Seroprevalence and risk factors predicting Toxoplasma gondii (Toxoplasmosis) infection in pregnant women in Koula-Moutou and surrounding departments in central-eastern Gabon

Abstract

Serological screening for toxoplasmosis in pregnant women in Gabon is not always systematic during pregnancy. However, whether in urban, rural or semi-rural areas, hygiene and living conditions are often precarious for these populations at risk. This state of affairs constitutes a favorable terrain for the dissemination of the disease. It is in this context that the objective of this study was to investigate the prevalence and risk factors predicting Toxoplama gondii infection in pregnant women in the province of Ogooué-Lolo, of which Koula-Moutou is the capital, a semi-rural area in central-eastern Gabon. This prospective, cross-sectional study was conducted from January 2 to February 28, 2022 in a population of pregnant women from two of the most frequented health centers in the commune of Koula-Moutou: the Centre Hospitalier Régional Paul MOUKAMBI (CHRPM) and the Centre de Santé Urbain (CSU) of Koula-Moutou, in east-central Gabon. From serum/plasma collected from pregnant women, the rapid diagnostic immunological technique “Onsite Rapid Test TOXO IgG/IgM Combo”, a lateral flow chromatography immunological test for the simultaneous detection and differentiation of anti- Toxoplasma gondii ( T. gondii ) IgG and IgM, was used to perform toxoplasma serologies . A pre-established and structured questionnaire on sociodemographic factors and risk factors associated with toxoplasmosis was submitted to the participants and the data obtained were analyzed using R software version 3.6.1. The study included 97 pregnant women from the city of Koula-Moutou and surrounding departments, aged 16 to 43 years, with a mean age of 27.9 ± 7.1 years. IgG antibodies to Toxoplasma gondii were found in 78 pregnant women, representing a seroprevalence of 80.41% ( n = 78), among whom 5.13% ( n = 4) were diagnosed as seropositive to IgM anti- Toxoplasma gondii in this study. In univariate analysis , pupils/students (COR = 14.65; 95% CI: [1.86–115.24]), women with a small trade (COR = 0.53; 95% CI: [0.12–2.28]), or even those with no professional status (COR = 0.19; 95% CI: [0.05–0.74]), those with primary (COR = 0.28; 95% CI: [0.09–0.83]), secondary (COR = 6.15; 95% CI: [2.1–18.04]) and university (COR = .2; 95% CI: [0.04–0.89]) education, those who were single (COR = 3.21; 95% CI: [0. 98–10.55]) and finally, those with a number of pregnancies ranging from 1 to 5 (OR = 4.11; 95% CI: [1.41–11.99]), were at high risk of Toxoplasmosis, After adjustment of risk factors by multivariate logistic regression , cohabitation with cats and/or dogs, rabbits, mice (Adjusted OR = 0.17; 95% CI: [0.00–0.67]) was identified as the only significant risk factor for Toxoplasmosis ( P = 0.037) in our study population. In order to prevent Toxoplasma gondii infections and protect newborns in Gabon, awareness of the risks of contamination, systematic serological surveillance and hygiene measures are necessary and should be proposed to pregnant women during prenatal consultations.