Epidemiological Studies on Toxoplasmosis in Pregnant Women Using Serological Methods in Gezira State-Central Sudan
Abstract
Objective: To study the relationship between toxoplasmosis and the outcome of pregnancy (full term and abortion) and to find out the epidemiological risk factors.
Methods: This case control study was carried out at Wad Medani Teaching hospital, Gezira State, Central Sudan during the period March 2002-May 2004. The cases were 100 pregnant women who presented with abortion between the second and fourth months of gestation, and the controls were 100 full term normally delivered women.
Results: ELISA IgG test (n = 94 in each group) revealed 35.1% and 39.4% seroprevalence rates in the study and control groups respectively with no significant difference (p=0.6). When performed on IgG seropositives, ELISA IgM seroprevalence rates were 15.2% and 16.2%, in the study and control groups respectively. Statistically, there was no significant difference between them (p=0.9). When correlated to sociodemographic characteristics and risk factors, Toxoplsma gondii seroprevalence showed significant relationship for age, education, occupation, parity and past history of congenital malformations in both groups. There was significant difference between the two groups for ethnicity. The most important risk factor in both groups was the intake of raw meat (herbivorous viscera).
Conclusion: The findings of this study suggests that, ingestion of infected raw meat is an important risk factor for toxoplasmosis. (OR, 3.87; 95%CI, 1.59-9.44) in the study group, while in the control group (OR, 4.41; 95%CI, 1.76-11.09).
References
References
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2. Tenter, A.M, Heckeroth, A.R. and Weiss, L.M. Toxoplasma gondii: from animals to humans. Int J Parasitol. 2000; 30:1217-1221.
3. Hall, S. M., Pandit, A., Golwilkar, A. and Williams, T. S.. How do Jain get Toxoplasma infection ?. Lancet. 1999; 486-487.
4. Hennequin, C., Dureau, P., Nguyen, L., Thulliez, P., Gagelin, B. and Dufier, J.L. Congenital toxoplasmosis acquired from immuned women. Pediatr Infect Dis J. 1997; 16:75-77.
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6. Montoya, J.G. and Liesenfeld, O. Toxoplasmosis. Lancet. 2004; 363(9425): 1965-1976.
7. Remington, J.S., Mcleod, R. and Desmonts, G. Toxoplasmosis. In: Remington, J.S. and Klein, J.O. Infectious diseases of the fetus and newborn. 4th ed. Pennsylvania: WB .Saunders. 1995; 140-267.
8. Nabias, R., Ngouamizokou, A., Nabias, M., F., Moutsimbi, M.R. and Soukate, L.J. Serological investigation of toxoplasmosis in patients of the M.I.P. center of Franceville, Gabon. Bull Soc Pathol Exot. 1998; 91(4): 318-320.
9. Hussein, A.H., Ali, A.E., Saleh, M.H., Nagaty, I.M. and Rezk, A.Y. Prevalence of Toxoplasma infection in Qualyobia Governorate, Egypt. J Egypt Soc Parasitol. 2001; 31(2): 355-363
10. Abd Elhameed, A.A. Sero-epidemiology of toxoplasmosis in Gezira-Sudan. J Trop Med Hyg. 1991; 94:329-332.
11. Elnahas, A.H. Sero-epidemiology of toxoplasmosis in Sudanese pregnant women in Khartoum State. A thesis submitted for the degree of clinical M.D. In: Obstetrics and Gynaecology. Faculty of Medicine. University of Khartoum ;1997.
12.Satti, A. The presence of Toxoplasma gondii in the different risk groups of Sudanese populations in Khartoum State. A thesis submitted for the degree of Master of Medical Parasitology. Faculty of Medical Basic Science. Omdurman Islamic University. 2003.
13. Adnan, I. Sero-epidemiology of human toxoplasmosis and internal parasites of cats in Khartoum. A thesis submitted for the degree of Master of Science in zoology, faculty of sciences. University of Khartoum. 1994.
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15. Sahwi, S.Y., Zaki, M.S., Hayba, N.Y., Elsaid, O.K., Anwar, M.Y., and Abd-Rabbo, S.A. Toxoplasmosis as a cause of repeated abortion. J Obstet Gynaecol. (1995); 21(2): 145-148.
