Toxoplasmose e toxocaríase em gestantes da região Oeste do Estado de São Paulo: associação entre a presença de anticorpos e fatores de risco associados

Abstract

Toxocariasis and toxoplasmosis are two widespread parasitic zoonoses caused by nematodes of the genus Toxocara spp. and the protozoan Toxoplasma gondii, respectively. The agents of both diseases can affect various organs and can be vertically transmitted, leading to disorders in fetuses and/or neonates. Similarities in the transmission pathways to humans may result in congruent risk factors for both diseases. Co-infection by Toxocara spp. and T. gondii has been demonstrated in pregnant women, even though in limited numbers, justifying the evaluation of risk factor and coinfection by toxoplasmosis and toxocarisis in pregnant women. Therefore, the aim of the present study was to assess co-infection and associated risk factors for the presence of anti-Toxocara spp. and anti-T. gondii antibodies in pregnant women attended by the Unified Health System (SUS) in the Presidente Prudente region, Western São Paulo State. Blood samples from 280 pregnant women were collected for the detection of anti-Toxocara spp. and anti-T. gondii IgG antibodies using ELISA and chemiluminescence tests, respectively. A questionnaire was applied to gather socioeconomic information (age, gestational trimester, educational level, monthly family income, presence of sewage system at home), pet ownership, and hygiene/dietary habits (filtered water intake, contact with soil, nail-biting, pica behavior, consumption of raw/undercooked meat, and washing of vegetables). The evaluation of potential predictors for seropositivity was performed through univariate analysis followed by logistic regression. According to the results, the seroprevalence was 69/280 (24.6%; 95% CI: 19.96-30.01) for T. gondii and 56/280 (20.0%; 95% CI: 15.73-25.08) for Toxocara spp. Coinfection was observed in 25/280 (8.9%; 95% CI: 6.12-12.85) pregnant women, with a statistically significant association (OR: 3.3; 95% CI: 1.77-6.14; p=0.0002). Logistic regression revealed that owning cats increased the likelihood of toxocariasis, while having a high school or higher educational degree decreased the chances of seropositivity for both agents. Furthermore, the chances of seropositivity for T. gondii were significantly higher in older pregnant women. The study confirms co-infection between toxocariasis and toxoplasmosis in pregnant women from the Presidente Prudente region attended by SUS, particularly in those with lower educational level. The results highlight the importance of educational programs for health promotion and prevention of these zoonoses in pregnant women.