Skip to main content

Advertisement

SpringerLink
Log in

Indication of Risk of Mother-to-Child Toxoplasma gondii Transmission in the Greater Accra Region of Ghana

  • Published:
Maternal and Child Health Journal Aims and scope Submit manuscript

Abstract

Objectives Congenital infection with Toxoplasma gondii is known to result in neurological and brain disorders including ophthalmic disorders later in life. Research in Ghana revealed high sero-prevalence among pregnant women and eye patients. This study determines the risk of congenital transmission of T. gondii infection in Accra, Ghana. Methods One hundred consented pregnant women aged 18–45 years (mean 29.85 ± 5.76) participated. Venous blood and tissue samples were taken from the maternal side of each placenta after delivery. Cord blood samples were also taken after they were separated from the infants. Finger-prick blood was taken from infants of participating women at 2 or 6 weeks post-natal. ELISA was used to detect T. gondii antibodies in all blood samples while Nested-PCR was used to detect T. gondii DNA from placental tissues. Data was analysed using SPSS v. 16. Results Overall, 37.6 % of maternal blood, 39.5 % of umbilical cord blood, and 57.5 % of post-natal infant blood were positive for anti-T. gondii IgG. No anti-T. gondii IgM was detected in any of those samples. Toxoplasma gondii DNA was detected in 39.8 % of placental tissue samples. Strong association was observed in the occurrence of placental T. gondii DNA and anti-T. gondii IgG positive women (ø = 0.810, p < 0.00001) as well as high Relative risk shown in the likelihood of foetal exposure to infection in latently-infected women (RR 10.39; CI 4.47–24.17; p < 0.00001). Conclusions for Practice The presence of anti-T. gondii IgG antibodies only, and T. gondii DNA in placental tissues indicate the women might have been infected early during the pregnancy, placing about 39.8 % of the babies at risk. These results can strongly influence policy to screen and treat pregnant women for T. gondii infection.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  • Abu, E., Boampong, J., Amoabeng, J., Ilechie, A., Kyei, S., Owusu-Ansah, A., et al. (2016). Epidemiology of ocular toxoplasmosis in three community surveys in the central region of Ghana, West Africa. Opthalmic Epidemiology, 1(14), 9. doi:10.3109/09286586.2015.1089579.

    Google Scholar 

  • Abu, E. K., Boampong, J. N., Ayi, I., Ghartey-Kwansah, G., Afoakwah, R., Nsiah, P., & Blay, E. (2014). Infection risk factors associated with seropositivity for Toxoplasma gondii in a population-based study in the Central Region, Ghana. Epidemiology and Infection, 143(9), 1904–1912. doi:10.1017/S0950268814002957.

    Article  PubMed  Google Scholar 

  • Abu, E. K., Boampong, J. N., Afoakwah, R., Ameyaw, E. O., Ntodie, M., & Ayi, I. (2015). Visual outcome in ocular toxoplasmosis: A case series of 30 patients from Ghana. Journal of Clinical & Experimental Ophthalmology, 06(04), 458. doi:10.4172/2155-9570.1000458.

    Google Scholar 

  • Agyei, A., & Lartey, M. (2004). Spectrum of opportunistic infections causing death in patients with AIDS in Ghana: Correlation of clinical diagnosis with autopsy results (pp. 8–11). Conf Retrovir Opportunistic Infect.

  • Anteson, R. K., Sekimoto, S., Furukawa, S., & Quakyi, I. A. (1978a). Studies on toxoplasmosis in Ghana II. The prevalence of toxoplasmosis in a group of pregnant women and their neonates. A preliminary report. Ghana Medical Journal, 17, 203–206.

    Google Scholar 

  • Anteson, R. K., Sekimoto, S., Furukawa, S., Tkao, Y., & Nyanotor, M. A. (1978b). Studies on toxoplasmosis in Ghana I. The prevalence of Toxoplasma antibodies as measured by the haemagglutination (Eiken) test. Ghana Medical Journal, 17, 147–149.

