Prevalence of Toxoplasma Gondii in Women Population in Swat, Pakistan

Parasitic protozoans cause many diseases in human such as
malaria, sleeping sickness, leishmaniasis, toxoplasmosis and Chagas
disease...

nervous damage, hydrocephalus, meningoencephalitis, intracranial calcifications, and epilepsy or spontaneous abortion in about 10% of cases are also caused by T. gondii. Congenital infection cause lesions in the retina of the eye, which lead to loss of vision power and sometimes pain in the eyes [10]. Most of the people show no symptoms after birth, however some people suffer from mild disease or in rare cases more severe systemic illness [11]. Flu like illness or cervical lymphadenopathy may develop in 10-20% patients with acute infection [12].
Host tissue removed by biopsy or necropsy can be used for the diagnosis of T. gondii. Microscopic examination is a rapid diagnosis of impression smears of lesions [13]. PCR is used in molecular diagnosis [14]. Antibody detection is usually used for the diagnosis of toxoplasmosis. High frequency of IgG antibodies is an indication thatthe person is previously infected [15]. Detection of specific IgM antibodies show a recent infection. Human toxoplasmosis can be diagnosed typically using Indirect Fluorescent Antibody Testing (IFAT), Latex Agglutination Test (LAT), Immuno-chromatographic Test (ICT), or Enzyme Linked Immunosorbent Assay (ELISA) [15].
Toxoplasmosis infecting most genera of homoeothermic animals (more than 30 species of birds and 300 species of mammals).
In Europe about 30% prevalence of toxoplasmosis is reported while across USA its prevalence rate is about 10% [10]. In Pakistan overall prevalence rate of toxoplasmosis is 29.45% [17]. Prevalence in adult human population of Dera Ghazi Khan, Punjab, is 29.5% [9], while in district Mardan Khyber Pakhtunkhwa is 28.44% [10]. In Pakistan the seroprevalence of T. gondii antibodies in pregnant women varies. Highest prevalence (63%) was recorded from Punjab, followed by Azad Kashmir (48%). Low prevalence was reported from Khyber Pakhtunkhwa with infection rate of 33.03% and 14.4% from Dir Upper and Swabi respectively [18]. Aims of the current study was to find out prevalence of toxoplasmosis in local population, to determine the rate of abortion and still births in pregnant women and to find the risk factors of toxoplasmosis in district Swat.

Study Area
Swat is one of the districts of Khyber Pakhtunkhwa, Pakistan [19]. It is a lush green valley lying between 34 0 34" and 35 0 55" north latitudes and 72 0 08" and 72 0 50" East longitudes. The climate of Swat is somewhat warm and humid with short and moderate summers; temperature seldom rises above 37°C [20]

Samples Collection
This study was conducted during June to September 2016. 300 blood samples (2-3 ml) were collected using disposable syringes from symptomatic individuals belongs to different localities of District Swat. After collection, blood was transferred to EDTA tubes and the tubes were stored at low temperature until diagnosis.

Laboratory Procedure
The detection of T. gondii in present research was done by in-Site Toxo IgG/IgM rapid test, which is a lateral flow chromatographic immunoassay.

Results
In present study total 216 blood samples were collected from    Along with other pathogenic infections toxoplasmosis is also one of the possible cause of abortion. The abortion rate in pregnant women was 28%. Toxoplasma gondii can cross placenta, reach to fetus and cause serious complicated congenital problems like still birth, blindness, hydrocephaly, mental and physical retardations etc. During our present study 21% females were found who have experienced still births (Table 1). Risk factors were also observed.
Possible ways of infection in the patients were contact with cats and cattle, use of unpasteurized milk, use raw/poorly cooked meat and use of unwashed fruits and vegetables ( Table 2).

Complications of Toxoplasmosis Percentage
Abortion 28% Still Birth 21%

Conclusion and Recommendations
The present study concluded that in District Swat toxoplasmosis is prevalent in females which lead to complications such as still birth and abortions. It is also concluded that most of the people are unaware from the infections, their risk factors and complications.
So, it is recommended that public awareness is necessary to minimize the infection in Swat.