Epidemiology of Toxoplasmosis in SERBIA: A Cross-Sectional Study on Blood Donors

Abstract

Toxoplasmosis is a globally distributed parasitic zoonosis, affecting approximately one third of the human population. Epidemiological studies on toxoplasmosis conducted in Serbia so far have been focused on women of childbearing age, without a clear insight into the prevalence in the general population. We conducted a cross-sectional study in a representative sample of the healthy adult population consisting of 1095 blood donors of both genders to establish the prevalence and risk factors for Toxoplasma gondii infection. Data on the demographic and clinical characteristics of all study participants, as well as on their lifestyle habits, were collected by means of a questionnaire. The overall prevalence of infection was 20.5% (224/1095) and the avidity of the specific IgG antibodies detected was high in a vast majority of the seropositive donors (98.2%). Interestingly, the remaining 1.8% of the specific IgG positive samples were of borderline avidity (4/224), in complete absence of specific IgM. The multivariate logistic regression analysis showed that independent risk factors included age (from OR (95% CI) 1.9 (1.13–3.28) in the 30–39 age group, to 6.8 (3.27–14.24) in the age group of >60 years), suburban living (OR (95% CI) 2.2 (1.43–3.34)) and contact with soil (OR (95% CI) 1.4 (1.01–1.94)). This first large-scale study on toxoplasmosis in the general population in Serbia shows the lowest prevalence ever reported in this country. Moreover, the novel perspective on risk factors provides an updated basis for future prevention programs.

Seroepidemiology of Toxoplasma gondii Infection in Blood Donors from Western Romania

“…Gender was not associated with T. gondii infection in our survey, and this is in accordance with results of previous studies [ 7 , 8 , 10 , 25 ].…”

“…This is the first report on the seroprevalence and risk factors of T. gondii infection in blood donors from Western Romania. The 45.9% seroprevalence found in our study is higher than the 20.5%, 30.6%, 32.1%, 36% and 38.1% seroprevalence reported by European investigators in blood donors from Serbia [ 7 ], Bosnia and Herzegovina [ 21 ], Czech Republic [ 22 ], United Kingdom [ 23 ] and Portugal [ 13 ], respectively. These differences between countries may be explained by different sample size and various sampling strategies with the study group [ 7 ], environmental conditions [ 3 ], eating and hygiene habits [ 2 , 24 ] and different assays (with different sensitivities and/or specificities) [ 6 ] used to identify the presence of T. gondii antibodies.…”

“…As previously shown by former authors, we noticed that the prevalence of T. gondii antibodies increased with age, and this is a result of a prolonged length of exposure to the parasite [ 7 , 12 , 21 , 25 ].…”

“…Blood donors can impose risk of T. gondii infection for the susceptible recipients, such as immunosuppressed individuals and pregnant women [ 5 , 6 ]. Moreover, assessing the seroprevalence of T. gondii in blood donors offers important data regarding the prevalence of infection in apparently healthy individuals [ 7 , 8 ] and may indicate the spreading of infection in the general population.…”

“…Foroutan-Rad et al estimated that approximately 33% of blood donors worldwide are infected with T. gondii , with the highest global rates on the African continent (46%) and the lowest in Asia (29%) [ 6 ]. Seroprevalence varies between countries: 6.26% in China [ 9 ], 9.3% in Taiwan [ 10 ], 19.66% in India [ 11 ], 20.5% in Serbia [ 7 ], 25.6% Turkey [ 12 ], 36% in Portugal [ 13 ], 48.1% in Brasil [ 14 ], and 67.92% in Côte d’Ivoire [ 15 ].…”