    Google Scholar 

  • Antsaklis, A., Daskalakis, G., Papantoniou, N., Mentis, A., & Michalas, S. (2002). Prenatal diagnosis of congenital toxoplasmosis. Prenatal Diagnosis, 22(12), 1107–1111. doi:10.1002/pd.476.

    Article  PubMed  Google Scholar 

  • Ayi, I., Akao, N., Bosompem, K. M., Akafo, S. K., Clarke, J., Nyador, L., et al. (2005). Development of membrane-based tests for the detection of urinary antigens and antibodies in human toxoplasmosis: Preliminary studies in Ghanaian patients. Acta Tropica, 93(2), 151–159.

    Article  CAS  PubMed  Google Scholar 

  • Ayi, I., Edu, S. A., Apea-Kubi, K. A., Boamah, D., Bosompem, K. M., & Edoh, D. (2009). Sero-epidemiology of toxoplasmosis amongst pregnant women in the greater accra region of ghana. Ghana Medical Journal, 43(3), 107–114.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Bessières, M. H., Berrebi, A., Rolland, M., Bloom, M. C., Roques, C., Cassaing, S., et al. (2001). Neonatal screening for congenital toxoplasmosis in a cohort of 165 women infected during pregnancy and influence of in utero treatment on the results of neonatal tests. European Journal of Obstetrics, Gynecology, and Reproductive Biology, 94(1), 37–45.

    Article  PubMed  Google Scholar 

  • Daffos, F., Forestier, F., Capella-Pavlovsky, M., Thulliez, P., Aufrant, C., Valenti, D., et al. (1988). Prenatal management of 746 pregnancies at risk of congenital toxoplasmosis. New England Journal of Medicine, 31, 271–275.

    Article  Google Scholar 

  • Di Cristina, M., Marocco, D., Galizi, R., Proietti, C., Spaccapelo, R., & Crisanti, A. (2008). Temporal and spatial distribution of Toxoplasma gondii differentiation into bradyzoites and tissue cyst formation in vivo. Infection and Immunity, 76(8), 3491–3501.

    Article  PubMed  PubMed Central  Google Scholar 

  • Dubey, J. P. (2008). The history of Toxoplasma gondii–the first 100 years. The Journal of Eukaryotic Microbiology, 55(6), 467–475. doi:10.1111/j.1550-7408.2008.00345.x.

    Article  PubMed  Google Scholar 

  • Fernandes, M. A., Batista, G. I., da Costa-Silveira-Carlos, J., Gomes, I. M., Lopes de Azevedo, K. M., Setúbal, S., et al. (2012). Toxoplasma gondii antibody profile in HIV-1-infected and uninfected pregnant women and the impact on congenital toxoplasmosis diagnosis in Rio de Janeiro, Brazil. Brazilian Journal of Infectious Diseases, 16(2), 170–174.

    Article  CAS  PubMed  Google Scholar 

  • Foulon, W., Villena, I., Stray-Pedersen, B., Decoster, A., Lappalainen, M., Pinon, J. M., et al. (1999). Treatment of toxoplasmosis during pregnancy: a multicenter study of impact on fetal transmission and children’s sequelae at age 1 year. American Journal of Obstetrics and Gynecology, 180(2 I), 410–415.

    Article  CAS  PubMed  Google Scholar 

  • Gomez-Marin, J. E. (2010). Congenital toxoplasmosis in South American children. Scientia Medica (Porto Alegre), 20(6), 103–107.

    Google Scholar 

  • Hezard, N., Marx-Chemla, C., Foudrinier, F., Villena, I., Quereux, C., Leroux, B., et al. (1997). Prenatal diagnosis of congenital toxoplasmosis in 261 pregnancies. Prenatal Diagnosis, 17(11), 1047–1054.

