-toxoplasmosis-epidemiology-3p2tand7aw.pdf

The One Health Approach to Toxoplasmosis: Epidemiology, Control, and Prevention Strategies

Background:Some studies have been conducted to assess the composition of the bacterial communities inhabiting human milk, but they did not evaluate the presence of other microorganisms, such as fungi, archaea, protozoa, or viruses.Objective:This study aimed to compare the metagenome of human milk samples provided by healthy and mastitis-suffering women.Methods:DNA was isolated from human milk samples collected from 10 healthy women and 10 women with symptoms of lactational mastitis. Shotgun libraries from total extracted DNA were constructed and the libraries were sequenced by 454 pyrosequencing.Results:The amount of human DNA sequences was ≥ 90% in all the samples. Among the bacterial sequences, the predominant phyla were Proteobacteria, Firmicutes, and Bacteroidetes. The healthy core microbiome included the genera Staphylococcus, Streptococcus, Bacteroides, Faecalibacterium, Ruminococcus, Lactobacillus, and Propionibacterium. At the species level, a high degree of inter-individual variability was observ...

Metagenomic Analysis of Milk of Healthy and Mastitis-Suffering Women

* Abbreviations:
 AC/HS — : differential agglutination (test)
 AF — : amniotic fluid
 CI — : confidence interval
 CNS — : central nervous system
 CSF — : cerebrospinal fluid
 CT — : congenital toxoplasmosis
 ELISA — : enzyme-linked immunosorbent assay
 EMSCOT — : European Multicenter Study of Congenital Toxoplasmosis
 EUROTOXO — : European Toxoprevention Study
 FDA — : US Food and Drug Administration
 GRADE — : Grading of Recommendations Assessment, Development, and Evaluation
 HR — : hazard ratio
 Ig — : immunoglobulin
 ISAGA — : immunosorbent agglutination assay
 MTCT — : mother-to-child transmission
 NCCCT — : National Collaborative Chicago-Based Congenital Toxoplasmosis Study
 NPV — : negative predictive value
 OR — : odds ratio
 PAMF-TSL — : Palo Alto Medical Foundation Toxoplasma Serology Laboratory
 PCR — : polymerase chain reaction
 PPV — : positive predictive value
 P/S — : pyrimethamine/sulfadiazine
 RCT — : randomized controlled trial
 SNHL — : sensorineural hearing loss
 SNSD — : serious neurologic sequelae or death
 SYROCOT — : Systematic Review on Congenital Toxoplasmosis

Congenital toxoplasmosis (CT) is a parasitic disease that can cause significant fetal and neonatal harm. Coordinated efforts by pregnant women, researchers, physicians, and health policy makers regarding potential primary and secondary preventive measures for CT and their implementation may lead to a lower incidence of CT as well as lower morbidity and mortality rates associated with CT. In the United States, the age-adjusted seroprevalence of Toxoplasma gondii among women of childbearing age (15–44 years) has declined over time (15%, 11%, and 9% in 1988–1994, 1999–2004, and 2009–2010, respectively; among US-born women only, the seroprevalence rates during these time periods were 13%, 8%, and 6%, respectively). Thus, approximately 91% of women of childbearing age in the United States are susceptible to Toxoplasma infection. Should these women become infected during pregnancy and remain undiagnosed and untreated, they could deliver an infant with CT. However, the incidence of acute primary infection is likely very low in the current era and is probably much lower than the 1.1 in 1000 pregnant women originally reported in 1960s.

There are 3 ways CT can occur. First, CT can develop through transmission of T gondii to the fetus from a previously seronegative, immunocompetent mother who acquired acute primary infection during pregnancy or within 3 months before …

/pdf/diagnosis-treatment-and-prevention-of-congenital-1w5e4oq23h.pdf

Diagnosis, Treatment, and Prevention of Congenital Toxoplasmosis in the United States

Background: Toxoplasmosis is becoming a global health hazard as it infects 30–50% of the world human population. Clinically, the life-long presence of the parasite in tissues of a majority of infected individuals is usually considered asymptomatic. However, a number of studies show that this ‘asymptomatic infection’ may also lead to development of other human pathologies. Aims of the Study: The purpose of the study was to collect available geoepidemiological data on seroprevalence of toxoplasmosis and search for its relationship with mortality and disability rates in different countries. Methods and Findings: Prevalence data published between 1995–2008 for women in child-bearing age were collected for 88 countries (29 European). The association between prevalence of toxoplasmosis and specific disease burden estimated with age-standardized Disability Adjusted Life Year (DALY) or with mortality, was calculated using General Linear Method with Gross Domestic Product per capita (GDP), geolatitude and humidity as covariates, and also using nonparametric partial Kendall correlation test with GDP as a covariate. The prevalence of toxoplasmosis correlated with specific disease burden in particular countries explaining 23% of variability in disease burden in Europe. The analyses revealed that for example, DALY of 23 of 128 analyzed diseases and disease categories on the WHO list showed correlations (18 positive, 5 negative) with prevalence of toxoplasmosis and another 12 diseases showed positive trends (p,0.1). For several obtained significant correlations between the seroprevalence of toxoplasmosis and specific diseases/clinical entities, possible pathophysiological, biochemical and molecular explanations are presented. Conclusions: The seroprevalence of toxoplasmosis correlated with various disease burden. Statistical associations does not necessarily mean causality. The precautionary principle suggests however that possible role of toxoplasmosis as a triggering factor responsible for development of several clinical entities deserves much more attention and financial support both in everyday medical practice and future clinical research.

/pdf/toxoplasmosis-a-global-threat-correlation-of-latent-51kbfh1eag.pdf

Toxoplasmosis – A Global Threat. Correlation of Latent Toxoplasmosis with Specific Disease Burden in a Set of 88 Countries

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Toxoplasmosis – A Global Threat. Correlation of Latent Toxoplasmosis with Specific Disease Burden in a Set of 88 Countries