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Toxoplasma gondii infection in Kyrgyzstan: seroprevalence, risk factor analysis, and estimate of congenital and AIDS-related toxoplasmosis.
[congenital toxoplasmosis]
HIV-prevalence
,
as
well
as
incidence
of
zoonotic
parasitic
diseases
like
cystic
echinococcosis
,
has
increased
in
the
Kyrgyz
Republic
due
to
fundamental
socio-economic
changes
after
the
breakdown
of
the
Soviet
Union
.
The
possible
impact
on
morbidity
and
mortality
caused
by
Toxoplasma
gondii
infection
in
congenital
toxoplasmosis
or
as
an
opportunistic
infection
in
the
emerging
AIDS
pandemic
has
not
been
reported
from
Kyrgyzstan
.
We
screened
1
,
061
rural
and
899
urban
people
to
determine
the
seroprevalence
of
T
.
gondii
infection
in
2
representative
but
epidemiologically
distinct
populations
in
Kyrgyzstan
.
The
rural
population
was
from
a
typical
agricultural
district
where
sheep
husbandry
is
a
major
occupation
.
The
urban
population
was
selected
in
collaboration
with
several
diagnostic
laboratories
in
Bishkek
,
the
largest
city
in
Kyrgyzstan
.
We
designed
a
questionnaire
that
was
used
on
all
rural
subjects
so
a
risk-
factor
analysis
could
be
undertaken
.
The
samples
from
the
urban
population
were
anonymous
and
only
data
with
regard
to
age
and
gender
was
available
.
Estimates
of
putative
cases
of
congenital
and
AIDS-related
toxoplasmosis
in
the
whole
country
were
made
from
the
results
of
the
serology
.
Specific
antibodies
(
IgG
)
against
Triton
X-
100
extracted
antigens
of
T
.
gondii
tachyzoites
from
in
vitro
cultures
were
determined
by
ELISA
.
Overall
seroprevalence
of
infection
with
T
.
gondii
in
people
living
in
rural
vs
.
urban
areas
was
6
.
2
%
(
95
%
CI
:
4
.
8
-
7
.
8
)
(
adjusted
seroprevalence
based
on
census
figures
5
.
1
%
,
95
%
CI
3
.
9
-
6
.
5
)
,
and
19
.
0
%
(
95
%
CI
:
16
.
5
-
21
.
7
)
(
adjusted
16
.
4
%
,
95
%
CI
14
.
1
-
19
.
3
)
,
respectively
,
without
significant
gender-
specific
differences
.
The
seroprevalence
increased
with
age
.
Independently
low
social
status
increased
the
risk
of
Toxoplasma
seropositivity
while
increasing
numbers
of
sheep
owned
decreased
the
risk
of
seropositivity
.
Water
supply
,
consumption
of
unpasteurized
milk
products
or
undercooked
meat
,
as
well
as
cat
ownership
,
had
no
significant
influence
on
the
risk
for
seropositivity
.
We
present
a
first
seroprevalence
analysis
for
human
T
.
gondii
infection
in
the
Kyrgyz
Republic
.
Based
on
these
data
we
estimate
that
173
(
95
%
CI
136
-
216
)
Kyrgyz
children
will
be
born
annually
to
mothers
who
seroconverted
to
toxoplasmosis
during
pregnancy
.
In
addition
,
between
350
and
1
,
000
HIV-infected
persons
are
currently
estimated
to
be
seropositive
for
toxoplasmosis
.
Taken
together
,
this
suggests
a
substantial
impact
of
congenital
and
AIDS-related
symptomatic
toxoplasmosis
on
morbidity
and
mortality
in
Kyrgyzstan
.
Diseases
Validation
Diseases presenting
"specific antibodies"
symptom
benign recurrent intrahepatic cholestasis
congenital toxoplasmosis
cutaneous mastocytosis
hereditary cerebral hemorrhage with amyloidosis
inclusion body myositis
omenn syndrome
scrub typhus
typhoid
x-linked adrenoleukodystrophy
zellweger syndrome
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