A contemporary insight into the sero-epidemiology of Toxoplasma gondii infection in the foot-hills of Himalayas: A cross-sectional study from a tertiary care center in Northern India.

Deepjyoti Kalita,Pratima Gupta,Sangeeta Deka,Yogendra Pratap Mathuria

doi:10.3126/nje.v11i1.34228

Deepjyoti Kalita, Pratima Gupta + Show 2 more

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https://doi.org/10.3126/nje.v11i1.34228

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Abstract

BackgroundToxoplasma gondii infects 30-50% of the world’s population with high diversity in the geo-epidemiology and seroprevalence. The burden of toxoplasmosis and its determinants from remote and vulnerable regions of India is unknown. Therefore, this study aim to evaluate the prevalence of toxoplasma antibodies and factors associated with seropositivity among individuals from Uttarakhand and adjoining areas.MethodsSerum samples from 442 cases were tested for anti-Toxoplasma IgG and IgM antibodies by Enzyme-linked Immunosorbent Assay. Association of seropositivity of toxoplasmosis with age, gender, place of residence, dietary habits, and comorbidities were analyzed using binary logistic regression analysis.ResultsThe overall Toxoplasma seropositivity was found to be 36.88% [95% Confidence Interval (CI)=30.40–39.28]. While anti-T. gondii IgG was present in 34.84% [95% CI=30.40–39.28], anti-IgM was detected in 6.33% [95% CI=4.06–8.61]. The overall and IgG seroprevalence increased with age in both the genders and there was a sharp increase in the seropositivity after the age of 40 years [adjusted Odds Ratio (aOR)=2.98, p-value=0.030]. The seropositivity rate was significantly higher in individuals from Uttarakhand in both the hilly region (aOR=5.61; 95%CI:[2.14-14.68]) and plains (aOR=5.14; 95%CI:[2.2-12.02]). Multivariable logistic regression analysis also showed that being rural residents (aOR=3.23; 95%CI:[1.67-6.23]) and presence of comorbidities (aOR=8.64; 95%CI:[4.62-16.18]) were potential risk factors of Toxoplasmosis. On the other hand, consumption of vegetarian diet was found to have a protective effect (aOR=0.46; 95%CI:[0.28-0.75]).ConclusionSeroprevalence of T. gondii antibodies was relatively high in Uttarakhand, particularly in rural and hilly terrain, indicating a necessity for the implementation of integrated public health strategies to prevent and control toxoplasmosis in this region.

Highlights

Toxoplasma gondii (T. gondii) is an obligate intracellular apicomplexan parasite which is distributed worldwide among all warm-blooded animals and affects nearly one-third of the world population [1]
Mean age of the study population was 18.65 + 2.42 years; with age ranged between 4 days after birth to 71 years. 57.24% (n=253) cases were from Uttarakhand (Hills: n=114; Plains: n=139), 29.19% (n=129) were from the Western Uttar Pradesh (UP) and 13.57% (n=60) were from the adjacent states including Himachal Pradesh, Rajasthan, Haryana and Punjab. 66.52% of cases resided in rural areas while 33.48% hailed from Urban places
Seroprevalence of T. gondii antibodies were relatively higher in the Uttarakhand region, in the rural and hilly terrain, indicating a necessity for the implementation of integrated public health strategies to prevent and control toxoplasmosis in this region

Summary

Introduction

Toxoplasma gondii (T. gondii) is an obligate intracellular apicomplexan parasite which is distributed worldwide among all warm-blooded animals and affects nearly one-third of the world population [1]. Toxoplasmosis infection is mainly caused by ingestion of T. gondii oocyst present on raw and unwashed vegetables or undercooked meat containing tissue cysts [10] Both acute infection and reactivation of past infection are possible, and in either case, clinical spectrum may range from asymptomatic/mild non-specific flu-like symptoms to severe lethal forms like cerebral, pulmonary or disseminated toxoplasmosis depending upon immune status of the patients [11,12]. The present study was undertaken to detect the seroprevalence of T. gondii among inhabitants of Uttarakhand and adjoining areas, and to identify its association with socio-demographic characteristics, epidemiological profile and possible risk factors of toxoplasmosis. Conclusion: Seroprevalence of T. gondii antibodies was relatively high in Uttarakhand, in rural and hilly terrain, indicating a necessity for the implementation of integrated public health strategies to prevent and control toxoplasmosis in this region.

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