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Toxoplasmosis is one of the most widespread zoonotic diseases in the world. Human infection rates range from 10% to 80% in many countries. Female cancer patients receiving chemotherapy are more susceptible to developing acute forms of toxoplasmosis, which can cause brain defects, neurological damage, and encephalitis. The aim of the present study was to investigate the effect of Toxoplasma gondii infection on the induction of interferon-gamma in breast cancer patients from Iraq. This descriptive cross-sectional study was performed on women had breast cancer in Al-Haboubi Teaching Hospital in Nasiriya City-Thi-Qar Province (Iraq) during the period from January to September 2022. Approximately three ml of blood was drawn from all participants and sera were collected. The Sera were then tested for Toxoplasma IgM, IgG, and IFN-γ (Nova Tec Immunodiagnostica GmbH, Germany) using the enzyme-linked immunosorbent assay (ELISA) kits according to the protocols of the manufacturer. Before blood collection, participants completed a printed questionnaire with some demographic information, such as age and place of residence. The total number of positive T. gondii infections from breast cancer patients in the current study was 60 (85.7%). The results of sample analysis by ELISA assay showed that 85.7% and 74.2% of patients were positive for IgG and IgM, respectively. The mean IFN-γ levels in breast cancer patients with toxoplasmosis, without toxoplasmosis, and in the control group were 47.66, 0.00, and 0.57 pg/ml, respectively. Higher IgG and interferon gamma levels were detected in the group of breast cancer patients with toxoplasmosis than in the group without toxoplasmosis. According to the ELISA findings, T. gondii was the most common parasite in female cancer patients. [ABSTRACT FROM AUTHOR]

In a representative sample of female children and adolescents in Germany, Toxoplasma gondii seroprevalence was 6.3% (95% CI 4.7%-8.0%). With each year of life, the chance of being seropositive increased by 1.2, indicating a strong force of infection. Social status and municipality size were found to be associated with seropositivity.

Toxoplasmosis is a zoonotic infection contracted through Toxoplasma gondii-contaminated food, soil, or water. Seroprevalence in Germany is high, but estimates of disease incidence are scarce. We investigated incidences for various toxoplasmosis manifestations using anonymized healthcare claims data from Germany for 2011-2016. Patients with a toxoplasmosis diagnosis during the annual observational period were considered incident. The estimated incidence was adjusted to the general population age/sex distribution. We estimated an annual average of 8,047 toxoplasmosis patients in Germany. The average incidence of non-pregnancy-associated toxoplasmosis patients was 9.6/100,000 population. The incidence was highest in 2011, at 10.6 (95% CI 9.4-12.6)/100,000 population, and lowest in 2016, at 8.0 (95% CI 7.0-9.4)/100,000 population. The average incidence of toxoplasmosis during pregnancy was 40.3/100,000 pregnancies. We demonstrate a substantial toxoplasmosis disease burden in Germany. Public health and food safety authorities should implement toxoplasmosis-specific prevention programs. [ABSTRACT FROM AUTHOR]

Toxoplasmosis is one of the major foodborne parasitic diseases in Germany, with 49% of its population chronically infected with its causative agent, Toxoplasma gondii. Although the acute disease is usually benign in immunocompetent individuals, it is a threat for immunocompromised patients as well as for fetuses of seronegative mothers. As a result of infection, congenital and ocular toxoplasmosis can have serious lifelong consequences. Here I will highlight the epidemiologic situation, from its past in the two separate parts of Germany, to its unification 30 years ago and up to the present day. The main identified risk factor for infection in Germany is thought to be the consumption of undercooked or raw meat or sausages. However, the relative impact of this risky eating habit as well as that of other risk factors are changing and are discussed and compared to the situation in the Netherlands. Finally, the importance of robust and efficient high-throughput serological assays for obtaining reliable epidemiological data, on which public health decisions can be made, is highlighted. The potential of bead-based multiplex assays, which allow the incorporation of multiple antigens with different analytical properties and thus yield additional information, are described in this context. It illustrates the interdependence of new analytic assay developments and sound epidemiology, a foundation that decades-old data from Germany did not have. [ABSTRACT FROM AUTHOR]

