Prenatal Diagnosis and Genetic Characterization of Toxoplasmosis in Immunocompetent and Immunocompromised Pregnant Women and the Risk of Congenital Toxoplasmosis: A Prospective Study in Ghana

Dr Bhavana Singh; Alex Yaw  Debrah; Linda Batsa  Debrah; Georgina Djameh

doi:10.4314/just.v41i2.1333

Dr Bhavana Singh UNIVERSITY HOSPITAL, Kwame Nkrumah University of Science and Technology
Prof Alex Yaw Debrah School of Allied Health, Kwame Nkrumah University of Science and Technology
Dr Linda Batsa Debrah Department of Clinical Microbiology, Kwame Nkrumah University of Science and Technology
Ms. Georgina Djameh Department of the Noguchi Memorial Institute for Medical Research-University of Ghana,

DOI: https://doi.org/10.4314/just.v41i2.1333

Keywords: Clonal types,, Ghana,, Immune compromisedImmune competent,, Toxoplasma gondii

Abstract

Background: Toxoplasmosis, a protozoan parasitic disease caused by Toxoplasma gondii is of public health concern. Studies on trans-placental transmission of T. gondii is limited in Africa. This study aimed at assessing the seroprevalence and genetically characterize T. gondii infection among pregnant women.

Methods: HIV-negative pregnant women in their first trimester and HIV-positive pregnant women attending Antenatal Clinic at a University Hospital were screened for anti-Toxoplasma antibodies (IgG and IgM) using ELISA. Multi-locus gene detection was done using nested Polymerase Chain Reaction to target the Surface Antigen Gene 3 and the Dense Granule Antigen protein 6 of T. gondii parasite, followed by sequencing to identify the prevalent T. gondii strain in Ghana.

Results: The prevalence of acute T. gondii infection (ATI) among the HIV-negative pregnant women was 1.5% (6/400), transmission rate was 50% (3/6) and prevalence of congenital toxoplasmosis (CT) was 0.75% (3/400). From HIV-positive women, the prevalence of ATI was 56% (14/25), transmission rate 57% (8/14) and prevalence of CT 32% (8/25). Older aged and unemployed HIV positive women were significantly associated with T. gondii seropositivity (p=0.021) and (p=0.016) respectively. T. gondii DNA was detected in 16.7% (12/72) samples and were clonal type GRA6 type II sequences.

Conclusion: Seroprevalence of toxoplasmosis were higher in HIV-positive pregnant women. The seropositivity to T. gondii specific antibodies in the babies did not fully translate into clinical Toxoplasmosis. The strain identified was the clonal type GRA6 type II sequence. It is important to follow newborn with CT for 10 years for clinical toxoplasmosis.

Author Biographies

Dr Bhavana Singh, UNIVERSITY HOSPITAL, Kwame Nkrumah University of Science and Technology

Dr Bhavana Singh is a Principal Medical Officer at UHS, KNUST and have successfully
completed her PhD VIVA VOCE and due for graduation in November 2022 towards her PhD
degree in Clinical Microbiology from KNUST. She is a practicing Clinician at UHS, KNUST,
Kumasi,Ghana.

Prof Alex Yaw Debrah, School of Allied Health, Kwame Nkrumah University of Science and Technology

Prof Alex Yaw Debrah is the of Dean of School of Allied Health and a Scientist at KCCR in
Tropical Medicine, KNUST, Kumasi, Ghana.

Dr Linda Batsa Debrah, Department of Clinical Microbiology, Kwame Nkrumah University of Science and Technology

Dr Linda Batsa Debrah is a Senior lecturer at the Department of Clinical Microbiology, School
of Medicine and Dentistry and also a Scientist at KCCR in Tropical medicine, KNUST, Kumasi,
Ghana.

Ms. Georgina Djameh, Department of the Noguchi Memorial Institute for Medical Research-University of Ghana,

Ms. Georgina Djameh is currently a Ph.D. student at the Tokyo Medical and Dental University,
Japan. Before her Ph.D. position, she was a Principal research assistant at the Parasitology
Department of the Noguchi Memorial Institute for Medical Research-University of Ghana,
Ghana.