First use of rapid ICT screening for Toxoplasma in pregnant women in Ethiopia: A multicenter study in Bahir Dar, Ethiopia.

Abstract

Background: Toxoplasma gondii primary infection during pregnancy can lead to congenital transmission and cause serious fetal and neonatal complications. Seroprevalence for toxoplasmosis is an indicator of the intensity of transmission and of the risk of infection during pregnancy, yet such data are limited in Ethiopia. This multi-center study utilizing the immunochromatographic test (Toxoplasma ICT IgG-IgM, LD Bio) aimed at determining the seroprevalence of toxoplasmosis among pregnant women and its associated risk factors in Bahir Dar, Ethiopia.

Methods: A cross-sectional study was conducted at two tertiary hospitals. Pregnant women below 20 weeks of gestation were included during the first antenatal care consultation. Participants were selected using systematic random sampling. A blood sample was collected for Toxoplasma serology, and socio-demographic and clinical data were collected through a questionnaire. Serology was performed using a rapid immunochromatographic test (ICT Toxo IgG/IgM, LD Bio). The test detects any Toxoplasma antibody (recent or chronic infection), but not separately reported. Data were analysed using SPSS version 23. Individual data were compared between Toxoplasma-seropositive and seronegative women to determine risk factors for infection. Bivariable and multivariable binary logistic regression were performed to identify factors associated with seropositivity.

Results: Overall, 1010 women were included in the study at their first antenatal care visit (13.89 ± 4.26 weeks of gestation). Their mean age was 26.8 ± 4.67 years, 85.2% resided in urban areas, and the median monthly income was 5000 Ethiopian Birr. The seroprevalence was 75.8%. Seroprevalence increased with age and parity (p < 0.001), but did not differ according to socio-economic parameters, including educational level, monthly income, occupation, residence, or any hygienic factors. Multivariable analysis showed that age (AOR = 1.09), Parity (AOR = 1.33), eating undercooked meat (AOR = 1.29), and consumption of raw milk (AOR = 1.82) were significantly associated with the seropositivity of T. plasma gondii among pregnant women.

Conclusion: The burden of toxoplasmosis among pregnant women was high in Bahir Dar. Therefore, efforts should be made to increase women's awareness of risk factors, particularly the habit of consuming raw meat and raw milk. The ease of use of the Toxoplasma ICT test allows serologic screening of pregnant women at antenatal care facilities.