SERO-PREVALENCE AND FACTORS ASSOCIATED WITH TOXOPLASMOSIS AMONG PREGNANT WOMEN RECEIVING ANTENATAL CARE IN PLATEAU STATE

SERO-PREVALENCE AND FACTORS ASSOCIATED WITH TOXOPLASMOSIS AMONG PREGNANT WOMEN RECEIVING ANTENATAL CARE IN PLATEAU STATE

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SUMMARY

Toxoplasmosis, one of the TORCH’s infections in pregnancy is caused by Toxoplasma

gondii an obligate intracellular protozoan parasite which can cause severe complications

for an infected mother if the primary infection was acquired during pregnancy. This

includes spontaneous abortions, low birth weight, congenital deformities and intrauterine

deaths. In many developed countries routine screening for Toxoplasma gondii is offered

to pregnant mothers as part of the routine screening services offered during antenatal care

visits for early detection and prompt treatment. This service in Plateau State and

elsewhere in Nigeria is largely limited as it is not part of the routine screening program.

This study was therefore undertaken to determine the Sero-prevalence of T. gondii

infection in pregnant women attending antenatal and factors associated with it. The type

of immune response in the infected women as well as their awareness of zoonotic

infections was also investigated.

The study was a cross-sectional study involving 356 pregnant women in the reproductive

age group who were attending antenatal care in Plateau State Specialist Hospital and Vom

Christian Hospital, Plateau State, Nigeria between February and April 2015. Consenting

pregnant women were recruited based on systematic sampling. Enzyme-Linked

Immunosorbent Assay (ELISA) method was used to determine the Sero-prevalence of

Toxoplasma IgG and IgM antibodies. A semi- structured questionnaire was used to collect

information socio-demographic characteristics and factors associated with the

Toxoplasma infection. Sero-prevalence was determined through frequency distribution of

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seropositivity to T. gondii. Multivariate logistic regression was used to identify factors

associated with toxoplasmosis.

The overall sero-prevalence of antibodies against T. gondii among the study participants

was 12.1%. Forty-three (12.1%) of them were sero-positive for IgG and 1 (0.8%) was

positive for IgM. The sero-prevalence of T. gondii infection was higher in pregnant

women with no formal education (OR=4.27; 95% CI=1.47 -12.59), among the

Hausa/Fulani ethnic group (OR=2.99; 95% CI=1.35 - 6.61). And in those who drank

untreated water (OR=3.05; 95% CI=1.36 - 6.86). The study also demonstrated that tasting

meat while cooking was protective against s T. gondii infection (OR=0.47; 95% CI=0.24 -

0.94). Similarly, Other factors such as HIV status, owning a cat, cleaning cat litter, type

of meat preference, living in urban areas, being married and eating raw vegetables were

not significantly associated.

At multivariate analysis Educational level, tasting of meat while cooking, drinking

untreated water and ethnicity were all found to be associated with T. gondii infection in

the study participants. The awareness of zoonotic infection among the pregnant women

was based on myths.

We recommend health education on preventive measures against T. gondii infection and

other zoonotic diseases by avoiding factors that could predispose the pregnant women to

the infection during antenatal care. Policy makers and caregivers should consider

introducing routine screening of toxoplasmosis on the high risk group.

CHAPTER ONE

INTRODUCTION

1.1 Background

Toxoplasmosis is a parasitic zoonotic disease caused by Toxoplasma gondii (T. gondii).

The organism was first described in 1908 by Charles Nicolle and Louis Manceaux in a

North African rodent Ctenodactylus gundi.1 T. gondii is a member of the TORCH group

of infections which include (Toxoplasmosis, Other Agents (Syphilis, Varicella-Zoester,

human parvovirus B19), Rubella, Cytomegalovirus (CMV) and Herpes viruses which can

cause congenital abnormalities and even death in foetuses. It is one of the most common

parasitic zooonoses globally where it has been estimated that up to one-third of the world

human populations has been exposed to this parasite.2 It is an obligate intracellular

protozoan parasite capable of infecting all warm-blooded mammals and birds including

humans which are secondary hosts.1 The primary host are cats (felids) where sexual

reproduction occurs in the digestive epithelium.2

Toxoplasmosis can be transmitted horizontally (acquired) or vertically (congenitally). The

acquired infection involves ingestion of oocyst excreted by cats via ingestion of raw or

uncooked infected meat containing encysted bradyzoites of the parasite, consumption of

fruits, vegetables and water contaminated by oocyst of the parasite, consumption of

unpasteurized milk due to poor domestic hygienic pra


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