Association between Toxoplasma gondii Infection, Depression and Infertility among Women Attending Obstetric Health Centres in Bamenda, Cameroon

Abstract

Background and Aims: Toxoplasma gondii (T. gondii), with a neurotropic nature represents a potential causative agent for psychiatric and behavioural disorders, which can lead to infertility. The aim of this study was to analyse the effect of T. gondii infection on depression in infertile women. Study Design:  This study was a case-control hospital-based study. Place and Duration of Study: A total of 200 women (100 fertile and 100 infertile women) were recruited at People’s Clinic, Upstation polyclinic, Abi Polyclinic and PMI district hospital in Bamenda between May 2024 and May 2025. Methodology: Blood sample were collected from all participants and were tested for T. gondii antibodies (IgG and IgM) and cortisol levels by using enzyme-linked immunosorbent assay. Beck questionnaires were used to evaluate depression. SPSS version 22 was used to analyse the data. Results: There was a significant gap in mental health, with 52% of infertile women diagnosed with depression compared to 22% of fertile women (p = 0.00). A significant overall association between T. gondii infection and the stages of depression was also observed (p= 0.000) with the highest prevalence of 100% for “Severe” depression. Furthermore, a significant association was found between T. gondii infection and elevated cortisol levels (p = 0.02), where infected women were significantly less likely to maintain a normal hormonal balance compared to the high cortisol group. Chronic IgG cases showed the highest mean cortisol levels (267.12±241,40). Conclusion: This study reveals a significant association between latent T. gondii infection, depression, and infertility in women. The parasite may act as a chronic biological stressor that triggers the HPA axis, resulting in elevated cortisol levels.