Comparative study on Toxoplasma infection between Malaysian and Myanmar pregnant women

Seroinfection of Antibodies to Toxoplasma gondii, Parvovirus B19, Treponema pallidum, and HIV in a Pregnant Attending a Medical Center in Northern Peru

Introduction

Transplacental infections are frequent, especially in developing countries, where limited screening is performed to find infectious agents in the pregnant population. We aim to determine the clinical and epidemiological characteristics and seroinfection of antibodies against Toxoplasma, parvovirus B19, T. pallidum, and HIV in pregnant women who attended the Motupe Health Center in Lambayeque, Peru during July-August 2018.

Methods

A descriptive cross-sectional study was conducted in 179 pregnant women interviewed with a standardized questionnaire. ELISA was used to determine antibodies to Toxoplasma and parvovirus B19. The detection of syphilis and HIV was conducted using immunochromatography, while the detection of hepatitis B was conducted using FTA-ABS and immunofluorescence, respectively.

Results

Of 179 pregnant women, syphilis and HIV infections routinely included in the screening of pregnant women presented a seroinfection of 2.2 and 0.6%, respectively. Toxoplasmosis seroinfection was 25.1%, while IgM antiparvovirus B19 was 40.8%, revealing that pregnant women had an active infection at the time of study.

Conclusion

The level of seroinfection of toxoplasmosis reveals the risk to which pregnant women who participated in the study are exposed. The high seroinfection of parvovirus B19 could explain the cases of spontaneous abortion and levels of anemia in newborn that have been reported in Motupe, Lambayeque, Peru. However, future causality studies are necessary to determine the significance of these findings.

Seroprevalence of toxoplasmosis at referral hospitals in the northwestern region, Saudi Arabia

BACKGROUND

Toxoplasmosis is induced by Toxoplasma gondii, which affects 30 percent of the global population and is responsible for deaths related to foodborne pathogens. This study aimed to describe the seroprevalence of T. gondii infections in patients attending referral hospitals in the northwestern region of Saudi Arabia.

MATERIALS AND METHODS

The serology test results for T. gondii antibodies of 797 patients were retrospectively analyzed using the hospitals' database. The enzyme-linked immunosorbent assay was used to detect anti-T. gondii antibodies (IgG and/or IgM).

RESULTS

Overall, the prevalence of anti-T. gondii antibodies was 8.3%. Higher (9.9%) prevalence of positive results among patients aged 30 years and above was observed. Statistically, the various age groups (P = 0.031) were found to be significant. Female was noted to have increased (8.1%) seroprevalence, and the incidence of infection occurred largely among participants living in rural areas (8.2%).

CONCLUSIONS

Toxoplasmosis remains a public health concern. The seroprevalence of T. gondii antibodies was relatively low in the study area. IgG antibodies to T. gondii were mainly detected. Increasing awareness on the mode of transmission, source of infection, and disease prevention through health education and dissemination is vital to reduce or eliminate toxoplasmosis.

Seroprevalence of Toxoplasma gondii IgG and IgM antibodies and associated risk factors among pregnant women consulted in three health centers in Dschang, Cameroon

Background

Toxoplasmosis is a zoonosis caused by Toxoplasma gondii, an obligate intracellular protozoan responsible for one of the most common congenital infections in the world. This study aimed to determine the seroprevalence and risk factors associated with toxoplasmosis in pregnant women consulted in three health centers in the city of Dschang.

Methods

This study was a cross-sectional study that was conducted, with a total of 242 participants. A questionnaire was administered after obtaining the free and informed consent of the participants. Blood sample was collected to assay IgG and IgM antibodies specific to Toxoplasma gondii using the enzyme-linked immunosorbent assay (ELISA) kit, and potential risk factors were evaluated with the administration questionnaire using a binary logistic regression model. Statistical significance was measured at P < 0.05.

Results

The overall seroprevalence of toxoplasmosis was 82.7%,with a seroprevalence of toxoplasma IgG of 62.8% (152), that of IgM at 11.6% (28) and that of IgG/IgM at 8.3% (20). The Saint Vincent Paul Hospital had a seroprevalence of 43.8% IgG and 8.7% IgM; followed by the Dschang District Hospital (11.6% IgG and 2.1% IgM). The seroprevalence of toxoplasma IgG (35.5%) and IgM (6.2%) was higher in multiparous pregnant women, and in the group of women who performed their first toxoplasmosis serology in the first trimester of pregnancy, 70 (28.9%), 9 (3.7%) respectively for IgG and IgM. The multivariate logistic regression analysis showed that the possession of a cat at home or its presence in the neighborhood, the consumption of undercooked or uncooked meat and having a history of blood transfusion were found to be statistically significant risk factors associated with toxoplasmosis seroprevalence among pregnant women.

