Sero-prevalence and risk factors associated with toxoplasma gondii infection among pregnant women in Alexandria, Egypt

Background: Toxoplasma gondii infection during pregnancy can result in fetal death, neonatal death or various congenital defects. This study aimed to estimate the seroprevalence of toxoplasma gondii infection using two different diagnostic tests, Enzyme-Linked Immunosorbent Assay (ELISA) versus Immunochromatographic assay (ICA) and to study the potential risk factors for acquiring infection in pregnant women attending antenatal care clinics in Alexandria, Egypt.Methods: A cross sectional study, conducted between May 2015 and June 2016. The study was done in antenatal care centers of most districts of Alexandria Governorate, Egypt. 382 pregnant women, of a gestational age between 8-40 weeks were included in the study and were given pretested structured questionnaire to assess risk factors, which included: demographic, socio-economic data, kitchen hygiene and behavioral variables. Blood samples were taken and sera were divided into two parts; the first part was examined for anti-T.gondii IgG and IgM antibodies using rapid diagnostic test RDT kit, the other part tested by ELISA.Results: The overall seroprevalence of T.gondii infection was (11.3%) detected by RDT, significantly increased to (57.9%) by ELISA test (X2= 5.3; p=0.001). RDT had the sensitivity of (15.8%), the specificity of (95%), PPV of (81.4%), NPV of (45.1%), with overall diagnostic efficiency of (49.2%). The association between T.gondii infection and the age of the pregnant women was found to be statistically significant (OR=2.84, 95%CI=1.251-6.455).Conclusions: The present study has documented a bad diagnostic performance of RDT in detection T.gondii in serum samples of infected pregnant women as compared to ELISA technique. Age is the only risk factor to be associated statistically with toxoplasma gondii infection