Maternal Toxoplasma Gondii Infection and Vertical Transmission Patterns among Pregnant Women at a Tertiary Health Facility

Abstract

Background: Gestational toxoplasmosis when transmitted from a mother to her child leads to miscarriages, preterm labour, and intrauterine fetal death. For babies who survive intrauterine life congenital toxoplasmosis is characterized by hydrocephalus, microcephaly, seizures, learning difficulties and mental retardation. Aim and Objectives: To determine the prevalence of Toxoplasma gondii in pregnant women, associated risk factors, neonatal outcomes and the risk of vertical transmission. Methodology: A prospective cross-sectional study of 179 pregnant women, 28 weeks and above, who had antenatal care and delivery at the University of Port Harcourt Teaching Hospital was conducted. The women were tested for Toxoplasma gondii IgG and IgM antibodies at delivery after relevant data was collected with a semi structured questionnaire during the antenatal period. For mothers who tested positive, blood sample was taken from the umbilical cord immediately after delivery of the baby and tested for IgG and IgM to check for vertical transmission. Data was analyzed with SPSS version 25. Means and standard deviations, proportions and frequencies were used to categorize data. Association of risk factors was analyzed using Chi-square, Odds ratio and Fisher’s exact test. Statistical significance was set at P value ≤ 0.05. Results: Mean age was 31.6 ± 4.1 years. The prevalence of Toxoplasma gondii infection was 30.2%. More than half 12 (66.7%) of pregnant women 40 years and above were positive for Toxoplasma IgG antibody, which indicates chronic infection. Infection rate was statistically lower in younger age groups (p=0.01). Eating meat from external vendors, previous blood transfusion, drinking untreated water, having a domestic pet and farming increased the risk for Toxoplasma gondii infection (p ≤ 0.05). There was no vertical transmission. Conclusion: Knowledge of Toxoplasma gondii infection was very low. There was a higher rate of infection with advancing age, low level of education, occupation, drinking of untreated water and previous history of blood transfusion. There is need for more public awareness on Toxoplasma gondii infection and its risk factors.