Conclusion

The present study revealed a high seroprevalence of toxoplasmosis. Given this high seroprevalence, screening for toxoplasmosis in women of childbearing age should be encouraged.

Seroprevalence and associated risk factors of Toxoplasma gondii infection among slaughterhouse workers in Yangon Region, Myanmar: A cross-sectional study

BACKGROUND

Toxoplasmosis, having the significant consequences affecting mortality and quality of life, is still prevalent in various places throughout the world. The major gap in surveillance for Toxoplasma gondii infection among high-risk population, slaughterhouse workers, is an obstacle for the effective policies formulation to reduce the burden of toxoplasmosis in Myanmar. Therefore, this study aimed to assess the seroprevalence of toxoplasmosis and associated factors of seropositivity among slaughterhouse workers in Yangon Region, Myanmar.

METHODS

A cross-sectional study that was conducted from June to November 2020 included 139 slaughterhouse workers involving at five main slaughterhouses under Yangon City Development Committee, Myanmar. The presence of IgG and IgM anti-T. gondii antibodies in serum was detected using the OnSite Toxo IgG/IgM Combo Rapid Test. A face-to-face interview was also performed using pretested structured questionnaires to obtain the detail histories: sociodemographic characteristics, level of knowledge, occupational factors, and environmental factors related to T. gondii infection. Bivariate logistic regression was used to determine the factors associated with T. gondii infection.

RESULTS

Of all participants, the overall seroprevalence of anti-T. gondii was 43.9% (95% CI: 35.5-52.5%), of whom 98.4% (95% CI: 91.2-100.0%) were reactive only for IgG antibody and 1.6% (95% CI: 0.0-8.8%) were reactive for IgG and IgM antibodies. The significant factors associated with the seropositivity of T. gondii antibodies were blood transfusion history (OR: 5.74, 95% CI: 1.17-28.09), low level of knowledge (OR: 2.91, 95% CI: 1.46-5.83), contact with animal organs, muscles or blood (OR: 14.29, 95% CI: 1.83-111.51), and animals most frequently slaughtered (cattle) (OR: 3.22, 95% CI: 1.16-8.93).

CONCLUSIONS

A high seroprevalence of toxoplasmosis was detected among slaughterhouse workers in Yangon Region and it raises a significant public health concern. Therefore, providing health education regarding toxoplasmosis, enforcement of personal hygiene practices in workplaces, the establishment of training for occupational hygiene, and commencement of the risk assessment and serological screening for toxoplasmosis are crucial to curtail the prevalence of T. gondii infection among slaughterhouse workers.

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.

Toxoplasma gondii Infection Is Associated with Low Birth Weight: Findings from an Observational Study among Rural Bangladeshi Women

Gestational Toxoplasma gondii (T. gondii) infection may cause substantial adverse effects on developing fetuses, newborns and also mothers. This study aims to estimate the seroprevalence of T. gondii among rural Bangladeshi pregnant women and determine the risk of a low birth weight (LBW). We followed a longitudinal design where 208 pregnant women were followed until the birth of their infants. Levels of IgG and IgM of T. gondii were assessed using chemiluminescent immunoassay. Modified Poisson regression was used to estimate crude and adjusted associations and multiple regression analysis was performed to understand the confounding and modifying effects of the variables. Thirty-nine (19%) children were born with LBW, among whom 15 (39%) mothers were positive for T. gondii IgG during pregnancy. After adjusting for several confounders and modifiers, pregnant women with T. gondii IgG or IgM seropositivity were significantly associated with LBW of infants (aRR: 2.00, 95% CI: 1.17–3.42). The strength of this association increased after adjusting for maternal education (aRR: 4.88, 95% CI: 1.74–13.69). The final model had an AROC of 0.84 with a sensitivity of 36% and specificity of 97%. Although causality is yet to be established, the study observed an association between T. gondii infection during pregnancy among rural Bangladeshi women and LBW of newborns.

