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H. Dadgostar, C. Silveira, J. L. Jones, G. Lee, C. Muccioli, R. Belfort, Jr., G. N. Holland; Risk Factors for Ocular Toxoplasmosis Among Individuals Recently Infected by Toxoplasma gondii in Southern Brazil. Invest. Ophthalmol. Vis. Sci. 2008;49(13):5529.
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To investigate epidemiologic risk factors associated with ocular involvement among individuals with serologic evidence of recently-acquired Toxoplasma gondii infection.
We evaluated 130 individuals with anti-T-gondii IgG and IgM antibodies who were recruited from June 2003 through June 2004 at Clinica Silveira in Erechim, Brazil. All subjects underwent a complete ophthalmic evaluation and completed a survey on demographic factors and lifestyle-related factors within the past 12 months that were considered likely to be associated with post-natal acquisition of T. gondii infection. Associations between risk factors and ocular disease status were analyzed using both univariate and multiple logistic regression analyses.
Ocular involvement was significantly associated with consumption of rare chicken (p=0.01) and raw lamb (p=0.05). In multiple logistic regression analyses, rare chicken remained significantly associated with ocular involvement (OR=5.1 [95% CI 1.6-22.9]; p=0.03). Additional factors associated with ocular involvement included age >30 years (OR=4.9, 95% CI 1.2-20.4, p=0.03) and male gender (OR=5.3, 95% CI 1.1-25.8, p=0.04).
These findings suggest that infection with tissue cysts (from meat) is more likely to result in ocular disease than infection with oocysts (from contaminated water or soil). Possible explanations include ingestion of higher parasite numbers from meat or selection for more virulent T. gondii strains in food animals. Our findings do not support the hypothesis that oocyst exposure is associated with an increased risk of ocular involvement and more severe ocular disease. Understanding mechanisms of ocular involvement has important global public health implications for reducing the incidence of vision loss attributable to T. gondii infection.
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