High prevalence of anti-toxoplasma antibodies and absence of Toxoplasma gondii infection risk factors among pregnant women attending routine antenatal care in two Hospitals of Addis Ababa, Ethiopia

Toxoplasma gondii seroprevalence among pregnant women in Africa: A systematic review and meta-analysis

BACKGROUND

Toxoplasmosis is a serious endemic zoonotic disease caused by the protozoan parasite Toxoplasma gondii. Toxoplasma infection during pregnancy can result in congenital transmission and serious fetal and neonatal complications. This systematic review and meta-analysis aimed to assess the pooled seroprevalence of T. gondii infection and its determinants among pregnant women in African countries.

METHODS

All articles reporting the seroprevalence of toxoplasmosis among pregnant women in African countries and published from 2010 to 2023 were searched using various databases. The pooled prevalence of toxoplasmosis was calculated using a random-effect model. The variation between the included studies was assessed using a funnel plot and I2 heterogeneity statistics. To identify the sources of heterogeneity, sub-group analysis was further conducted by country, diagnostic method, and sub-African region. The association of prevalence rates with the socio-economic level and geoclimatic parameters was also explored.

RESULTS

In total, 29,383 pregnant women from 60 articles were included for analysis. The pooled T. gondii seroprevalence was 42.89% with high heterogeneity (I2 = 99.4%, P < 0.001). Sub-group analysis revealed variation by country (ranging from 2.62% in Namibia to 80.28% in Congo), diagnostic method used (from 8.66% in studies using a rapid diagnostic test to 55.69% in those using an agglutination test), and sub-African region (from 4.14% in regions of Southern Africa to 53.96 in Central Africa). Cat ownership (OR = 1.58) and the consumption of raw meat (OR = 1.50) and raw vegetables (OR = 1.48) had a statistically significant combined effect on T. gondii seroprevalence. No association was found between T. gondii prevalence and the level of income of the country or geoclimatic parameters.

CONCLUSION

The prevalence of toxoplasmosis infection among pregnant women in Africa is high, particularly in Central and Eastern Africa. The determinants of prevalence are multifactorial. Therefore, efforts should be made to increase the awareness of women concerning the risk factors for toxoplasmosis.

Seroprevalence and risk factors for Toxoplasma gondii infection among pregnant women at Debre Markos Referral Hospital, northwest Ethiopia

BACKGROUND

To assess the seroprevalence and risk factors of Toxoplasma gondii infection in pregnant women at the Debre Markos Referral Hospital, northwest Ethiopia.

METHODS

A facility-based cross-sectional study was undertaken among pregnant women from March 2020 to May 2021. Sociodemographic and clinical data were collected from randomly selected participants. Five millilitres of blood was collected and an enzyme-linked immunosorbent assay kit was used to test for T. gondii immunoglobulin G (IgG) antibodies. A logistic regression model was computed to identify the risk factors. The adjusted odds ratio (aOR) was estimated along with the 95% confidence interval (CI). A statistically significant association was defined as p<0.05.

RESULTS

T. gondii IgG antibody positivity was found in 38.8% (n=132) of 340 pregnant women. Contact with cats (AOR 2.5 [95% CI 1.5 to 4.2]), eating raw/undercooked meat (AOR 5.7 [95% CI 3.2 to 10.3]), consuming unwashed vegetables (AOR 4.1 [95% CI 2.1 to 8.0]), a history of abortion (AOR 1.9 [95% CI 1.1 to 3.3]) and drinking water sources (AOR 2.5 [95% CI 1.2 to 5.2]) demonstrated a statistically significant association with T. gondii infection.

CONCLUSIONS

Toxoplasmosis was found to be fairly common in pregnant mothers. Proper cat excreta disposal, not eating raw/undercooked meat, maintaining hand cleanliness and following environmental sanitation protocols could be important to decrease T. gondii infection.

Prevalence of preconception TORCH infections and its influential factors: evidence from over 2 million women with fertility desire in southern China

BACKGROUND

TORCH (Toxoplasma gondii [TOX], Cytomegalovirus [CMV], Rubella virus [RV], and Herpes simplex virus [HSV]) represents pathogens known to traverse the maternal-fetal barrier and cause severe neonatal anomalies. We aimed to assess the prevalence of preconception TOX, CMV, and RV infections among women with fertility desire in southern China, and identify related risk factors.

METHODS

Data were obtained from a population-based cross-sectional study conducted as part of the National Free Preconception Health Examination Project. Women planning to conceive within the next 6 months in Guangdong Province were enrolled between 2014 and 2019. Information on sociodemographic, gynecological, and obstetric characteristics was collected. Sera were analyzed for TOX IgG, CMV IgG, and RV IgG antibodies using an enzyme-linked immunosorbent assay. Descriptive, univariate, and multivariate logistic regression analyses were performed to assess the association between TORCH infections and related factors.

RESULTS

Among 2,409,137 participants, the prevalence of IgG antibodies for TOX, CMV, and RV was 3.20% (95% CI: 3.18-3.22%), 77.67% (95% CI: 77.62-77.71%) and 76.03% (95% CI: 75.98-76.07%), respectively. Of all participants, 141,047 women (5.85%, 95% CI:5.83-5.88%) reported a history of immunization for RV. Women living in the Pearl River Delta, a more developed region, have significantly lower vaccination rates than those living in other regions. The seropositivity of TOX IgG was highest among women aged 35 years and above, with primary or lower education levels, and rural registration. Factors such as being older, having a higher educational level, and being of other ethnicities were associated with a higher prevalence of naturally acquired CMV and RV infections. Women living in the Pearl River Delta showed a higher risk of TOX, CMV, and RV infections, with aORs of 2.21, 4.45, and 1.76, respectively. A history of pregnancy, gynecological diseases, and sexually transmitted infections were potentially associated with TORCH infections, but this association varied across pathogens.

CONCLUSION

The findings of this study update the baseline of preconception TORCH infections among women with fertility desire in southern China, helping to estimate the risk of congenital infection and guide the development and implementation of effective prevention measures for preconception TORCH infections.

Foodborne disease hazards and burden in Ethiopia: A systematic literature review, 1990–2019

Background

Foodborne disease (FBD) affects millions of people each year, posing a health burden similar to malaria, tuberculosis or HIV. A recent World Bank study estimated the productivity losses alone attributed to unsafe food within Africa at $20 billion in 2016, and the cost of treating these illnesses at an additional $3.5 billion. Ethiopia faces multiple food safety challenges due to lack of infrastructure and basic pre-requisites for food safety such as clean water and environment, washing facilities, compounded by limited implementation of food safety regulations, and a lack of incentives for producers to improve food safety. A consolidation of our understanding and evidence of the source, nature and scale of FBD in Ethiopia is needed to inform policy and future research. We performed a Systematic Literature Review (SLR) of publications on FBD occurrence in Ethiopia including hazard presence and impact.