    Article  CAS  PubMed  Google Scholar 

  • Israelski, D. M., & Remington, J. S. (1993). Toxoplasmosis in the non-AIDS immunocompromised host. Current Clinical Topics in Infectious Diseases, 13, 322–356.

    CAS  PubMed  Google Scholar 

  • Jones, J. L., Kruszon-Moran, D., Wilson, M., McQuillan, G., Navin, T., & McAuley, J. B. (2001). Toxoplasma gondii infection in the United States: Seroprevalence and risk factors. American Journal of Epidemiology, 154(4), 357–365.

    Article  CAS  PubMed  Google Scholar 

  • Khan, A., Su, C., German, M., Storch, G. A., Clifford, D. B., & Sibley, L. D. (2005). Genotyping of toxoplasma gondii strains from immunocompromised patients reveals high prevalence of type I Strains Genotyping of Toxoplasma gondii strains from immunocompromised patients reveals high prevalence of type I Strains. Journal of Clinical Microbiology, 43(12), 5881–5887. doi:10.1128/JCM.43.12.5881.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Kravetz, J. (2013). Congenital toxoplasmosis. Clinical Evidence, 1, 33–36. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/24502733.

  • Ling, V. J., Lester, D., Mortensen, P. B., Langenberg, P. W., & Postolache, T. T. (2011). Toxoplasma gondii seropositivity and suicide rates in women. The Journal of Nervous and Mental Disease, 199(7), 440–444.

    Article  PubMed  PubMed Central  Google Scholar 

  • Montoya, J. G., & Remington, J. S. (2008). Management of Toxoplasma gondii infection during pregnancy. Clinical Infectious Diseases, 47(4), 554–566. doi:10.1086/590149.

    Article  PubMed  Google Scholar 

  • Morris, A., & Croxson, M. (2004). Serological evidence of Toxoplasma gondii infection among pregnant women in Auckland. New Zealand Medical Journal, 117(1189), 1–6.

    Google Scholar 

  • Palmeira, P., Quinello, C., Silveira-Lessa, A. L., Zago, C. A., & Carneiro-Sampaio, M. (2012). IgG placental transfer in healthy and pathological pregnancies. Clinical & Developmental Immunology, 2012, 985646. doi:10.1155/2012/985646.

    Article  Google Scholar 

  • Prestrud, K. W., Asbakk, K., Mørk, T., Fuglei, E., Tryland, M., & Su, C. (2008). Direct high-resolution genotyping of Toxoplasma gondii in arctic foxes (Vulpes lagopus) in the remote arctic Svalbard archipelago reveals widespread clonal Type II lineage. Veterinary Parasitology, 158(1–2), 121–128. doi:10.1016/j.vetpar.2008.08.020.

    Article  CAS  PubMed  Google Scholar 

  • Remington, J. S., McLeod, R., Thulliez, P., & Desmonts, G. (2006). Toxoplasmosis. In J. S. Remington & J. O. Klein (Eds.), Infectious diseases of the fetus and newborn infant (pp. 947–1091). Philadelphia: W. B. Saunders.

    Chapter  Google Scholar 

  • Remington, J. S., McLeond, R., & Desmonts, G. (1995). Infectious diseases of the Fetus and newborn infant. Philadelphia: W. B. Saunders Company.

    Google Scholar 

  • Rorman, E., Zamir, C. S., Rilkis, I., & Ben-David, H. (2006). Congenital toxoplasmosis-prenatal aspects of Toxoplasma gondii infection. Reproductive Toxicology, 21(4), 458–472.

    Article  CAS  PubMed  Google Scholar 

  • Simpore, J., Savadogo, A., Ilboudo, D., Nadambega, M. C., Esposito, M., Yara, J., et al. (2006). Toxoplasma gondii, HCV, and HBV seroprevalence and co-infection among HIV-Positive and -Negative Pregnant Women in Burkina Faso. Journal of Medical Virology, 733, 730–733. doi:10.1002/jmv.

