Seroepidemiological map of Toxoplasma gondii infection and associated risk factors in preconception period in China: A nationwide cross-sectional study.

Abstract

The aims of this study were to investigate the regional differences in seroepidemiology of toxoplasmosis in preconception period among Chinese women of reproductive age and to evaluate associated risk factors. This national, population-based, cross-sectional serosurvey covered all 31 provinces and province-level municipalities in Mainland China. Married women intending to get pregnant within 6 months between 2010 and 2012 were recruited. Information on demographic characteristics (age, place of residence, occupation, dietary habits and exposure to cat) was obtained using interviews, and venous blood samples were collected to screen for Toxoplasma gondii infection. Of 2 008 561 women recruited to the study, 45 405 (2.3%) were Toxoplasma gondii IgG positive, and 6884 (0.3%) were IgM positive. Geographical variation for seropositivity ranged from 0.2% in Heilongjiang to 11.2% in Tianjing for IgG and from 0% in Tibet to 0.9% in Anhui for IgM. Advanced maternal age, occupation of a farmer, vegetarian diet and exposure to cat was significantly associated with Toxoplasma gondii IgM seropositivity, and its association with occupation of farmer and exposure to cat was significant after adjusting for province of residence (P < 0.05). There were significant regional variations in Toxoplasma gondii seropositivity and associated risk factors among Chinese women of reproductive age during preconception period. This calls for a targeted primary prevention strategy. Screening and treatment before conception and preconception health education may have potential for reducing congenital Toxoplasmosis in China.