title: Toxoplasma infection in pregnant women: a current status in Songklanagarind hospital, southern Thailand.
abstract: BACKGROUND
  Toxoplasmosis, being one of the TORCH's infections in pregnant women, is caused by Toxoplasma gondii, an obligate intracellular protozoan parasite. This parasitic infection in pregnancy congenitally causes severe outcomes to their fetus and newborn. This study aimed to determine the seroprevalence and stages of Toxoplasma infection in pregnant women and its associated risks exposures.
  
  
  METHODS
  The study was conducted within the pregnant women attending the antenatal clinic (ANC) at Songklanagarind hospital, Hat Yai, Songkhla province, Thailand. The sera of a total of 760 consecutive pregnant women were screened using standard commercial ELISA kits for detection of anti-Toxoplasma IgG and IgM antibodies. IgG avidity in the seropositive for both anti-Toxoplasma IgG and IgM antibodies were also assessed. The pregnant women's socio-demographic, obstetrics and risk factors associated with Toxoplasma seropositivity data were analyzed using univariate and multivariate analyses.
  
  
  RESULTS
  From the total 760 pregnant women, 190 (25%, 95% CI = 22.05-28.20) were positive for anti-Toxoplasma antibodies. Of these, 167 (22.0%, 95% CI = 19.0-25.0) were positive for only anti-Toxoplasma IgG antibody and 23 (3.0%, 95% CI = 2.0-4.0) were positive for both anti-Toxoplasma IgG and IgM antibodies. All these samples were high avidity, indicated the infection occured prior to four to five months. By applying statistical univariate analysis, age group, occupation and sources of drinking water showed a significant association with Toxoplasma seropositivity (p < 0.05). Multivariate logistic regression analysis further indicated that the significant factors associated with Toxoplasma seropositivity are age ≥26 (OR = 1.65, 95% CI = 1.11-2.44), working as laborer (OR = 1.57, 95% CI = 1.13-2.18) and drinking unclean (piped/tap/rain) water (OR = 1.75, 95% CI = 1.08-2.84).
  
  
  CONCLUSIONS
  The pregnant women in the active age group, working as laborers and exposure to unclean drinking water from various sources were at higher risk of Toxoplasma infection. Therefore, health education and the awareness of risk exposures regarding this parasitic disease are required to minimize the effects of this parasitic infection in pregnant women as well as in the general population.
authors.forename: Hemah
authors.initials: H
authors.lastname: Andiappan
authors.affiliation: Department of Parasitology, Faculty of Medicine, University of Malaya, Kuala Lumpur 50603, Malaysia. nissapat@gmail.com.
authors.forename: Veeranoot
authors.initials: V
authors.lastname: Nissapatorn
authors.forename: Nongyao
authors.initials: N
authors.lastname: Sawangjaroen
authors.forename: Waenurama
authors.initials: W
authors.lastname: Chemoh
authors.forename: Yee Ling
authors.initials: YL
authors.lastname: Lau
authors.forename: Thulasi
authors.initials: T
authors.lastname: Kumar
authors.forename: Subashini
authors.initials: S
authors.lastname: Onichandran
authors.forename: Chitkasaem
authors.initials: C
authors.lastname: Suwanrath
authors.forename: Verapol
authors.initials: V
authors.lastname: Chandeying
mesh_terms: D000293:Adolescent; D000328:Adult; D000913:Antibodies, Protozoan / Q000097:blood; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D008875:Middle Aged; D011247:Pregnancy; D015597:Pregnancy Complications, Parasitic / Q000097:blood / Q000453:epidemiology*; D011933:Reagent Kits, Diagnostic; D012307:Risk Factors; D012959:Socioeconomic Factors; D013785:Thailand / Q000453:epidemiology; D014122:Toxoplasma / Q000276:immunology; D014123:Toxoplasmosis / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D000913:Antibodies, Protozoan; D007074:Immunoglobulin G; D011933:Reagent Kits, Diagnostic