Seroprevalence and associated behavioral factors of Toxoplasma gondii infection among pregnant women in Pokhara Valley, Nepal.

Background: Toxoplasma gondii is a protozoan parasite that can cause congenital infections with serious health implications. In pregnant women, T. gondii infection poses significant risks, including miscarriage, stillbirth, and congenital abnormalities in the fetus. The burden of toxoplasmosis is often underrecognized in many developing countries, including Nepal, where awareness and routine screening are limited. This study was aimed at determining the prevalence of T. gondii infection among pregnant women in Pokhara Valley, Nepal, and to identify behavioral risk factors associated with the transmission of this parasite.

Methods: A cross-sectional study was conducted at Gandaki Medical College Teaching Hospital, Pokhara Valley, Nepal, from October 2024 to January 2025. A total of 257 serum samples were collected, 91 of which were randomly selected and tested for anti-T. gondii IgG/IgM antibodies using a rapid diagnostic test (RDT) and enzyme-linked immunosorbent assay (ELISA). Sociodemographic and behavioral data were collected using structured questionnaires. Statistical analyses included Fisher's exact test to assess associations and Cohen's kappa coefficient to evaluate the consistency between the two diagnostic methods.

Results: The RDT detected IgG antibodies in 19.78% (18/91) of the participants, whereas the ELISA identified 38.46% (35/91) of the participants as seropositive. No IgM-positive cases were detected by either method. Compared with the ELISA, the RDT exhibited low sensitivity (34.3%) but high specificity (89.3%), with fair consistency (kappa = 0.26). Cat ownership showed a borderline significant association with seropositivity (OR = 3.79, p = 0.05). Notably, none of the participants demonstrated any knowledge of toxoplasmosis (0%).

Conclusions: The findings reveal a significant public health concern. The relatively high seroprevalence of T. gondii, combined with a lack of awareness and identifiable risk factors, underscores the urgent need for educational interventions and prenatal screening programs to reduce the risk of congenital toxoplasmosis in Nepal.