title: Seroepidemiology of Toxoplasma gondii infection in psychiatric inpatients in a northern Mexican city.
abstract: BACKGROUND
  Patients with psychiatric disorders were found to show a high seroprevalence of Toxoplasma gondii infection. There is scarce information about the epidemiology of T. gondii infection in psychiatric patients in Mexico. Therefore, we sought to determine the prevalence of T. gondii infection and associated socio-demographic, clinical and behavioural characteristics in a population of psychiatric patients in Durango City, Mexico. Seroprevalence in patients was compared with that obtained in a control population.
  
  
  METHODS
  One hundred and thirty seven inpatients of a public psychiatric hospital and 180 controls were examined for the presence of IgG and IgM antibodies against T. gondii by enzyme-linked immunoassay (Diagnostic Automation Inc., Calabasas, CA, USA). The control population consisted of blood donors of a public blood bank and elderly persons attending a senior center in the same city. Age in controls (42 years +/- 20.2) was comparable with that of the psychiatric patients (43.7 years +/-13.8) (p = 0.42). Socio-demographic, clinical and behavioral characteristics from the patients were also obtained.
  
  
  RESULTS
  Anti-T. gondii IgG antibodies indicating latent infection with T. gondii was found in 25 (18.2%) of 137 psychiatric inpatients and 16 (8.9%) of 180 controls (p = 0.02). Ten (26.3%) of 38 schizophrenic patients had latent infection and this prevalence was also significantly higher than that observed in controls (p = 0.005). Prevalence of anti-T. gondii IgM antibodies was comparable among patients and controls (4.4% vs 2.2%, respectively, p = 0.22). Multivariate analysis showed that T. gondii infection in inpatients was positively associated with sexual promiscuity (adjusted OR = 15.8; 95% CI: 3.8-64.8), unwashed raw fruit consumption (adjusted OR = 5.19; 95% CI: 2.3-11.3), and a history of surgery (adjusted OR = 6.5; 95% CI: 2.6-16), and negatively associated with lamb meat consumption (adjusted OR = 0.26; 95% CI: 0.10-0.63).
  
  
  CONCLUSIONS
  In the present study, psychiatric inpatients in Durango, Mexico, in general and schizophrenia inpatients in particular had a significantly higher prevalence of T. gondii infection than the control group. Results suggest that unwashed raw fruit consumption might be the most important route of T. gondii transmission in our psychiatric inpatients while lamb meat consumption the less important. Additional studies will have to elucidate the causative relation between infection with T. gondii and psychiatric disorders.
authors.affiliation: Faculty of Medicine, Juárez University of Durango State (UJED), Durango, Mexico. alvaradocosme@yahoo.com
authors.forename: Cosme
authors.initials: C
authors.lastname: Alvarado-Esquivel
authors.forename: Olga-Patricia
authors.initials: OP
authors.lastname: Alanis-Quiñones
authors.forename: Miguel-Angel
authors.initials: MA
authors.lastname: Arreola-Valenzuela
authors.forename: Alfredo
authors.initials: A
authors.lastname: Rodríguez-Briones
authors.forename: Luis-Jorge
authors.initials: LJ
authors.lastname: Piedra-Nevarez
authors.forename: Ehecatl
authors.initials: E
authors.lastname: Duran-Morales
authors.forename: Sergio
authors.initials: S
authors.lastname: Estrada-Martínez
authors.forename: Sergio-Arturo
authors.initials: SA
authors.lastname: Martínez-García
authors.forename: Oliver
authors.initials: O
authors.lastname: Liesenfeld
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D000913:Antibodies, Protozoan / Q000097:blood; D002947:Cities; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D001523:Mental Disorders / Q000150:complications*; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D014122:Toxoplasma / Q000276:immunology / Q000302:isolation & purification*; D014123:Toxoplasmosis / Q000150:complications / Q000453:epidemiology* / Q000469:parasitology
chemical_list: D000913:Antibodies, Protozoan