Serological prevalence of toxoplasmosis in pregnant women in Luanda (Angola): Geospatial distribution and its association with socio-demographic and clinical-obstetric determinants

Co-infections and risk factors of Toxoplasma gondii infection among pregnant women in Ghana: A facility-based cross-sectional study

This study assessed the prevalence of co-infections (human immunodeficiency virus, hepatitis B, and syphilis) and associated risk factors for Toxoplasma gondii infection among pregnant women in Mampong Municipality, Ghana. A cross-sectional design was used to recruit 201 pregnant women from six health facilities conveniently. Participants' socio-demographics, clinical and environmental data were collected using a structured questionnaire. Using 2 ml of blood, T. gondii seroprevalence was determined by the TOXO IgG/IgM Rapid Test Cassette. Data was analyzed using descriptive and logistic regression analysis with SPSS version 27 to determine the prevalence and associations of T. gondii infection with other variables, respectively. The seroprevalence of T. gondii was 49.75%, of which 40.30%, 2.49%, and 6.97% tested positive for IgG, IgM, and IgG/IgM, respectively. Co-infection of toxoplasmosis with viral hepatitis B, human immunodeficiency virus (HIV), and syphilis rates were 15%, 1%, and 4%, respectively and were not risk factors for T. gondii transmission. Educational level and residential status were associated with toxoplasmosis [p < 0.05]. Participants with higher education had a reduced risk of T. gondii infections compared to a lower level of education [AOR = 0.39 (0.13, 0.99) p = 0.049]. Similarly, the risk of T. gondii infection was significantly lower among individuals residing in peri-urban [AOR = 0.13 (0.02-0.70), p = 0.02] and urban areas [AOR = 0.10 (0.02-0.78), p = 0.03] compared to those in rural areas. Backyard animals with extensive and semi-intensive systems, without veterinary care, and contact with animal droppings and water sources were significant risk factors for T. gondii infection [p < 0.05]. Miscarriage was associated with T. gondii infection [p < 0.05]. The burden of T. gondii infection was high among the study population, posing a risk of mother-to-child transmission. Key risk factors included low education, rural residence, backyard animal exposure, poor hygiene, and unsafe water sources. Toxoplasmosis was associated with miscarriage; thus, integrating it into routine antenatal screening could improve pregnancy outcomes. Health promotion interventions such as education on zoonotic risks, improved sanitation, safe water practices, and veterinary care for domestic animals are recommended to reduce infection risk among pregnant women.

Assessment of simultaneous IgM, IgG avidity, and IgA testing in diagnosis of acute toxoplasmosis in pregnant women: a systematic review and meta-analysis study

BACKGROUNDS

Toxoplasma gondii is a relatively common parasite with a global prevalence that can cause toxoplasmosis. This infection usually does not have clear symptoms, so timely and accurate detection plays a major role in the treatment of this disease. This study reviewed Toxoplasma antibodies dependent serologic tests in pregnancy, assessing their diagnostic effectiveness to guide healthcare providers, particularly obstetricians and gynecologists.

METHODS

In this systematic review and meta-analysis, we utilized four different databases for our search and adhered to the PRISMA guidelines to collect pertinent studies in duration of 2000 to April 2024. After carefully evaluating the inclusion/exclusion criteria list, we ultimately selected 67 qualifying studies for our analysis and subjecting the obtained data to statistical scrutiny.

RESULTS

Data analysis revealed that the pooled seroprevalence of IgM anti-T. gondii among pregnant women tested were 2.1% (95% CI = 1.67 to 3.03). Moreover, the weighted seroprevalence rate estimate of low IgG avidity in IgM-positive pregnant women was 30% (95% CI = 28 to 31) and the seroprevalence of IgA in IgM-positive pregnant women was 43% (95% CI = 18 to 70). Combining the IgG avidity test results with those of IgM and IgA can significantly improve the accuracy of diagnosing recent and past Toxoplasma infections.

