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Towards improving interventions against toxoplasmosis by identifying routes of transmission using sporozoite-specific serological tools.

Title: Towards improving interventions against toxoplasmosis by identifying routes of transmission using sporozoite-specific serological tools.
Authors: Milne, G
Webster, JP
Walker, M
Item Type: Journal Article
Abstract: BACKGROUND: Horizontal transmission of Toxoplasma gondii occurs primarily via ingestion of environmental oocysts or consumption of undercooked/raw meat containing cyst-stage bradyzoites. The relative importance of these two transmission routes remains unclear. Oocyst infection can be distinguished from bradyzoite infection by identification of IgG antibodies against T. gondii-embryogenesis-related protein (TgERP). These antibodies are, however, thought to persist for only 6-8 months in human sera, limiting the use of TgERP serology to only those patients recently exposed to T. gondii. Yet recent serological survey data indicate a more sustained persistence of anti-TgERP antibodies. Elucidating the duration of anti-TgERP IgG will help to determine whether TgERP serology has epidemiological utility for quantifying the relative importance of different routes of T. gondii transmission. METHODS: We developed a sero-catalytic mathematical model to capture the change in seroprevalence of non-stage-specific IgG and anti-TgERP IgG antibodies with human age. The model was fitted to published datasets collected in an endemic region of Brazil to estimate the duration of anti-TgERP IgG antibodies, accounting for variable age-force of infection profiles and uncertainty in the diagnostic performance of TgERP serology. RESULTS: We found that anti-TgERP IgG persists for substantially longer than previously recognised, with estimates ranging from 8.3 to 41.1 years. The Brazilian datasets were consistent with oocysts being the predominant transmission route in these settings. CONCLUSIONS: The longer than previously recognised duration of anti-TgERP antibodies indicates that anti-TgERP serology could be a useful tool for delineating T. gondii transmission routes in human populations. TgERP serology may therefore be an important epidemiological tool for informing the design of tailored, setting-specific public health information campaigns and interventions.
Issue Date: 15-Nov-2020
Date of Acceptance: 10-Apr-2020
URI: http://hdl.handle.net/10044/1/85689
DOI: 10.1093/cid/ciaa428
ISSN: 1058-4838
Publisher: Oxford University Press (OUP)
Start Page: e686
End Page: e693
Journal / Book Title: Clinical Infectious Diseases
Volume: 71
Issue: 10
Copyright Statement: © The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
Keywords: Toxoplasma gondii
mathematical model
Toxoplasma gondii
mathematical model
06 Biological Sciences
11 Medical and Health Sciences
Publication Status: Published
Conference Place: United States
Online Publication Date: 2020-04-13
Appears in Collections:School of Public Health

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