Ruminant farmers' knowledge, attitude and practices towards zoonotic diseases in Selangor, Malaysia

This study aimed to assess knowledge, attitude and practices about zoonotic diseases and associated factors among ruminant farmers in Selangor, Malaysia. A cross-sectional survey was conducted between January 2018 and December 2020. The survey was developed in English and Malay, validated, administered to ruminant farmers in Selangor. A total of 84 farmers completed the structured questionnaire. The data were analysed using descriptive statistics, principal component factor analysis and binary logistic regression models. Only 42 % (35/84) had heard of the term "zoonotic diseases" before this study but the majority of farmers (52/84; 61.9 %) were aware that certain diseases could be transmitted between humans and animals. A higher proportion was aware of rabies (20.8 %), followed by tuberculosis (17.8 %) and brucellosis (15.7 %), and most respondents identified the diseases as zoonotic. The majority of farmers stated (60 %) that zoonosis could be prevented and they preferred to learn more about such diseases through veterinary personnel. Higher proportions (>80 %) agreed to practices such as hand washing, proper cooking of meat, and keeping animal health records. However, the need to pasteurise milk before drinking and selling were the least items that farmers agreed to, which was reflected in their practices. Sixty-four per cent of the farmers had stray animals on their farm with dogs (45.5 %) being predominant. Overall, 34.5 % (29/84), 51.1 % (43/84), and 60.7 % (51/84) were considered to have satisfactory knowledge, attitude and practices regarding zoonotic diseases, respectively. Farmers with higher education (odds ratio; OR = 16.6; 95 % CI 3.7-71.4) and rearing exotic breeds of animals (OR = 6.0; 95 % CI 1.3-27.7) were more likely to have satisfactory knowledge about zoonoses, but less likely for those with small herd size (51-100 animals) (OR = 0.19; 95 % CI 0.04-0.95). The odds of having satisfactory attitude towards preventive measures against zoonoses were higher in farmers with higher education (OR = 3.2; 95 % CI 1.1-8.9). Farms with herd health programs were more likely to engage in satisfactory practices towards zoonoses (OR = 3.2; 95 % CI 1.2-10.0) relative to farms lacking programs. These areas might need to be considered by public health authorities to improve the current knowledge and attitude of ruminant farmers about zoonotic diseases in the Malaysian context.

Seroprevalence of ToRCH Pathogens in Southeast Asia

ToRCH is the acronym for several pathogens associated with pregnancy complications and sequelae in the unborn or newborn child. Particularly primary infections during pregnancy are associated with increased risk. Seroprevalence data of ToRCH infections are important, especially in countries with weak disease surveillance systems, to estimate immunity and vaccination levels, as well as exposure rates and thus the risk of infection during pregnancy. A systematic literature search spanning a 30-year time period was conducted to identify serosurveys on ToRCH pathogens in Southeast Asia. The 96 identified studies showed that some pathogens were well studied, while only limited data were available for others. Studies from the better-developed countries of the region were more abundant. Moreover, seroprevalence data were often limited to a certain geographical region within the country or to certain cohorts, there was an evident lack of recent serosurveys, and the study quality was often not adequate. Well-designed and area-wide serosurveys of ToRCH pathogens are clearly warranted. If combined with risk factor analysis, these studies may guide the development and implementation of effective measures for infection prevention, especially during pregnancy. In addition, educational programs for health care workers and for pregnant women during antenatal care are urgently needed.

Seroprevalence of toxoplasmosis among reproductive-aged women in Myanmar and evaluation of luciferase immunoprecipitation system assay

BACKGROUNDS

Primary infection with Toxoplasma gondii during pregnancy can pose serious health problems for the fetus. However, the epidemiological status of toxoplasmosis among reproductive-aged population in Myanmar is largely unknown. Although luciferase immunoprecipitation system (LIPS) assays for serodiagnosis of toxoplasmosis was developed mostly using mouse infection model, had not been tested by using field-derived human samples.

METHODS

A total of 251 serum samples were collected from reproductive-aged women, residing in Shwegyin township, Bago region, Myanmar and analyzed with a commercial ELISA kit, as well as in-house LIPS assays.

