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

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Department of Medicine

ABSTRACT
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 vii 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.