Method

The SLR followed Cochrane and PRISMA guidelines. We searched PubMed and CAB-Direct for relevant publications between 1990 and 2019 (inclusive). Observational studies and reviews were included. Two reviewers screened titles and abstracts, and retained publications were reviewed in full for quality and data extraction.

Result

In total 128 articles met the inclusion criteria. Most articles focused on the identification of biological hazards in food. High levels of microbial contamination in different food value chains were often found in the small, ad hoc, observational studies that dominated the literature. Raw milk (22/128, 17.0%) and raw beef (21/128, 16.4%) were the most studied food products. Foodborne (FB) parasites were often found at higher rates in food than bacterial and viral pathogens, possibly due to differences in ease of identification. High levels of bacterial contamination on the hands of food handlers were widely reported. There were no reports on the incidence of human FBDs or resulting health and economic impacts.

Conclusion

Our findings reflect existing concerns around food safety in Ethiopia. A lack of substantial, coordinated studies with robust methodologies means fundamental gaps remain in our knowledge of FBD in Ethiopia, particularly regarding FBD burden and impact. Greater investment in food safety is needed, with enhanced and coordinated research and interventions.

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.

Seroprevalence of Gestational and Neonatal Toxoplasmosis as well as Risk Factors in Yaoundé, Cameroon

Background

Toxoplasmosis, caused by Toxoplasma gondii in pregnant women, is a significant public health problem due to risk of mother to child transmission. The aim of the study was to determine the seroprevalence of toxoplasmosis in pregnant women and corresponding cord blood among women attending Biyem-Assi and CASS Nkoldongo hospitals in Yaoundé, Cameroon.

Methods

An institutional based cross-sectional study was conducted between June 2019 and May 2020 on 300 pregnant women from late second trimester to third trimester. A total of 259 cord blood samples were collected at birth from these women. Toxoplasma gondii-specific IgG and IgM antibodies in maternal and cord blood were detected using the Toxoplasma Enzyme Immunosorbent Assay kit, and potential risk factors captured through questionnaire were identified using binary logistic regression model. Statistical significance was measured at P < 0.05.

Results

The overall seroprevalence of gestational and neonatal toxoplasmosis was 80% and 88%, respectively. IgG seropositivity was 72.7%, IgM only was 1.3% and cooccurrence of IgG/IgM was 6% amongst pregnant women. Out of 259 newborn cord bloods, 72.2% were positive for IgG only, 8.9% for IgM only, and 23.9% for both IgG/IgM. Pregnant women 15-24 years (AOR = 4.6, P = 0.011) and women with primary level of education (AOR = 3.9, P = 0.042) were significantly at risk of infection with Toxoplasma gondii.

Conclusion

Gestational and neonatal toxoplasmosis appears to be more common with higher risk of infection in younger women and less educated women. Hence, these findings will serve as baseline data for further investigations on mother to child transmission of toxoplasmosis in Yaoundé and the need for reinforcement of pregnant women toxoplasmosis-related health measures.

Toxoplasmosis infection among pregnant women in Africa: A systematic review and meta-analysis

The epidemiology of toxoplasmosis in pregnancy is a major issue in public health. Toxoplasmosis is caused by the protozoan parasite. Toxoplasma parasite is at high risk for life-threatening diseases during pregnancy. Congenital toxoplasmosis results from a maternal infection acquired during gestation. Therefore, this systematic review and meta-analysis was aimed to determine the seropositive prevalence of toxoplasmosis infection among pregnant women who attended antenatal care in a health facility in Africa. A systematic review and meta-analysis of published and unpublished studies were included. Databases such as MEDLINE, PubMed, EMBASE, CINAHL, Web of Science, African Journals Online were used with relevant search terms. The quality of the articles was critically evaluated using the tool of the Joanna Briggs Institute. Data were extracted on Microsoft word 2016. Meta-analysis was conducted using STATA 14 software. The heterogeneity and publication bias were assessed using the I² statistics and Egger’s test, respectively. Forest plots were used to present the pooled prevalence and odds ratio with a 95% confidence interval of meta-analysis using the random effect model. In total, 23 studies comprising 7,579 pregnant women across ten countries in Africa were included in this meta-analysis. The overall prevalence of seropositive toxoplasmosis among pregnant women in Africa was 51.01% (95% CI; 37.66, 64.34). The heterogeneity test showed that heterogeneity was high, I² = 99.6%, P-value < 0.001. The variables responsible for the source of heterogeneity were included from Cameroon, the Democratic Republic of Congo, and Ethiopia. Overall prevalence of toxoplasmosis in Africa showed that more than one-half of pregnant women were infected. The risk of acquiring toxoplasmosis infection during pregnancy is high; hence, preventive measures to avoid exposure of pregnant women to Toxoplasma infection should be strictly applied.

Toxoplasma gondii infection and spontaneous abortion: A systematic review and meta-analysis

Toxoplasmosis is one of the most common parasitic infections in humans, which is caused by Toxoplasma gondii. It is usually asymptomatic but primary infection in a pregnant woman can cause severe consequences in the fetus such as miscarriage. This study aimed to estimate the global prevalence of T. gondii infection in women with spontaneous abortion. It also evaluates the possible relationship between recent Toxoplasma infection and miscarriage. Five electronic databases were reviewed. We used the random effects model and 95% confidence intervals(CI) to determine the overall prevalence and odds ratio (OR). Heterogeneity was calculated using Cochran's Q test and I² statistic. The included studies were divided into three sub-groups based on antibody class against T. gondii and the existence of parasite DNA. Based on PCR, the pooled random-effects estimates that the prevalence of T. gondii infection in women with abortion was 10% (95% CI 7-14%). The pooled random effect favored a statistically significant increased risk of latent Toxoplasma infection [OR = 1.84; 95% CI: 1.41-2.40, P < 0.001] and recent infection [OR = 3.72; 95% CI: 2.21-6.26, P < 0.001] in women with spontaneous abortions. In recent infections, significant pooled ORs of positive association were observed in women with miscarriage [OR = 4.2; 95% CI: 2.04-8.85; χ2 = 17.2; I² = 42.0%, P = 0.07]. This study demonstrates that recent T. gondii infection is associated with an elevated risk of spontaneous abortion. Further studies concerning all risk factors related to toxoplasmosis, and undertaking confirmatory tests at the time of abortion should be performed to investigate the impact of T. gondii infection and spontaneous abortion.

Seroepidemiology of Toxoplasma gondii Among Pregnant Women Attending Antenatal Care in Northwest Ethiopia

Introduction

Toxoplasmosis is a life-threatening disease in pregnant women, having social and economic impacts due to congenital toxoplasmosis. However, in Ethiopia, it is neglected zoonotic disease, which requires screening and identifying risk factors in pregnant women to plan a public health intervention.

