Cuban Ocular Toxoplasmosis Epidemiology Study (COTES): incidence and prevalence of ocular toxoplasmosis in Central Cuba.

Background: Serological studies indicate that rates of ocular toxoplasmosis (OT) vary geographically, with higher rates in tropical regions. Little is known about population-based rates of active OT. We aimed to describe the epidemiology of OT in Central Cuba.
Methods: This large-population, cross-sectional cohort study used a prospective database at a large regional referral centre in Central Cuba. The patient database was searched for all patients who presented with OT during the 12-month study period from 1 April 2011 to 31 March 2012. Inclusion criteria were the clinical diagnosis of OT, characterised by focal retinochoroidal inflammation and a response to therapy as expected. Gender-stratified and age-stratified study population data from the 2012 Cuban Census were used to calculate incidence rates and prevalence ratios.
Results: Among 279 identified patients with OT, 158 presented with active OT. Of these, 122 new-onset and 36 prior-onset cases were confirmed. Based on the total population in the Sancti Spiritus province (466,106 persons), the overall incidence of active OT was 26.2 per 100,000 person-years (95% CI 21.7 to 31.3) with an annual prevalence ratio of 33.9 per 100,000 persons (95% CI 28.8 to 39.6). The incidence of active OT was lowest in the oldest age group and highest in patients aged 25-44 years (4.5 and 42.1 per 100,000 person-years, respectively).
Conclusions: This first report describing population-based rates of OT in the Cuban population highlights the importance of patient age as a likely risk factor for OT. Disease rates were found to be highest in females and young to middle-aged adults.
(Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)