Toxoplasma gondii seroprevalence and associated factors among pregnant women attending their first antennal care visit in rural Burkina Faso.

Abstract

Toxoplasma gondii, responsible for toxoplasmosis, is one of the worldwide prevalent parasitic zoonoses infecting warm-blooded animals including humans with cats being the definitive host. Congenital transmission can occur and leads to congenital toxoplasmosis, which may result in foetal or neonatal death, or severe malformations. In this study, we aimed to determine the seroprevalence and associated factors among pregnant women in a rural setting of Burkina Faso. We conducted a cross-sectional study from December 2020 to March 2021 in the Nanoro health district area. Women attending antenatal care for the first time at the selected health centers were enrolled in the study. For each participant, socio-demographic and clinical data were collected through a questionnaire. In addition, venous blood was drawn for the detection and avidity determination of IgG antibodies to T. gondii by enzyme-linked immunosorbent assay. Logistic regression was used to identify factors associated with seropositivity. Out of 416 participants, 37.3% were positive for specific anti-T. gondii IgG antibodies and only two of 149 women with interpretable results (1.3%) had low avidity IgG antibodies suggestive of recent primary infection. Younger age (16-18 years) was significantly associated with seronegativity (OR = 0.48, 95% CI:0.27-0.86, p = 0.013), while multipara (OR = 2.20, 95% CI:1.37-3.76, p value = 0.001) and multigravida (OR = 2.27, 95% CI:1.37-3.76, p = 0.001) were significantly more likely seropositive. The multivariate logistic regression showed that being at the third trimester of pregnancy (OR = 4.17, 95% CI:1.68-10.36, p = 0.002) and being often in contact with a cat (OR = 1.72, 95% CI:1.03-2.37, p = 0.035) were significantly associated with seropositivity. Our findings suggest that Toxoplasma gondii is widespread in the area, resulting in a high exposure risk of pregnant women and we indeed found two women with evidence of recent exposure. To avoid the potentially serious consequences to the foetus, there is an urgent need for systematic screening during antenatal care visits and awareness campaigns.