Toxoplasma infection in pregnant women: a current status in Songklanagarind hospital, southern Thailand.

Hemah Andiappan,Chitkasaem Suwanrath,Nongyao Sawangjaroen,Verapol Chandeying,Thulasi Kumar,Yee Ling Lau,Veeranoot Nissapatorn,Waenurama Chemoh,Subashini Onichandran

doi:10.1186/1756-3305-7-239

Abstract

BackgroundToxoplasmosis, being one of the TORCH’s infections in pregnant women, is caused by Toxoplasma gondii, an obligate intracellular protozoan parasite. This parasitic infection in pregnancy congenitally causes severe outcomes to their fetus and newborn. This study aimed to determine the seroprevalence and stages of Toxoplasma infection in pregnant women and its associated risks exposures.MethodsThe study was conducted within the pregnant women attending the antenatal clinic (ANC) at Songklanagarind hospital, Hat Yai, Songkhla province, Thailand. The sera of a total of 760 consecutive pregnant women were screened using standard commercial ELISA kits for detection of anti-Toxoplasma IgG and IgM antibodies. IgG avidity in the seropositive for both anti-Toxoplasma IgG and IgM antibodies were also assessed. The pregnant women’s socio-demographic, obstetrics and risk factors associated with Toxoplasma seropositivity data were analyzed using univariate and multivariate analyses.ResultsFrom the total 760 pregnant women, 190 (25%, 95% CI = 22.05-28.20) were positive for anti-Toxoplasma antibodies. Of these, 167 (22.0%, 95% CI = 19.0-25.0) were positive for only anti-Toxoplasma IgG antibody and 23 (3.0%, 95% CI = 2.0-4.0) were positive for both anti-Toxoplasma IgG and IgM antibodies. All these samples were high avidity, indicated the infection occured prior to four to five months. By applying statistical univariate analysis, age group, occupation and sources of drinking water showed a significant association with Toxoplasma seropositivity (p < 0.05). Multivariate logistic regression analysis further indicated that the significant factors associated with Toxoplasma seropositivity are age ≥26 (OR = 1.65, 95% CI = 1.11-2.44), working as laborer (OR = 1.57, 95% CI = 1.13-2.18) and drinking unclean (piped/tap/rain) water (OR = 1.75, 95% CI = 1.08-2.84).ConclusionThe pregnant women in the active age group, working as laborers and exposure to unclean drinking water from various sources were at higher risk of Toxoplasma infection. Therefore, health education and the awareness of risk exposures regarding this parasitic disease are required to minimize the effects of this parasitic infection in pregnant women as well as in the general population.

Highlights

Toxoplasmosis, being one of the TORCH’s infections in pregnant women, is caused by Toxoplasma gondii, an obligate intracellular protozoan parasite
The questionnaire [10] was designed to detect socio-demographic and biologically plausible risk factors associated with Toxoplasma infection, and clinical history and presenting signs and symptoms relating to toxoplasmosis
Our findings showed high Toxoplasma infection rates in this group of pregnant women and showed significantly higher risk with age group, low socioeconomic status and drinking unclean water

Summary

Introduction

Toxoplasmosis, being one of the TORCH’s infections in pregnant women, is caused by Toxoplasma gondii, an obligate intracellular protozoan parasite This parasitic infection in pregnancy congenitally causes severe outcomes to their fetus and newborn. Toxoplasma gondii, an obligate intracellular protozoan parasite [1], is capable of causing severe and life threatening conditions in pregnant women and immunocompromised individuals. The sources of this parasitic infection are by the ingestion of raw and/or undercooked meat containing parasite cysts in the animal tissues, by consuming oocysts infected water and/or food, or having contact with cat fecal contaminated soil [2]. The result of this avidity test is most helpful in determining the infection of Toxoplasma in pregnant woman, especially for those who are in their first trimester [9]

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