Seroprevalence of Toxoplasma gondii infection among children in Swaziland, southern Africa

Toxoplasma gondii Infections in Animals and Humans in Southern Africa: A Systematic Review and Meta-Analysis

Background: Toxoplasma gondii is an apicomplexan parasite with zoonotic importance worldwide especially in pregnant women and immunocompromised people. This study is set to review the literature on T. gondii infections in humans and animals in southern Africa. Methods: We extracted data regarding T. gondii infections from published articles from southern Africa from 1955 to 2020 from four databases, namely Google Scholar, PubMed, EBSCO Host, and Science Direct. Forty articles from eight southern African countries were found eligible for the study. Results: This review revealed a paucity of information on T. gondii infection in southern African countries, with an overall prevalence of 17% (95% CI: 7–29%). Domestic felids had a prevalence of 29% (95% CI: 7–54%), wild felids 79% (95% CI: 60–94), canids (domestic and wild) 69% (95% CI: 38–96%), cattle 20% (95% CI: 5–39%), pigs 13% (95% CI: 1–29%), small ruminants (goats and sheep) 11% (95% CI: 0–31%), chicken and birds 22% (95% CI: 0–84%), and humans 14% (95% CI: 5–25%). Enzyme-linked immunosorbent assay (ELISA) and immunofluorescence antibody test (IFAT) constituted the most frequently used diagnostic tests for T. gondii. Conclusions: We recommend more focused studies be conducted on the epidemiology of T. gondii in the environment, food animals and human population, most especially the at-risk populations.

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.

Toxoplasma gondii: seroprevalence and associated risk factors among preschool-aged children in Osun State, Nigeria

Background

Toxoplasma gondii is an ubiquitous apicomplexan parasite, which causes toxoplasmosis in animals and humans worldwide. However, little is known about T. gondii infection among preschool-aged children in Nigeria.

Methods

A cross-sectional study of 272 preschool children aged 2.25±1.09 years from four communities (Edunabon, Erin-Ijesha, Ijebu-jesa and Ile-Ife) in Osun State, Nigeria was conducted between January and July 2016, and the demographic data was obtained via questionnaires. Antibody titres against T. gondii of serum samples were assessed by ELISA.

Results

The overall seroprevalence of T. gondii infection was 6.9% (19/272). There was no significant difference in seroprevalence of T. gondii infection between boys (7.04%; 10/142) and girls (6.92%; 9/130; p=0.97). No associations were found between age, gender, parental educational level, occupation and religion, and T. gondii seropositivity. None showed statistical significance between the risk factors tested after multivariate adjustment; nevertheless, residing in Ijebu-jesa community was shown to be associated with an increased risk of infection (p=0.04).

Conclusion

This is the first report of T. gondii infection among preschool children in Nigeria. Prevalence studies such as this could help in the development of strategies for the future for disease prevention and control of T. gondii transmission.

Toxoplasma gondii infection: seroprevalence and associated risk factors among primary school children in the capital area of the Republic of the Marshall Islands

Although Toxoplasma gondii infection is commonly prevalent in the tropical/subtropical regions, the prevalence of toxoplasmosis in the Republic of the Marshall Islands (RMI) remains unclear. A seroepidemiological survey was undertaken for investigating T. gondii infection in primary school children (PSC) using the latex agglutination (LA) test in the capital area of RMI. Information on demographic characteristics and environmental risk factors was collected via a structured questionnaire. Logistic regression model was applied for multivariate analysis. The overall infection rate of T. gondii was found to be 54.8%. Significant gender differences were found at different urbanization levels. PSC with LA titers of ≥ 1:1,024, indicating high responders, were found to be younger age group than others (8.7 years vs. 10.3 years, P = 0.003); moreover, infection rates among both age groups as well as high responders showed a decreasing trend with age. Multivariate analysis revealed that residing in urban rather than suburban settings was associated with increased risk of infection (P = 0.04). No associations were found between raw meat consumption, drinking unboiled water, and cleaning of cat hutch using gloves. This is the first serological survey of T. gondii infection among PSC in RMI and could help in the development of strategies in the future for disease prevention and control of T. gondii transmission.

Toxoplasma gondii infection: relationship between seroprevalence and risk factors among primary schoolchildren in the capital areas of Democratic Republic of São Tomé and Príncipe, West Africa

Background

The status of Toxoplasma gondii infection among primary schoolchildren (PSC) of the Democratic Republic of São Tomé and Príncipe (DRSTP), West Africa, remains unknown to date.

Methods

A serologic survey and risk factors associated T. gondii infection among PSC in the DRSTP was assessed by the latex agglutination (LA) test and a questionnaire interview including parents’ occupation, various uncomfortable symptoms, histories of eating raw or undercooked food, drinking unboiled water, and raising pets, was conducted in October 2010. Schoolchildren from 4 primary schools located in the capital areas were selected, in total 255 serum samples were obtained by venipuncture, of which 123 serum samples were obtained from boys (9.8 ± 1.4 yrs) and 132 serum samples were obtained from girls (9.7 ± 1.3 yrs).

Results

The overall seroprevalence of T. gondii infection was 63.1% (161/255). No significant gender difference in seroprevalence was found between boys (62.6%, 77/123) and girls (63.6%, 84/132) (p = 0.9). The older age group of 10 years had insignificantly higher seroprevalence (69.9%, 58/83) than that of the younger age group of 8 year olds (67.7%, 21/31) (p = 0.8). It was noteworthy that the majority of seropositive PSC (75.8%, 122/161) had high LA titers of ≥1: 1024, indirectly indicating acute or repeated Toxoplasma infection. Parents whose jobs were non-skilled workers (73.1%) showed significantly higher seroprevalence than that of semiskilled- (53.9%) or skilled workers (48.8%) (p < 0.05). Children who had a history of raising cats also showed significantly higher seroprevalence than those who did not (p < 0.001).

Children who claimed to have had recent ocular manifestation or headache, i.e. within 1 month, seemed to have insignificantly higher seroprevalence than those who did not (p > 0.05).

Conclusions

Parents’ educational level and cats kept indoors seemed to be the high risk factors for PSC in acquisition of T. gondii infection. While, ocular manifestation and/or headache of PSC should be checked for the possibility of being T. gondii elicited. Measures such as improving environmental hygiene and intensive educational intervention to both PSC and their parents should be performed immediately so as to reduce T. gondii infection of DRSTP inhabitants including PSC and adults.