Background: To estimate the prevalence of posterior segment eye lesions and to identify their ocular and systemic associations within the Gutenberg Health Study (GHS) in Germany. Methods: Assessment and grading of fundus images as well as physical examination and history taking were performed in the cross-sectional analysis of 15,010 subjects (aged 35–74 years) using standardised procedures to determine the prevalence and associations of various posterior segment eye lesions. Results: Fundus photographs of both eyes were available for 12,782 (85.2%; 50% female) subjects. The prevalence weighted to the region of Mainz and Mainz-Bingen in Germany was for choroidal nevi 2.4%, drusen of the optic nerve head 0.2%, tilted discs 1.5%, chorioretinal scars suggestive of toxoplasmosis 0.2%, retinitis pigmentosa 0.04% and persistent hyaloid artery 0.02%. Choroidal nevi were positively associated with a history of myocardial infarction (OR = 2.7, 95% confidence interval 1.2–6.2, p value = 0.017). Tilted discs were positively associated with increased intraocular pressure (OR = 1.09 per mm Hg (1.02–1.16), p = 0.011) and negatively associated with smoking (OR 0.4 (0.3–0.7), p = 0.0022). Participants with tilted discs had a mean spherical equivalent of − 3.6 dioptres (standard deviation 4.0) compared with − 0.4 dioptres (2.4) to those without. Conclusion: Our study is—to the best of our knowledge—the first to determine the prevalence of drusen of optic nerve head among Caucasians, to show a positive association between tilted discs and increased intraocular pressure and questions a possible link between choroidal nevi and myocardial infarction. It also showed that participants with tilted discs had a lower mean spherical equivalent than those without. [ABSTRACT FROM AUTHOR]

Background: With approximately 30% of the world population infected, Toxoplasma gondii is one of the most widespread pathogenic parasites in both humans and animals and a major problem for health economics in many countries. Methods: This review is based on the findings of individual studies, meta-analyses, and Cochrane Reviews retrieved by a selective literature survey of the Medline and Google Scholar databases. Results: Current data indicate a high rate of Toxoplasma gondii infection in Germany, ranging from 20% to 77% depending on age (95% confidence interval for 18- to 29-year-olds [17.0; 23.1]; for 70- to 79-year-olds [72.7; 80.5]). Male sex, caring for a cat, and a body mass index of 30 or more are independent risk factors for seroconversion. Postnatally acquired (food-related) infection is predominant, but maternal-to-fetal transmission still plays an important role. While most infections are asymptomatic, congenital toxoplasmosis and reactivated Toxoplasma encephalitis in immunosuppressed persons (transplant recipients and others) are sources of considerable morbidity. Toxoplasma gondii infection of the retina is the most common cause of infectious uveitis in Germany. The diagnosis and treatment of this type of parasitic infection are particular to the specific organs involved in the individual patient. Conclusion: Desirable steps for the near future include development of an effective treatment for the cystic stage and identification of biomarkers to assess the risk of reactivation and predict the disease course. [ABSTRACT FROM AUTHOR]

Background: Congenital toxoplasmosis is associated with severe complications. German state health insurance covers rubella, but not toxoplasmosis, immunity screening. We analysed the effect of socioeconomic factors on the efficiency of private toxoplasmosis screening during pregnancy.Methods: Toxoplasmosis and rubella screening data (n = 5402 mothers) were collected within the population-based Survey of Neonates in Pomerania (SNiP).Results: At the first-trimester screening, 34.4 % (88.1 %) of expecting mothers were immune to toxoplasmosis (rubella). Susceptibility for toxoplasmosis (rubella) was observed in 39.6 % (8.9 %) and 25.8 % (2.95 %) were not tested. Data on a 2(nd) screening were available in a subgroup of women with negative immunity showing less than 45 % participation rate. Active toxoplasmosis (no rubella) infection was observed in 0.3 % (n = 17) of pregnant women. A multiple logistic regression model (AIC = 719.67; AUC = 0.725) revealed that the likelihood of participating in a second toxoplasmosis screening increased among women with a good level of education and a steady partnership and decreased with paternal unemployment and the absence of breastfeeding. The highest probability of non-participation in toxoplasmosis screening was found among women with temporal burden and family responsibilities. A cost-benefit analysis showed that covering general screening for toxoplasmosis with health insurance saved costs.Conclusion: Toxoplasmosis carried a substantial risk of infection during pregnancy. Although increased socioeconomic status was positively associated with the participation in toxoplasmosis screening, this was not the case when pregnant women had strong temporal burden and family responsibilities. This data supports the need for toxoplasmosis screening among pregnant women as a general healthcare benefit covered by insurance. [ABSTRACT FROM AUTHOR]

