title: Toxoplasmosis in female high school students, pregnant women and ruminants in Cyprus.
abstract: The protozoan parasite Toxoplasma gondii is important to human and animal health worldwide. This is the first study of prevalence of infection with T. gondii and associated risk factors in human populations and small ruminants in Cyprus.
  
  
  
  A random sample of 18 schools out of 46 participated: 1056 girls aged 16 to 18 years completed a questionnaire and were serologically tested for Toxoplasma between 2008 and 2011 (response rate 30%). In addition, infection with T. gondii laboratory results of 23 076 pregnant women tested between 2009 and 2014 were obtained from hospital records. Finally, 163 (out of 3123) farms were randomly sampled and blood samples from 515 sheep and 581 goats were obtained.
  
  
  
  Estimated seropositivity prevalence in female students was 6.5% (95% CI 4.3 to 8.7%) and 18% (95% CI 17 to 19%) in pregnant women. Overall, 40.1% of the ruminants tested were seropositive (95% CI 37.2% to 43.0%). Seropositivity differed according to geographical region in all three groups.
  
  
  
  Further studies are needed to investigate the differences between regions that lead to differing prevalence levels and patterns between ruminants and humans so that health education policies can be developed to help prevent infection and reduce environmental contamination.
authors.affiliation: Laboratory of Clinical Bacteriology, Parasitology, Zoonoses and Geographical Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece.
authors.forename: Marios
authors.initials: M
authors.lastname: Liassides
authors.affiliation: Veterinary Services of Cyprus, Nicosia, Cyprus.
authors.forename: Vasiliki
authors.initials: V
authors.lastname: Christodoulou
authors.affiliation: Biostatistics Laboratory, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece.
authors.forename: Joanna
authors.initials: J
authors.lastname: Moschandreas
authors.affiliation: Microbiology Department, Nicosia General Hospital, Nicosia, Cyprus.
authors.forename: Christos
authors.initials: C
authors.lastname: Karagiannis
authors.affiliation: Immunology Department, Nicosia General Hospital, Nicosia, Cyprus.
authors.forename: George
authors.initials: G
authors.lastname: Mitis
authors.affiliation: Department of Pediatrics, Infectious Diseases and Immunology Unit, Archbishop Makarios Hospital, Nicosia, Cyprus Control of Communicable Disease, Medical and Public Health Services, Ministry of Health, Cyprus.
authors.forename: Maria
authors.initials: M
authors.lastname: Koliou
authors.affiliation: Laboratory of Clinical Bacteriology, Parasitology, Zoonoses and Geographical Medicine, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece antoniou@med.uoc.gr.
authors.forename: Maria
authors.initials: M
authors.lastname: Antoniou
mesh_terms: D000293:Adolescent; D000383:Agriculture; D000820:Animal Diseases / Q000453:epidemiology / Q000469:parasitology; D000818:Animals; D003535:Cyprus; D004781:Environmental Exposure; D005260:Female; D006041:Goats / Q000469:parasitology*; D006801:Humans; D011247:Pregnancy; D037841:Pregnant People; D015995:Prevalence; D012307:Risk Factors; D012574:Schools; D016036:Seroepidemiologic Studies; D012756:Sheep / Q000469:parasitology*; D013334:Students; D014122:Toxoplasma / Q000254:growth & development*; D014123:Toxoplasmosis / Q000453:epidemiology* / Q000469:parasitology
keywords: Cyprus; Female students; Goats; High School; Sheep; Toxoplasmosis