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Table of Contents   
ORIGINAL ARTICLE  
Year : 2017  |  Volume : 10  |  Issue : 2  |  Page : 362-365
Seroepidemiological survey of toxoplasmosis among female university students in Shiraz, southern Iran


1 Department of Parasitology and Mycology, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
2 Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
3 Basic Sciences in Infectious Diseases Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

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Date of Web Publication22-Jun-2017
 

   Abstract 

Background: Seroprevalence of toxoplasmosis in different populations in Iran varies according to the people eating behaviors and also geographic and climatic differences of each area. Objective: The current study aimed to provide recent data regarding the seroprevalence of toxoplasmosis among female university students in Shiraz University of Medical Sciences, in Fars province, southern Iran. Materials and Methods: The subjects of the study were 503 female university students. Blood samples were collected from each participant and tested for anti-Toxoplasma IgG and IgM antibodies, using a commercial Enzyme-Linked Immunosorbent Assays (ELISA) kit. Demographic characteristics and risk factor related to Toxoplasma were also recorded during the samples collection. Results: The mean age of participants was 22.2 (±3.83) years and the majority (54.9%) of subjects was in the age group of 20-25 years old. Anti T. gondii antibodies was detected in sera of 43 out of 503 enrolled students, corresponding to an overall seroprevalence of 8.5%. Of these, 37 (7.4%) were seropositive for only IgG, 7 (1.4%) were seropositive for only IgM and 1 (0.2%) were seropositive for both IgG and IgM. The differences between age and animal contact with seropositivity to toxoplasmosis were not statistically significant. Conclusion: The findings of the study indicated that more than 90 % of the female university students in this study were seronegative for toxoplasmosis. As these students are in their childbearing age, there is a possibility for their newborns to become infected with Toxoplasma. The control and preventative measurements are necessary to reduce the rate of T. gondii infection in such individuals.

Keywords: Female students, seroepidemiology, Shiraz, southern Iran, toxoplasmosis

How to cite this article:
Taghizadeh H, Shahriarirad R, Erfani A, Nekouei F, Seifbehzad S, Khabisi SA, Sarkari B. Seroepidemiological survey of toxoplasmosis among female university students in Shiraz, southern Iran. Ann Trop Med Public Health 2017;10:362-5

How to cite this URL:
Taghizadeh H, Shahriarirad R, Erfani A, Nekouei F, Seifbehzad S, Khabisi SA, Sarkari B. Seroepidemiological survey of toxoplasmosis among female university students in Shiraz, southern Iran. Ann Trop Med Public Health [serial online] 2017 [cited 2019 Nov 22];10:362-5. Available from: http://www.atmph.org/text.asp?2017/10/2/362/208724

   Introduction Top


Toxoplasma gondii is an intra-cellular protozoan parasite that can cause toxoplasmosis in a wide range of warm-blooded animals, including humans. T. gondii can be transmitted to humans by ingestion of oocysts in water, food or soil contaminated with cat's feces, or by eating raw or undercooked meat, containing tissue cysts.[1],[2] The other routes of acquisition include blood transfusion, organ transplantation, and congenital transmission via the transplacental transfer of tachyzoites, especially when the mother becomes infected for the first time during pregnancy. Most of Toxoplasma infections in immunocompetent individuals are asymptomatic while in a few of infected individuals symptoms such as, cervical lymphadenopathy or ocular disease may occur.[3]

T. gondii can also cause severe encephalitis via acute infection or reactivation of latent infection in immunocompromised persons, including those with acquired immunodeficiency syndrome, those who are on immunosuppressive drugs. Newly acquired toxoplasmosis in a pregnant woman can be transmitted to the fetus and may cause mental retardation, blindness, epilepsy, and death.[4]

About one-third of the global population is estimated to be infected with T. gondii. However, its seroprevalence varies in different countries or even in different areas of a given country, according to the people eating behaviors and also geographic and climatic differences of the area. Toxoplasmosis is a common infection in animals and human in all areas of Iran, including Fars province.[5],[6],[7] Childbearing age and pregnant women are two main groups, which are important in case of T. gondii infection. Because of this, most of the seroprevalence studies of toxoplasmosis are focused on these groups.[8],[9],[10],[11],[12] It has been reported that about 40% of the Iranian pregnant women are seropositive for toxoplasmosis.[9] The testing of all pregnant women for T. gondii infection during their pregnancy is a part of prenatal care in some of the developed countries where the rate of Toxoplasma infection is relatively high.

Female university students are at or close to childbearing age and their status of T. gondii infection is important. The current study was designed to provide recent data regarding the Toxoplasma infection among female university student who were studying at Shiraz University of medical sciences, in Fars province, southern Iran.


   Materials and Methods Top


This study was conducted from March to June 2016 in Shiraz, capital of Fars Province. The subjects of the study were female university students in different faculties of Shiraz University of Medical Sciences (SUMS). The study was approved by ethic committee of SUMS and an informed consent was obtained from each participant. A pre-designed questionnaire was filled by every volunteer participant, regarding their socio-demographic (age, city of residence, faculty, etc.) and behavioral such as, having contact with animals or keeping animal at home, etc. related to toxoplasmosis.

The sample size was estimated based on both the population of female students at the university, and also on the prevalence of toxoplasmosis in the region.[7],[10] Blood samples were collected from 503 female students, using heparinized hematocrit tubes. The samples were taken to the serology laboratory at the department of parasitology and mycology of SUMS. The hematocrit tubes were centrifuged for 6 minutes at 800 g, and then were cut and the separated serum was transferred to labeled Eppendorf tubes and stored at - 20°C until use. Sera samples were tested for anti-Toxoplasma IgG and IgM antibodies, using a commercial (Euroimmun, Germany) Enzyme-Linked Immunosorbent Assays (ELISA) kit, according to the manufacturer's instructions.