RESULTS

The overall seroprevalence for Toxoplasma gondii infection by the commercial ELISA was 11.5%. No clear risk factor was identified except for being in the younger age group (15-30 years old). Overall, LIPS assays showed low sensitivity when the commercial ELSA was used as a reference test.

CONCLUSION

We identified the epidemiological situation of toxoplasmosis in some rural communities in Myanmar. The data obtained here will serve as a primary information for the effort to reduce toxoplasmosis in this region. Although looked promising in the previous experiments with mouse infection model, we found that the reported LIPS procedures need further improvements to increase the sensitivities.

Seroprevalence of Toxoplasma gondii in household cats in Myanmar and molecular identification of parasites using feline faecal oocysts

Felids play an important role in the transmission of Toxoplasma gondii to humans and other animals since they can excrete millions of oocysts into the environment as definitive hosts. In the present study, seroprevalence and risk factors of feline Toxoplasma infection were investigated, and molecular identification was conducted for T. gondii oocysts isolated from faecal samples of seropositive cats. A total of 276 cat serum samples collected from the Yangon, Myanmar were tested for T. gondii antibodies by ELISA. The overall seroprevalence of T. gondii infection was 41.30% (114 seropositive cats). Age between 1 and 6 years (OR = 3.284; 95% CI = 1.462-7.375), age > 6 years (OR = 4.560; 95% CI = 1.588-13.100) and sex (OR = 1.725; 95% CI = 1.026-2.899) were found to be significant (P < 0.05) factors associated with T. gondii infection. DNA samples extracted from a single oocyst of seropositive cats were employed in three PCR assays amplifying parasite TOX-element and mitochondrial COI, and SAG2 locus. The obtained sequences of TOX-elements (n = 6) and COI (n = 5) were identical to those of T. gondii previously deposited in Genbank. SAG2 PCR yielded three different sequences, all of which were clustered with Type I T. gondii isolates in a phylogenetic tree. This study reported the seroprevalence and risk factors for T. gondii infection in cats and provided the molecular information on the parasite in Myanmar.

Molecular Detection and Genetic Diversity of Toxoplasma gondii Oocysts in Cat Faeces from Klang Valley, Malaysia, Using B1 and REP Genes in 2018

The major route for Toxoplasma gondii (T. gondii) infection is through the ingestion of foods contaminated with oocyst from cat faeces. The microscopic detection of T. gondii oocysts in cat faeces is challenging, which contributes to the failure of detecting or differentiating it from other related coccidian parasites. This study aims to detect T. gondii oocysts in cat faeces using two multicopy-target PCR assays and to evaluate their genetic diversity. Cat faecal (200) samples were collected from pet cats (PCs; 100) and free-roaming cats (FRCs; 100) within Klang Valley, Malaysia, and screened for coccidian oocysts by microscopy using Sheather's sucrose floatation. PCR assays were performed on each faecal sample, targeting a B1 gene and a repetitive element (REP) gene to confirm T. gondii oocysts. Additionally, the PCR amplicons from the REP gene were sequenced to further confirm T. gondii-positive samples for phylogenetic analysis. Microscopy detected 7/200 (3.5%) T. gondii-like oocysts, while both the B1 gene and the REP gene detected 17/200 (8.5%) samples positive for T. gondii. All samples that were microscopically positive for T. gondii-like oocysts were also shown to be positive by both B1 and REP genes. The BLAST results sequenced for 16/200 (8.0%) PCR-positive T. gondii samples revealed homology and genetic heterogeneity with T. gondii strains in the GenBank, except for only one positive sample that did not show a result. There was almost perfect agreement (k = 0.145) between the two PCR assays targeting the B1 gene and the REP gene. This is the first report on microscopic, molecular detection and genetic diversity of T. gondii from cat faecal samples in Malaysia. In addition, the sensitivities of either the B1 gene or REP gene multicopy-target PCR assays are suitable for the accurate detection of T. gondii from cat faeces.

Seroprevalence and Risk Factors of Toxoplasma gondii in Ruminant Meats from Wet Markets in Klang Valley and Abattoirs in Selangor, Malaysia

Simple Summary

This study investigated the prevalence of Toxoplasma. gondii in meats of cattle, goat and sheep from wet markets and abattoirs in Selangor, Malaysia. Meat samples from wet markets in various districts and diaphragm samples from abattoirs were analyzed using ELISA to check for T. gondii IgG antibodies. Furthermore, attempts were made to detect T. gondii DNA from meat samples using the nested PCR technique. Twenty-five percent of the samples were positive for T. gondii antibodies, with the highest recorded in goat (55%), followed by sheep (35%) and cattle meat (9%). T. gondii DNA was not detected in any of the meat samples. Being the first report in Malaysia, the findings highlight the need for proper control in reducing exposure of ruminant meats to the parasite, especially those destined for human consumption.

