title: Toxoplasma gondii infection in interstate truck drivers: a case-control seroprevalence study.
abstract: BACKGROUND
  Infection with Toxoplasma gondii can be acquired via the ingestion of undercooked or raw meat containing tissue cysts, or via ingestion of water contaminated with oocysts. Professional long distance truck driving may have epidemiological importance for food-borne infections since drivers eat out of home and in places where hygiene and cooking practices are uncertain. We aimed to determine whether interstate truck drivers in Durango, Mexico have an increased risk of infection with T. gondii as indicated by seropositivity; and to determine the socio-demographic, work, clinical, and behavioral characteristics associated with T. gondii seropositivity in interstate truck drivers.
  
  
  METHODS
  Through a case-control study design, 192 truck drivers and 192 controls from the general population of the same region matched by gender and age were examined with enzyme-linked immunoassays for the presence of anti-Toxoplasma IgG and IgM antibodies. Socio-demographic, work, clinical and behavioral characteristics from the truck drivers were obtained.
  
  
  RESULTS
  Anti-T. gondii IgG antibodies were found in 23 (12.0%) of 192 truck drivers and in 13 (6.8%) of 192 controls (OR = 21.0; 95% CI: 1.23-358.38; P = 0.002). Anti-T. gondii IgM antibodies were found in 7 (3.6%) cases and in 7 (3.6%) controls (P = 1.00). The seroprevalence of T. gondii infection was higher in drivers with reflex impairment than in those without this impairment (4/13, 30.8% vs 19/179, 10.6%, respectively; P = 0.05), and in drivers with hearing impairment than in those without this impairment (3/7, 42.9% vs 20/185, 10.8%, respectively; P = 0.03). Multivariate analysis of work and behavioral characteristics of truck drives showed positive associations of T. gondii exposure with trips to the south of Mexico (OR = 3.11; 95% CI: 1.02-9.44; P = 0.04) and consumption of horse meat (OR = 5.18; 95% CI: 1.62-16.55; P = 0.005).
  
