Seroprevalences of <i>Toxoplasma gondii</i> and <i>Neospora caninum</i> infections in Jordanian women who had a recent spontaneous abortion

Abo-Shehada, Mahmoud N.; Khalil, Raida; Abu-Halaweh, Marwan; Sweis, Kanar; Amr, Zuhair; Billeh, Lena

doi:10.1590/S1984-29612021076

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Original Article • Rev. Bras. Parasitol. Vet. 30 (3) • 2021 • https://doi.org/10.1590/S1984-29612021076 copy

Seroprevalences of Toxoplasma gondii and Neospora caninum infections in Jordanian women who had a recent spontaneous abortion

Soroprevalências de infecções por Toxoplasma gondii e Neospora caninum em mulheres jordanianas que tiveram um aborto espontâneo recente

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

This cross-sectional study investigates Toxoplasma gondii and Neospora caninum among 445 recently spontaneously aborted (RSA) Jordanian women using ELISA and indirect fluorescent antibody (at a cut-off value of 1/200) tests, respectively. The type of hospital, age, cat and dog contacts, raw and barbecued meat and wild plant consumption, number of abortions, and stillbirths were tested as independent variables using univariate and multivariate logistic regression analyses. The true seroprevalences were 22.1% for T. gondii-IgG, 22.7% for N. caninum-IgG, 2.6% for T. gondii-IgM, 10.6% for N. caninum-IgM, 0% for T. gondii-IgG and IgM, 6.7% for N. caninum-IgG and IgM, and 4.6% and 0% for both parasite IgG and IgM, respectively. T. gondii-IgM-seropositivity was associated with the number of abortions with odds ratios (OR) of 2.4 and eating barbecued meat (OR = 0.12). N. caninum-IgG-seropositivity was associated with having a dog in the house (OR = 2.6), and with stillbirth (OR = 0.1). N. caninum-IgM was associated with visiting a private-hospital (OR = 2.7). RSA Jordanian women are equally exposed to both parasites with significantly (p < 0.05) higher seroprevalence of N. caninum-IgM compared to T. gondii-IgM suggestive of active infections among RSA women in Jordan.

Keywords:
Toxplasma gondii; Neospora caninum; seroprevalence; risk factors; abortion; Jordan

Ig class	No. +ve	Seroprevalence % (95% CI)
Ig class	No. +ve	Apparent	True
T. gondii (ELISA)
G	133	29.9 (25.7, 34.2)	22.1 (18.2, 26.0)
M	26	5.8 (03.6, 08.0)	2.6 (01.1, 04.0)
G&M	9	2.0 (0.1, 3.3)	0.0 (0, 0)
Neospora caninum (IFAT, at a titer of 1:200)
G	110	24.7 (20.7, 28.7)	22.7 (18.8, 26.6)
M	55^* * Significantly higher than that of T. gondii (X2 = 11.4, df = 1, p = 0.007).	12.4 (09.3, 15.5)	10.6 (07.7, 13.4)
G&M	39	8.8 (06.2, 11.4)	6.7 (04.4, 09.0)
Both parasites
G	31	7.0 (04.6, 09.4)	04.6 (02.7, 06.6)
M	0	0.0 (0, 0)	0.0 (0, 0)
G&M	0	0.0 (0, 0)	0.0 (0, 0)

Variable	Category	No.	No. IgG +ve (%) (n = 133)	p
Type of hospital	Public	410	121 (30)	0.985	26 (6)	0.407
	Private	35	12 (34)		1 (3)
Age group	15-20	15	4 (27)	0.767	1 (5)	0.127
	21-25	169	47 (28)		6 (4)
	26-30	131	40 (31)		7 (5)
	31-35	69	22 (32)		5 (7)
	36-40	57	18 (32)		8 (14)
	41-45	4	2 (50)		0 (0)
Cats in house	No	42	14 (33)	0.346	2 (5)	0.503
	Yes	81	20 (25)		3 (4)
	Garden/yard	300	99 (33)		22 (7)
Dogs in house	No	338	106 (31)	0.677	21 (6)	0.797
	Yes	29	11 (38)		2 (7)
	Garden/yard	56	16 (29)		4 (7)
Eating raw meat	No	417	123 (30)	0.518	24 (6)	0.237
	Yes	28	10 (36)		3 (11)
Eating Barbecued meat	No	9	3 (33)	1.000	3 (33)	0.013
	Yes	436	130 (30)		24 (6)
Eating wild plants	No	294	90 (31)	0.664	19 (7)	0.626
	Yes	151	43 (29)		8 (5)
No. of abortions	1	149	47 (32)	0.337	4 (3)	0.001
	2	215	62 (29)		14 (7)
	3	69	18 (26)		3 (4)
	>4	12	6 (50)		6 (50)
Stillbirth	No	422	129 (31)	0.239	24 (6)	0.156
	Yes	23	4 (17)		3 (13)

Variable	Category	No.	No. IgG +ve (%) (n = 110)	p	No. IgM +ve (%) (n = 55)	p
Type of hospital	Public	410	101 (25)	0.841	45 (11)	0.012
	Private	35	09 (26)		10 (29)
Age group	15-20	15	5 (33)	0.018	2 (13)	0.302
	21-25	169	35 (21)		19 (11)
	26-30	131	25 (19)		12 (9)
	31-35	69	25 (36)		10 (15)
	36-40	57	20 (35)		12 (21)
	41-45	4	0 (0)		0 (0)
Cats in house	No	44	13 (30)	0.104	4 (9)	0.823
	Yes	87	14 (16)		10 (12)
	Garden/yard	314	83 (26)		41 (13)
Dogs in house	No	358	71 (20)	0.001	40 (11)	0.235
	Yes	29	10 (34)		5 (17)
	Garden/yard	58	29 (50)		10 (17)
Eating raw meat	No	417	101 (24)	0.347	49 (12)	0.139
	Yes	28	9 (32)		6 (21)
Eating Barbecued meat	No	9	3 (33)	0.696	0 (0)	0.605
	Yes	436	107 (25)		55 (13)
Eating wild plants	No	294	73 (25)	0.940	41 (14)	0.156
	Yes	151	37 (25)		14 (9)
No. of abortions	1	149	39 (26)	0.538	22 (15)	0.214
	2	215	47 (22)		20 (9)
	3	69	19 (28)		10 (15)
	>4	12	5 (42)		3 (33)
Stillbirth	No	422	109 (26)	0.022	54 (13)	0.337
	Yes	23	1 (4)		1 (4)

Protozoal-Ig class	Risk factor	Category	p	OR	95% CI
T. gondii-M ^a a Likelihood ratio of chi-square (LR x2) = 23.25 on 2 degrees of freedom, p = 0.001, Adjusted R-Squared (AR2) = 0.072;	Number of abortions	>4	0.001	2.4	1.5, 3.7
	Eating barbecued meat	Yes	0.012	0.1	0.02, 0.6
N. caninum-G ^b b (LR x2) = 31.4 on 2 degrees of freedom, p = 0.001, AR2 = 0.068;	Dog (s) contact	In The house	0.001	2.1	1.5, 2.7
	Had a stillbirth	Yes	0.038	0.1	0.02, 0.9
N. caninum-M ^c c LR x2 = 5.1 on 1 degrees of freedom, p = 0.024, AR2 = 0.011.	Type of hospital	Private	0.016	2.7	1.2, 6.2

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[1] *Corresponding author: Mahmoud N. Abo-Shehada. Mahmoud.abo-shehada@lshtm.ac.uk