Abstract

(1) Background: The objective of this study was to determine the prevalence of T. gondii in meats of cattle, goat and sheep from wet markets in Klang Valley, and abattoirs in Selangor, Malaysia; (2) Methods: A total of 192 meat samples were purchased from 51 wet markets in six districts in Klang Valley (Gombak, Klang, Kuala Lumpur, Hulu Langat, Petaling and Putrajaya). Meanwhile, a total of 200 diaphragm samples were collected from two government abattoirs located in Shah Alam and Banting, Selangor. All meat juices from samples were subjected to an indirect-ELISA kit for the presence of T. gondii IgG antibodies. Furthermore, all 184 meat samples of goat and sheep were subjected to conventional nested PCR (B1 genes) for the detection of T. gondii DNA; (3) Results: T. gondii antibodies were detected in 25% (n = 98/392) of the samples with seroprevalence of 9.1% (19/208, CI: 5.9%–13.8%) in cattle meat; 54.7% (41/75, 95% CI: 43.5%–65.4%) in goat meat and 34.9% (38/109, CI: 26.6%–44.2%) in sheep meat. No T. gondii DNA was detected in any of the meat samples of goat and sheep. T. gondii seropositivity in wet market samples was higher in goat (OR = 37.1 CI 12.4–110.3) and sheep meat (OR 9.03 CI: 3.28–24.8) compared to cattle meat (OR = 1.0) At univariate level, meat from non-licensed abattoirs (OR = 6.0 CI: 2.9–12.3) and female animals (OR = 6.7; CI 1.9–22.6) had higher risks of being seropositive for T. gondii antibodies than licensed abattoirs and male animals, respectively. (4) Conclusions: This is the first report of seroprevalence of T. gondii in ruminant meats for human consumption in Malaysia. The findings signified high exposure of meat samples from wet markets to T. gondii and the need for control measures to reduce the likelihood of infection when such raw or undercooked meats are consumed.

Majid R. A Review on the Prevalence of Toxoplasma gondii in Humans and Animals Reported in Malaysia from 2008-2018

Toxoplasmosis is a disease caused by the protozoan parasite Toxoplasma gondii (T. gondii). Human toxoplasmosis seroprevalence in Malaysia has increased since it was first reported in 1973 as shown in previous reviews of 1991 and 2007. However, over a decade since the last review, comprehensive data on toxoplasmosis in Malaysia is lacking. This work aimed at reviewing articles on toxoplasmosis research in Malaysia in order to identify the research gaps, create public awareness, and efforts made so far and proffer management options on the disease. The present review examines the available published research articles from 2008 to 2018 related to toxoplasmosis research conducted in Malaysia. The articles reviewed were retrieved from nine credible databases such as Web of Science, Google Scholar, ScienceDirect, PubMed, Scopus, Springer, Wiley online library, Ovid, and Cochrane using the keywords; Malaysia, toxoplasmosis, Toxoplasma gondii, toxoplasma encephalitis, seroprevalence, human immunodeficiency virus (HIV) patients, pregnant women, genotype strain, anti-toxoplasma antibodies, felines, and vaccine. The data highlighted seropositive cases from healthy community members in Pangkor Island (59.7%) and among migrant workers (57.4%) at alarming rates, as well as 42.5% in pregnant women. Data on animal seroprevalence were limited and there was no information on cats as the definitive host. Genetic characterization of Toxoplasma gondii from HIV patients; pregnant women, and domestic cats is lacking. This present review on toxoplasmosis is beneficial to researchers, health workers, animal health professionals, and policymakers. Therefore, attention is required to educate and enlighten health workers and the general public about the risk factors associated with T. gondii infection in Malaysia.

Global prevalence of latent toxoplasmosis in pregnant women: a systematic review and meta-analysis

BACKGROUND

Toxoplasma gondii infection, if acquired as an acute infection during pregnancy, can have substantial adverse effects on mothers, fetuses and newborns. Latent toxoplasmosis also causes a variety of pathologies and has been linked to adverse effects on pregnancy.