16. Olusi, T., Gross, U. and Ajayi, J. High incidence of toxoplasmosis during pregnancy in Nigeria. Scand J Infect Dis. 1996; 28(6): 645-646.
17. Allain, J.P., Palmer, C.R. and Pearson, G. Epidemiological study of latent and recent infection by Toxoplasma gondii in pregnant women from a regional population in the UK. J Infect. 1998; 36:189-196.
18. Jones, J.L, Moran, D. K., Wilson, M., Mcquillan, G., Navin, T., and Mc- Auley, J.B. Toxoplasma gondii infection in the United States: Seroprevalence and risk factors. Am J Epidemiol. 2001; 154(4): 357-365
19. Varella, I.S., Wagner, M.B., Darela, A.C., Nunes, L.M. and Muller, R.W. Seroprevalence of toxoplasmosis in pregnant women. J Pediatr (Rio J) . 2003; 79(1):69-74.
20. Lebech, M., Larsen, S.O. and Petersen, E. Prevalence, incidence and geographical distribution of Toxoplasma gondii antibodies in pregnant women in Denmark. Scand J Infect Dis. 1993; 25(6):751-756.
21. Ljungstrom, I., Gille, E., Nokes, J., Linder, E. and Forsgren, M. Seroepidemiology of Toxoplasma gondii among pregnant women in different parts of Sweden. Eur J Epidemiol. 1995; 11(2):149-156
22. Fan, C.K., Su, K.E, Wu, G.H. and Chiou, H.Y. Seroepidemiology of Toxoplasma gondii infection among two mountain aboriginal populations and Southeast Asian laborers in Taiwan. J.Parasitol. 2002; 88(2): 411-414.
23. Nissapatorn, V. Azmi, N.M. ,Cho, S.M., Fong, M.Y., Init, I., Rohela M., Anuar, k.A., Quek, K.F.and Latt, H.M. Toxoplasmosis: Prevalence and risk factors. J Obstet Gynaecol. 2003 ; 23(6):618-624.
24. Zadik, p.M., kudesia, G. and Siddons, A.D. Low incidence of primary infection with Toxoplasma among women in sheffeld: a seroconversion study. Br J Obstet Gynaecol. 1995; 102: 608-610.
25. Julvez, J. Magnaval, J.F., Meynard, D., Perie, C. and Baixench, M.T. Seroepidemiology of toxoplasmosis in Niamy, Niger. Med Trop (Mars). 1996; 56(1):48-50.
26. Spalding, S.M., Maria, R.R, Carlos, H.K. and Luis, C.E. Serological screening and toxoplasmosis exposure factors among pregnant women in South Brazil. Rev Soc Bras Med Trop. 2005; 38(2).
27. Ahmed, M.M. (1992). Sero-epidemiology of Toxoplasma infection in Riyadh, Saudi Arabia. J Egypt Soc Parasitol. 22(2): 407-413.
28. Almalki, J.S. Sero-epidemiological studies of toxoplasmosis in a group of Saudi females. A thesis submitted for the degree of Master of Science in zoology, faculty of science, King Saud University. Riyadh. KSA ;2001.
29. Joshi, Y.R., Vyas S. and Joshi, K.R. Seroprevalence of toxoplasmosis in Jodhpur, India. J Commun Dis.1998; 30(1): 32-37.
30. Dar, F.K., Alkarmi, T., Uduman, S., Abdulrazzaq, Y., Grundsell, H. and Hughes, P. Gestational and neonatal toxoplasmosis: regional seroprevalence in the United Arab Emirates. Eur J Epidemiol. 1997;13(5): 567-571.
31. Luis, C. and Isabel, L. Sero-prevalence of toxoplasmosis in Fortaleza, Ceara, Brazil. Rev Inst Med Trop S Paulo. 1999; 41(3):171-174.
32. Pereira-Bueno, J., Quintanilla-Gozalo, A., perezperez, V., Alvarez- Garcia, G., Collantes- Fernandez, E. and Ortega, M.O. Evaluation of ovine abortion associated with Toxoplasma gondii in Spain by different diagnostic techniques. Vet parasitol. 2004; 121(1-2): 33-43.
