Globally, congenital toxoplasmosis remains a significant cause of morbidity and mortality, and outbreaks of infection with T. gondii represent a significant, emerging public health burden, especially in the developing world. This parasite is a threat to public health. Disease often is not recognized and is inadequately managed. Herein, we analyze the status of congenital toxoplasmosis in Morocco, Colombia, the United States, and France. We identify the unique challenges faced by each nation in the implementation of optimal approaches to congenital toxoplasmosis as a public health problem. We suggest that developed and developing countries use a multipronged approach, modeling their public health management protocols after those in France. We conclude that education, screening, appropriate treatment, and the development of novel modalities will be required to intervene successfully in caring for individuals with this infection. Gestational screening has been demonstrated to be cost-effective, morbidity-sparing, and life-saving. Recognition of the value and promise of public health interventions to prevent human suffering from this emerging infection will facilitate better patient and societal outcomes.
Toxoplasmosis is a disease caused by a protozoal parasite: Toxoplasma gondii. This infection can cause severe illness when the organism is contracted congenitally or when it is reactivated in immunosuppressed people. In this paper we review for the first time prevalence and risk factors of T. gondii among pregnant women and HIV-infected adults in Morocco. A systematic review methodology was used to consult three databases: Pub Med, Science Direct and Google Scholar dated until 2015, regarding prevalence data and risk factors of infection among pregnant women and people living with HIV. Data collection and eligibility criteria were established in this paper. No statistical method was employed in this study. Our review resulted in a total of 6 publications meeting the inclusion criteria of prevalence and risk factors of toxoplasmosis in Morocco. Seropositive rates of T. gondii infection reach up to 51% in pregnant women. Risk factors that were reported included contact with soil, lack of knowledge about toxoplasmosis, and a low educational level. For HIV-infected adults, the limited data show a 62.1% prevalence rate of T. gondii .According to our review, there is still very little information on toxoplasmosis disease in pregnant women and HIV infected patients in Morocco. Further research on toxoplasmosis is needed to better ascertain the human disease burden in Morocco.
Background
Toxoplasmosis is an infectious disease caused by a protozoan parasite named Toxoplasma gondii (T.gondii). Pregnant women are considered one of the risk groups. The objective of this retrospective study is to provide an updated estimate of the seroprevalence of anti-T. gondii antibodies among a group of Moroccan pregnant women monitored at the Parasitology Laboratory of the National Institute of Hygiene in Rabat in Morocco.
Methods
Serum samples were tested for the presence of specific anti-T. gondii immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies using indirect enzyme-linked immunosorbent assay (ELISA). Anti-Toxoplasma IgM- and IgG-positive cases were also evaluated with the anti-Toxoplasma IgG avidity test. All cases were evaluated according to the age, parity, and historical of abortion.
Results
Among 677 pregnant women, 94.1% (637/677) were serologically screened for the first time and therefore had no knowledge of their serological status, and only 5.9% (40/677) were screened for the second or third time. The overall anti-T. gondii IgG and IgM seropositivity among the 637 pregnant women included in the study analysis was 43% (274/637) and 3.9% (25/637), respectively. The use of the IgG avidity test allowed excluding recent infection among 83% of cases with IgG and IgM positive sera. The mean age was 29.4 ± 6.3 years. The result of the bivariate analysis revealed that the age influenced significantly the seroprevalence rate, while the parity and the existence of previous spontaneous abortion did not have any significant statistical correlation with seropositivity to T. gondii.
Conclusion
This study shows that 43% of pregnant women were positive and 57% of them had no antibody against the T. gondii infection. However, the pregnancy follow-up and the counseling of pregnant women remain essential for the prevention of congenital toxoplasmosis.
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