OBJECTIVE

Here, we present results of a comprehensive systematic review and meta-analysis of the global prevalence of latent toxoplasmosis in pregnant women.

DATA SOURCE

We searched PubMed, EMBASE, Web of Science, SciELO and Scopus databases for relevant studies that were published between 1 January 1988 and 20 July 2019.

STUDY ELIGIBILITY CRITERIA

All population-based, cross-sectional and longitudinal studies reporting the prevalence of latent toxoplasmosis in healthy pregnant women were considered for inclusion.

PARTICIPANTS

Pregnant women who were tested for prevalence of latent toxoplasmosis.

INTERVENTIONS

There were no interventions.

METHOD

We used a random effects model to calculate pooled prevalence estimates with 95% confidence intervals (CIs). We grouped prevalence data according to the geographic regions defined by the World Health Organization (WHO). Multiple subgroup and meta-regression analyses were performed.

RESULTS

In total, 311 studies with 320 relevant data sets representing 1 148 677 pregnant women from 91 countries were eligible for inclusion in the meta-analysis. The global prevalence of latent toxoplasmosis in pregnant women was estimated at 33.8% (95% CI, 31.8-35.9%; 345 870/1 148 677). South America had the highest pooled prevalence (56.2%; 50.5-62.8%) of latent toxoplasmosis in pregnant women, whereas the Western Pacific region had the lowest prevalence (11.8%; 8.1-16.0%). A significantly higher prevalence of latent toxoplasmosis was associated with countries with low income and low human development indices (p < 0.001).

CONCLUSION

Our results indicate a high level of latent toxoplasmosis in pregnant women, especially in some low- and middle-income countries of Africa and South America, although the local prevalence varied markedly. These results suggest a need for improved prevention and control efforts to reduce the health risks to women and newborns.

Prevalence and predictors of Toxoplasma gondii infection in pregnant women from Dhamar, Yemen

BACKGROUND

Toxoplasmosis is a common and serious parasitic infection caused by the ubiquitous obligatory intracellular protozoan organism, Toxoplasma gondii. Although infection with T. gondii is usually asymptomatic in healthy individuals, it can lead to severe pathological effects in congenital cases and immunocompromised patients. This study aimed to determine the seroprevalence of T. gondii and its predictors among pregnant women seeking prenatal and medical care at the general maternal and child health facility in Dhamar district of Dhamar governorate, Yemen.

METHODS

A total of 420 pregnant women were randomly selected for this cross-sectional study. Participants were screened for anti-T. gondii antibodies (i.e. immunoglobulin M; IgM and immunoglobulin G; IgG) using electrochemiluminescence immunoassay. Demographic, socioeconomic, obstetric and behavioural data were collected using a pretested questionnaire via face-to-face interview. Univariate and multivariate analyses were used to identify the independent predictors of T. gondii seroprevalence.

RESULTS

The overall seroprevalence of anti-T. gondii antibodies (IgG and/or IgM) among the participants was 21.2% (89/420; 95% CI = 17.3-25.1). Anti-T. gondii IgG antibodies were detected in 20.0% (84/420) of the women of which 12.9% (54/420) were positive for only IgG and 7.1% (30/420) were positive for both IgG and IgM antibodies. Moreover, 5 women (1.2%) were reactive only for IgM antibodies. Significant associations between T. gondii seroprevalence and history of spontaneous abortion (P <  0.001), raw vegetables consumption (P = 0.036), and presence of cats in household (P = 0.049) were reported. Multivariate analysis confirmed that history of spontaneous abortion (AOR = 4.04; 95% CI = [2.46, 6.63]) and presence of cats in household (AOR = 1.77; 95% CI = [1.02, 3.07]) are significant predictors of T. gondii seroprevalence among the studied participants.

CONCLUSION

The study found a high seroprevalence (21.2%) of T. gondii infection during pregnancy in Dhamar district, which is significantly associated with adverse pregnancy outcomes. The provision of adequate maternal healthcare and health education pertaining to the prevention of T. gondii infection is therefore imperative to curtail the prevalence of infection among the studied population.