Methods

This institutional-based cross-sectional study was employed from March to April 2019 to estimate the seropositivity and assess potential risk factors for T. gondii among pregnant women attending antenatal care in four public hospitals in Northwest Ethiopia. Four hundred and one pregnant women were recruited to collect serum samples. Toxoplasma gondii antibodies were tested using Toxo-Latex slide agglutination test.

Results

Thus, the overall seropositivity for T. gondii was found 70.8% (95% CI: 66.3–75.5). Multivariable logistic regression analysis showed that the average monthly income, occupational status, habits of handwashing practices after handling raw meat, water sources for drinking and agroclimatic situations revealed significant (p < 0.05) effects on seropositivity for T. gondii in pregnant women.

Conclusion

This survey showed high seropositivity for T. gondii among pregnant women in Northwest Ethiopia. Therefore, further studies on bioassay, isolation and genotype of the pathogen are crucial. It also requires action to prevent and control the infection with T. gondii in pregnant women, which poses a potential threat to a foetus.

Serological survey and risk factors associated with Toxoplasma gondii infection among HIV-infected pregnant women attending Abuja Tertiary Hospital, Nigeria

Background

Toxoplasmosis in pregnancy could induce miscarriage, congenital anomalies in foetuses and encephalitis in HIV-infected people. Hence, there is a need to determine the prevalence of toxoplasmosis in HIV-infected pregnant women to inform clinicians about the significance of maternal toxoplasmosis in antenatal care.

Aim

This study aimed to determine the seroprevalence of Toxoplasma gondii infection, associated CD4+ T-cell profile and sociodemographic risk factors among pregnant women with or without HIV infection attending the University of Abuja Teaching Hospital, Abuja, Nigeria.

Methods

This hospital-based cross-sectional study involved blood samples collected from 160 HIV-infected and 160 HIV-seronegative pregnant women. These samples were analysed for anti-T. gondii (IgG and IgM) and CD4+ T-cell count using ELISA and flow cytometry, respectively. Sociodemographic variables of participants were collected using structured questionnaires.

Results

The overall seroprevalence of anti-T. gondii IgG and IgM was 28.8% and 3.8%, respectively. The seroprevalence of anti-T. gondii IgG and IgM was 29.4% and 4.4%, respectively, among HIV-seropositive pregnant women and 28.1% and 3.1%, respectively, among HIV-seronegative women. There was no significant association between the seroprevalence of anti-T. gondii-IgG and anti-T. gondii-IgM with age, gestational age, education level, parity or place of residence of HIV-infected pregnant women (P > 0.05). However, there was significant association between the seroprevalence of anti-T. gondii-IgG (P = 0.03) and anti-T. gondii-IgM (P = 0.01) with education level. CD4+ T-cell count varied significantly between HIV-infected and HIV-uninfected pregnant women (P = 0.035).

Conclusion

In this study, the seroprevalence of anti-T. gondii IgG and IgM did not differ in HIV-seropositive or HIV-seronegative pregnant women. However, women with primary T. gondii and HIV coinfection had lower CD4+ T-cell count than those with toxoplasmosis monoinfection.

Potential risk factors associated with seropositivity for Toxoplasma gondii among pregnant women and HIV infected individuals in Ethiopia: A systematic review and meta-analysis

BACKGROUND

Toxoplasma gondii is an obligate intracellular and neurotropic apicomplexan protozoan parasite infecting almost all warm-blooded vertebrates including humans. To date in Ethiopia, no systematic study has been investigated on the overall effects of potential risk factors associated with seropositivity for Toxoplasma gondii among pregnant women and HIV infected individuals. We intended to determine the potential risk factors (PRFs) associated with seropositivity for Toxoplasma gondii from published data among pregnant women and HIV infected individuals of Ethiopia.

METHODOLOGY

An systematic review of the previous reports was made. We searched PubMed, Science Direct, African Journals Online, and Google Scholar for studies with no restriction on the year of publication. All references were screened independently in duplicate and were included if they presented data on at least two risk factors. Meta-analysis using the random or fixed-effects model was made to calculate the overall effects for each exposure.

RESULTS

Of the 216 records identified, twenty-four reports met our eligibility criteria, with a total of 6003 individuals (4356 pregnant women and 1647 HIV infected individuals). The pooled prevalences of anti-Toxoplasma gondii antibodies were found at 72.5% (95% CI: 58.7% - 83.1%) in pregnant women and 85.7% (95% CI: 76.3% - 91.8%) in HIV infected individuals. A significant overall effect of anti-Toxoplasma gondii seropositivity among pregnant women (p < 0.05) was witnessed with age, abortion history, contact with cats, cat ownership, having knowledge about toxoplasmosis, being a housewife and having unsafe water source. Age, cat ownership, and raw meat consumption were also shown a significant effect (p < 0.05) to anti-Toxoplasma gondii seropositivity among HIV infected individuals.

CONCLUSIONS

This review showed gaps and drawbacks in the earlier studies that are useful to keep in mind to design accurate investigations in the future. The pooled prevalence of anti-Toxoplasma gondii antibodies was found to be higher among pregnant women and HIV infected individuals. This suggests that thousands of immunocompromised individuals (pregnant women and HIV infected patients) are at risk of toxoplasmosis due to the sociocultural and living standards of the communities of Ethiopia. Appropriate preventive measures are needed to reduce the exposure to Toxoplasma gondii infection. Further studies to investigate important risk factors are recommended to support the development of more cost-effective preventive strategies.

Exposure to Toxoplasma gondii Through Consumption of Raw or Undercooked Meat: A Systematic Review and Meta-Analysis

Toxoplasma gondii is a globally distributed protozoan that mainly causes health issues in the fetuses of pregnant women who have never been exposed to this parasite and patients with deficient immune systems. Except in these vulnerable populations, the primary infection generally goes unnoticed in most healthy individuals. Apart from transplant/transfusion, congenital transmission, direct contact with infected cats or their feces, and environmental contamination (i.e., oocysts in food, water, and soil) pathways, humans can acquire the parasite through consumption of animal tissues infected by T. gondii. This meta-analysis estimated the risk of acquiring T. gondii by consuming raw or undercooked meat, regardless of which animal species are eaten. Using a random-effect model, crude and adjusted pooled measures of association (risk and odds ratio) were estimated according to study design (cohort, case-control, and cross-sectional studies). The meta-analysis included measures of heterogeneity as well as quality rating scales for each study design. Our results suggest that individuals who eat raw or undercooked meat have, respectively, 1.2-1.3 times the risk and 1.7-3.0 times the odds of T. gondii infection compared to those who thoroughly cook meat, regardless of the animal species they consume. These results align with the current understanding that adequately cooking meat inactivates the parasite and decreases the risk of transmission. Seroprevalence ranged from 1.3% to 88.6%, while the proportion of individuals eating raw or undercooked meat fluctuated from 0.7% to 98.3% across the studies in the meta-analysis. These numbers reflect various preferences with regard to eating meat (i.e., eating tartar, sausages, or salamis) as well as individual, cultural and religious food habits, and personal awareness.

