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A Community-based Survey of Human Toxoplasmosis in Rural Amazonia: Seroprevalence, Seroconversion Rate, and Associated Risk Factors

IgG antibodies to Toxoplasma gondii were detected in, March–April 2004, in 65.8% (95% confidence interval, 60.8–70.8%) of 342 systematically sampled subjects 5–90 years of age (87.5% of the eligible) living in a rural settlement in Amazonia, with a seroconversion rate of 9% over 1 year of follow-up of 99 seronegative subjects. Multiple logistic regression analysis identified age as the only significant independent predictor of seropositivity at the baseline. Each additional year of age increases the odds of being seropositive by 6%, and 76.8% of the subjects are expected to be seropositive at 30 years of age. A single high-prevalence spatial cluster, comprising 11.9% of the seropositive subjects, was detected in the area; households in the cluster were less likely to have dogs as pets and their heads had a lower education level, when compared with households located outside the cluster. The challenges for preventing human toxoplasmosis in tropical rural settings are discussed.

Received January 27, 2009. Accepted for publication April 22, 2009.

Acknowledgments: We thank the inhabitants of Ramal do Granada for their enthusiastic participation in this study; Sebastião Bocalom Rodrigues, Damaris de Oliveira, and Nésio M. Carvalho (Municipal Government of Acrelândia) for their logistic support; and Adamílson L. de Souza for his help in fieldwork.

Financial support: This study was supported by a grant from the Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP, 05/51988-0). MdSN was supported by a PhD scholarship from FAPESP; NSdS and MUF received scholarships from the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), Brazil.

^* Address correspondence to Marcelo U. Ferreira, Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, Av. Prof. Lineu Prestes 1374, 05508-900 São Paulo (SP), Brazil. E-mail: muferrei{at}usp.br

Authors’ addresses: Marcelo U. Ferreira and Natal S. da Silva, Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, Av. Prof. Lineu Prestes 1374, 05508-900 São Paulo (SP), Brazil, Tel: 55-11-30917746, Fax: 55-11-30917417, E-mails: muferrei{at}usp.br and natalss{at}gmail.com. Mônica da Silva-Nunes, Department of Parasitology, Institute of Biomedical Sciences, University of São Paulo, Av. Prof. Lineu Prestes 1374, 05508-900 São Paulo (SP), Brazil, Tel: 55-11-30917746, Fax: 55-11-30917417 and Department of Health Sciences, Federal University of Acre, BR-364 km 4, Campus Universitário, 69915-900 Rio Branco (AC), Brazil, Tel: 55-68-39012648, Fax: 55-68-3901-2648, E-mail: msnunes1{at}yahoo. Roberto M. Hiramoto and Débora P. Aureliano, Section of Systemic Parasitic Diseases, Adolfo Lutz Institute, Av. Dr. Arnaldo 355, 8th floor, Cerqueira César, 01246-000 São Paulo (SP), Brazil, Tel: 55-11-3068-2891, Fax: 55-11-3088-5237, E-mails: hiramoto{at}usp.br and dpicansso{at}hotmail.com. Rosely S. Malafronte, Institute of Tropical Medicine of São Paulo, Av. Dr. Enéas de Carvalho Aguiar 470, Cerqueira César, 05403-000 São Paulo (SP), Brazil, Tel: 55-11-30617026, Fax: 55-11-30885237, E-mail: rmalafronte{at}usp.br. Pascoal T. Muniz, Department of Health Sciences, Federal University of Acre, BR-364 km 4, Campus Universitário, 69915-900 Rio Branco (AC), Brazil, Tel: 55-68-39012648, Fax: 55-68-3901-2648, E-mail: pascoal{at}ufac.br.