Jesús Hernández-Tinoco

Toxoplasma gondii infection and suicide attempts: A case-control study in psychiatric outpatients

Abstract The association of Toxoplasma gondii infection with suicide attempts has been scarcely evaluated. Two hundred eighty-three psychiatric outpatients (156 patients with history of suicide attempt and 127 control patients without history of suicide attempt) were examined with enzyme-linked immunoassays for Toxoplasma immunoglobulin G (IgG) and IgM antibodies. Seroprevalences of Toxoplasma IgG and IgM in the cases and the controls were similar: 7 (4.5%) and 3 (1.9%) vs. 10 (7.9%) and 3 (2.4%) (p = 0.23 and p = 0.55), respectively. In contrast, the Toxoplasma IgG levels higher than 150 IU/ml were more frequently observed in the cases than in the controls (100% vs. 50%, respectively; p = 0.04). The seroprevalence of Toxoplasma infection increased with age and with the number of suicide attempts. Toxoplasma seropositivity was associated with reflex impairment, national trips, and snake meat consumption. Our results suggest that although seroprevalence of Toxoplasma infection is not associated with suicide attempts, a high anti-Toxoplasma antibody level is, therefore warranting further research.

Seroepidemiology of Hepatitis E Virus Infection in General Population in Rural Durango, Mexico

Background: The seroepidemiology of hepatitis E virus (HEV) infection in rural areas in Mexico has been poorly studied. Objectives: The aim of the study was to determine the seroprevalence and correlates of anti-HEV IgG antibodies in adults in rural areas in Durango, Mexico. Materials and Methods: We performed a cross-sectional study to determine the frequency of anti-HEV IgG antibodies in 273 adults living in rural Durango, Mexico using an enzyme-linked immunoassay. In addition, we searched for an association of HEV exposure with the socio-demographic and behavioral characteristics of the subjects studied. Results: One hundred (36.6%) of the 273 rural adults (mean age: 39.85 ± 17.15 years) had anti-HEV IgG antibodies. Multivariate analysis of socio-demographic and behavioral characteristics of the participants showed that HEV exposure was associated with increasing age (OR = 1.04; 95% CI: 1.04-1.05; P < 0.001), consumption of untreated water (OR = 1.92; 95% CI: 1.06-3.46; P = 0.03), and availability of water at home (OR = 1.87; 95% CI: 1.07-3.27; P = 0.02). In contrast, other socio-demographic and behavioral characteristics including educational level, occupation, socio-economic status, foreign travel, consumption of unwashed raw fruits, consumption of raw or undercooked meat and raising animals did not show associations with HEV exposure. Conclusions: The seroprevalence of HEV infection found in rural Durango is higher than those reported in other Mexican populations. Consumption of untreated water is an important factor for HEV exposure in rural areas in Durango. The correlates of HEV seropositivity found in the present study can be used for an optimal planning of preventive measures against HEV infection.

Lack of association between Toxoplasma gondii infection and hypertensive disorders in pregnancy: a case–control study in a Northern Mexican population

BackgroundThe outcome of pregnancy is often threatened by hypertension disorders, i.e. eclampsia. Rate of infection with the protozoan parasite Toxoplasma gondii can be as high as 80% in pregnant women, and infection acquired during pregnancy can lead to fetal death. Very little is known about a potential association between infections, i.e. those with Toxoplasma gondii, and hypertensive disorders during pregnancy.MethodsThrough a case–control study design, we investigated the presence of anti-Toxoplasma IgG and anti-Toxoplasma IgM antibodies in 146 pregnant women suffering from hypertensive disorders (cases) and 146 age-matched normotensive pregnant women (controls) attending a public hospital in Durango City, Mexico. Obstetric and blood pressure characteristics from cases and controls were also obtained.ResultsSeroprevalence of anti-Toxoplasma IgG antibodies and IgG titers did not differ significantly in controls (8/146; 5.5%) and cases (9/146; 6.2%). Anti-Toxoplasma IgM antibodies were found in 2 (1.2%) controls and none of the cases. Seroprevalence of T. gondii in controls (5.5%) was similar to seroprevalences found in patients with mild preeclampsia (4/27: 14.8%), severe preeclampsia (5/95: 5.3%), eclampsia (0/16: 0%) and HELLP syndrome (hemolysis, elevated liver enzymes, and low platelet count) (0/8: 0%) (P = 0.23).ConclusionsOur results suggest that latent infection with T. gondii is not associated with hypertensive disorders in pregnant women in Northern Mexico. Further studies with larger sample sizes are needed to elucidate the association of infection with T. gondii with hypertensive disorders in pregnancy.