Seroprevalence of Toxoplasma gondii among School Children in Pyin Oo Lwin and Naung Cho, Upper Myanmar

Toxoplasma gondii is an apicomplexan parasite that can cause toxoplasmosis in a wide range of warm-blooded animals including humans. In this study, we analyzed seroprevalence of T. gondii among 467 school children living in the rural areas of Pyin Oo Lwin and Naung Cho, Myanmar. The overall seroprevalence of T. gondii among school children was 23.5%; 22.5% of children were positive for T. gondii IgG, 0.4% of children were positive for T. gondii IgM, and 0.6% of children were positive for both T. gondii IgG and IgM. Geographical factors did not significantly affect the seroprevalence frequency between Pyin Oo Lwin and Naung Cho, Myanmar. No significant difference was found between males (22.2%) and females (25.0%). The overall seroprevalence among school children differed by ages (10 years old [13.6%], 11–12 years old [19.8%], 13–14 years old [24.6%], and 15–16 years old [28.0%]), however, the result was not significant. Polymerase chain reaction analysis for T. gondii B1 gene for IgG-positive and IgM-positive blood samples were negative, indicating no direct evidence of active infection. These results collectively suggest that T. gondii infection among school children in Myanmar was relatively high. Integrated and improved strategies including reinforced education on toxoplasmosis should be implemented to prevent and control T. gondii infection among school children in Myanmar.

Sero-epidemiological status and risk factors of toxoplasmosis in pregnant women in Northern Vietnam

Background

In Vietnam, few studies have determined the epidemiological status of toxoplasmosis in pregnant women and no routine prenatal screening is in place. This study was conducted to evaluate the seroprevalence of this zoonotic parasitic infection in pregnant women in Northern Vietnam and to assess the association with awareness, risk factors and congenital toxoplasmosis.

Methods

Approximately 800 pregnant women were included in the study from two hospitals, one in Hanoi and one in Thai Binh province, which is known to have a dense cat population. Serological immunoglobulin G (IgG) and immunoglobulin M (IgM) detection was performed to estimate the seroprevalence of toxoplasmosis and sero-incidence of maternal and congenital toxoplasmosis. In addition, a survey was conducted about awareness, clinical history, presentation of signs and symptoms relating to toxoplasmosis and to detect biologically plausible and socio-demographic risk factors associated with toxoplasmosis. Associations with seroprevalence were assessed using univariable and multivariable analysis.

Results

The mean IgG seroprevalence after the full diagnostic process was 4.5% (95% confidence interval(CI): 2.7–7.0) and 5.8% (95% CI: 3.7–8.6) in Hanoi and Thai Binh hospital, respectively, and included one seroconversion diagnosed in Thai Binh hospital. Only 2.0% of the pregnant women in Hanoi hospital and 3.3% in Thai Binh hospital had heard about toxoplasmosis before this study.

Conclusion

Since the percentage of seronegative, and thus susceptible, pregnant women was high and the awareness was low, we suggest to distribute information about toxoplasmosis and its prevention among women of child bearing age. Furthermore, future studies are recommended to investigate why such a low seroprevalence was seen in pregnant women in Northern Vietnam compared to other countries in South East Asia and globally.

Electronic supplementary material

The online version of this article (10.1186/s12879-019-3885-7) contains supplementary material, which is available to authorized users.

Seroprevalence of Toxoplasma gondii Infection in Refugee and Migrant Pregnant Women along the Thailand-Myanmar Border

Toxoplasma gondii primary infection in pregnancy is associated with poor obstetric outcomes. This study aimed to determine the seroprevalence of Toxoplasma infection in pregnant migrant and refugee women from Myanmar attending antenatal care in Thailand. A random selection of 199 residual blood samples from first antenatal screen in 2014–2015 was tested for Toxoplasma IgG and IgM antibodies. Seroprevalence of Toxoplasma infection was 31.7% (95% confidence interval = 25.6–38.4). Avidity testing in the three positive IgM cases indicated all were past infections. Multiparity (≥ 3 children) was significantly associated with higher Toxoplasma seropositivity rates. Seroprevalence of T. gondii infection in this pregnant population is similar to the only other report from Myanmar, where multiparity was also identified as a significant association. Toxoplasma infection is important in pregnant women. Nevertheless, in this marginalized population, this infection may be given less priority, due to resource constraints in providing the most basic components of safe motherhood programs.

