Prevalence and risk factors for <i>Toxoplasma gondii</i> infection among pregnant and postpartum women attended at public healthcare facilities in the City of Niterói, State of Rio de Janeiro, Brazil

Moura, Fernanda Loureiro de; Amendoeira, Maria Regina Reis; Bastos, Otílio Machado Pereira; Mattos, Danuza Pinheiro Bastos Garcia de; Fonseca, Ana Beatriz Monteiro; Nicolau, José Leonardo; Neves, Leandro Baptista das; Millar, Patricia Riddell

doi:10.1590/0037-8682-1613-2013

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Revista da Sociedade Brasileira de Medicina Tropical

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Major Articles • Rev. Soc. Bras. Med. Trop. 46 (2) • Mar-Apr 2013 • https://doi.org/10.1590/0037-8682-1613-2013 copy

Prevalence and risk factors for Toxoplasma gondii infection among pregnant and postpartum women attended at public healthcare facilities in the City of Niterói, State of Rio de Janeiro, Brazil

Authorship SCIMAGO INSTITUTIONS RANKINGS

Introduction

To determine the prevalence of immunoglobulin G (IgG) and immunoglobulin M (IgM) anti-Toxoplasma gondii antibodies among pregnant and postpartum women attended within the public healthcare system in Niterói, State of Rio de Janeiro, and to detect possible exposure factors associated with T. gondii infection in this population.

Methods

IgM and IgG anti-T. gondii antibodies were investigated in 276 pregnant and 124 postpartum women by using the indirect immunofluorescence (IFAT) and immunoenzymatic assay (ELISA) techniques. The participants were selected by convenience sampling. All these 400 patients filled out a free and informed consent statement, answered an epidemiological questionnaire and were informed about the disease.

Results

Among the 400 samples analyzed, 234 (58.5%) were reactive to IgG anti-T. gondii antibodies, according to the IFAT and/or ELISA assay. One pregnant woman was found to be reactive to IgM anti-T. gondii antibodies, with an intermediate IgG avidity test. Risk factor analysis showed that seropositivity was significantly associated (p<0.05) with age, contact with cats and presence of rodents at home. Through a logistic regression model, these associations were confirmed for age and contact with cats, while education at least of the high school level was found to be a protective factor.

Conclusions

The prevalence rate of IgG anti-T. gondii antibodies in the City of Niterói was high and the risk factors for infection detected after multivariate analysis were: age over 30 years, contact with cats and education levels lower than university graduate level.

Toxoplasma gondii ; Pregnant women; Postpartum women; Seroprevalence

	Reactive IgG		Non-reactive IgG		Total
Variables	n	%	n	%	n	%	OR	95%CI	p
Age group (years)
14-20^* * Reference category. OR: odds ratio; CI: confidence interval; IgG: immunoglobulin G.	40	43.5	52	56.5	92	100.0
21-30	113	60.4	74	39.6	187	100.0	1.98	1.19-3.29	0.002
31-45	81	66.9	40	33.1	121	100.0	2.63	1.50-4.60
total	234	58.5	166	41.5	400	100.0
Education
incomplete basic education^* * Reference category. OR: odds ratio; CI: confidence interval; IgG: immunoglobulin G.	77	65.3	41	34.7	118	100.0
complete basic education	22	62.9	13	37.1	35	100.0	0.90	0.41-1.97	0.171
incomplete high school	45	58.4	32	41.6	77	100.0	0.74	0.41-1.35
complete high school	77	55.8	61	44.2	138	100.0	0.67	0.40-1.11
incomplete university degree	8	47.1	9	52.9	17	100.0	0.47	0.17-1.31
complete university degree	5	33.3	10	66.7	15	100.0	0.26	0.08-0.83
total	234	58.5	166	41.5	400	100.0
Abortion
yes	59	64.1	33	35.2	92	100.0	1.35	0.83-2.20	0.212
no	175	56.8	133	43.2	308	100.0
total	234	58.5	166	41.5	400	100.0

