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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
vi
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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