33. Baril, L., Ancelle, T., Goulet, V., Thulliez, P., Tirard, V. and Carme, B. Risk factors for Toxoplasma gondii infection in pregnancy. A case-control study in France. Scand J Infect Dis.1999; 31(3): 305-309.
34. Qublan, H.S., Jumaian, N., Abu-Salem A., Hamadelil, F.Y., Mashagbeh, M. and Abd Elghani, F. Toxoplasmosis and habitual abortion. J Obstet Gynaecol. 2002; 22(3): 296-298.
35. Jenum, P.A, Kapperud, G. Pedersen, B.S., Melby, k.k., Eskild, A. and Eng, J. Prevalence of Toxoplasma gondii specific immunoglobulin G antibodies among pregnant women in Norway. Epidemiol infect. 1998; 120:87-92.
36. Elfakahani, A.F., Abdel-Maboud, A.L., Elgarhy, M.F. and Eraky, M.A. Comparitive study between ELISA IgG, IgM, and PCR in diagnosing and studying toxoplasmosis in Qualyobia Governorate, Egypt. Egypt Soc Parasitol J. 2002; 32(2): 475-486..
37. Oadeko, M.O., Joynson, D.H., Payne, R.A. and Francis, J. The prevalence of Toxoplasma antibodies in pregnant Nigerian women and the occurrence of stillbirth and congenital malformations. Afr J Med Sci. 1996; 25(4):331-334.
38. Sharma, P., Gupta, I. Ganguly, N.K., Mahajan, R.E. and Malla, N. Increasing Toxoplasma seropositivity in women with bad obstetric history and in newborns. Natl Med J India. 1997; 10(2): 65-68.
39. Sun, R. G., Liu, Z.L. and Wang, D.C. The prevalence of Toxoplasma infection among pregnant women and their newborn infants in Chengdu, China. Zhonghua Liu Xing Bing Xue Za Zhi. 1995; 16(2): 98-100.
1. Cook, A.J., Gilbert, R.E., Buffolano, W., Zufferey, J., Petersen, E., Jerium, P.A., Foulon, W., Semprini, A.E. and Dunn, D.T.. Sources of Toxoplasma infection in pregnant women. European multicentre case-control study. BMJ. 2000; 321(7254):142-147.
2. Tenter, A.M, Heckeroth, A.R. and Weiss, L.M. Toxoplasma gondii: from animals to humans. Int J Parasitol. 2000; 30:1217-1221.
3. Hall, S. M., Pandit, A., Golwilkar, A. and Williams, T. S.. How do Jain get Toxoplasma infection ?. Lancet. 1999; 486-487.
4. Hennequin, C., Dureau, P., Nguyen, L., Thulliez, P., Gagelin, B. and Dufier, J.L. Congenital toxoplasmosis acquired from immuned women. Pediatr Infect Dis J. 1997; 16:75-77.
5. Freeman, K., Oakley, L., Pollak, A., Buffolano, W., Petersen, E., Semprini, A.E., Salt, A., and Gilbert, R. Association between congenital toxoplasmosis, preterm birth and low birth weight. European Multicentre study on congenital toxoplasmosis. Br J Obstet Gynaecol. 2005; 112(1):31-37.
6. Montoya, J.G. and Liesenfeld, O. Toxoplasmosis. Lancet. 2004; 363(9425): 1965-1976.
7. Remington, J.S., Mcleod, R. and Desmonts, G. Toxoplasmosis. In: Remington, J.S. and Klein, J.O. Infectious diseases of the fetus and newborn. 4th ed. Pennsylvania: WB .Saunders. 1995; 140-267.
8. Nabias, R., Ngouamizokou, A., Nabias, M., F., Moutsimbi, M.R. and Soukate, L.J. Serological investigation of toxoplasmosis in patients of the M.I.P. center of Franceville, Gabon. Bull Soc Pathol Exot. 1998; 91(4): 318-320.
