ABSTRACT

Background: Toxoplasma gondii infection in early pregnancy has been associated with significant adverse pregnancy
outcomes. Despite being common in the city of Mwanza, its association with spontaneous abortion has never been stud-
ied. Here, we report the IgG and IgM seropositivity and histopathological changes of toxoplasmosis among women with
spontaneous abortion.

Methods: A total of 260 women with spontaneous abortion were enrolled between November 2015 and April 2016 from
4 hospitals in Mwanza city. Specific T. gondii IgG and IgM antibodies were detected from sera by indirect enzyme-linked
immunosorbent assay (ELISA) while the conceptus tissues were stained with haematoxylin and eosin to demonstrate histo-
pathological changes. Data were analysed by using Stata version 13.

Results: The mean age of the enrolled women was 2665.9 years. The seropositivity of IgG and IgM antibodies were
144/260 (55.4%; 95% confidence interval [CI], 49–61) and 6/260 (2.3%; 95% CI, 3–8), respectively. IgG seropositivity
was significantly high among women in the first trimester (59.1% vs.43.5%; P=.03). Only low gestation age (odds ratio
[OR] 1.11; 95% CI, 1.02–1.20; P=.02) and keeping a cat (OR 11.80; 95% CI, 1.32–10.5; P=.03) independently pre-
dicted IgG and IgM seropositivity, respectively. Presence of inflammation (OR 1.95; 95% CI, 1.05–3.64; P=.03), calcifi-
cation (OR 3.28; 95% CI, 1.01–10.63; P=.04), necrosis (OR 2.86; 95% CI, 1.39–5.89; P=.04), and lymphocyte
infiltrations (OR 2.24; 95% CI, 1.17–4.24; P=.01) were significantly associated with T. gondii IgG seropositivity.

Conclusions: Almost half of women with spontaneous abortion in the city of Mwanza have specific T. gondii IgG anti-
bodies. Placental histopathological changes suggestive of toxoplasmosis were significantly found among IgG seropositive
women. This calls for the need to screen these women during antenatal visits in order to institute appropriate measures,
such as treatment and counselling, to prevent complications associated T. gondii infection.