Human toxoplasmosis in Mozambique: gaps in knowledge and research opportunities

Toxoplasmosis is a parasitic zoonotic disease caused by Toxoplasma gondii that afflicts humans worldwide and wild and domestic warm-blooded animals. In immunocompetent individuals, the acute phase of infection presents transient low or mild symptoms that remain unnoticed. In immunocompromised patients, T. gondii is a life-threatening opportunistic infection, which can result from the reactivation of latent infection or primary infection. Moreover, congenital toxoplasmosis, which results from the transplacental passage of tachyzoites into the fetus during a pregnant primary infection, can lead to miscarriage, stillbirth, or ocular and neurologic disease, and neurocognitive deficits in the newborns. Thus, the present review aims to address the current knowledge of T. gondii infection and toxoplasmosis in Africa and especially in Mozambique, stressing the importance of identifying risk factors and promote awareness among the health care providers and population, assessing the gaps in knowledge and define research priorities. In Mozambique, and in general in southern African countries, clinical disease and epidemiological data have not yet been entirely addressed in addition to the implications of T. gondii infection in immunocompetent individuals, in pregnant women, and its relation with neuropsychiatric disorders. The main gaps in knowledge in Mozambique include lack of awareness of the disease, lack of diagnostic methods in health facilities, lack of genetic data, and lack of control strategies.

Seroprevalence of Anti-Toxoplasma gondii Antibodies and Associated Factors Among Pregnant Women Attending Antenatal Care at Debre Markos Referral Hospital, Northwest Ethiopia

Background

Toxoplasma gondii is an obligate intracellular protozoan parasite that causes a zoonotic disease called toxoplasmosis. If the infection acquired during pregnancy is not detected and treated early, the parasite can be transmitted transplacentally to the fetus, resulting in congenital toxoplasmosis, which likely leads to serious consequences in the fetus. Toxoplasmosis constitutes a major public health problem particularly in low- and middle-income countries including Ethiopia. This study aimed to determine the seroprevalence and to assess the potential risk factors of toxoplasmosis among pregnant women attending antenatal care at Debre Markos Referral Hospital, Northwest Ethiopia.

Methods

In this cross-sectional study, data on the sociodemographic and potential obstetric and behavioral risk factors were gathered through pretested structured questionnaires, and 3 mL of venous blood was also drawn from each of randomly selected 233 study subjects. The serum samples were separated from the blood samples and tested for anti-Toxoplasma antibody using Toxo-latex slide agglutination test. Logistic regression analysis was used to examine the association between risk factors considered and T gondii infection.

Results

The overall prevalence of T gondii infection was 67.8%, indicating a high prevalence of toxoplasmosis in the study area. In multivariate analysis, keeping domestic cat at home was found to be the only explanatory variable of toxoplasmosis (adjusted odds ratio = 2.449, 95% confidence interval = 1.183-5.070, P = .016). All sociodemographic variables and most of the potential obstetric and behavioral risk factors were not statistically significant explanatory variables of T gondii infection.

Conclusion

The prevalence of toxoplasmosis is high in the study area. Thus, pregnant women should be aware of the potential risk of the disease when keeping cats at home and management of their litter. Inclusion of serologic screening for T gondii infection at antenatal care is warranted for prevention of congenital toxoplasmosis.

The global seroprevalence of anti-Toxoplasma gondii antibodies in women who had spontaneous abortion: A systematic review and meta-analysis

BACKGROUND

Toxoplasma gondii (T. gondii) is an intracellular pathogen that can lead to abortion in pregnant women infected with this parasite. Therefore, the present study aimed to estimate the global seroprevalence of anti-T. gondii antibodies in women who had spontaneous abortion based on the results of published articles and evaluate the relationship between seroprevalence of anti-T. gondii antibodies and abortion via a systematical review and meta-analysis.

METHODS

Different databases were searched in order to gain access to all studies on the seroprevalence of anti- T. gondii antibodies in women who had spontaneous abortion and association between seroprevalence of anti-T. gondii antibodies and abortion published up to April 25th, 2019. Odds ratio (OR) and the pooled rate seroprevalence of T. gondii with a 95% confidence interval (CI) were calculated using the random effects model.

RESULTS

In total, 8 cross-sectional studies conducted on 1275 women who had abortion in present pregnancy, 40 cross-sectional studies performed on 9122 women who had a history of abortion, and 60 articles (involving 35 cross-sectional studies including 4436 women who had spontaneous abortion as case and 10398 as control and 25 case-control studies entailing 4656 cases and 3178 controls) were included for the final analyses. The random-effects estimates of the prevalence of anti-T. gondii IgG antibody in women who had abortion in present pregnancy and women who had a history of abortion were 33% (95% CI: 17%-49%) and 43% (95% CI: 27%-60%), respectively. In addition, the pooled OR for anti-T. gondii IgG antibody in cross-sectional and case-control studies among women who had spontaneous abortion were 1.65 (95% CI: 1.31-2.09) and 2.26 (95% CI: 1.56-3.28), respectively. Also, statistical analysis showed that the pooled OR of the risk of anti-T. gondii IgM antibody 1.39 (95% CI: 0.61-3.15) in cross-sectional and 4.33 (95% CI: 2.42-7.76) in case-control studies.

CONCLUSION

Based on the results of the current study, T. gondii infection could be considered a potential risk factor for abortion. It is recommended to carry out further and more comprehensive investigations to determine the effect of T. gondii infection on abortion to prevent and control toxoplasmosis among pregnant women around the world.

Toxoplasmosis in a Cohort of Italian Patients With Bipolar and Psychotic Disorders: How Infection May Affect Clinical Features?

This study investigated the seroprevalence of Toxoplasma gondii in a cohort of 101 Italian inpatients affected by mood or schizophrenia-spectrum disorders and compared clinical features between seronegative and seropositive subjects. Patients diagnosed according to DSM-5 criteria underwent clinical assessments and blood collection to test parasite-specific IgG/IgM serum levels. Twenty-eight patients (27.7%) had IgG anti-T. gondii, and none had IgM antibodies. We found higher prevalence rate in patients aged 40 years or older, as compared with younger. No significant association was detected between T. gondii and a specific diagnostic category; however, bipolar disorder (BD)-II showed the highest positivity rate (40.9%). The seropositive status was significantly associated with a lower presence of psychotic symptoms, higher number of total episodes of predominant excitatory polarity, longer illness duration, and lower severity of current episode, particularly anxiety, depressive, and withdrawal/retardation symptoms. These preliminary results seem to point out an association between chronic toxoplasmosis and a specific subtype of BD.