9. Hussein, A.H., Ali, A.E., Saleh, M.H., Nagaty, I.M. and Rezk, A.Y. Prevalence of Toxoplasma infection in Qualyobia Governorate, Egypt. J Egypt Soc Parasitol. 2001; 31(2): 355-363
10. Abd Elhameed, A.A. Sero-epidemiology of toxoplasmosis in Gezira-Sudan. J Trop Med Hyg. 1991; 94:329-332.
11. Elnahas, A.H. Sero-epidemiology of toxoplasmosis in Sudanese pregnant women in Khartoum State. A thesis submitted for the degree of clinical M.D. In: Obstetrics and Gynaecology. Faculty of Medicine. University of Khartoum ;1997.
12.Satti, A. The presence of Toxoplasma gondii in the different risk groups of Sudanese populations in Khartoum State. A thesis submitted for the degree of Master of Medical Parasitology. Faculty of Medical Basic Science. Omdurman Islamic University. 2003.
13. Adnan, I. Sero-epidemiology of human toxoplasmosis and internal parasites of cats in Khartoum. A thesis submitted for the degree of Master of Science in zoology, faculty of sciences. University of Khartoum. 1994.
14. Abd Elraoaf, M. The rate of active Toxoplasma antibodies and the relationship to the different clinical manifestations of selected risk groups in Khartoum State. A thesis submitted for the degree of Master of Medical Parasitology. Faculty of Medical laboratories. University of Elzaeem Elazhari. 2000.
15. Sahwi, S.Y., Zaki, M.S., Hayba, N.Y., Elsaid, O.K., Anwar, M.Y., and Abd-Rabbo, S.A. Toxoplasmosis as a cause of repeated abortion. J Obstet Gynaecol. (1995); 21(2): 145-148.
16. Olusi, T., Gross, U. and Ajayi, J. High incidence of toxoplasmosis during pregnancy in Nigeria. Scand J Infect Dis. 1996; 28(6): 645-646.
17. Allain, J.P., Palmer, C.R. and Pearson, G. Epidemiological study of latent and recent infection by Toxoplasma gondii in pregnant women from a regional population in the UK. J Infect. 1998; 36:189-196.
18. Jones, J.L, Moran, D. K., Wilson, M., Mcquillan, G., Navin, T., and Mc- Auley, J.B. Toxoplasma gondii infection in the United States: Seroprevalence and risk factors. Am J Epidemiol. 2001; 154(4): 357-365
19. Varella, I.S., Wagner, M.B., Darela, A.C., Nunes, L.M. and Muller, R.W. Seroprevalence of toxoplasmosis in pregnant women. J Pediatr (Rio J) . 2003; 79(1):69-74.
20. Lebech, M., Larsen, S.O. and Petersen, E. Prevalence, incidence and geographical distribution of Toxoplasma gondii antibodies in pregnant women in Denmark. Scand J Infect Dis. 1993; 25(6):751-756.
21. Ljungstrom, I., Gille, E., Nokes, J., Linder, E. and Forsgren, M. Seroepidemiology of Toxoplasma gondii among pregnant women in different parts of Sweden. Eur J Epidemiol. 1995; 11(2):149-156
22. Fan, C.K., Su, K.E, Wu, G.H. and Chiou, H.Y. Seroepidemiology of Toxoplasma gondii infection among two mountain aboriginal populations and Southeast Asian laborers in Taiwan. J.Parasitol. 2002; 88(2): 411-414.
23. Nissapatorn, V. Azmi, N.M. ,Cho, S.M., Fong, M.Y., Init, I., Rohela M., Anuar, k.A., Quek, K.F.and Latt, H.M. Toxoplasmosis: Prevalence and risk factors. J Obstet Gynaecol. 2003 ; 23(6):618-624.
24. Zadik, p.M., kudesia, G. and Siddons, A.D. Low incidence of primary infection with Toxoplasma among women in sheffeld: a seroconversion study. Br J Obstet Gynaecol. 1995; 102: 608-610.
25. Julvez, J. Magnaval, J.F., Meynard, D., Perie, C. and Baixench, M.T. Seroepidemiology of toxoplasmosis in Niamy, Niger. Med Trop (Mars). 1996; 56(1):48-50.
