Rural residence remains a risk factor for Toxoplasma infection among pregnant women in a highly urbanized Brazilian area: a robust cross-sectional study

Abstract Background Despite high seroprevalence of asymptomatic infection in humans, toxoplasmosis can manifest as a severe systemic disease, as occurs in the congenital infection. Here we evaluate the seroprevalence of Toxoplasma infection among pregnant women in a highly urbanized area of Brazil....

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Published in:Transactions of the Royal Society of Tropical Medicine and Hygiene 2021-08, Vol.115 (8), p.896-903
Main Authors: Antinarelli, Luciana Maria Ribeiro, Silva, Márcio Roberto, Guimarães, Ricardo José de Paula Sousa e, Terror, Mariana Sequetto, Lima, Patrícia Enham, Ishii, Joelma de Souza Coimbra, Muniz, Patrícia Fabiano, Coimbra, Elaine Soares
Format: Article
Language:English
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Summary:Abstract Background Despite high seroprevalence of asymptomatic infection in humans, toxoplasmosis can manifest as a severe systemic disease, as occurs in the congenital infection. Here we evaluate the seroprevalence of Toxoplasma infection among pregnant women in a highly urbanized area of Brazil. Methods A robust seroepidemiological study was conducted using laboratory databases of anti-Toxoplasma gondii serological results together with information on age, month/year of diagnosis and place of residence of pregnant women in the public health system of the city of Juiz de Fora, Brazil. Results Of 5895 pregnant women analysed, 54.7% showed seronegativity and 44.4% showed seropositivity for immunoglobulin G (IgG) antibodies against Toxoplasma gondii. This seropositivity rate increased to 68.3% when only considering participants from rural areas. Multivariate analysis revealed higher odds of being seropositive associated with age (odds ratio [OR] 1.06 [confidence interval {CI} 1.05 to 1.07]) and with living in rural areas (OR 2.96 [CI 1.64 to 5.36]). The spatial distribution of IgG seropositivity indicated a higher prevalence concentrated in rural and peripheral neighbourhoods. Conclusions This is the first report to use spatial analysis to show a cluster of Toxoplasma infection in rural and peripheral neighbourhoods of a highly urbanized municipality, which highlights the need for adequate healthcare actions to be implemented for women living in these areas.
ISSN:0035-9203
1878-3503
DOI:10.1093/trstmh/traa153