Seroprevalence and Risk Factors of Toxoplasma gondii Infection among Pregnant Women in Kumasi: A Cross-Sectional Study at a District-Level Hospital, Ghana

Abstract

Background. This study investigated the prevalence and risk factors of Toxoplasma gondii infection among pregnant women in a district-level hospital in Ghana and compared the diagnostic performance of the rapid diagnostic test (RDT) and enzyme-linked immunosorbent assay (ELISA) for T. gondii diagnosis. Method. This cross-sectional study included 400 consecutive consenting women in their first-trimester stage of pregnancy. A validated well-structured closed-ended questionnaire was used to collect sociodemographic data and possible risk factors of each participant. Blood samples were collected for analysis of T. gondii IgG and IgM using the commercial ELISA Kit and RDT. Results. Seroprevalence of toxoplasmosis was 21.5% and 57.3% based on the RDT and ELISA technique, respectively. Secondary education ( cOR = 1.9 , 95% CI (1.1-3.1), and p = 0.020 ) and contact with cats ( cOR = 1.7 , 95% CI (1.1-2.8), and p = 0.030 ) were significant predictors of T. gondii infection, with the former being the only independent risk factor for T. gondii infection ( aOR = 1.8 , 95% CI (1.0-3.0), and p = 0.034 ) by the ELISA method. The sensitivity, specificity, and area under the curve (AUC) of RDT-IgM against ELISA were 42.9%, 95.9%, and 0.694, respectively, whereas those of RDT-IgG were 31.0%, 91.2%, and 0.611, respectively. The diagnostic consistency between the two methods was fair for both RDT-IgM ( κ = 0.304 ) and RDT-IgG ( κ = 0.201 ). Conclusion. The prevalence of T. gondii infection among pregnant women at Kumasi is 21.5% and 57.3% based on the RDT and ELISA technique, respectively. Secondary education and contact with cats were the major risk factors of T. gondii infection. Using ELISA as the reference, the RDT used in this study for the diagnosis of T. gondii infection has low sensitivity, and therefore, it is unreliable. However, this finding does not invalidate all RDTs because there are several other brands of RDT with good sensitivity and specificity. Further studies to ascertain the performance of other commercially available RDT kits are needed.

Sero and Salivary Toxoplasma Immunoglobulins: In Silico Study on Anti-genicity-Based Therapies Docked TgERP and its Dysregulatory Action on Immunoglobulins Running title: Sero and salivary toxoplasmosis and drug docking

“…This finding is consistent with reports from various parts of the world, suggesting that the source of drinking water can impact the transmission of Toxoplasma 52 . Recently, Okojokwu et al 2023 43 discovered a greater frequency among those who use pipe-borne water as their source of drinking water, and the same was reported by Singh et al 2021 39 .…”

“…Robert-Gangneux et al 38 revealed that toxoplasmosis seroprevalence among patients with cerebral, pulmonary, and post-transplant toxoplasmosis were (100%, 90%, and 89%, respectively). In contrast, lower rates were observed in the levels of IgG and IgM in serum samples among pregnant women (57.3%, and 3.5%, respectively) 39 .…”

Toxoplasma gondii among pregnant women attending antenatal care in a district hospital in Ghana

“…During pregnancy, early infection with T. gondii increases the risk of foetal transmission, with an increase between 60% and 81% in the third trimester [42,43]. Infections in the first trimester can be severe, resulting in abnormalities in foetal development or abortion [25]. When infection occurs in the third trimester, 80% of new-borns are asymptomatic [44].…”

“…A polymerase chain reaction confirms current infections [29]. Early detection of the infection is crucial in preventing negative consequences on the pregnancy and her unborn child [25]. We describe the seropositivity of T. gondii among pregnant women attending antenatal care at a general hospital in Atwima‐Nwabiagya District, Ghana.…”

“…In Ghana, the seropositivity among pregnant women ranged from 51.2% to 92.5% in Accra [10,22] and 71.8% in Ashanti Region [23]. In Kumasi, the seropositivity was 45.1% among women and 22.7% among infants [24], and 57.3% by enzyme-linked immune assay (ELISA) and 21.5% by rapid diagnostic test (RDT) [25] among pregnant women in their first trimester. In the Greater Accra region, the seropositivity was 39.5% in samples from the umbilical cord, 37.6% among mothers and 57.5% among infants [26].…”