26. Spalding, S.M., Maria, R.R, Carlos, H.K. and Luis, C.E. Serological screening and toxoplasmosis exposure factors among pregnant women in South Brazil. Rev Soc Bras Med Trop. 2005; 38(2).
27. Ahmed, M.M. (1992). Sero-epidemiology of Toxoplasma infection in Riyadh, Saudi Arabia. J Egypt Soc Parasitol. 22(2): 407-413.
28. Almalki, J.S. Sero-epidemiological studies of toxoplasmosis in a group of Saudi females. A thesis submitted for the degree of Master of Science in zoology, faculty of science, King Saud University. Riyadh. KSA ;2001.
29. Joshi, Y.R., Vyas S. and Joshi, K.R. Seroprevalence of toxoplasmosis in Jodhpur, India. J Commun Dis.1998; 30(1): 32-37.
30. Dar, F.K., Alkarmi, T., Uduman, S., Abdulrazzaq, Y., Grundsell, H. and Hughes, P. Gestational and neonatal toxoplasmosis: regional seroprevalence in the United Arab Emirates. Eur J Epidemiol. 1997;13(5): 567-571.
31. Luis, C. and Isabel, L. Sero-prevalence of toxoplasmosis in Fortaleza, Ceara, Brazil. Rev Inst Med Trop S Paulo. 1999; 41(3):171-174.
32. Pereira-Bueno, J., Quintanilla-Gozalo, A., perezperez, V., Alvarez- Garcia, G., Collantes- Fernandez, E. and Ortega, M.O. Evaluation of ovine abortion associated with Toxoplasma gondii in Spain by different diagnostic techniques. Vet parasitol. 2004; 121(1-2): 33-43.
33. Baril, L., Ancelle, T., Goulet, V., Thulliez, P., Tirard, V. and Carme, B. Risk factors for Toxoplasma gondii infection in pregnancy. A case-control study in France. Scand J Infect Dis.1999; 31(3): 305-309.
34. Qublan, H.S., Jumaian, N., Abu-Salem A., Hamadelil, F.Y., Mashagbeh, M. and Abd Elghani, F. Toxoplasmosis and habitual abortion. J Obstet Gynaecol. 2002; 22(3): 296-298.
35. Jenum, P.A, Kapperud, G. Pedersen, B.S., Melby, k.k., Eskild, A. and Eng, J. Prevalence of Toxoplasma gondii specific immunoglobulin G antibodies among pregnant women in Norway. Epidemiol infect. 1998; 120:87-92.
36. Elfakahani, A.F., Abdel-Maboud, A.L., Elgarhy, M.F. and Eraky, M.A. Comparitive study between ELISA IgG, IgM, and PCR in diagnosing and studying toxoplasmosis in Qualyobia Governorate, Egypt. Egypt Soc Parasitol J. 2002; 32(2): 475-486..
37. Oadeko, M.O., Joynson, D.H., Payne, R.A. and Francis, J. The prevalence of Toxoplasma antibodies in pregnant Nigerian women and the occurrence of stillbirth and congenital malformations. Afr J Med Sci. 1996; 25(4):331-334.
38. Sharma, P., Gupta, I. Ganguly, N.K., Mahajan, R.E. and Malla, N. Increasing Toxoplasma seropositivity in women with bad obstetric history and in newborns. Natl Med J India. 1997; 10(2): 65-68.
39. Sun, R. G., Liu, Z.L. and Wang, D.C. The prevalence of Toxoplasma infection among pregnant women and their newborn infants in Chengdu, China. Zhonghua Liu Xing Bing Xue Za Zhi. 1995; 16(2): 98-100.
Published
2007-01-01
How to Cite
ELAMIN, Maha Hussein et al.
Epidemiological Studies on Toxoplasmosis in Pregnant Women Using Serological Methods in Gezira State-Central Sudan.
Gezira Journal of Health Sciences, [S.l.], v. 3, n. 2, jan. 2007.
ISSN 1810-5386. Available at: <http://37.60.236.48/index.php/gjhs/article/view/262>. Date accessed: 03 june 2026.
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