Abstract
Purpose:
To determine the prevalence of ocular toxoplasmosis (OT) in the Sancti Spiritus province of Central Cuba.
Methods:
This large-population, retrospective cohort study utilized a prospective database at Centro Oftalmológico Provincial Hospital, Sancti Spiritus, Cuba. The patient database was searched for all patients who presented with ocular toxoplasmosis during the 24-month study period from April 1, 2011 to March 31, 2013. Inclusion criteria were the clinical diagnosis of OT, characterized by focal retinochoroidal inflammation and response to therapy as expected. Serologic tests such as serum anti-Toxoplasma titers of IgM and IgG and other diagnostic modalities also helped support the diagnosis. Patients not residing in the Sancti Spiritus province were excluded. Medical records were reviewed to confirm inclusion criteria. Age- and gender- stratified study population data from the 2011 Cuban Census were used to calculate prevalence ratios.
Results:
279 patients from 20 municipalities (in 5 provinces) in Central Cuba were identified, with 102 meeting inclusion criteria. Eighty-three patients (81.4%) presented with acute symptomatic OT (33.7% male, 66.3% female) with a mean age of 39.4 and 19 patients (18.6%) with inactive OT (52.6% male, 47.4% female) with a mean age of 32.3 (p = .124 and p = 0.0869 for gender and age comparisons, respectively). Based on population data from Sancti Spiritus (466,106 persons), the study estimates a period prevalence of active OT at 17.8/100,000 persons during the study period. After inclusion of patients with inactive OT, the period prevalence was estimated to be 21.9/100,000 persons. Prevalence of active OT was lowest in pediatric and older age groups and was highest in patients aged 25-44 (11.9/100,000, 15.8/100,000, and 31.4/100,000 persons, respectively, p = 0.001). The prevalence of active OT was higher in women than in men (p = 0.002). Recurrences occurred during the 24 month study period in 29.4% of patients (73 total episodes, range 1-4) and occurred most commonly in patients between the ages of 25 and 44 (56.7%, n=17).
Conclusions:
In this first Index Medicus-listed report on population-based prevalence rates of OT in the Cuban population, the prevalence and recurrence of OT was found to be highest in younger to middle-aged adults. Continued expansion of this study will increase understanding of the epidemiology of ocular toxoplasmosis in the Cuban population and the Caribbean.
Keywords: 734 toxoplasmosis •
746 uveitis-clinical/animal model •
463 clinical (human) or epidemiologic studies: prevalence/incidence