Towards an Integrated Approach for Monitoring Toxoplasmosis in Southern Italy

SIMPLE SUMMARY: Toxoplasmosis is a significant public health issue worldwide, caused by the intracellular protozoan Toxoplasma gondii. It has a heteroxenous life cycle in which felines act as definitive reservoirs and a wide range of warm-blooded animals, including humans, act as intermediate hosts. Due to the complex life cycle, monitoring, prevention and control of this parasite are very difficult. A thorough analysis of the epidemiology of T. gondii in humans, animals and food as well as the risk factors associated with the infection are needed to plan adequate control strategies in a given geographical area. Based on this, an integrated approach for monitoring toxoplasmosis was developed and conducted in an endemic area of southern Italy. The main tasks of this approach were based on the following strategies: parasitological and risk factor analysis for T. gondii in livestock farms, serological and molecular monitoring in meat-producing livestock at slaughterhouses, hospital discharge records (HDRs) analysis and outreach activities. The findings of this study confirmed the spread of T. gondii infection in southern Italy with high prevalence values in ruminants and the need of valid control strategies based on comprehensive and transdisciplinary actions according to the One Health approach. ABSTRACT: Toxoplasmosis is a widespread worldwide zoonotic infection caused by the intracellular protozoan Toxoplasma gondii. This protozoan infection is considered one of the most important food-borne parasitic zoonoses globally. Beyond its impact on public health, toxoplasmosis has also important veterinary implications, because it causes miscarriage or congenital malformations in livestock with negative economic impacts. An integrated monitoring programme aimed to deepen the epidemiological data on toxoplasmosis and to identify the risk factors that may favour T. gondii infections in animals and humans was conducted in an endemic area of southern Italy. The monitoring activities were based on the following tasks: (i) parasitological analysis and risk factors for T. gondii in livestock (sheep, goat, cattle and water buffalo) farms; (ii) serological and molecular monitoring at slaughterhouse in meat-producing livestock; (iii) analysis of hospital discharge records (HDRs); (iv) outreach activities (information, dissemination and health education) to farmers, vet practitioners and school-age children. The present study confirmed a very high seroprevalence of T. gondii infection in livestock farms (e.g., up to 93.1% in sheep farms) in southern Italy and highlighted the potentially significant public health risk in this area.