SERO-EPIDEMIOLOGY OF TOXOPLASMOSIS AMONG PREGNANT WOMEN AND IMMUNOCOMPROMISED (HIV) PATIENTS IN PARTS OF OSUN STATE, NIGERIA

Abstract

This study was aimed at determining the seroprevalence of anti-Toxoplasma IgG and IgM antibodies and associated risk factors among randomly selected pregnant women and immunocompromised (HIV) patients in some tertiary and primary health establishments in the three major towns (Ile-Ife, Osogbo and Ilesha) in Osun State Southwestern, Nigeria. Structured questionnaires were administered to obtain participants’ socio-demographic data and blood samples were collected from pregnant women and immunocompromised (HIV) patients, who consented to be part of this study between November 2015 and December 2016. Serological test for anti-Toxoplasma IgG and IgM were carried out in duplicates using commercially procured ELISA test kits. Also, HIV screening was carried out on pregnant women using HIV ½ Test Kits (Trinity Biotech, Ireland). A total of 1,552 sera comprising 166(10.70%) male and 1,386(89.30%) female were randomly obtained from fifteen selected clinics located in the three towns of Osun State. The ages of the subjects ranged between 15years and 72years and the number of sera collected ranged from 32 at OS-Asubiaro IHVN to 218 at IF-OAUTHC IHVN. Out of the 1,552 sera tested for anti-Toxoplasma IgG antibodies, 432(27.84%) were seropositive to IgG and were consequently screened for IgM antibodies to facilitate classification into active, latent, recently acquired or previously acquired infections. 253(59.72%) sera tested positive to IgM antibodies. Analysis of the data generated indicated that prevalence of Toxoplasma infection in the study area varied among the age groups, sex, occupation, educational status and other associated risk factors. A high prevalence of infection was recorded among both sexes although a non-significantly higher prevalence was recorded among the male (28.31%) than their female counterparts (P≥0.05). Among the selected towns where sample collection took place, a non-significantly higher prevalence was recorded at Ilesha (34.00%) (P≥0.05). The analysis of results also revealed that the seropositivity of Toxoplasma infection increase as the age of the participant’s increases (P≥0.05). Seropositivity to Toxoplasma infection decreases with an increase in educational attainment among the studied population. Also, higher seropositivity to Toxoplasma infection was recorded among cat owners and those in the habit of tasting raw/undercooked meat. Generally, high prevalence (29.43%) of Toxoplasma infection was recorded among pregnant subjects and the prevalence of infection was revealed to be age dependent. This is because seropositivity of infection increase as the age group of the pregnant women increases. It was also observed that seropositivity to infection was higher among younger pregnant women than their older counterparts. The result also revealed that seropositivity to Toxoplasma infection increases along with increase in gestational age of the pregnancy. Pregnant women in their third trimester recorded the highest prevalence rate of 30.67% while the least infection was recorded among those in their first trimester (26.66%) (P>0.05). The result also showed that prevalence of Toxoplasma antibodies among HIV-infected individual increases with age and was higher among female than their male counterparts. None of the HIV- infected pregnant women at their first trimester tested positive but higher seroprevalence was reported among those in third trimesters. Low level of knowledge about the parasite, its transmission, symptoms, treatments, risk factors and preventive measures were observed in this study.Analysis of results showed that approximately 91% of the respondents did not know about the infection and none of the participants in this study claimed to have undergone toxoplasmosis screening despite the fact that toxoplasmosis was found to be endemic in Osun State. There should be quick and powerful sensitization among the residents of Osun State about toxoplasma infection, its transmission, symptoms and risk factors. Also, the Federal Government should as a matter of urgency make screening for T. gondii compulsory in all hospitals most especially, the pregnant women attending antenatal care clinic so as to reduce the incidence of congenital transmission.