The questionnaires' data along with the findings of serological assay were entered in SPSS software (version 22) and analyzed. Chi-squared was used to compare the seroprevalence values related to the characteristics of the subjects, including age, area of resident, animal contact, etc. The differences with P<0.05 were considered statistically significant.


   Results Top


The mean age of participants was 22.2 (±3.83) years. The majority (54.9%) of individual who participated in this study was in the age group of 20-25 years old; while those aged above 36 years old were the least (1.2%). Most of the participants were from the faculty of midwifery and nursing (27.8%), followed by medicine (22.2%), and international branch (13.3%). Considering the residence of the participants, most of the cases (67.8%) were from Fars province, followed by Bushehr (5.9%) and Kohgiluyeh and Boyer-Ahmad (4.5%) provinces. Anti T. gondii antibodies was detected in sera of 43 out of 503 female students corresponding to an overall seroprevalence of 8.5% in this population. Of these, 37 (7.4%) were seropositive for only IgG, 7 (1.4%) were seropositive for only IgM and 1 (0.2%) were positive for both IgG and IgM. Demographic features of enrolled subjects and relative seropositivity to toxoplasmosis are shown in [Table 1].
Table 1: Demographic features of university female students and relative seropositivity to T. gondii in Shiraz University of Medical Sciences, in Fars province, southern Iran

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The seroprevalence rate of toxoplasmosis among the studied population ranged from 5.9% to 16.7% in which the highest rate of seropositivity was seen in the age group above 36 years and the lowest rate was equally seen in the age groups of 21-25 and 25-30 years old. The differences between age and presence of anti-Toxoplasma antibodies were not statistically significant (for IgM χ²=3.529, df=4, p=0.473 and for IgG χ²=3.652, df=4, p=0.455). Out of the 503 enrolled participants, 41.8% of cases reported having contact with animals including cats, dogs, rabbits, cattle and birds. However, there was no correlation between animal contact and seropositivity to toxoplasmosis in this study.


   Discussion Top


Toxoplasmosis is a serious health problem and a major risk factor for women of childbearing age. This zoonotic parasitic disease is one of the most prevalent infections, both in human and animals in Iran.[4],[5],[6],[7],[13],[14] Most studies conducted on seroprevalence of toxoplasmosis are focused on childbearing age and pregnant women and also immunodeficient patients.[8],[9],[10],[11],[12] The overall seroprevalence of T. gondii among the general population in Iran is 39.3%.[13] Moreover, the seroprevalence rate of T. gondii in the Iranian pregnant women has been reported to be 43%.[9] Female university students are at or close to childbearing age and their status of T. gondii infection is important. In the present study, among 503 university female students, 8.5% were seropositive for Toxoplasma. Comparing to other studies conducted in different regions of the Iran, the seroprevalence of T. gondii in female university students in the current study is relatively low.[9],[15],[16],[17] This could be the result of higher education, as shown to be decreasing factor to T.gondii infection.[10] Another reason of lower prevalence rate of toxoplasmosis among the female students in the current study might be the lower age of the participants, which in turn lowered the exposure to T. gondii and the subsequent infection.

Previous studies show that the seroprevalence of T. gondii increased with age.[7],[11],[12],[13],[17],[18] This increase in the seropositivity to toxoplasmosis is likely a reflection of the increasing exposure to contaminated sources of T. gondii. However, similar to our finding, some studies didn't find a significant correlation between Toxoplasma infection and age.

In the current study, contact with animals such as cats was not associated with Toxoplasma seropositivity. This also has been reported in some previous studies.[19],[20] It is worth knowing that the main sources of Toxoplasma infection for human are postulated to be undercooked meat rather than contaminated soil or vegetables.[6] Therefore, it is not surprising to see that people without having contact with animals are equally infected with T. gondii, in comparison with those who have animal contact. Besides, few Iranians keep cats at home; therefore they have less contact with cat feces.

More than 90% of the female students in the present study were seronegative for T. gondii antibodies. These women are susceptible to acute Toxoplasma infection during their childbearing period, and their infants might be at risk of congenital toxoplasmosis, if the mothers become infected during their first pregnancy. Infected infants can develop convulsion, chorioretinitis, pneumonitis, jaundice, cataract, hydrocephalus, microcephalus, fever, hepatosplenomegaly, lymphadenopathy, hypothermia, and rash.[4],[21] Moreover, most of children with Toxoplasma infection only develop clinical manifestations at several years after birth.[21] Therefore, it is important that women of childbearing age, and especially pregnant women, be educated regarding the risk of eating raw or undercooked meat, having contact with cats or contaminated soil and also consumption of contaminated vegetables.[22]


   Conclusion Top


The findings of the current study indicate that more than 90% of the female students who enrolled in this study were seronegative for toxoplasmosis. This means that they are prone to toxoplasmosis and, as most of them are in their childbearing age, there is a possibility for their new-borns to become infected with Toxoplasma. Therefore, control and preventative measurements for T. gondii, including washing hands before meals, prevention of soil contamination by cat feces, consumption of properly cooked meat and other preventive actions are necessary to be taken to reduce the rate of T. gondii infection in such individuals.

Acknowledgement

The study was the subject of DrHajar Taghizadeh MD thesis. We thank the students of SUMS for providing the blood samples.

Financial support and sponsorship

The study was financially supported by the office of vice-chancellor for research of Shiraz University of Medical Sciences (Grant No. 93-01-21-8976).

Conflicts of interest

There are no conflicts of interest.

 
   References Top

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Correspondence Address:
Bahador Sarkari
Basic Sciences in Infectious Diseases Research Center, Shiraz University of Medical Sciences, Shiraz
Iran
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1755-6783.208724

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