Toxoplasma gondii seropositivity and the associated risk factors in sheep and pregnant women in El-Minya Governorate, Egypt

BACKGROUND AND AIM

The cosmopolite protozoan, Toxoplasma gondii, has a significant economic and medical impact. Cats traditionally play a predominant role in the disease maintenance cycle; however, humans can be infected as a result of milk and meat consumption of Toxoplasma-infected livestock. In addition, infected pregnant women, even symptomless, can pass the disease to their unborn fetus. The limited clinical records and absence of specific national educational programs in countries like Egypt underscore the need for periodic toxoplasmosis disease evaluation. Here, we identified T. gondii seroprevalence among sheep and pregnant women and the associated risk factors in El-Minya Governorate, Egypt.

MATERIALS AND METHODS

Using peripheral blood, we detected T. gondii-specific antibodies in 151 sheep and 96 pregnant women sera from El-Minya Governorate using latex agglutination and indirect enzyme-linked immunosorbent assay. The impact of different environmental and behavioral risk factors identified with in-person interviews and serology results on acquiring toxoplasmosis was statistically analyzed.

RESULTS

The overall toxoplasmosis seroprevalence was 39.1% and 22.9% in sheep and pregnant women, respectively. Significantly higher seroprevalence was correlated with increasing sheep age and geographical location. Nonetheless, no statistical significance was found based on abortion history and pregnancy status of the examined sheep. Exposure factors important for pregnant women included pregnancy trimester, contact with cats, and the habit of eating undercooked sheep meat, which all had a statistically significant association with Toxoplasma seropositivity.

CONCLUSION

The current study confirms increased antibodies against toxoplasmosis in both sheep and pregnant women in El-Minya Governorate and a clear association between women's age, contact with cats, and the habit of eating undercooked sheep meat and seroreactivity to T. gondii. These results strongly suggest the need for a more comprehensive epidemiological study and public health awareness education for toxoplasmosis.

Seroprevalence of Toxoplasma gondii among pregnant women attending antenatal clinics at Hawassa University comprehensive specialized and Yirgalem General Hospitals, in Southern Ethiopia

BACKGROUND

Toxoplasmosis is caused by infection with the protozoan parasite Toxoplasma gondii. It is acquired by consumption of raw or undercooked meat containing tissue cyst, food or water contaminated with oocyst and congenital infection through the placenta leading to serious congenital abnormalities in the fetus like miscarriage, stillbirth, intrauterine death and neurologic defects. Therefore; this study was aimed to determine the prevalence of toxoplasmosis infection and its possible risk factors associated with pregnant women attending antenatal clinics in Hawassa and Yiregalem Hospitals, Southern Ethiopia.

METHODS

A hospital-based cross-sectional study was conducted from December 2016 to May 2017. The study was done in antenatal care clinics of Hawassa and Yiregalem Hospitals in Southern, Ethiopia. Five hundred pregnant women were interviewed with a pretested structured questionnaire to collect risk factors and socio-demographic data. Blood samples were collected and serum was separated and tested for anti- Toxoplasma gondii antibodies using ELISA (Enzyme-linked Immunosorbent Assay). Data were analyzed using SPSS version 20 statistical software. The risk factors were tested for significance using Bivariate and multivariate analysis. P-value < 0.05 was considered statistically significant.

RESULTS

The weighted prevalence of this study was 81.8% for the anti- Toxoplasma gondii antibody. Almost all participants (99.6%) had no information about the disease. A significant association was observed between seroprevalence and contact with domestic cats (OR = 1.206, 95% CI (1.627-2.206, P = 0.043), consumption of raw meat (OR = 0.848, 95% CI: 1.517-2.941, P = 0.019) and unpasteurized milk (OR = 0.871, 95% CI 1.531-2.221, P = 0.032). A significant association was not observed between seroprevalence and age, history of abortion, and blood transfusion.

CONCLUSIONS

The findings of this study demonstrated a relatively higher prevalence of seropositivity than studies reported from other countries. Existence of domestic cats at home, consumption of undercooked meat and unpasteurized milk were identified as risk factors for T. gondii infection. Therefore, a health education program to increase the mother's knowledge about toxoplasmosis towards avoiding eating undercooked meat, contact with cats and consumption of unpasteurized milk during pregnancy is recommended. Furthermore, our results suggested that the implementation of newborn screening and follow-up testing can lead to reducing of toxoplasmosis associated complications.

Evaluation of the level of awareness of congenital toxoplasmosis and associated practices among pregnant women and health workers in Tanzania's Temeke district in Dar es Salaam

BACKGROUND

Toxoplasmosis caused by the obligate intracellular coccidian protozoan Toxoplasma gondii (T. gondii) infects all warm-blooded animals including humans. This parasite may develop in both immune-compromised and immunocompetent hosts but usually the disease manifestations strongly differ according to immune status. Immunocompromised hosts develop more severe disease than immunocompetent hosts. Infections in pregnancy carry the risk of foetal involvement and can lead to serious clinical outcomes including psychomotor and ocular disorders in congenitally infected foetuses and children.

OBJECTIVE

To assess the level of awareness and practices towards congenital toxoplasmosis among health workers and pregnant women in Tanzania's Temeke municipality.

METHODS

This was a cross-sectional study involving 371 pregnant women and 22 health workers from six healthcare facilities in Temeke municipality of Dar es Salaam, Tanzania. A structured questionnaire and review of prenatal screening forms were used to collect information. The questionnaire focused on knowledge of disease aetiology, signs and symptoms, modes of transmission, treatment and management.

RESULTS

Of the pregnant women, 96% (95% CI: 0. 94-0.98) were unaware of the disease, had never heard, read or seen any information regarding toxoplasmosis. The majority of respondents including those who had heard, read or seen information concerning toxoplasmosis were unaware of the disease aetiology, signs and symptoms. However, 90% (95% CI: 0.86-0.93) of respondents unknowingly observed preventive practices towards the disease including avoiding eating raw, cured or rare meat. There was a significant statistical relationship between practices towards toxoplasmosis and age of pregnant women, such that for every increase in age by ten years the risk practices towards toxoplasmosis increased by 41% (OR=1.41, 95%, C.I. 1.05-1.90). Preventive practices towards toxoplasmosis decreased significantly by 74% and 78% for the age of 19-25 and 26-35 years old pregnant women respectively, as compared to those < 19 years. No significant difference was observed for those aged > 35 years. Multigravidae was associated with at-risk practices towards toxoplasmosis (OR=2.65, CI: 1.38-5.08). Of the 22 health workers who participated in the study, 36% (95% CI: 0.15-0.58) were aware of the congenital toxoplasmosis and its clinical outcomes. None of them had diagnosed the disease before.