Miscarriage history and Toxoplasma gondii infection:A cross-sectional study in women in Durango City, Mexico

Through a cross-sectional study design, 326 women with a history of miscarriage were examined for anti-Toxoplasma gondii IgG and IgM antibodies in Durango City, Mexico. Prevalence association with sociodemographic, clinical, and behavioral characteristics in women with miscarriage was also investigated. Twenty-two (6.7%) of the 326 women studied had anti-T. gondii IgG antibodies and two (0.6%) were also positive for anti-T. gondii IgM antibodies. Seroprevalence of T. gondii infection was not influenced by age, birth place, occupation, educational level, or socioeconomic status. In contrast, logistic regression showed that T. gondii exposure was associated with consumption of raw or undercooked meat (OR = 6.84; 95% CI: 1.04-44.95; P = 0.04) and consumption of chicken brains (OR = 18.48; 95% CI: 1.26-269.43; P = 0.03). This is the first study on the seroepidemiology of T. gondii infection in women with a history of miscarriage in Northern Mexico. Of interest, we also observed an association of T. gondii exposure with consumption of chicken brains. Contributing factors for T. gondii exposure found in the present study should be taken into consideration for public health measures to avoid infection with T. gondii and its sequelae.

Seroepidemiology of Leptospira Exposure in General Population in Rural Durango, Mexico

The magnitude of Leptospira exposure in rural Mexico is largely unknown. We sought to determine the seroprevalence of Leptospira IgG antibodies in adults in rural Durango, Mexico, and to determine the sociodemographic, behavioral, and housing characteristics of the subjects associated with Leptospira seropositivity. We performed a cross-sectional study in 282 adults living in rural Durango, Mexico. Sera from participants were analyzed for Leptospira IgG antibodies using a commercially available enzyme immunoassay. Seroprevalence association with the characteristics of the subjects was analyzed by bivariate and multivariate analyses. Of the 282 rural subjects (42.91 ± 17.53 years old) studied, 44 (15.6%) had anti-Leptospira IgG antibodies. Seropositivity to Leptospira was not associated with gender, educational level, employment, socioeconomic status, contact with animals or soil, or type of floors at home. In contrast, multivariate analysis showed that Leptospira exposure was associated with national trips (OR = 2.09; 95% CI: 1.05–4.16; P = 0.03) and poor education of the head of the family (OR = 2.96; 95% CI: 1.51–5.78; P = 0.001). We demonstrated serological evidence of Leptospira exposure in adults in rural northern Mexico. The contributing factors associated with Leptospira exposure found in the present study may be useful for optimal planning of preventive measures against Leptospira infection.

High seroprevalence of Toxoplasma gondii infection in inmates: A case control study in Durango City, Mexico