  
  CONCLUSIONS
  Results suggest that interstate truck drivers may have an increased risk for T. gondii infection, and that T. gondii exposure may be impacting neurological functions in truck drivers. Contributing factors for T. gondii exposure should be taken into account for the design of optimal prevention measures against T. gondii infection.
authors: Faculty of Medicine and Nutrition, Juárez University of Durango State, Avenida Universidad S/N, 34000, Durango, Dgo, Mexico. alvaradocosme@yahoo.com.
authors: Cosme
authors: C
authors: Alvarado-Esquivel
authors: Faculty of Medicine and Nutrition, Juárez University of Durango State, Avenida Universidad S/N, 34000, Durango, Dgo, Mexico. sandy_janet38@hotmail.com.
authors: Sandy Janet
authors: SJ
authors: Pacheco-Vega
authors: Institute for Scientific Research "Dr. Roberto Rivera Damm", Juárez University of Durango State, Avenida Universidad S/N, 34000, Durango, Durango, Mexico. jhtinoco@yahoo.com.
authors: Jesús
authors: J
authors: Hernández-Tinoco
authors: Faculty of Medicine and Nutrition, Juárez University of Durango State, Avenida Universidad S/N, 34000, Durango, Dgo, Mexico. mi_sael_sal@hotmail.com.
authors: Misael
authors: M
authors: Salcedo-Jáquez
authors: Institute for Scientific Research "Dr. Roberto Rivera Damm", Juárez University of Durango State, Avenida Universidad S/N, 34000, Durango, Durango, Mexico. lfsanguiano@hotmail.com.
authors: Luis Francisco
authors: LF
authors: Sánchez-Anguiano
authors: Faculty of Medicine and Nutrition, Juárez University of Durango State, Avenida Universidad S/N, 34000, Durango, Dgo, Mexico. drluisomarberumen@gmail.com.
authors: Luis Omar
authors: LO
authors: Berumen-Segovia
authors: Faculty of Medicine and Nutrition, Juárez University of Durango State, Avenida Universidad S/N, 34000, Durango, Dgo, Mexico. rabagopediatria@hotmail.com.|General Hospital, Secretary of Health, Avenida 5 de febrero 220, 34000, Durango, Mexico. rabagopediatria@hotmail.com.
authors: Elizabeth
authors: E
authors: Rábago-Sánchez
authors: Institute for Microbiology and Hygiene, Campus Benjamin Franklin, Charité Medical School, Hindenburgdamm 27, D-12203, Berlin, Germany. olitoxo@yahoo.com.|Current address: Medical and Scientific Affairs, Roche Molecular Systems, Pleasanton, CA, 94588, USA. olitoxo@yahoo.com.
authors: Oliver
authors: O
authors: Liesenfeld
mesh_terms: D000328:Adult; D000368:Aged; D000913:Antibodies, Protozoan / Q000097:blood; D001334:Automobile Driving; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D006920:Hygiene; D007074:Immunoglobulin G / Q000097:blood; D008297:Male; D008800:Mexico; D008875:Middle Aged; D009784:Occupational Diseases / Q000097:blood / Q000453:epidemiology* / Q000469:parasitology; D009790:Occupations / Q000706:statistics & numerical data; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D014122:Toxoplasma / Q000276:immunology* / Q000302:isolation & purification; D014123:Toxoplasmosis / Q000097:blood / Q000453:epidemiology* / Q000469:parasitology; D055815:Young Adult
chemical_list: D000913:Antibodies, Protozoan; D007074:Immunoglobulin G
references: Otol Neurotol. 2013 Aug;34(6):1165-9
references: 23598697
references: Schizophr Res. 2013 Oct;150(1):258-61
references: 23953218
references: J Nerv Ment Dis. 2013 Nov;201(11):948-52
references: 24177481
references: Epidemiol Infect. 2014 Jan;142(1):149-55
references: 23587449
references: Parasit Vectors. 2014;7:301
references: 24984845
references: Parasit Vectors. 2013;6:113
references: 23601076
references: BMC Infect Dis. 2002 Jul 2;2:11
references: 12095427
references: Lancet. 2004 Jun 12;363(9425):1965-76
references: 15194258
references: Acta Pathol Jpn. 1981 May;31(3):527-34
references: 6267876
references: Clin Infect Dis. 2005 Apr 1;40(7):1005-15
references: 15824993
references: Bull Soc Pathol Exot. 1997;90(1):19-21
references: 9264742
references: Foodborne Pathog Dis. 2008 Oct;5(5):687-90
references: 18681796
references: Mem Inst Oswaldo Cruz. 2009 Mar;104(2):364-9
references: 19430665
references: J Nerv Ment Dis. 2009 Dec;197(12):905-8
references: 20010026
references: Int J Audiol. 2010 Jan;49(1):65-8
references: 20053157
references: Arch Ophthalmol. 2010 Jan;128(1):28-32
references: 20065213
references: J Parasitol. 2010 Jun;96(3):505-8
references: 20557194
references: J Parasitol. 2011 Feb;97(1):40-3
references: 21348604
references: Parasitol Int. 2011 Jun;60(2):151-5
references: 21292026
references: Parasit Vectors. 2011;4:75
references: 21569516
references: Emerg Infect Dis. 2011 Jul;17(7):1327-8
references: 21762609
references: Parasit Vectors. 2011;4:235
references: 22177118
references: Vector Borne Zoonotic Dis. 2012 Feb;12(2):138-42
references: 22214274
references: Parasit Vectors. 2012;5:13
references: 22236539
references: Schizophr Bull. 2012 May;38(3):642-7
references: 22446566
references: J Parasitol. 2012 Oct;98(5):944-5
references: 22559329
references: Vet Parasitol. 2004 Dec 9;126(1-2):57-72
references: 15567579
references: Am J Respir Crit Care Med. 2013 May 15;187(10):1143-5
references: 23675724
references: Am J Vet Res. 1985 Aug;46(8):1753-4
references: 4037503
references: Salud Publica Mex. 1992 Mar-Apr;34(2):222-9
references: 1631735
references: Med Trop (Mars). 1996;56(1):48-50
references: 8767792
references: Schizophr Bull. 2007 May;33(3):757-60
references: 17218612