CONCLUSION

Due to general lack of awareness towards toxoplasmosis observed among both health workers and pregnant women in Temeke Municipality, we recommend health policy on maternal and child healthcare to address prenatal screening that is aimed at providing early diagnosis for any possible congenital toxoplasmosis as well as diseases that are currently screened in Tanzania such as HIV, syphilis and malaria. Integrating a One Health approach in educating medical professionals and the vulnerable population of pregnant women on the importance of congenital zoonoses will promote awareness and preventive practices towards the disease.

Toxoplasmosis in pregnancy: a neglected bane but a serious threat in Nigeria

Toxoplasmosis is a global health threat in which occurrence in pregnant women poses grave consequences to fetal wellbeing. Studies on prenatal Toxoplasma gondii infection are generally limited in sub-Saharan African countries, including Nigeria. The risk of transmission of toxoplasmosis is very high in Nigeria due to the favourable climatic conditions and prevailing behavioural and socio-economic factors that could aid transmission. Currently, there are no systematic and organized procedures for diagnosis and treatment of maternal toxoplasmosis in Nigeria. These conditions forecast possible unabated transmission in many areas and exponential impact on associated adverse events of the disease during pregnancy. This paper highlights the importance of early diagnosis and treatment during pregnancy which may forestall subsequent development of infection in children delivered by infected mothers. Inclusion of toxoplasmosis control policy in the routine antenatal care of pregnant women is therefore strongly recommended.

Toxoplasmosis in Pregnant Women and HIV/AIDS Patients in Ethiopia: A Systematic Review and Meta-Analysis

Background

Although Toxoplasma gondii infection in immune-competent individuals is usually asymptomatic or causes a mild flu-like illness, it may become severe and can occasionally be fatal in immune-compromised people, such as AIDS patients or pregnant women.

Method

Electronic English databases (Pubmed, Google Scholar, Science Direct, and Scopus), parasitology congresses, and theses of Ethiopian medical universities, were systematically searched (published or unpublished data). Full-length articles and abstracts were collected using keywords such as Toxoplasma gondii, Toxoplasmosis, pregnant women, HIV/AIDS, and Ethiopia.

Results

Analysis of seroprevalence estimates was pooled using a random effects meta-analysis. Seventeen studies were included in the present systematic review and meta-analysis. One of these studies reported seroprevalence of T. gondii in HIV/AIDS patients and pregnant women. In this review, a total of 4,030 individuals were included and analyzed. The pooled prevalence of T. gondii in this review was 81.00% (95% CI = 69.10–89.78). Sub-group analysis showed that 2,557 pregnant women were evaluated. In pregnant women, the pooled sero-prevalence was 71.2 (95% CI = [51.9%, 87.1%]. In HIV/AIDS patients, 1,473 individuals were evaluated and the pooled seroprevalence was 88.45 (95% CI = 80.87%–94.31%).

Conclusion

This systematic review and meta-analysis identified a high seroprevalence of Toxoplasma infection of 81% among immunocompromised patients. Scaling up prevention and control methods mainly strengthening educational efforts are necessary to avoid reactivation and to stop the spread of T. gondii infection.

Diagnosis of acute toxoplasmosis by IgG avidity method in pregnant women referred to health centers in south-eastern Iran

Toxoplasmosis, one of the most common parasitic infections, can cause abortions in human. The purpose of this study was to determine seroprevalence of toxoplasmosis and acute form of toxoplasmosis in pregnant women. 208 pregnant women who referred to health centers in south-eastern Iran were taken under study after signing the informed consent forms and filling out the checklists. For those with high levels of IgG or IgM antibody titers, IgG Avidity test was performed to determine the acute infection. High level of IgG anti-body were found in sera of 81 pregnant women and 7 persons had borderline titer. IgM antibody results were positive in 33 and borderline in 4 cases. Then, the samples with positive and borderline results for IgM and IgG were evaluated by IgG avidity test. In this study, approximately 60% of pregnant women were not immune to risks posed by Toxoplasma gondii. Therefore, this group are at risk of acquiring primary infection of toxoplasmosis during gestation.

Prevalence and risk factors profile of seropositive Toxoplasmosis gondii infection among apparently immunocompetent Sudanese women

Objectives

Toxoplasma gondii is an opportunistic parasite that causes a clinical manifestation known as toxoplasmosis. We investigated the prevalence and potential risk factors of T. gondii infection among women in Khartoum, Sudan. A sero-parasitological cross-sectional study included 100 women aging between 15 and 50 years old was conducted between January and November 2018. Serum samples were collected and investigated for the presence of anti-T. gondii immunoglobulins.

Results

Mean age of the women population included was 26.75 ± 8.25 with a range between 15 and 50 years. Sero-prevalence of T. gondii antibodies was 27% (27/100) with a 95% confidence interval (CI) of 18.6–36.8%. Among seropositive population 81% (22/27), 15% (4/27) and 4% (1/27) were seropositive for IgG antibodies, IgM antibodies and both antibodies respectively. Age group 21–30 years old had the highest frequency of detected IgG (10/45) and IgM (3/45). Married women had the highest frequency of detected IgG or IgM, 18/79 and 3/79, respectively. Risk factors analysis showed a total of 37/100 participants were having direct contact with cats and 66/100 have a frequent raw meat consumption, neither direct cats contact nor raw meat consumption had a statistically significant association with seropositivity to T. gondii (P value = 0.052 and 0.565, respectively).

Electronic supplementary material

The online version of this article (10.1186/s13104-019-4314-0) contains supplementary material, which is available to authorized users.

Lack of circulating toxoplasma gondii DNA in seropositive patients with bipolar or schizophrenia spectrum disorders

Toxoplasmosis has been previously associated with an increased risk of having Schizophrenia or Bipolar disorder in several epidemiological studies. The aim of this observational, cross-sectional study was to examine the seroprevalence of Toxoplasma infection in a cohort of Italian psychiatric inpatients and to verify the presence of circulating Toxoplasma gondii DNA in the seropositive subjects. Sixty-three patients affected by bipolar or schizoaffective disorders according to DSM-5 criteria were enrolled. The presence of Toxoplasma infection was firstly examined using an indirect serological method (ELFA), and three different direct PCR-based methods were performed to detect circulating DNA in the seropositive patients. The seroprevalence of infection was 28.6%, with a significant association between higher age and the infection status. PCR, nested-PCR and Real-Time PCR revealed no positive samples for Toxoplasma gondii. This result is in contrast with recent data from case-control studies that detected parasite genome in patients with different neuropsychiatric diagnosis without clinical evidence of acute toxoplasmosis. Our findings are to be interpreted with caution, because of the small sample size, the heterogeneity of enrolled patients and the observational nature of the study. Further studies are needed to better define the clinical features correlated to the seropositive status in neuropsychiatric patients.

