SPATIAL ANALYSIS AND RISK FACTORS OF HUMAN
TOXOPLASMOSIS AT SPECIAL PROVINCE OF YOGYAKARTA
TROUGHT ECOHEALTH APPROACHES
EcoHealth Conference, K
E H lth C f Kunming Chi 2012
i China
Wayan T. Artama1. Sujono2, Dyah Ayu Widiasih4, Tjut Sugandawati Djohan6, Pande Made
Kutanegara7, Adhiheru Sutomo3, Dewa Ayu Sri Laksmi5, Fihiruddin3,
1. Department of Biochemistry Faculty of Veterinary Medicine, Universitas Gadjah Mada (UGM), 2. Health Polytechnic, Yogyakarta;
3. Department of Public Health Faculty of Medicine, UGM, 4. Department of Public Health Faculty of Vet. Medicine, UGM, 5. Department of
Parasitology University of Udayana, 6. Faculty of Biology, UGM, 7. Department of Anthropology Faculty of Social Culture, UGM,

Contents
1
TOXOPLASMOSIS
2 SURVEY ON TOXO
Objectives, methodology, selected results
3 ECOHEALTH APPROACH

Classification and Taxonomy
SUB-PHYLUM: APICOMPLEXA
CLASS : COCCIDEA (“COCCIDIA“)
ORDER : EIMERIIDA
Family : Eimeriidae
Cyst-forming
C t f i Family
F il : Sarcocystidae
S tid
coccidia Toxoplasma gondii
Neospora
Hammondia
Besnoitia
Sarcocystis*
y
Frenkelia

Life cycle of Toxoplasma gondii
Gamogony
Defenitive
host Unsporulated
oocyst in faeces
Endogenic cyst
with bradyzoites IH
Sporogony
S
Merogony(ies)
Sporulated oocyst
“Pseudocyst“ with sporozoites
with tachyzoites in environment
in tissue cells
facultative heteroxenic cycle

“Key figures“ (after 1st infection of DH*)
Pre-patent period
(time interval between infection and first oocyst shedding)
- after infection with tissue cysts
f f y = 3-10 days
y
- after infection with sporulated oocysts = 3-5 weeks
• Patency: 1-21 days
• Oocyst output
1.000.000 oocysts / g faeces Large
600.000.000
600 000 000 oocysts i t t l d i patency
t in total during t
contamination of
the environment
with oocysts

Life cycle of Toxoplasma gondii
Oral infection of cat with = the only DH shedding
(i) sporulated oocysts or oocysts; gamogony
(ii) endogenic cysts (sexual development)
in the intestines
Development in the intestine of cat
Oral (horizontal) infection of IH with
(i) sporulated oocysts (sporozoites) from environment or
(ii) endogenic cysts (bradyzoites) in tissue
Prenatal/diaplacentar/intrauterine (
P t l/di l t /i t t i (vertical)
ti l)
infection of IH’s foetus with tachyzoites (in case
of 1st infection of the mother during pregnancy)

Invasion of T. gondii

Tachizoit T. gondii Rhoptries Micronemes
Dense granule
Gp 22
Nucleus p 23
Gp 30
Gp
G 35

Toxoplasma gondii
Cycle in humans
Cycle in humans
Infected
• by ingesting infective oocysts (in >4 day old cat
feces)
• by ingesting tachyzoites or bradyzoites in rare
cooked or raw meat
• by receiving blood or tissues with “zoites”
• congenitally by transplacental tachyzoites
congenitally by transplacental tachyzoites

Hydrocephalus

Survey on Toxoplasmosis
Objective:
The i
Th aims of this research i t study serological prevalence
f thi h is to t d l i l l
of toxoplasmosis in the population and get an overview of
association between risk factors and human toxoplasmosis
trough ecohealth approaches.
Material and methods:
Material and methods:
• Serological survey in Yogyakarta using GRA‐
Recombinant Protein as an antigen in ELISA based test
R bi P i i i ELISA b d
• Study in 5 District & 1050 human sera from population
• QX

PREVALENCE OF TOXOPLASMOSIS
IN ANIMAL – selected results
Study area: Yogyakarta
Study
St d period: 2011 2012
i d 2011-2012
Study type: Surveillance
Goat
51%
Pig
?
Sheep
49% ANIMAL
Wild Cat
79%
Dairy cow
Bali cattle
21%
7,1%

PREVALENCE OF TOXOPLASMOSIS
IN HUMAN – selected results
Study area: Yogyakarta
Study period: 2011-2012
Study type: Surveillance Kodya
54,7%
Sleman
60% Kulon P
K l Progo
Human 77,1%
Bantul
Gunung K
48,5%
20,5%

Selected results
Map of Seroprevalence for Toxoplasmosis at Yogyakarta in Human
p p p gy

Selected results from EcoZD project
Map of Seroprevalence for Toxoplasmosis in Human (Sleman
Map of Seroprevalence for Toxoplasmosis in Human (Sleman District)

Spatial analysis of Toxoplasmosis

ECOHEALTH APPROACH
1.Systems Thinking
2.Transdisciplinary
3.Participation
3 P ti i ti
4.Sustainability
y
5.Gender and Social Equity
6K l d A i
6.Knowledge to Action

Human-Animal-Ecosystem (Rural Ecosystem at Yogyakarta)
The intact rural ecosystem is an unbroken chain linking nature, society and economy

Potential risk factor in correlation to Toxoplasmosis in the study area
No Characteristic/Risk Factor (based on Logistic Binary Regression)
Odds Ratio
1. Gender *1,180
2. Place where the respondent stay 0,646
3. Have contact with cat *1,261
4. Eat goat meat (not well cooked) *4 087
4 Eat goat meat (not well cooked) 4,087
5. Eat unwashed vegetable in the food vendor *7,927
6. Occupation that is related to meat vendor *1,393
7. Source of water 0,849
8. Occupation that are related/ activities
that mostly contact to soil *2,753 *

Conclusion
Toxoplasmosis in humans – Suggested Prevention measures
• Don‘t eat uncooked meat
Don t
• Wash fruits and vegatable carefully with
drinking
d inkin water, and/or c k it
t nd/ cook
Prevention of
accidental • Drink mineral water only
infection
• Wear gloves when working in garden etc. and
wash hands carefully
• Clean the cat toilet with hot water daily
Prevention of
• Feed your cat with can/dry food only and
environmental
contamination • Do EcoHealth approach