Purpose The seroprevalence of infection with the parasite Toxoplasma gondii and the association with risk factors has not been determined in inmates. Through a case-control study, 166 inmates from a state correctional facility in Durango City, Mexico and 166 age- and gender-matched non-incarcerated subjects were examined for the presence of anti-T. gondii IgG and IgM antibodies using enzyme-linked immunoassays. Results Seroprevalence of anti-T. gondii IgG antibodies was higher in inmates (35, 21.1%) than in controls (14, 8.4%) (OR = 2.90; 95% CI: 1.43–5.94; P = 0.001). Anti-T. gondii IgM antibodies were detected in two (1.2%) inmates and in seven (4.2%) controls (P = 0.17). Multivariate analysis of socio-demographic, incarceration, and behavioral characteristics of inmates revealed that T. gondii seropositivity was associated with being born out of Durango State (OR = 3.91; 95% CI: 1.29–11.79; P = 0.01). In addition, T. gondii seroprevalence was higher (P = 0.03) in inmates that had suffered from injuries (17/56: 30.4%) than those without such history (18/110: 16.4%). Conclusions The seroprevalence of T. gondii infection in inmates in Durango City is higher than the seroprevalences found in the general population in the same city, indicating that inmates may represent a new risk group for T. gondii infection. Further research on T. gondii infection in inmates is needed.

Toxoplasma gondii Infection and Mixed Anxiety and Depressive Disorder: A Case-Control Seroprevalence Study in Durango, Mexico.

Background The parasite Toxoplasma gondii (T. gondii) may invade the brain and might induce behavioral changes. We sought to determine the association of T. gondii infection and mixed anxiety and depressive disorder. Methods Through an age- and gender-matched case-control seroprevalence study, we examined 65 patients suffering from mixed anxiety and depressive disorder (WHO ICD-10 code: F41.2) attending in a public hospital of mental health and 260 control subjects without this disorder from the general population. Sera of participants were analyzed for anti-Toxoplasma IgG and IgM antibodies using enzyme-linked immunoassays. Results Fifteen (23.1%) of the 65 patients and 18 (6.9%) of the 260 controls had anti-T. gondii IgG antibodies (odds ratio (OR): 4.03; 95% confidence interval (CI): 1.90 - 8.53; P < 0.001). The frequency of high (> 150 IU/mL) anti-T. gondii IgG levels was similar in cases and controls (OR: 0.25; 95% CI: 0.05 - 1.06; P = 0.05). Seroprevalence was similar in male cases and controls (P = 1.0); however, seroprevalence was significantly higher in female cases than in female controls (OR: 7.08; 95% CI: 2.83 - 17.67; P < 0.00001). Patients aged 31 - 50 years old had a significantly higher seroprevalence of T. gondii infection than controls of the same age group (OR: 21.04; 95% CI: 5.22 - 84.80; P < 0.00001). Anti-T. gondii IgM antibodies were found in four (26.7%) of the 15 anti-T. gondii IgG seropositive cases and in 10 (55.6%) of the 18 anti-T. gondii IgG seropositive controls (P = 0.15). Conclusions Results support for the first time an association between seropositivity to T. gondii and mixed anxiety and depressive disorder. Further research to confirm this association and to determine the seroepidemiology of T. gondii infection in patients with this disorder is needed.

Seroepidemiology of Hepatitis E Virus Infection in Mennonites in Mexico

Background The seroepidemiology of hepatitis E virus (HEV) infection in Mennonites has not been studied. We aimed to determine the seroprevalence of anti-HEV IgG antibodies in Mennonites in Durango, Mexico, and to compare it with the seroprevalence in general population in rural Durango. The socio-demographic, clinical and behavioral characteristics of Mennonites associated with HEV seropositivity were also investigated. Methods We performed a case-control study to determine the frequency of anti-HEV IgG antibodies in 150 Mennonites (mean age 38.40 ± 15.53 years old) and 150 age- and gender-matched non-Mennonites controls using an enzyme-linked immunoassay. We used a standardized questionnaire to obtain the socio-demographic, clinical and behavioral characteristics of the Mennonites. Results Anti-HEV IgG antibodies were detected in 10 (6.7%) of 150 Mennonites and in 61 (40.7%) of 150 controls. Seroprevalence of anti-HEV IgG antibodies was significantly lower in Mennonites than in controls (odds ratio (OR) = 0.009; 95% confidence interval (CI): 0.0006 - 0.15; P < 0.000001). Logistic regression of socio-demographic and behavioral characteristics of Mennonites showed that HEV seropositivity was only associated with increasing age (OR = 1.05; 95% CI: 1.00 - 1.09; P = 0.03). While sex, birth place, residence, educational level, socio-economic status, occupation, animal contacts, foreign travel, frequency of eating away from home, consumption of raw or undercooked meat, type of meat consumed, consumption of unpasteurized milk or untreated water, and consumption of unwashed raw vegetables or fruits were not associated with HEV seropositivity. None of the Mennonites suffered from clinical hepatitis. Conclusions Results demonstrate: 1) serological evidence of HEV exposure in Mennonites; however, Mennonites have a lower seroprevalence of HEV antibodies than controls from the rural general population; 2) seroprevalence in Mennonites increased with age. Further studies with a larger sample size to determine more contributing factors for HEV infection in Mennonites are needed.

