The The Burden of Congenital Toxoplasmosis on Pregnancy Outcomes and Public Health Implications

Abstract

The Burden of Congenital Toxoplasmosis on Pregnancy Outcomes and Public Health Implications

Iman Maikano Khalid 1, Muhammad Adamu Abbas 2, Abdulsalami Yayo Manu 1, Yusuf Mohammed 1, Alhassan Abdullahi Sharif 1

asabdullahi.mcp@buk.edu.ng

1Department of Medical Microbiology and Parasitology, Faculty of Basic Clinical Sciences, College of Health Science, Bayero University, Kano

2Department of Community Medicine, Faculty of Clinical Sciences, College of Health Science, Bayero University, Kano

ABSTRACT

Toxoplasma gondii is a globally distributed protozoan parasite that poses a significant risk to pregnant women. Primary infection during pregnancy can result in congenital toxoplasmosis (CT). This condition is linked to severe fetal complications, including chorioretinitis, hydrocephalus, intracranial calcifications, neurological impairments, and intrauterine growth restriction. Since the probability of congenital transmission is lower in early pregnancy (10–15% in the first trimester) compared to later stages (60–90% in the third trimester), first-trimester infections are more often associated with severe outcomes such as spontaneous abortion, stillbirth, and congenital anomalies, compared to third-trimester infections that result in delayed manifestations, such as chorioretinitis.

In Nigeria, reports on abortion rates range from 41.6% to 60%, stillbirth rates from 6.8% to 61.5%, and neonatal mortality rates can be as high as 62.5%. A systematic review estimated the overall seroprevalence of T. gondii among pregnant women in Nigeria to be 40.25%, though variations exist due to geographic, socioeconomic, and methodological differences. Although seroprevalence appears to be higher in the southern regions, while severe complications are more frequently reported in the north, possibly due to co-infections, lower educational levels, and inadequate healthcare infrastructure, however epidemiological data on T. gondii remains limited. Diagnostic techniques such as ELISA, latex agglutination, indirect fluorescent antibody tests, and PCR contribute to inconsistencies in prevalence estimates.

The diagnosis of toxoplasmosis during pregnancy is hindered by limited access to routine prenatal screening, high testing costs, and inadequate diagnostic infrastructure. Managing this public health challenge requires an extensive approach, including routine screening, improved health education, sanitary measures, and standardized treatment protocols, while continuous vaccine research provides hope for future prevention. Collaborative efforts among researchers, healthcare providers, and public health officials are crucial to reducing the burden of congenital toxoplasmosis in Nigeria.

Keywords; Toxoplasmosis, Pregnancy, Congenital Toxoplasmosis, Nigeria, Seroprevalence, Adverse Pregnancy outcomes