title: Risk factors for acute Toxoplasma gondii diseases in Taiwan: a population-based case-control study.
abstract: Although human toxoplasmosis is a notifiable disease in Taiwan since 2007, little is known about its risk factors. This study aimed to investigate the risk factors for acute Toxoplasma gondii diseases in Taiwan. We conducted a nationwide population-based case-control study. Cases of acute human toxoplasmosis notified to the Taiwan Centers for Diseases Control (Taipei, Taiwan) during 2008-2013 were compared with controls that were randomly selected from healthy T. gondii-seronegative blood donors who participated in a nationwide T. gondii seroepidemiologic study during 2009-2010. Cases and controls were matched according to age, gender and residency at an 1:8 ratio. Structured questionnaires were used to gather information regarding risk factors. A total of 30 laboratory-confirmed acute T. gondii disease cases and 224 controls were enrolled. The most common clinical manifestation of the cases was flu-like symptoms (n = 20), followed by central nervous system disease (n = 4), ocular diseases (n = 3), abortion (n = 2), and congenital infection (n = 1). Multivariate conditional logistic regression showed that raw clam consumption (adjusted odds ratio [OR] = 3.7; 95% confidence interval [CI] = 1.4-9.9) and having a cat in the household (adjusted OR = 2.9; 95% CI = 1.1-7.9) were two independent risk factors for acute T. gondii disease. We conclude that raw shellfish consumption and domestic cat exposure were risk factors for acquiring acute T. gondii diseases in Taiwan. This finding may guide future research and control policies.
authors.affiliation: Center for Research, Diagnostics and Vaccine Development, Centers for Disease Control, Ministry of Health and Welfare, Taipei, Taiwan; Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
authors.forename: Ting-Yi
authors.initials: TY
authors.lastname: Chiang
authors.affiliation: Center for Research, Diagnostics and Vaccine Development, Centers for Disease Control, Ministry of Health and Welfare, Taipei, Taiwan.
authors.forename: Ming-Chu
authors.initials: MC
authors.lastname: Kuo
authors.affiliation: Division of HIV/AIDS and TB, Centers for Disease Control, Ministry of Health and Welfare, Taipei, Taiwan.
authors.forename: Chang-Hsun
authors.initials: CH
authors.lastname: Chen
authors.affiliation: Center for Research, Diagnostics and Vaccine Development, Centers for Disease Control, Ministry of Health and Welfare, Taipei, Taiwan.
authors.forename: Jyh-Yuan
authors.initials: JY
authors.lastname: Yang
authors.affiliation: Center for Research, Diagnostics and Vaccine Development, Centers for Disease Control, Ministry of Health and Welfare, Taipei, Taiwan.
authors.forename: Cheng-Feng
authors.initials: CF
authors.lastname: Kao
authors.affiliation: Center for Research, Diagnostics and Vaccine Development, Centers for Disease Control, Ministry of Health and Welfare, Taipei, Taiwan; Department of Tropical Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Dar-Der
authors.initials: DD
authors.lastname: Ji
authors.affiliation: Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan; Ministry of Health and Welfare and National Taiwan University Infectious Diseases Research and Education Center, Taipei, Taiwan.
authors.forename: Chi-Tai
authors.initials: CT
authors.lastname: Fang
mesh_terms: D000293:Adolescent; D000328:Adult; D000818:Animals; D049872:Bivalvia / Q000469:parasitology*; D016022:Case-Control Studies; D002371:Cat Diseases / Q000469:parasitology / Q000635:transmission*; D002415:Cats; D004197:Disease Reservoirs; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013624:Taiwan / Q000453:epidemiology; D014122:Toxoplasma / Q000472:pathogenicity / Q000502:physiology*; D014123:Toxoplasmosis / Q000453:epidemiology* / Q000469:parasitology / Q000635:transmission*