	Reactive IgG		Non-reactive IgG		Total
Variables	n	%	n	%	n	%	OR	95%CI	p
Contact with cats
yes	91	65.5	48	34.5	139	100.0	1.56	1.02-2.39	0.039
no	143	54.8	118	45.2	261	100.0
total	234	58.5	166	41.5	400	100.0
Contact with soil
yes	54	64.3	30	35.7	84	100.0	1.36	0.82-2.24	0.226
no	180	56.9	136	43.1	316	100.0
total	234	58.5	166	41.5	400	100.0
Consumption of raw meat
yes	29	53.7	25	46.3	54	100.0	0.79	0.44-1.42	0.442
no	205	59.2	141	40.8	346	100.0
total	234	58.5	166	41.5	400	100.0
Consumption of undercooked meat
yes	70	55.1	57	44.9	127	100.0	0.81	0.53-1.24	0.349
no	164	60.1	109	39.9	273	100.0
total	234	58.5	166	41.5	400	100.0
Consumption of embedded meat
yes	200	57.8	146	42.2	346	100.0	0.80	0.44-1.45	0.474
no	34	63.0	20	37.0	54	100.0
total	234	58.5	166	41.5	400	100.0
Consumption of raw milk
yes	33	66.0	17	34.0	50	100.0	1.43	0.77-2.68	0.250
no	201	57.4	149	42.6	350	100.0
total	234	58.5	166	41.5	400	100.0
Water source
drinking water from public supply system	187	60.9	120	39.1	307	100.0	1.52	0.95-2.43	0.075
other sources (well water, mineral water bottles)	47	50.5	46	49.5	93	100.0
total	234	58.5	166	41.5	400	100.0
Presence of rats at home
yes	98	67.1	48	32.9	146	100.0	1.77	1.15-2.70	0.008
no	136	53.5	118	46.5	254	100.0
total	234	58.5	166	41.5	400	100.0
Garbage collection
public collection	226	58.5	160	41.5	386	100.0	1.05	0.36-3.11	0.916
other (buried, burned)	8	57.1	6	42.9	14	100.0
total	234	58.5	166	41.5	400	100.0

	Reactive IgG		Non-reactive IgG		Total
Variables	n	%	n	%	n	%	OR	95%CI	p
Age group (years)
14-20^* * Reference category. OR: odds ratio; CI: confidence interval; IgG: immunoglobulin G.	40	43.5	52	56.5	92	100.0
21-30	113	60.4	74	39.6	187	100.0	2.69	1.66-4.36	<0.001
31-45	81	66.9	40	33.1	121	100.0	3.97	2.27-6.92	<0.001
total	234	58.5	166	41.5	400	100.0
Education
incomplete basic education^* * Reference category. OR: odds ratio; CI: confidence interval; IgG: immunoglobulin G.	77	65.3	41	34.7	118	100.0
complete basic education	22	62.9	13	37.1	35	100.0	0.65	0.29-1.45	0.297
incomplete high school	45	58.4	32	41.6	77	100.0	0.68	0.39-1.18	0.175
complete high school	77	55.8	61	44.2	138	100.0	0.44	0.25-0.77	0.004
incomplete university degree	8	47.1	9	52.9	17	100.0	0.30	0.10-0.92	0.036
complete university degree	5	33.3	10	66.7	15	100.0	0.20	0.06-0.69	0.011
total	234	58.5	166	41.5	400	100.0
Contact with cats
yes	59	64.1	33	35.2	92	100.0	1.68	1.09-2.60	0.019
no	175	56.8	133	43.2	308	100.0
total	234	58.5	166	41.5	400	100.0

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[1] Address to: Dra. Patricia Riddell Millar. Depto. Microbiologia e Parasitologia/Instituto Biomédico/UFF. Rua Professor Hernani Melo 101, São Domingos, 24210-130 Niterói RJ, Brasil. Phone: 55 21 2629-2424; 55 21 2629-2425. e-mail: patriciariddell@vm.uff.br