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Sero Burden of Toxoplasma gondii and Associated Risk Factors among HIV Infected Persons in Armed Forces Referral and Teaching Hospital, Addis Ababa, Ethiopia

Fewzia Mohammed*, Mulusew Alemneh Sinishaw, Negash Nurahmed, Shemsu Kedir Juhar, Kassu Desta

Background: Toxoplasmosis is a zoonotic disease, worldwide distribution caused by an obligate intracellular coccidian parasite, known as Toxoplasma gondii. T. gondii can lead to serious diseases in immuno-compromised patients such as HIV/AIDS patients. In most cases, central nervous system involvement can lead to encephalitis, which is one of the most important reasons for death among patients with HIV due to reactivation of tissue cysts that remained latent after the primary infection. This study was conducted to assess the sero burden of Toxoplasma gondii infection and identify associated risk factors among HIV infected individuals in Armed Forces Referral and Teaching Hospital, Addis Ababa, Ethiopia.

Methods: A cross-sectional study was conducted from March to May 2016. After getting an informed consent a pretested questionnaire was used to gather socio-demographic information and data on factors predisposing to T. gondii infection using convenience sampling methods. Serum samples from each volunteered patients were screened for the presence of anti-T. gondii IgG and IgM antibodies by using ELISA test kit (CTKBIOTECH, USA). Data were entered and analyzed using SPSS version 15.0. The chi-square test was used to observe any difference between variables. p-values were determined and taken as a level of significance when they found less than 0.05.

Results: The study recruited a total of 174 HIV infected patients, of whom 99 (56.9%) were males. The study also included different age strata ranging from 18-68 years. Most of the sampled subjects were found in the age group of 31-40 years old. About 154 (88.5%), were seropositive for anti-T. gondii IgG antibody and 3 (1.7%) seropositivity for anti-T. gondii IgM antibodies. None were positive for IgM antibody alone. Of all the variables included in the study, only the presence of the cat depicted an association with sero-burden of anti-Toxoplasma gondii IgG antibody (p=0.038).

Conclusion: This study revealed a high sero burden of chronic toxoplasmosis in HIV/AIDS patients. HIV/AIDS patients having a domestic cat at their home were at higher risk of T. gondii infection. It would be important to increase public awareness about different routes of transmission of T. gondii. Besides, routine screening for Toxoplasma should be undertaken for all HIV-infected patients to minimize complications related to reactivation.

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