Primoinfection by Toxoplasma gondii in pregnant women in Primary Health Care in Havana

Abstract

Introduction: Primoinfection by Toxoplasma gondii acquired during pregnancy can cause severe clinical manifestations in the newborn parameters; it is a treatable and preventable event, though.

Objective: To describe serological evidence of primoinfection by T. gondii in pregnant women in Primary Health Care (PHC) in Havana.

Methods: A retrospective descriptive study of serological results of pregnant women screened in the PHC, Havana, from 2005 to 2011 was conducted. A total of 1820 sera were processed at the National Reference Laboratory of Parasitology of Pedro Kourí Institute (LNRP-IPK) through indirect immunofluorescence assay (IFA), VIDAS TOXO IgM and Toxo IgG Avidity. Samples with antibody titers ≥ 1/128 by IFA were tested for IgM; if positive, IgG avidity was determined.

Results: 1151 sera (63.2%) yielded negative results. Most were pregnant women between 16 and 35 years of age with an average positivity of 34.1%, without significant distinction between municipalities of origin. Anti-Toxoplasma IgG titers prevailed 1/16-1/64. In pregnant women over 35 years of age, titers were 120/209 (57.4%), a significant result when compared with the group under 16 years of age (4/14; 28.5%). IgG titers ≥ 1/128 (3.1%) appeared in 5858 women, and those under 16 years of age predominated (2/14; 14.2%). IgG and IgM were positive in 17.2% of pregnant women, a relevant aspect in Old Havana (6.8%). Low levels of avidity were found in 5/10 (index < 0.200 IgG), which represented 0.2% of the total number of pregnant women studied.

Conclusion: In pregnant women in some health areas in Havana, primoinfection by T. gondii was confirmed.