Public Opinions on Strategies for Managing Stray Cats and Predictors of Opposition to Trap-Neuter and Return in Brisbane, Australia

A survey of Brisbane residents was undertaken to investigate community attitudes toward urban stray cats and their management. Surveys were distributed to 84 medical and dental practices across Brisbane City, and were completed by 305 patients and staff. Practices were targeted to achieve a sample of respondents from a representative distribution of socioeconomic backgrounds. After being informed about trap, neuter, and return (TNR) programs for management of urban stray cats, most respondents (79%), chose TNR as their preferred management strategy, while a lesser proportion (18%) expressed a preference to continue the current Brisbane City Council lethal control program (catching and culling ~1,000 cats annually), and 3.4% selected to leave the cats alone. Differences in beliefs and attitudes toward urban stray cats as a function of demographic variables were investigated. Statistical analyses indicated that respondents who were male, older, non-cat owners, those who believed euthanasia of stray cats was humane, and that urban stray cats spread disease to humans were significantly more likely to express a preference for lethal control, as opposed to non-lethal population management. Based on these findings, we recommend that information is disseminated to mitigate these concerns or negative beliefs, where warranted. Ultimately, findings from this study demonstrate that current Queensland legislation does not reflect public views and opinions on stray cat management and should be reviewed. Formal research evaluating the efficacy of TNR programs for urban stray cats in Australia would be in the public interest.

Potential public health benefits from cat eradications on islands

Cats (Felis catus) are reservoirs of several pathogens that affect humans, including Toxoplasma gondii. Infection of pregnant women with T. gondii can cause ocular and neurological lesions in newborns, and congenital toxoplasmosis has been associated with schizophrenia, epilepsy, movement disorders, and Alzheimer's disease. We compared seroprevalence of T. gondii and risk factors in people on seven islands in Mexico with and without introduced cats to determine the effect of cat eradication and cat density on exposure to T. gondii. Seroprevalence was zero on an island that never had cats and 1.8% on an island where cats were eradicated in 2000. Seroprevalence was significantly higher (12-26%) on the five islands with cats, yet it did not increase across a five-fold range of cat density. Having cats near households, being male and spending time on the mainland were significant risk factors for T. gondii seroprevalence among individuals, whereas eating shellfish was protective. Our results suggest that cats are an important source of T. gondii on islands, and eradicating, but not controlling, introduced cats from islands could benefit human health.

Seroprevalence and associated risk factors of Toxoplasma gondii among Manchu pregnant women in northeastern China

Toxoplasma gondii is an intracellular protozoan parasite infecting human and almost all warm-blooded animals. It may cause several severe symptoms if pregnant women infection with T. gondii, including misbirth. A cross-sectional study was conducted containing 313 Manchu pregnant women attending antenatal care from 2016 to 2017 in Jilin province, northeastern China, and were assessed by enzyme-link immunosorbent assay and the study utilized univariate analysis to identify the potential risk factors for T. gondii infection. Of the 313 investigated Manchu pregnant women, 51 (16.29%, 95% CI 12.2-20.4) were tested as T. gondii-seropositive, with 47 (15.02%) seropositive for T. gondii IgG antibodies and 8 (2.56%) IgM positive. The seroprevalence of T. gondii in different age groups varied from 13.50% (8.7-18.3) to 23.90% (13.9-41.9). Pregnant raising cat at home has a significantly higher seroprevalence of T. gondii than no cat at home. Pregnant consuming raw/undercooked meat has a significantly higher T. gondii seroprevalence than individuals did not consuming raw/undercooked meat. This is the first study of T. gondii infection seroprevalence in Manchu pregnant women. Risk factors analysis suggested that seroprevalence of T. gondii in investigated Manchu pregnant women was mainly related to consumption of raw/undercooked meat and raising cat at home. The findings will provide key and baseline data for prevention and control of toxoplasmosis among Manchu pregnant women and other people.

The Seroprevalence and Risk Factors of Toxoplasmosis Among Female Undergraduate University Students in Saudi Arabia

Objectives

Toxoplasma gondii (T. gondii) is a serious public health issue, but limited data has been published to date on the seroprevalence of T. gondii infection in Saudi Arabia. Therefore, this study aimed to establish the seroprevalence and risk factors of T. gondii infection using a sample of females enrolled at a university in Northern Saudi Arabia.

Methods

Using a cross-sectional research approach, we recruited a convenience sample of 180 healthy females studying at the University of Tabuk between February and June 2016. We used a questionnaire to gather sociodemographic data on the participants to establish the risk factors leading to exposure to toxoplasma. Blood samples were taken from the participants and analyzed to detect T. gondii antibodies (immunoglobulin M and immunoglobulin G) via the enzyme-linked immunosorbent assay technique. Multivariate logistic regression modeling was employed to establish the potential predictor variables for T. gondii infection.

Results

Of the 180 participants, 17 (9.4%) were seropositive for T. gondii IgG. None tested positive for IgM antibodies exclusively. The sole variable positively associated with seropositive T. gondii IgG was the participants' consumption of raw, unwashed fruit or vegetables (odds ratio = 3.36, 95% confidence interval: 1.11-10.22).

Conclusions

Our findings emphasize the need for higher awareness of toxoplasmosis in Saudi Arabia, specifically knowledge of the way toxoplasma infection occurs so that women can more easily avoid it. Large-scale research is therefore required to inform the design of future public health interventions.

Nursing infant with acquired toxoplasmosis in the first months of life - a case report

Toxoplasmosis is caused by Toxoplasma gondii and the probability of this infection occurring in the first months of life is usually low because its transmission is related to eating habits. A 6-month-old nursing infant was diagnosed with acute toxoplasmosis, which was identified through anti- T. gondii IgA, IgM and low-avidity IgG serologic assays, polymerase chain reaction (PCR) and mouse bioassay test although its mother was seronegative. This serological divergence between mother and child led us to interview the mother regarding epidemiological factors. During this interview, she reported that she had given her 2-month-old baby a piece of undercooked beef to suck on. After some time, the baby presented fever and cervical lymphadenitis. This report emphasizes the importance of serological surveys of toxoplasmosis in nursing infants presenting with fever and lymphadenitis, in view of the possible acquisition of toxoplasmosis in the first months of life.

Seroprevalence and risk factors of Toxoplasma gondii infection in pregnant women from Bobo Dioulasso, Burkina Faso

BACKGROUND

Toxoplasmosis is one of the common worldwide parasitic zoonosis due to Toxoplasma gondii (T. gondii). Toxoplasmosis during pregnancy can result in fetal and neonatal death or various congenital defects. The aim of this study was to assess the seroprevalence and risk factors of T. gondii infection in pregnant women following antenatal care (ANC) services at Bobo Dioulasso.

METHODS

A cross-sectional study was conducted enrolling a sample of 316 pregnant women attending ANC at centers for maternal and child health of Bobo-Dioulasso town from March 2013 to February 2014. Data on socio-demographic and potential risk factors were collected from each study participant using structured questionnaire through face-to-face interview. Moreover, venous blood specimens were collected and tested for IgM and IgG anti-T. gondii antibodies by enzyme-linked immunosorbent assay and enzyme linked fluorescent assay, respectively. Multivariable logistic regression modeling was used to identify the potential predictor variables for T. gondii infection.