    Article  Google Scholar 

  • Smyth, J. D. (1996). Animal parasitology. New York: Cambridge University Press.

    Google Scholar 

  • Stepick-Biek, P., Thulliez, P., & Edwards, M. E. (2002). Fungal and protozoan infections. In A. A. Fanaroff & R. J. Martin (Eds.), Neonatal-perinatal medicine, diseases of fetus and infant (7th ed.). St Louis: Mosby.

    Google Scholar 

  • Su, C., Zhang, X., & Dubey, J. P. (2006). Genotyping of Toxoplasma gondii by multilocus PCR-RFLP markers: A high resolution and simple method for identification of parasites. International Journal for Parasitology, 36(7), 841–848. doi:10.1016/j.ijpara.2006.03.003.

    Article  CAS  PubMed  Google Scholar 

  • Tenter, A. M., Heckeroth, A. R., & Weiss, L. M. (2000). Toxoplasma gondii: from animals to humans. International Journal for Parasitology, 30, 1217–1258.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Thulliez, P., Daffos, F., & Forestier, F. (1992). Diagnosis of toxoplasma infection in the pregnant woman and the unborn child: Current problems. Scandinavian Journal of Infectious Diseases. Supplementum, 84, 18–22.

    CAS  PubMed  Google Scholar 

  • Trojovsky, A. (1998). Congenital toxoplasmosis. Retrieved from http://www.trojovsky.net/toxo/

Download references

Acknowledgments

This study was partially funded by the Japan Initiative for Global Research Network on Infectious Diseases (J-GRID). We also acknowledge the assistance offered us by the doctors and Midwives of the maternity block of the Obstetrics and Gynaecology Department of the KBTH during our sample collection. Our appreciation also goes to the entire staff of the Department of Parasitology, NMIMR who helped in diverse ways on this study from sample collection to analyses of results.

Authors’ contribution

The study idea was conceived by IA. The study was developed and designed by IA, KDK AG, SO, EF, TS and NO. Experiments and analyses were conducted by KDK, JHNO, and KKF. Manuscript was drafted by KDK and IA. Proofreading of manuscript was done by AG, SO, DAB, EF, IA, TS and NO.

Author information

Authors and Affiliations

  1. Department of Parasitology, Noguchi Memorial Institute for Medical Research, College of Health Sciences, University of Ghana, P. O. Box LG 581, Legon, Accra, Ghana

    Kofi Dadzie Kwofie, Anita Ghansah, Joseph Harold Nyarko Osei, Kwadwo Kyereme Frempong, Daniel A. Boakye, Takashi Suzuki & Irene Ayi

  2. Department of Clinical Microbiology, School of Medical Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana

    Kofi Dadzie Kwofie & Eric H. Frimpong

  3. Department of Obstetrics and Gynaecology, Korle-Bu Teaching Hospital, Korle-Bu, Accra, Ghana

    Samuel Obed

  4. Section of Environmental Parasitology, Tokyo Medical and Dental University, Tokyo, Japan

    Takashi Suzuki & Nobuo Ohta

Authors
  1. Kofi Dadzie Kwofie
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Anita Ghansah
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Joseph Harold Nyarko Osei
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Kwadwo Kyereme Frempong
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Samuel Obed
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Eric H. Frimpong
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Daniel A. Boakye
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Takashi Suzuki
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Nobuo Ohta
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Irene Ayi
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Irene Ayi.

Ethics declarations

Conflict of interest

We declare no competing interests.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Kwofie, K.D., Ghansah, A., Osei, J.H.N. et al. Indication of Risk of Mother-to-Child Toxoplasma gondii Transmission in the Greater Accra Region of Ghana. Matern Child Health J 20, 2581–2588 (2016). https://doi.org/10.1007/s10995-016-2084-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10995-016-2084-z

Keywords

Search

Navigation