Background: Different clonal types of Toxoplasma gondii are thought to be associated with distinct clinical manifestations of infections. Serotyping is a novel technique which may allow to determine the clonal type of T. gondii humans are infected with and to extend typing studies to larger populations which include infected but non-diseased individuals. Methodology: A peptide-microarray test for T. gondii serotyping was established with 54 previously published synthetic peptides, whichmimic clonal type-specific epitopes. The test was applied to human sera (n = 174) collected fromindividuals with an acute T. gondii infection (n = 21), a latent T. gondii infection (n = 53) and from T. gondii-seropositive forest workers (n = 100). Findings: The majority (n = 124; 71%) of all T. gondii seropositive human sera showed reactions against synthetic peptides with sequences specific for clonal type II (type II peptides). Type I and type III peptides were recognized by 42% (n = 73) or 16% (n = 28) of the human sera, respectively, while type II-III, type I-III or type I-II peptides were recognized by 49% (n = 85), 36% (n = 62) or 14% (n = 25) of the sera, respectively. Highest reaction intensities were observed with synthetic peptides mimicking type II-specific epitopes. A proportion of the sera (n = 22; 13%) showed no reaction with type-specific peptides. Individuals with acute toxoplasmosis reacted with a statistically significantly higher number of peptides as compared to individuals with latent T. gondii infection or seropositive forest workers. Conclusions: Type II-specific reactions were overrepresented and higher in intensity in the study population, which was in accord with genotyping studies on T. gondii oocysts previously conducted in the same area. There were also individuals with type I- or type III-specific reactions. Well-characterized reference sera and further specific peptide markers are needed to establish and to perform future serotyping approaches with higher resolution. [ABSTRACT FROM AUTHOR]

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A plethora of different parasites and fungi can lead to infections of the central nervous system (CNS) and cause different clinical symptoms and outcomes depending on the pathogen and the anatomic location of the infection. The diagnosis and treatment of these eukaryotic infections is challenging. The prevalence of CNS infections depends on many factors, including geographical location, living conditions, genetic background and the immune status of the individual. In Germany, infections of the CNS by fungi and parasites are rare but can lead to considerable morbidity. Some parasitic and fungal CNS infections are becoming increasingly more prevalent and clinically relevant due to the increasing number of immunocompromised people. Case fatality rates of these infections, which are difficult to diagnose and to treat, are high. This article provides an overview of a subjective selection of parasitic and fungal infections of the CNS relevant to clinical practice in Germany and presents the diagnostic and therapeutic options.

Objective: To evaluate nutrition brochures for pregnant women in Germany based on evidence-based patient information (EBPI) criteria., Methods: Nutrition brochures for pregnant women in Germany were collected. Brochures addressing the risk of salmonellosis, toxoplasmosis or listeriosis were analyzed by two researchers independently., Results: Fifty brochures reporting any information on the risk of infection were analyzed. Most brochures did not include literature citations and only few brochures gave a risk description, predominantly verbally, which usually leads to an overestimation of the actual risk. Advertisement was present in 22% of the brochures., Conclusion: German nutrition brochures for pregnant women should be adapted to comply with evidence-based patient information (EBPI) criteria for achieving a better quality of the disseminated information., Practice Implications: The findings highlight the need of high quality nutrition brochures for pregnant women, which are relevant not only for pregnant women, but also to those responsible for creating brochures, and to physicians in charge of patient information., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)