Article Category:
Research Article

Seroprevalence and Risk Factors for Toxoplasma gondii Infection in Women of Reproductive Age in Nigeria in 2018

Dawn Blackburn Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia;
Epidemic Intelligence Service, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia;

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Nwando Mba Nigeria Centre for Disease Control and Prevention, Abuja, Nigeria;

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William Nwachukwu Nigeria Centre for Disease Control and Prevention, Abuja, Nigeria;

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Hong Zhou Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia;

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Andrew Hill Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia;

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Andrew Abbott Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia;

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Nishanth Parameswaran Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia;

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Samuel Awala Institute of Human Virology, Abuja, Nigeria;

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Stacie Greby Division of Global HIV and TB, U.S. Centers for Disease Control and Prevention, Abuja, Nigeria;

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Matthias Alagi Division of Global HIV and TB, U.S. Centers for Disease Control and Prevention, Abuja, Nigeria;

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Nnaemeka C. Iriemenam Division of Global HIV and TB, U.S. Centers for Disease Control and Prevention, Abuja, Nigeria;

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McPaul I. Okoye Division of Global HIV and TB, U.S. Centers for Disease Control and Prevention, Abuja, Nigeria;

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Mahesh Swaminathan Division of Global HIV and TB, U.S. Centers for Disease Control and Prevention, Abuja, Nigeria;

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Jeffrey W. Priest Division of Foodborne, Waterborne, and Environmental Diseases, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia

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Diana Martin Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia;

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Anne Straily Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Atlanta, Georgia;

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Chikwe Ihekweazu Nigeria Centre for Disease Control and Prevention, Abuja, Nigeria;

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DOI:
https://doi.org/10.4269/ajtmh.24-0107
Volume/Issue:
Ahead of Print
Open access
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Congenital transmission of Toxoplasma gondii can occur when a woman becomes infected for the first time during or just before pregnancy. Toxoplasma gondii in the fetus can lead to miscarriage, stillbirth, ocular or neurological abnormalities at birth, or progressive visual, hearing, motor, and cognitive deficiencies. The national seroprevalence of T. gondii infection in Nigeria was previously unknown. The 2018 Nigeria HIV/AIDS Indicator and Impact Survey collected demographic, socioeconomic, and HIV-related data and stored blood specimens with consent for future analysis for other pathogens of public health importance. We evaluated toxoplasmosis seropositivity and risk factors in a sample of 44,269 women of reproductive age (WRA) between 15 and 44 years. The national T. gondii seroprevalence among WRA was 26.8% (95% CI: 25.8–27.7%). We found that WRA from all 36 states and the Federal Capital Territory had T. gondii exposure. Seroprevalence was higher in 25- to 44-year-olds than in 15- to 24-year-olds. A similar proportion of pregnant and nonpregnant women were seropositive. Increased odds of seropositivity were associated with unimproved toilet facilities and drinking water sources, being in a higher wealth quintile, and primary and secondary education compared with no education. Decreased odds of seropositivity were associated with living in an urban area and owning livestock. This study provides the first-ever national seroprevalence estimate for WRA in Nigeria. Although information on known risk factors for toxoplasmosis (e.g., consumption of undercooked meat, cat ownership) was not collected, future studies could further investigate potential risk factors to inform the development of effective toxoplasmosis prevention measures.

Author Notes

Financial support: NAIIS was supported by the President’s Emergency Plan for AIDS Relief (PEPFAR) through the U.S. CDC under the cooperative agreement #U2GGH002108 to UMB and by the Global Funds to Fight AIDS, Tuberculosis, and Malaria through NACA, under the contract # NGA-H-NACA to the University of Maryland Baltimore. The Nigeria Multi-Disease Serologic Surveillance using Stored Specimens was financed by contributions by the PEPFAR, the U.S. President’s Malaria Initiative, the Global Immunization Division of the U.S. CDC, and The Global Fund to Fight AIDS, Tuberculosis, and Malaria; the Bill and Melinda Gates Foundation through the CDC Foundation.

Disclosures: The findings and conclusions in this report are those of the author(s) and do not necessarily represent the official position of the U.S. CDC. The findings and conclusions of this report are those of the authors and do not necessarily represent the official position of the NAIIS Group. Protocols for NAIIS and the additional testing using the stored specimens were reviewed and approved by human subject reviewers at the National Health Research Ethics Committee of Nigeria, the University of Maryland Baltimore, and U.S. CDC, and the conduct of this work was consistent with applicable federal laws of Nigeria and the United States and U.S. CDC policy (45 C.F.R. part 46; 21 C.F.R. part 56).

Current contact information: Dawn Blackburn, Hong Zhou, Andrew Hill, Andrew Abbott, Nishanth Parameswaran, Diana Martin, Jeffrey W. Priest, and Anne Straily, Division of Parasitic Diseases and Malaria, U.S. Centers for Disease Control and Prevention, Atlanta, GA, E-mails: tqx4@cdc.gov, fwd6@cdc.gov, fyu7@cdc.gov, qds3@cdc.gov, ofn2@cdc.gov, hzx3@cdc.gov, drjdk83@comcast.net, and yzv2@cdc.gov. Nwando Mba, William Nwachukwu, and Chikwe Ihekweazu, National Reference Laboratory, Nigeria Centre for Disease Control, Abuja, Nigeria, E-mails: ndomba2007@gmail.com, nwachukwu.william@ncdc.gov.ng, and chikwe.ihekweazu@gmail.com. Samuel Awala, Institute of Human Virology, Abuja, Nigeria, E-mail: sawala@ihvnigeria.org. Stacie Greby, Matthias Alagi, Nnaemeka C. Iriemenam, McPaul I. Okoye, and Mahesh Swaminathan, U.S. Centers for Disease Control and Prevention, Abuja, Nigeria, E-mails: sig6@cdc.gov, pki7@cdc.gov, iqd4@cdc.gov, luo9@cdc.gov, and iyq0@cdc.gov.

Address correspondence to Dawn Blackburn, U.S. Centers for Disease Control and Prevention, 1600 Clifton Rd., NE, H24-12, Atlanta, GA 30333. E-mail: dblackburn@cdc.gov
Copyright:
© The author(s) 2024
Received:
13 Feb 2024
|
Accepted:
28 Jun 2024
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Published Online:
10 Sep 2024
Cover The American Journal of Tropical Medicine and Hygiene
The American Journal of Tropical Medicine and Hygiene
Print ISSN:
0002-9637
Online ISSN:
1476-1645
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