title: Adverse socioeconomic conditions and oocyst-related factors are associated with congenital toxoplasmosis in a population-based study in Minas Gerais, Brazil.
abstract: OBJECTIVE
  Congenital toxoplasmosis is a public health problem in Brazil. This study aimed to determine risk factors associated with congenital toxoplasmosis in Minas Gerais which is the second largest Brazilian State based on number of inhabitants, and its territorial extension is larger than that of France.
  
  
  METHODS
  Population-based case-control study to assess the association between congenital toxoplasmosis and maternal exposure to infection risk factors. The study included mothers/children participating in the Minas Gerais Newborn Screening Program. The cases consisted of 175 mothers of infected children, and the controls consisted of 278 mothers of children without suspected infection. The associations were assessed through binomial logistic regression with p ≤ 0.05.
  
  
  RESULTS
  The variables associated with lower probability of toxoplasmosis were: older mother age (OR = 0.89; CI95%  = 0.85-0.93), higher level of education (OR = 0.85; CI95% = 0.78-0.92), access to potable water (OR = 0.21; CI95% = 0.08-0.51), and home with flush toilet (OR = 0.18; CI95% = 0.04-078). The variables associated with higher probability of infection were: cats in the neighborhood (OR = 2.27; CI95%  = 1.27-4.06), owning or visiting homes with domestic cats (OR = 1.90; CI95%  = 1.09-3.31), handling the soil (OR = 2.29; CI95%  = 1.32-3.96), and eating fresh meat not previously frozen (OR = 3.97; CI95%  = 2.17-7.25). After stratification according region of residence (rural or urban/peri-urban), home with flush toilet and consumption of treated water were protective against the disease only in the rural stratum.
  
  
  CONCLUSIONS
  In Minas Gerais, congenital toxoplasmosis has been associated with poor socioeconomic conditions. Considering maternal exposure to sources of Toxoplasma gondii, the predominating risk factors were those related to the ingestion of oocysts. It is expected that these results will contribute to development of a program for prevention of congenital toxoplasmosis adapted to the reality of the population of Minas Gerais. The differences between populations living in rural and urban areas regarding the main risk factors for toxoplasmosis point to the need of considering regional specificities in planning strategies to control congenital toxoplasmosis.
authors: Department of Pediatrics, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
authors: Ericka Viana Machado
authors: EV
authors: Carellos
authors: Department of Pediatrics, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
authors: Gláucia Manzan Queiroz
authors: GM
authors: de Andrade
authors: Department of Ophthalmology, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
authors: Daniel Vitor
authors: DV
authors: Vasconcelos-Santos
authors: Center for Newborn Screening and Genetic Diagnosis, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
authors: José Nélio
authors: JN
authors: Januário
authors: Department of Pediatrics, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
authors: Roberta Maia Castro
authors: RM
authors: Romanelli
authors: School of Nursing, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
authors: Mery Natali Silva
authors: MN
authors: Abreu
authors: Hospital Infantil João Paulo II, Fundação Hospitalar do Estado de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
authors: Fabiana Maria
authors: FM
authors: da Silva
authors: Hospital Infantil João Paulo II, Fundação Hospitalar do Estado de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
authors: Ivy Rosa Coelho
authors: IR
authors: Loures
authors: School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
authors: Juliana Queiroz
authors: JQ
authors: de Andrade
authors: Department of Preventive and Social Medicine, Observatory of Urban Health, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.
authors: Waleska Teixeira
authors: WT
authors: Caiaffa
mesh_terms: D000818:Animals; D000913:Antibodies, Protozoan / Q000097:blood; D001938:Brazil / Q000453:epidemiology; D016022:Case-Control Studies; D002415:Cats; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D018811:Maternal Exposure; D009035:Mothers; D015999:Multivariate Analysis; D033661:Oocysts; D012044:Regression Analysis; D012307:Risk Factors; D012424:Rural Population; D012923:Social Class; D014122:Toxoplasma / Q000276:immunology; D014125:Toxoplasmosis, Congenital / Q000453:epidemiology*
chemical_list: D000913:Antibodies, Protozoan