CONCLUSIONS

This approach is particularly valuable for pregnant women, as it improves the reliability of serological test outcomes and helps to provide timely treatment and mitigate irreversible complications associated with toxoplasmosis.

Global seroprevalence of Toxoplasma gondii in pregnant women: a systematic review and meta-analysis

BACKGROUND

Toxoplasmosis in pregnancy is associated with serious and irreversible maternal and fetal detrimental consequences. Also, different seroprevalence of Toxoplasma gondii in pregnancy is reported in many countries. The present systematic review and meta-analysis study aimed to determine the global seroprevalence of Toxoplasma gondii in pregnant women.

METHODS

This study was conducted based on the PRISMA 2020 criteria. Initial searching was conducted using MeSH (Medical Subject Headings)-based keywords with no time limitation (by August 1, 2024). Collected papers were transferred to Citation Management Software (EndNote). Duplicate studies were merged and primary and secondary screenings were applied based on the inclusion/exclusion criteria. Validation was considered to find high-quality assessments. Finally, eligible extractable papers were enrolled for data collection. Data was analyzed using Comprehensive Meta-Analysis software (v.2) The random effects model was used in case of I2 index above 50%.In order to investigate the factors affecting the heterogeneity of studies, meta-regression tests were used to examine factors such as sample size and year of study.

RESULTS

One hundred thirty-eight eligible studies with a total sample size of 135,098 pregnant women individuals were selected for data extraction and analysis. The heterogeneity index was found high (I2:98.9) and the random effect model was used for analysis. The egger test revealed the absence of publication bias in collected studies (p:0.088). Thus, the global seroprevalence of Toxoplasma gondii in pregnant women was reported at 36.6% (95%CI:33.7-39.6). the highest prevalence reported based on meta-analysis was reported in South America with 52.8% (95% CI:46.6-59), while only 15 studies were reviewed in this continent, most of which were in Brazil. Therefore, after the continent, the highest prevalence reported was reported in Africa with 46.8% (95% CI:39.5-54.3). Also, the lowest prevalence reported based on meta-analysis was in North America with 19.7% (95% CI:8.4-39.6) and Europe with 24.6% (95% CI:17.8-32.9).

CONCLUSION

This study revealed a high level of seroprevalence of Toxoplasma gondii in pregnant women worldwide. This value mostly depends on the individual's age, lifestyle, and disease awareness regarding toxoplasmosis in pregnant women. Thus, public awareness, along with comprehensive health programs regarding the detrimental effects of toxoplasmosis in pregnant women, seems necessary for prevention or even early diagnosis of toxoplasmosis in pregnant women.

Cross-sectional study to investigate the seroprevalence and risk factors of Toxoplasma gondii among women attending the antenatal clinic in Namwala, Zambia

BACKGROUND

Toxoplasmosis is a zoonotic parasitic disease caused by Toxoplasma gondii (T. gondii). It has a wide host range and is capable of vertical transmission in pregnant women, which may lead to undesirable pregnancy outcomes such as congenital malformations, miscarriage, premature birth and stillbirth. This study investigated the seroprevalence of T. gondii infection among pregnant women attending the antenatal clinic at Namwala District Hospital in Southern Zambia.

METHODS

This was a cross-sectional study where blood was collected, and the serum was tested for Toxoplasma IgG and IgM. A questionnaire was administered to participants on demographic characteristics and risk factors. Data were entered in Microsoft Excel and exported to STATA version 14 for analysis.

RESULTS

A total of 401 women were enrolled in the study from 3 March to 5 August 2021. The seroprevalence of Toxoplasma IgG was 4.2% (n=17), while the seroprevalence of Toxoplasma IgM was 0.7% (n=3). The median age was 27 (IQR: 24-30) years, and a larger proportion had primary-level education (n=223, 55.6%). The majority (81.6%) of the women were married. None of the risk factors investigated in this study were significant for T. gondii infection.

