Seroprevalence of Toxoplasma gondii Infection in Refugee and Migrant Pregnant Women along the Thailand-Myanmar Border.

Bert J D Van Enter,Clare L Ling,Wenn-Chyau Lee,Wanitda Watthanaworawit,Yaowalark Sukthana,Yee-Ling Lau,François Nosten,Rose Mcgready

doi:10.4269/ajtmh.16-0999

Abstract

.Toxoplasma gondii primary infection in pregnancy is associated with poor obstetric outcomes. This study aimed to determine the seroprevalence of Toxoplasma infection in pregnant migrant and refugee women from Myanmar attending antenatal care in Thailand. A random selection of 199 residual blood samples from first antenatal screen in 2014–2015 was tested for Toxoplasma IgG and IgM antibodies. Seroprevalence of Toxoplasma infection was 31.7% (95% confidence interval = 25.6–38.4). Avidity testing in the three positive IgM cases indicated all were past infections. Multiparity (≥ 3 children) was significantly associated with higher Toxoplasma seropositivity rates. Seroprevalence of T. gondii infection in this pregnant population is similar to the only other report from Myanmar, where multiparity was also identified as a significant association. Toxoplasma infection is important in pregnant women. Nevertheless, in this marginalized population, this infection may be given less priority, due to resource constraints in providing the most basic components of safe motherhood programs.

Highlights

Associated risk factors reported for Toxoplasma infection are older age, multiparity, drinking unclean water, contact with cats, lower educational levels, and less knowledge of toxoplasmosis.[9,10,14] In one study, of 2,598 pregnant women in Thailand, Philippines, and Malaysia, only 11% had heard or read about toxoplasmosis.[15]
We aimed to give a better understanding on the seroprevalence of T. gondii infection in women from Myanmar living along the Thailand–Myanmar border
This study was approved by the Oxford Tropical Research Ethics Committee (OXTREC: 28–09) and by the local committee with whom all research items were discussed before approval, the Tak Province Border Community Advisory Board (TCAB-4/1/2015)

Summary

Introduction

Associated risk factors reported for Toxoplasma infection are older age, multiparity, drinking unclean water, contact with cats, lower educational levels, and less knowledge of toxoplasmosis.[9,10,14] In one study, of 2,598 pregnant women in Thailand, Philippines, and Malaysia, only 11% had heard or read about toxoplasmosis.[15]. Associated risk factors reported for Toxoplasma infection are older age, multiparity, drinking unclean water, contact with cats, lower educational levels, and less knowledge of toxoplasmosis.[9,10,14] In one study, of 2,598 pregnant women in Thailand, Philippines, and Malaysia, only 11% had heard or read about toxoplasmosis.[15] Screening for T. gondii antibodies in pregnant women can identify women at risk for

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