Anti-toxoplasma Antibody Prevalence and Cost-effectiveness in Pregnant Women at the King Abdulaziz University Hospital, Jeddah, Saudi Arabia

Abstract

Background: Toxoplasma gondii (T. gondii) is one of the most prevalent infectious parasites in humans worldwide. The diagnosis of toxoplasmosis is based on serological screening through the detection of anti-toxoplasmosis antibodies: IgG, which indicates previous exposure and the presence of active immunity, and IgM, which indicates a recent infection. We aimed to determine the prevalence of anti-toxoplasma antibodies in pregnant women at King Abdulaziz University Hospital (KAUH), Jeddah, Saudi Arabia, and explore the cost-effectiveness of antitoxoplasma screening. Method: This was an analytic retrospective study of women who underwent serology testing for anti-toxoplasmosis antibodies at KAUH in 2013-2018. Data were collected from hospital documentation and IBM Statistical Package for Social Sciences (SPSS Inc., Chicago, IL) version 22 was used for analysis. Result: Of the 9,098 pregnant women seen at KAUH, 2,754 had undergone the test, and 38 had a positive result, i.e., a seroprevalence rate of 1.4%. Most women were Saudis (57.9%), and almost all were multiparous. Of those with a positive result, 36.8% were in the third trimester. Most births were by spontaneous vaginal delivery (65.8%). Twelve (31.6%) of the women with toxoplasmosis experienced obstetric complications. The estimated total cost of screening the pregnancies was US $919,646.00 Conclusion: The prevalence of pregnant women with a positive anti-toxoplasmosis test result was low, and we believe there is no net benefit from screening all pregnant women for toxoplasmosis. Primary prevention should be through health education, and we recommend screening only women with high-risk pregnancies.

Toxoplasmosis in immunocompetent Saudi women: Correlation with vitamin D

“… 6 – 8 Diagnosis of toxoplasmosis relies on serologic tests, polymerase chain reaction (PCR), and histological examination of infected tissue, these serological examinations efficiently and most commonly used in diagnosis as well as screening for toxoplasmosis. 9 , 10 Serological examination for human T. gondii immunoglobulin G (IgG) is the best measured by enzyme-linked immunosorbent assay (ELISA) method as it is cheap and easy to perform, whereas detection of toxoplasmosis thorough PCR is not common, costly, and requires proficiency. 9 – 11 Vitamin D is essential for regulation of calcium and phosphorus metabolism and most importantly it plays a role in normal regulation of the immune system.…”

“… 9 , 10 Serological examination for human T. gondii immunoglobulin G (IgG) is the best measured by enzyme-linked immunosorbent assay (ELISA) method as it is cheap and easy to perform, whereas detection of toxoplasmosis thorough PCR is not common, costly, and requires proficiency. 9 – 11 Vitamin D is essential for regulation of calcium and phosphorus metabolism and most importantly it plays a role in normal regulation of the immune system. 12 , 13 Interestingly, the receptors for 1,25-dihydroxy vitamin D 3 are present on human peripheral blood monocytes and also on active lymphocytes, indicating its role as an immune regulator.…”