Sero-prevalence and risk factors of Toxoplasma gondii infection among pregnant women attending antenatal care in Kigali, Rwanda

Abstract

Toxoplasmosis in pregnancy is associated with spontaneous abortions, low birth weight babies, congenital deformities and intrauterine deaths. In many developed countries, pregnant mothers are screened for infection with Toxoplasma gondii, the causative parasite, and treatment is offered early in order to prevent these complications. The disease is also associated with immunosuppressive disorders such as acquired immunodeficiency syndrome (AIDS). In most developing countries, including Rwanda, the burden and risk factors of T. gondii infection among pregnant women and among HIV infected persons is largely unknown thus making it difficult to plan and implement control measures. Study Objective: This study aimed at determining the prevalence of T. gondii infections and their risk factors among pregnant women attending antenatal care clinics in Kigali, Rwanda. Methodology: This was a cross-sectional descriptive study involving 384 pregnant women aged 18 years and above who were attending antenatal care clinics in Biryogo, Cor-Unum, Muhima and Nyarugunga health centres in Kigali city, Rwanda, between April and August 2014. Venous blood samples were collected from study participants and screened for IgG and IgM antibodies against T. gondii using the ELISA technique whereas information on their HIV status and CD4+ cell count were obtained from their medical records. The participants were also interviewed about selected behaviors that predispose individuals to infections with T. gondii. Results: The overall seroprevalence of antibodies against T. gondii among the women was 12.2%. Thirty seven (9.6%) of them were IgG seropositive and 15 (3.9%) were IgM seropositive. Ten of the 15 women who were positive for IgM were also positive for IgG, making the overall prevalence of pregnant women positive for both IgG and IgM 2.9%. The sero-positivity rate of T. gondii-specific antibodies was significantly higher among pregnant women who reported drinking untreated water than those who reported using treated water (22.4% versus 6.8%; OR=4.01, 95% CI: 2.08 - 7.69, p=0.001). Similarly, patients who reported eating undercooked meat had a significantly higher prevalence of anti-T.gondii seropositivity than those who reported ate well cooked meat (22.3% versus 8.1%; OR=3.32, 95% CI: 1.74-6.32, p<0.001). Conclusion: The seroprevalence of T. gondii antibodies is relatively low among the pregnant women. Undercooked meat consumption and drinking untreated water are significantly associated with sero-prevalence of anti-T. gondii IgG and IgM among the pregnant women.