Toxoplasma gondii infections among pregnant women, children and HIV-seropositive persons in Accra, Ghana

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Abstract

Background

Toxoplasma gondii infection can lead to severe disease outcomes in immune-compromised people. This study sought to determine the seroprevalence of anti- T. gondii antibodies among pregnant women, hospitalized children (<5 years old) and HIV-seropositive persons in Accra.

Methods

A cross-sectional study was conducted in two hospitals in Accra, and a total of 450 voluntary participants were recruited for the study consisting of 125 pregnant women, 200 children and 125 HIV-seropositive persons. Serum was obtained from venous blood safely drawn from each participant and tested for specific anti- Toxoplasma antibodies IgG and IgM by ELISA. A serological criterion for seropositivity was a positive test result for any of the two anti- Toxoplasma antibodies or a combination of both. Questionnaire interviews were conducted to obtain personal information and Toxoplasma infection risk-related data.

Results

Those who tested seropositive for anti- T. gondii antibodies were 51.2 % (64/125) pregnant women, 58.0 % (116/200) children and 57.6 % (72/125) HIV patients. The major risk factors associated with anti- T. gondii seropositivity were identified as age (in children), handling raw meat and gravida status (in pregnant women). The results of this study confirmed that the seroprevalence of T. gondii infection is high among pregnant women, hospitalized children <5 years old and HIV patients.

Conclusions

A further study to investigate pre-pregnancy infections with T. gondii among women of childbearing age, seroconversion rate in pregnant women, rate of mother-to-child transmission and reactivated infections among HIV-seropositive persons is recommended.

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Most cited references 33

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Toxoplasmic encephalitis in AIDS.

B. J. Luft, J Remington (1992)

Involvement of the central nervous system (CNS) is common in patients with advanced disease due to human immunodeficiency virus (HIV). Symptoms range from lethargy and apathy to coma, incoordination and ataxia to hemiparesis, loss of memory to severe dementia, and focal to major motor seizures. Involvement may be closely associated with HIV infection per se, as in the AIDS dementia complex, but is frequently caused by opportunistic pathogens such as Toxoplasma gondii and Cryptococcus neoformans or malignancies such as primary lymphoma of the CNS. The clinical presentations of attendant and direct CNS involvement are remarkably non-specific and overlapping, yet a correct diagnosis is critical to successful intervention. Toxoplasmic encephalitis is one of the most common and most treatable causes of AIDS-associated pathology of the CNS. A great deal has been learned in the last 10 years about its unique presentation in the HIV-infected patient with advanced disease. Drs. Benjamin J. Luft of the State University of New York at Stony Brook and Jack S. Remington of the Stanford University School of Medicine and Palo Alto Medical Foundation's Research Institute have studied T. gondii for many years and are two of the leading experts in the field. This commentary comprises an update of their initial review (J Infect Dis 1988;157:1-6) and a presentation of the current approaches to diagnosing and managing toxoplasmic encephalitis in HIV-infected patients.

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Management of Toxoplasma gondii infection during pregnancy.

Jose G Montoya, Jack Remington (2008)

Acute infection with Toxoplasma gondii during pregnancy and its potentially tragic outcome for the fetus and newborn continue to occur in the United States, as well as worldwide, despite the fact that it can be prevented. The infection can be acquired through ingestion of infected, undercooked meat or contaminated food or water. Transmission to the fetus occurs almost solely in women who acquire their primary infection during gestation and can result in visual and hearing loss, mental and psychomotor retardation, seizures, hematological abnormalities, hepatosplenomegaly, or death. Systematic education and serological screening of pregnant women are the most reliable and currently available strategies for the prevention, diagnosis, and early treatment of the infection in the offspring; this is largely because toxoplasmosis in pregnant women most often goes unrecognized. Treatment of the infection in the fetus and infant during the first year of life has been demonstrated to significantly improve the clinical outcome.

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Highly Endemic, Waterborne Toxoplasmosis in North Rio de Janeiro State, Brazil

Lilian Maria Garcia Bahia-Oliveira, Jeffrey L. Jones, Juliana Azevedo-Silva … (2003)

In Campos dos Goytacazes, northern Rio de Janeiro state, Brazil, reports of uveitis consistent with toxoplasmosis led to a survey of the prevalence and risk factors for Toxoplasma gondii infection in 1997–1999. The survey population was selected randomly from schools, randomly chosen communities, and an army battalion. Serum samples from 1,436 persons were tested. With results adjusted for age, 84% of the population in the lower socioeconomic group was seropositive, compared with 62% and 23% of the middle and upper socioeconomic groups, respectively (p<0.001). When multivariate analysis was performed, drinking unfiltered water was found to increase the risk of seropositivity for the lower socioeconomic (odds ratio [OR]: 3.0, 95% confidence interval [CI] 1.3 to 6.9) and middle socioeconomic (OR: 1.7, 95% CI 1.2 to 2.3) populations. We also found a high T. gondii seroprevalence in this Brazilian community. Drinking unfiltered water increased the risk of T. gondii seropositivity, indicating the potential importance of oocyst transmission in water in this region.

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Author and article information

Contributors

Irene Ayi: +233 243 670 493 , iayi@noguchi.ug.edu.gh

Journal

Journal ID (nlm-ta): Trop Med Health

Journal ID (iso-abbrev): Trop Med Health

Title: Tropical Medicine and Health

Publisher: BioMed Central (London )

ISSN (Print): 1348-8945

ISSN (Electronic): 1349-4147

Publication date (Electronic): 1 June 2016

Publication date PMC-release: 1 June 2016

Publication date Collection: 2016

Volume: 44

Electronic Location Identifier: 17

Affiliations

[ ]Department of Parasitology, Noguchi Memorial Institute for Medical Research, College of Health Science, University of Ghana, P. O. Box LG 581, Legon, Accra, Ghana

[ ]Korle-Bu Central Laboratory, Korle-Bu Teaching Hospital, P. O. Box 77, Korle-Bu, Accra, Ghana

[ ]Department of Environmental Parasitology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, 1-5-45 Yushima, Bunkyo-ku, Tokyo, 113-8519 Japan

[ ]School of Biological and Allied Health Sciences, College of Health Science, University of Ghana, Korle-Bu, Accra, Ghana

Article

Publisher ID: 18

DOI: 10.1186/s41182-016-0018-5

PMC ID: 4940749

PubMed ID: 27433136

SO-VID: da2d7c27-1cd1-4673-9b38-b1ebed0d3525

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 5 November 2015

Date accepted : 13 May 2016

Funding

Funded by: Japanese Initiative for Global Research Network on Infectious Diseases

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ScienceOpen disciplines: Medicine

Keywords: toxoplasma gondii,anti-toxoplasma gondii antibodies,immune-compromised

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ScienceOpen disciplines: Medicine

Keywords: toxoplasma gondii, anti-toxoplasma gondii antibodies, immune-compromised

Toxoplasma gondii infections among pregnant women, children and HIV-seropositive persons in Accra, Ghana

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Abstract

Background

Methods

Results

Conclusions

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Annual Reviews HIV/AIDS: Public Health and Society

Most cited references 33

Toxoplasmic encephalitis in AIDS.

Management of Toxoplasma gondii infection during pregnancy.

Highly Endemic, Waterborne Toxoplasmosis in North Rio de Janeiro State, Brazil

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