Seroprevalence of Toxoplasma gondii among healthy blood donors in two locations in Tunisia and associated risk factors.

Arwa Lachkhem,Ibtissem Lahmar,Marie-Laure Dardé,Hamouda Babba,Ahmed Lachkhem,Lokman Galal,Aurélien Mercier,Habib Mezhoud,Mohssen Hassine,Oussama Babba

doi:10.1051/parasite/2020049

Abstract

Toxoplasma gondii is a protozoan parasite that can be transmitted to humans through a variety of routes including blood transfusion. This study aimed to investigate the seroprevalence of T. gondii infection and associated risk factors in healthy blood donors in Tunisia. A total of 800 healthy blood donors from two blood centers in south and coastal Tunisia were analyzed for anti-T. gondii IgG and IgM antibodies by indirect immunofluorescence assay (IFA) and enzyme-linked immunoassays (ELISA), respectively. Structured questionnaires were used to gather information on risk factors for T. gondii infection during collection. The overall seroprevalence was 44.4% of which 352 (44%) and 3 (0.4%) were positive for IgG and both IgG and IgM anti-T. gondii antibodies, respectively. Multivariate analysis showed that T. gondii seropositivity was significantly associated with the birth place (adjusted odds ratio [OR] = 2.72; 95% confidence interval [CI]: 1.49–4.94) and the age of the donors (adjusted OR = 4.98; 95% CI: 1.50–16.58) which are independent risk factors. In addition, the variables of hand washing before eating (adjusted OR = 0.52; 95% CI: 0.37–0.74) and living in an urban environment (adjusted OR = 0.30; 95% CI: 0.13–0.71) are two protective factors. This study provided the first data on the seroprevalence and epidemiology of T. gondii infection in healthy blood donors in Tunisia.

Highlights

Toxoplasmosis is a widespread cosmopolitan zoonosis due to a protozoan parasite, Toxoplasma gondii, which affects one-third of the world’s population [14, 31]
Multivariate analysis was used to assess the association between characteristics of subjects and T. gondii infection
Of the 355 seropositive blood donors, 151 (42.5%) had a titer of anti-T. gondii IgG antibodies of 8 IU/mL, 114 (32.1%) had a titer of 16 IU/mL, 77 (21.7%) 32 IU/mL, and 13 (3.7%) 64 IU/mL

Summary

Introduction

Toxoplasmosis is a widespread cosmopolitan zoonosis due to a protozoan parasite, Toxoplasma gondii, which affects one-third of the world’s population [14, 31]. The clinical manifestations of toxoplasmosis are affected by the genotype of the parasite, which can be serious during infection with a strain of atypical genotype [18, 20, 23]. The seroprevalence of Toxoplasma infection in humans varies widely between countries (10–80%) and sometimes within a country, depending on social and cultural habits, geographic factors, climate, and transmission routes [37]. Blood transfusion could be another route of transmission of T. gondii infection that could cause serious problems in immunocompromized and multitransfused persons [27]. Seropositive blood donors, those who are in the acute stage of infection, could in rare cases play a role in transmission [13]

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