Seroepidemiology of Toxoplasma gondii infection in women of child-bearing age in central Ethiopia

Abstract

Background: Toxoplasma gondii infections during pregnancy can result in abortion or congenital defects. Prevalence and risk factors of toxoplasmosis in women of child-bearing age in Ethiopia are unknown. The current study was conducted with the objectives of estimating the seroprevalence and potential risk factors in acquiring T. gondii infection by women of child-bearing age in Central Ethiopia.

Methods: A cross-sectional study was conducted from March 2011 to September 2011. Sera of 425 women were analyzed by indirect enzyme linked immunosorbent assay (ELISA). A questionnaire survey was administered for all study participants to gather information on risk factors.

Results: The study revealed that anti- T. gondii IgG antibodies were detected in 81.4% of the samples of which 78.4% were positive for only IgG and 3.06% positive for both IgG and IgM antibodies. Seroprevalence of IgM antibodies to T. gondii (4.0%, 95% CI: 2.14, 5.86) was suggestive of recent infections. Of the 213 pregnant women 9 (4.2 %) were IgM reactive. Out of 17 potential risk factors investigated, univariate logistic regression showed significant association of T. gondii infection with study area, age, pregnancy status, raw vegetable consumption, source of water, presence of cats at home, contact with cats, HIV status and precaution during cats' feces cleaning (P ≤ 0.05). The final logistic regression model revealed that: the probability of acquiring T. gondii infection by women of Debre-Zeit was 4.46 times (95% CI of adjusted odds ratio [aOR]: 1.67, 11.89; P =0.003) higher compared to women of Ambo, pregnant women were twice (95% CI aOR: 1.13, 3.59; P = 0.018) more likely to be seropositive than non-pregnant women and women who consume raw vegetable were at increased risk of infection (aOR = 2.21, 95% CI: 1.03, 4.78; P = 0.043) than women who didn't consume.

Conclusion: The seroprevalence of T. gondii infection in women of child-bearing age in Central Ethiopia is high. Study area, pregnancy and raw vegetable consumption are risk factors to acquire T. gondii infection. Educational program, antenatal screening of pregnant women and further epidemiological studies to uncover the economic and health impact of toxoplasmosis are suggested.

Figure 1

Toxoplasma gondii IgG and IgM seroprevalence in women of child-bearing age in Central Ethiopia. The IgG (light blue bars) and IgM (dark red bars) percent seroprevalence were statistically significant between study sites (IgM: Chi-square = 31.706, P ≤ 0.001; IgG: Chi-square = 28.018, P ≤ 0.001).

Figure 2

Toxoplasma gondii IgG and IgM seroprevalence in pregnant women of Central Ethiopia. The figure shows difference in seroprevalence among pregnant women tested (N = 213) according to the stages of pregnancy, i.e., first trimester (conception to three months), second trimester (4 – 6 months) and third trimester (7 – 9 months). The percent seroprevalence were shown in light blue (IgG) and dark red (IgM) colored bars.