Seroprevalence, risk factors and impact of Toxoplasma gondii infection on haematological parameters in the Ashanti region of Ghana: a cross-sectional study [version 1; peer review: 2 approved with reservations]

Abstract

Background: Toxoplasma gondii is an obligate, intracellular, apicomplexan parasite that causes toxoplasmosis. Although the global prevalence of toxoplasmosis has been estimated to be approximately 30%, there is limited seroprevalence data in Ghana, with a dearth of information on the impact of T. gondii on haematological parameters in exposed persons. Methods: Questionnaires were administered to 300 consenting individuals to obtain demographic information and assessment of their risk of exposure to T. gondii. Using anti-T. gondii IgG/IgM combo test kits, seropositivity to parasite-specific IgG and/or IgM was determined. A haematological analyser was used to measure haematological parameters. Results: The participants included 58 males and 242 females, and ranged in age from 6 months to 84 years, with a median age of 27 years. There was an overall seroprevalence of 50.3% (n=151), with 49.7% (n=149) of the study participants seropositive for IgG and 1% (n=3) testing positive for IgM. Furthermore, the observed seroprevalence among pregnant women was 56.4% (n=62). With regards to the different communities in which the hospitals were located, a seroprevalence of 55.6% was observed in the rural community, 50.6% in the peri-urban community and 47.1% in the urban community. The study identified cat ownership, contact with cat litter [RR (95% CI: 1.76 (1.23-2.53), 1.66 (1.03-2.67), 1.25(1.00-1.57)] and age (p<0.001) as risk factors for infection. Analyses of haematological data also revealed significant differences between the red blood cell counts (p=0.038) and mean corpuscular volumes (p=0.0007) of seropositive and seronegative study participants. Conclusions: About half of the study population, including a significant number of women of reproductive age carried antibodies against T. gondii, raising questions about the risk of congenital toxoplasmosis, as well as possible links to anaemia. We, therefore, recommend that screening for Toxoplasma gondii be included in the routine screening of pregnant women seeking antenatal care.