CONCLUSION

There was a low seroprevalence of T. gondii infection among pregnant women in the Namwala district of Southern Province, Zambia, and regular screening may not be warranted in this population. Continued research on toxoplasmosis is recommended to understand its epidemiology across Zambia.

Seroprevalence of anti-Toxoplasma gondii antibodies and associated risk factors in pregnant women in Somalia

Toxoplasma gondii infection is a worldwide protozoan parasitic disease caused by the parasite Toxoplasma gondii. T. gondii infection in gestation period can lead to fetal or neonatal death, and besides congenital defects. So far, there are no data available regarding T. gondii seropositivity and associated risk factors in pregnant women in Somalia. The investigations of these aspects were done in 403 pregnant women attending the antenatal care (ANC) at Benadir hospital, in Mogadishu city. Blood samples were collected and analyzed for anti-T. gondii antibodies by enzyme-linked immunosorbent assay (ELISA). IgG seropositivity to T. gondii was 45.2% (182/403). None of the women were positive for IgM antibodies. Considering the first, second, and third trimesters of pregnancy, women IgG seropositivity was 44.2%, 26.3%, and 67.7%, respectively (p < 0.05). There was no significant association between seropositivity and age, sociodemographic features, history of abortion, presence of cats in house, contact cats feces, contact with soil, consumption of raw vegetables/meats, blood transfusion, and drinking of unboiled milk (p>0.05). Routine serological screening for T. gondii should be integrated with other ANC services to identify potential infections with the parasite.

Neuroimmunology of Common Parasitic Infections in Africa

Parasitic infections of the central nervous system are an important cause of morbidity and mortality in Africa. The neurological, cognitive, and psychiatric sequelae of these infections result from a complex interplay between the parasites and the host inflammatory response. Here we review some of the diseases caused by selected parasitic organisms known to infect the nervous system including Plasmodium falciparum, Toxoplasma gondii, Trypanosoma brucei spp., and Taenia solium species. For each parasite, we describe the geographical distribution, prevalence, life cycle, and typical clinical symptoms of infection and pathogenesis. We pay particular attention to how the parasites infect the brain and the interaction between each organism and the host immune system. We describe how an understanding of these processes may guide optimal diagnostic and therapeutic strategies to treat these disorders. Finally, we highlight current gaps in our understanding of disease pathophysiology and call for increased interrogation of these often-neglected disorders of the nervous system.

Seroprevalence and associated risk factors of Toxoplasma gondii infection among pregnant mother in Makassar, Indonesia

The protozoan parasite, Toxoplasma gondii is estimated to infect one-third of the world’s population. Infection in pregnant women can cause severe conditions for their babies. Until now, there is no data regarding Toxoplasma infection from Makassar pregnant mothers. This study aims to obtain information on Toxoplasma specific antibodies and to measure the risk factor associate with parasite infection. This cross-sectional study conducted in 9 of 47 primary health centres (Puskesmas) in Makassar. Blood samples and questionnaires were collected from 184 pregnant women aged 15–42 years old from September to October 2020. ELISA technique was used to examine the IgG and IgM antibodies. Univariable and multivariable analyses were carried out to measure factors that independently associate with Toxoplasma antibody positivity. Our result showed the range of Toxoplasma IgM and IgG are 0.06–1.01 and 0.09–3.01, respectively. While no one of our participants has an acute Toxoplasma gondii infection (IgM positive), we found 32,6% pregnant mothers are exposed to parasite (positive IgG). Contact with cats [OR(95%CI): 10.45(3.77–28.99)], consume chicken satay [OR(95%CI): 9.72(3.71–25.48)] and consume un-boiled water/ filtered water [OR(95%CI): 5.98(1.77–20.23)] are independently associate with positive Toxoplasma IgG antibody. Based on the result, we conclude that pregnant women in Makassar are exposed to T. gondii and the oocyst and tissue cyst of parasite contaminates food and water in Makassar.