Leptospira Exposure and Waste Pickers: A Case-Control Seroprevalence Study in Durango, Mexico

Background Infection with Leptospira may occur by contact with Leptospira-infected animals. Waste pickers are in contact with rodents and dogs while picking in the garbage. Whether waste pickers are at risk for Leptospira infection is largely unknown. This study was aimed to determine the association of Leptospira IgG seroprevalence with the occupation of waste picking, and to determine the epidemiological characteristics of the waste pickers with Leptospira exposure. Methods Through a case-control study, we determined the seroprevalence of anti-Leptospira IgG antibodies in 90 waste pickers and 90 age- and gender-matched control subjects in Durango City, Mexico using an enzyme immunoassay. Data were analyzed by bivariate and multivariate analyses. Results The prevalence of anti-Leptospira IgG antibodies was similar in waste pickers (4/90: 4.4%) to that in control subjects (5/90: 5.6%) (P = 1.00). Bivariate analysis showed that Leptospira exposure in waste pickers was associated with increasing age (P = 0.009), no education (P = 0.008), and consumption of rat meat (P = 0.04). However, these associations were no longer found by multivariate analysis. Leptospira exposure in waste pickers was not associated with health status, duration in the activity, wearing hand gloves and facemasks, history of injuries with sharp material of the garbage, or contact with animals or soil. Conclusions This is the first study about Leptospira exposure in waste pickers. Results suggest that waste pickers are not at increasing risk for Leptospira exposure in Durango City, Mexico. Further research with a larger sample size to elucidate the association of Leptospira exposure with waste picking activity is needed.

Seroepidemiology of cytomegalovirus infection in pregnant women in Durango City, Mexico

BackgroundCytomegalovirus causes congenital infections all around the world. The seroepidemiology of cytomegalovirus infection in pregnant women in Mexico is largely unknown. We sought to determine the seroprevalence of cytomegalovirus infection in pregnant women in Durango City, Mexico; and to determine seroprevalence association with socio-demographic, clinical and behavioral characteristics of pregnant women.MethodsThrough a cross-sectional study design, 343 pregnant women were examined for anti-cytomegalovirus IgG and IgM antibodies in Durango City, Mexico. We used a standardized questionnaire to obtain the general characteristics of the pregnant women. Multivariate analysis was performed to determine the association of cytomegalovirus infection with the characteristics of the pregnant women.ResultsAnti-CMV IgG and IgM antibodies were detected in 225 (65.6%) and in none of the 343 pregnant women studied, respectively. Multivariate analysis showed that CMV exposure was associated with increasing age (OR = 1.67; 95% CI: 1.01-2.76; P = 0.04). Other women characteristics including socioeconomic status, education, blood transfusion, transplantation, sexual promiscuity and number of previous pregnancies or deliveries did not show an association with CMV exposure.ConclusionsThis is the first seroepidemiology study of CMV infection in pregnant women in Mexico. A number of known factors associated with CMV infection were not associated with CMV exposure in the women studied. Further studies to determine routes of CMV infection in pregnant women in Mexico are needed.