RESUMEN
Toxoplasma gondii is an obligate intracellular protozoan parasite that infects almost all warm-blooded animals, including humans, causing serious public health problems. In this study, the seroprevalence of T. gondii in captive jaguars in 10 Mexican zoos was determined using single and mixtures of recombinant surface antigens (SAG1) and dense granular antigens (GRA1 and GRA7) in immunoglobulin G (IgG) enzyme-linked immunosorbent assays (ELISAs). Their efficacy was compared with the tachyzoite lysate antigen. All recombinant antigens were characterised by high sensitivity (92.5-97.5%); the specificity of the IgG ELISAs was variable (83.3-91.6%). Mixtures of the two recombinant proteins were generally more reactive than single antigens. GRA7 + SAG1 showed the highest sensitivity (97.5%) and specificity (91.6%), almost perfect agreement (96.2%), and a kappa value of 0.89. An area under the curve value of 0.998 represented a highly accurate test with a cutoff value of 0.8. The seroprevalence of anti-T. gondii IgG antibodies in the single and mixed recombinant antigen ELISAs was 75.0-76.9%. This study shows that GRA7 + SAG1 can be successfully used to diagnose T. gondii infection in jaguars for effective monitoring of prevalence and for devising control methods and prevention strategies against toxoplasmosis.
Asunto(s)
Antígenos de Protozoos/inmunología , Panthera/parasitología , Proteínas Protozoarias/inmunología , Toxoplasmosis Animal/epidemiología , Animales , Animales de Zoológico , Área Bajo la Curva , Ensayo de Inmunoadsorción Enzimática/veterinaria , Femenino , Inmunoglobulina G/sangre , Inmunoglobulina G/inmunología , Masculino , México/epidemiología , Prevalencia , Proteínas Protozoarias/normas , Curva ROC , Proteínas Recombinantes/inmunología , Proteínas Recombinantes/normas , Sensibilidad y Especificidad , Estudios Seroepidemiológicos , Toxoplasmosis Animal/diagnóstico , Toxoplasmosis Animal/inmunología , Toxoplasmosis Animal/prevención & controlRESUMEN
AIM: The extension of recombinant streptokinase (rSK) use in Cuba and to evaluate its effect on in-hospital mortality of patients with acute myocardial infarct (AMI). METHODS: A phase IV clinical study was performed in 52 hospitals from the 14 Cuban provinces. Patients (any age) with ST segment elevation or bundle branch block were included if they came less than 12 h after the onset of AMI symptoms, without contraindications for thrombolytic therapy. They received 1.5 x 10(6) IU of rSK (Heberkinasa, Heberbiotec, Havana) intravenously, during one hour. Endpoints were death due to cardiac (pump failure, wall rupture, arrhythmia) or any cause and cardiovascular events at hospital release. RESULTS: The study included 2,923 patients, 22-98 years-old, 74.4% men, which represented 37.2% of the total AMI patients attended at the participating hospitals from November 1992 to May 1995. Aspirin was given to 92.5% and betablockers to 65.3%. AMI was confirmed in 93.5% of the patients. The mean symptoms--rSK infusion time interval was 5.25 h (22.3% of the patients treated within the first 3 h). 302 patients died, 80.1% of them due to cardiac causes, 12 attributed to rSK treatment, and 16 to non-cardiac causes. This 10.4% mortality represents a 4% absolute and a 28.3% relative reduction (179 lives saved per year) as compared to a survey made before rSK treatment was introduced. In a logistic regression analysis, mortality was favored by age, symptoms--infusion time. Killip class, and not having taken aspirin or betablockers. Feminine gender was close to the limit of significance. The more frequent adverse events were arrhythmias and hypotension during infusion. Major bleeding occurred in 27 patients (9 strokes). CONCLUSION: Local recombinant-DNA biotechnology can influence on a major health problem with favorable cost/ and risk/benefit balances, not possible in a developing country with an imported drug. The further extension of this treatment in the country is feasible and recommended, monitored through an appropriate pharmacosurveillance program.