Seroprevalence and risk factors of Toxoplasma gondii infection among pregnant women in Trinidad and Tobago.

OBJECTIVE To determine the seroprevalence of toxoplasmosis and the frequency of risk factors for the disease in women attending antenatal clinics in hospitals and local health centers in Trinidad and Tobago. METHODS From November 2002-September 2003, 232 pregnant women at the antenatal clinics of two large hospitals were sampled during their first trimesters. From October 2003-February 2005, 218 pregnant women at five health care centers were followed through three trimesters, wherever possible, and blood samples collected. Sera were screened for Toxoplasma gondii IgG and IgM immunoglobulins using an enzyme immunoassay. Data on demographics, as well as practices considered to be risk factors for toxoplasmosis, were obtained. RESULTS Of the 232 women sampled at the two hospital clinics, 83 (35.8%) and 8 (3.4%) were seropositive for immunoglobulins of T. gondii IgG and IgM, respectively. Of the 218 women at the health centers, 76 (34.9%) had evidence of past infection (IgG), while 26 (11.9%) were seropositive for IgM immunoglobulin, suggesting new infections during pregnancy. Only having "3 or more" children was significantly associated with infection by T. gondii. CONCLUSION In Trinidad and Tobago, the seroprevalence of past infection by T. gondii in pregnant women is relatively low (39.3%) for patients in both hospital and health center clinics. Consequently, there is an elevated risk of primary infection during pregnancy and the potential for congenital infection.