Identification, production and assessment of two Toxoplasma gondii recombinant proteins for use in a Toxoplasma IgG avidity assay

The IgG avidity assay is an important tool in the management of suspected toxoplasmosis in pregnant women. This study aimed to produce new Toxoplasma gondii recombinant proteins and to assess their usefulness in an IgG avidity assay. Toxoplasma positive and negative serum samples were used, the former were categorized into low (LGA) and high (HGA) IgG avidity samples. Immunoblots were performed on 30 T. gondii cDNA clones to determine the reactivity and IgG avidity to the expressed proteins. Two of the clones were found to have diagnostic potential and were analyzed further; AG12b encoded T. gondii apical complex lysine methyltransferase (AKMT) protein and AG18 encoded T. gondii forkhead-associated (FHA) domain-containing protein. The His-tagged recombinant proteins, rAG12b and rAG18, were expressed and tested with LGA and HGA samples using an IgG avidity western blot and ELISA. With the IgG avidity western blot, rAG12b identified 86.4% of LGA and 90.9% of HGA samples, whereas rAG18 identified 81.8% of both LGA and HGA samples. With the IgG avidity ELISA, rAG12b identified 86.4% of both LGA and HGA samples, whereas rAG18 identified 77.3% of LGA and 86.4% of HGA serum samples. This study showed that the recombinant antigens were able to differentiate low avidity and high avidity serum samples, suggesting that they are potential candidates for use in the Toxoplasma IgG avidity assay.

Serological Survey and Factors Associated with Toxoplasma gondii Infection in Domestic Goats in Myanmar

Goat farming is important for the livelihood of millions of rural people because it contributes to food security and creation of assets. However, infection of goats with Toxoplasma gondii could be a source of parasite transmission to humans. The information on T. gondii infection of goat was not reported yet in Myanmar. A total of 119 goat serum samples were collected from three cities in the central region of Myanmar for T. gondii antibody survey. With the occurrence value obtained in this first study, a second one, more complete, with larger number (162) of animals and properties, was carried out and the risk factors and prevalence were determined. In both studies the samples were analyzed by the LAT. Of these, 32 (11.4%) samples were showed to be positive. The infection was associated with the presence of cats at the farm (odds ratio [OR] = 4.66, 95% confidential interval [CI] = 1.03-21.06), farming with different animal species (sheep, cattle, and pigs) (OR = 4.33, 95% CI = 1.57-11.94), and farming without good management practices (OR = 0.23, 95% CI = 0.06-0.83). This is the first T. gondii prevalence study in goats in the country.

Protective immunity induced by peptides of AMA1, RON2 and RON4 containing T-and B-cell epitopes via an intranasal route against toxoplasmosis in mice

Background

Toxoplasma gondii is a ubiquitous protozoan intracellular parasite, the causative agent of toxoplasmosis, and a worldwide zoonosis. Apical membrane antigen-1 (AMA1) and rhoptry neck protein (RON2, RON4) are involved in the invasion of T. gondii.

Methods

This study chemically synthesized peptides of TgAMA1, TgRON2 and TgRON4 that contained the T- and B-cell epitopes predicted by bioinformatics analysis. We evaluated the systemic response by proliferation, cytokine and antibody measurements as well as the mucosal response by examining the levels of antigen-specific secretory IgA (SIgA) in the nasal, vesical and intestinal washes obtained from mice after nasal immunization with single (AMA1, RON2, RON4) or mixtures of peptides (A1 + R2, A1 + R4, R2 + R4, A1 + R2 + R4). We also assessed the parasite burdens in the liver and brain as well as the survival of mice challenged with a virulent strain.

Results

The results showed that the mice immunized with single or mixed peptides produced effective mucosal and systemic immune responses with a high level of specific antibody responses, a strong lymphoproliferative response and significant levels of gamma interferon (IFN-γ), interleukin-2 (IL-2) and IL-4 production. These mice also elicited partial protection against acute and chronic T. gondii infection. Moreover, our study indicated that mixtures of peptides, especially the A1 + R2 mixture, were more powerful and efficient than any other single peptides.

Conclusions

These results demonstrated that intranasal immunisation with peptides of AMA1, RON2 and RON4 containing T- and B-cell epitopes can partly protect mice against toxoplasmosis, and a combination of peptides as a mucosal vaccine strategy is essential for future Toxoplasma vaccine development.