RESULTS

The overall seroprevalence for T. gondii infection was 31.1% (98/316). All the pregnant women were positive for IgG anti-bodies exclusively. Multivariable logistic regression analysis showed that having at least a secondary education level (AOR = 2.23; 95% CI: [1.04-4.63]); being urban resident (AOR = 2.81; 95% CI: [1.24-6.86]) and the consumption of meat combination (pork + beef + mutton + wild meat + poultry) (AOR = 4.00; 95% CI: [1.06-15.24]) were potential risk factors of T. gondii infection.

CONCLUSION

Toxoplasmosis is frequent in pregnant women and studies that show incidence of T. gondii among the neonates have to be done to introduce routine antenatal screening program to control congenital toxoplasmosis. There is the need for preventive measures such as education of pregnant women about the transmission routes and prevention methods of toxoplasmosis at ANC clinics.

IgG Avidity Test in Congenital Toxoplasmosis Diagnoses in Newborns

The goal of this study was to investigate the importance of IgG avidity testing in newborns (NBs) diagnosed with early congenital toxoplasmosis. We collected samples from 88 puerperae infected by Toxoplasma gondii (T. gondii) and their NBs (48 acutely-infected puerperae (AIP) and 40 chronically-infected puerperae (CIP)), from two public maternity hospitals in Goiania city, Goias, Brazil, from 2010 to 2015. Specific anti-T. gondii IgM and IgG serum levels and IgG avidity tests were evaluated using chemiluminescence. Congenital toxoplasmosis was observed in 66.66% (n = 32) of NBs with AIP, 94.1% presenting low avidity (LA) and 51.61% presenting high avidity (HA) test results. The IgG and IgM levels of NBs with LA and their puerperae were higher in comparison with HA NBs and puerperae (p = 0.0001). The avidity tests showed 100% specificity and 50% sensitivity (p = 0.0001). NBs with LA had a 15-fold increased risk of developing congenital toxoplasmosis in comparison with HA NBs. The IgG avidity test could be used to assist in early congenital toxoplasmosis diagnoses in NBs and LA, identifying a greater probability of vertical transmission.

Toxoplasmosis seroprevalence in Iranian women and risk factors of the disease: a systematic review and meta-analysis

BACKGROUND

Toxoplasmosis is caused by an intracellular obligatory parasite, Toxoplasma gondii, and it has global distribution. The purposes of this systematic review and meta-analysis were to evaluate the seroprevalence of toxoplasmosis in Iranian pregnant women, and girls and women of childbearing age, and identify potentially preventable risk factors.

METHODS

Between November 2014 and February 2017, nine electronic databases that reported data on the T. gondii seroprevalence in Iranian women were searched. Our search resulted in 83 reports published from 1994 to 2017.

RESULTS

The results showed that the pooled estimation for the prevalence of T. gondii using a random-effect model was 43% (95% confidence interval (CI) = 38-48%) in pregnant women and 33% (95% CI = 23-43%) in girls and the childbearing age groups. There was a significant association between the T. gondii seroprevalence with age and the gestational age of conception in pregnant women and those who had contact with cats in both groups.

CONCLUSIONS

This is the first comprehensive systematic review of T. gondii infection seroprevalence in Iranian women, which showed a high prevalence of Toxoplasma infection. Around 57% of pregnant women and 67% of girls and the childbearing age groups were seronegative and thus were susceptible to infection and should be monitored.

Seroprevalence and potential risk factors of T. gondii infection in pregnant women attending antenatal care at Bonga Hospital, Southwestern Ethiopia

OBJECTIVES

To determine the seroprevalence and associated risk factors of T.gondii infection in pregnant women attending antenatal care at Bonga Hospital, Southwestern Ethiopia.

METHODS

A cross-sectional study was carried out from February to May 2016. Systematic sampling technique was used to collect sera from 210 pregnant women. Sample was tested for anti-T.gondii- antibodies by Latex Agglutination Test (LAT). Risk factors associated with T.gondii infection in pregnant women was assessed through structured questionnaire. Univariate and multivariate logistic regression analysis was used to check association of T.gondii infection with different risk factors using SPSS version 20.

RESULTS

The overall seroprevalence of T.gondii infection in pregnant women was 75.7% (95% CI: 69.9-81.5). Multivariate logistic regression analysis indicated that the odds of T.gondii infection was higher in pregnant women between age range of 36-44 (AOR=2.82; 95% CI:1.2-7.82; P=0.031), in multigravidae (AOR=3.3; 95% CI:1.36-8.04; P=0.009), in those eating raw meat (AOR=5.1; 95% CI:2.22-11.68; P=0.000), in those eating raw vegetables (AOR=5.5; 95% CI:1.03-29.5; P=0.046), in those who have history of abortion (AOR=4.4;95% CI:1.10-17.49; P=0.036), in women who drink river/streams water (AOR=5; 95% CI: 1.67-15.44; P=0.004) and in those who didn't handle raw meat (AOR=2.4; 95% CI: 1-5.56; P=0.049).

CONCLUSION

The present result shows high seroprevalence of T.gondii infection in pregnant women. Public education on identified risk factors and screening of pregnant women during their antenatal care should be recommended.

Molecular detection and phylogenetic analyses of Toxoplasma gondii from naturally infected sheep in Northern and Central Tunisia

Toxoplasmosis is a worldwide zoonosis caused by the parasitic protozoan Toxoplasma gondii. It can infect all warm‐blooded vertebrate species and causes abortions and birth defects in pregnant women and pregnant ewes. The objective of this study was to estimate the prevalence of infection with T. gondii in sheep meat in the region of Sidi Bouzid (central Tunisia) and Beja (northern Tunisia), the realization of a descriptive study of risk factors and the phylogenetic analyses of T. gondii. Neck muscle samples were obtained from 174 ewes and ewe lamb slaughtered in Sidi Bouzid and 150 lambs slaughtered in Beja. DNA was extracted from the samples using the Wizard^® genomic DNA purification kit. A nested PCR using two pairs of primers (NN 1 and NN2, Tg‐NP1 and Tg‐NP2) were used to detect infection with T. gondii, which was then confirmed by sequencing. Eight T. gondii amplicons were sequenced (accession number KT896498) and deposited in GenBank. The T. gondii amplicons showed 97–100% identities with GenBank sequences. A phylogenetic tree was then constructed. The nested PCR detected T. gondiiDNA in 31% of animals tested in Sidi Bouzid and 32% of lambs tested in Beja. No significant difference in the prevalence of T. gondii infection was established between the two tested regions. In both regions, no significant variation of the infection depending on age, breed and locality was found.