Serological detection of Toxoplasma gondii and associated risk factors among pregnant women in Lahore Pakistan

Abstract

Background: Toxoplasma gondii, a parasite causing toxoplasmosis, a public health problem of zoonotic potential. Toxoplasma gondii (T. gondii) is transmitted through vertical and horizontal routes causing trans-placental infection that could leading towards still births, spontaneous abortions and further major complications in neonates like hydrocephaly, microcephaly, blindness etc. In Pakistani society human beings have close interaction with the livestock, pets and therefore issue of toxoplasmosis is considerably important hence this observational and prospective study was planned with the objectives, to determine the prevalence and risk factor associated with Toxo gondii infection among the pregnant women visiting public and private clinics in Lahore Pakistan. Methods & Materials: For the purpose blood samples were collected from the women visiting different public and private clinics from October 2014 to August 2016. A questionnaire was designed to find out the hygiene, health, education and socioeconomic status of pregnant women and their exposure to various risk factors like eating undercooked meat, salads, drinking water/milk and to assess their knowledge about toxoplasmosis. A total of 418 blood samples were collected using SOPs, and questionnaires were filled carefully. Samples were analyzed for presence of IgG and IgM antibodies against Toxo gondii using ELISA method. The results and data of risk factors were interpreted by using statistical analysis. Results: From a total of 418 pregnant women, 140 (33.5%) were found reactive for antibodies to Toxo gondii IgG while 28 (6.7%) were found reactive for Toxo gondii IgM, whereas 12 (2.9%) were found reactive to IgG and IgM both. The major associated risk factors identified were, age, illiteracy, unpasteurized milk, undercooked food, contact with pets, personal hygiene, trimester of pregnancy, number of pregnancies and hemoglobin level (p < 0.05). Conclusion: It is concluded that 33.5% pregnant women were infected with Toxo gondii. The high prevalence was found who were; less than 20 year, illiterate, consumed unpasteurized milk or undercooked food, belonged to upper class, contact with pets, poor personal hygiene, in first trimester of pregnancy, history of multiple pregnancies and low hemoglobin level. Only 7% were women aware about the infections while consuming raw/under cooked food, no one was aware of Toxoplasmosis.