Seroprevalence and Risk Factors for Toxoplasma gondii Infection among Women of Reproductive Age in Northeast Iran
Abstract
Background: We aimed to investigate the seroepidemiology of Toxoplasma gondii infection among women of childbearing age in Gonabad City, northeastern Iran, to assess the prevalence of infection and identify associated risk factors.
Methods: A cross-sectional study was conducted from March to April 2022 in Gonabad, Khorasan Razavi Province, northeastern Iran. A total of 320 blood samples were collected from consenting pregnant women. Each participant provided 5 mL of blood for serological analysis to detect anti-Toxoplasma IgG and IgM antibodies. Demographic and behavioral data were collected using a structured questionnaire.
Results: The mean age of participants was 29.74 ± 10.9 years. Of the 320 samples, 58 (18.12%) tested positive for anti-Toxoplasma IgG antibodies, while 1 (0.3%) tested positive for IgM antibodies. In addition, 81.9% of participants were seronegative. No significant associations were observed between anti-Toxoplasma antibodies and marital status, education level, vegetable washing practices, egg cooking methods, milk consumption, or fertility status. However, significant correlations were found between seropositivity and contact with cats (P= 0.01) and meat consumption (P< 0.05).
Conclusion: The majority of women of childbearing age in Gonabad remain susceptible to T. gondii infection, highlighting the risk of primary infection during pregnancy. To mitigate the risk of congenital toxoplasmosis, serological screening for Toxoplasma infection is recommended for women of childbearing age, coupled with targeted health education on transmission routes and preventive measures.
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2. Sanchez SG, Besteiro S. The pathogenicity and virulence of Toxoplasma gondii. Virulence. 2021;12(1):3095-3114.
3. Dubey J. Toxoplasmosis of animals and humans, CRC Press. Boca Raton. 2010; doi.org/10.1201/9781003199373.
4. Chaudhry SA, Gad N, Koren G. Toxoplasmosis and pregnancy. Can Fam Physician. 2014;60(4):334-336.
5. Shojaee S, Teimouri A, Keshavarz H, et al. The relation of secondary sex ratio and miscarriage history with Toxoplasma gondii infection. BMC Infect Dis. 2018;18(1):307.
6. McCluskey JM, Sato AI. Vertical Transplacental Infections. StatPearls [Internet]: StatPearls Publishing; 2024.
7. Faral-Tello P, Pagotto R, Bollati-Fogolín M, et al. Modeling the human placental barrier to understand Toxoplasma gondii´ s vertical transmission. Front Cell Infect Microbiol. 2023;13:1130901.
8. Rostami A, Riahi S, Gamble H, et al. Global prevalence of latent toxoplasmosis in pregnant women: a systematic review and meta-analysis. Clin Microbiol Infect. 2020;26(6):673-683.
9. Liu Q, Wang Z-D, Huang S-Y, et al. Diagnosis of toxoplasmosis and typing of Toxoplasma gondii. Parasites & Vectors volume. 2015;8(1):292.
10. Teimouri A, Mohtasebi S, Kazemirad E, et al. Role of Toxoplasma gondii IgG avidity testing in discriminating between acute and chronic toxoplasmosis in pregnancy. J Clin Microbiol. 2020; 58(9):e00505-20.
11. Teimouri A, Mahmoudi S, Behkar A, Sahebi K, et al. Current and emerging techniques for diagnosis of toxoplasmosis in pregnancy: A narrative review. Iran J Parasitol. 2024;19(4):384-396.
12. Hamidi F, Rostami A, Hosseini SA, et al. Anti-Toxoplasma gondii IgG seroprevalence in the general population in Iran: A systematic review and meta-analysis, 2000–2023. PLoS One. 2024;19(8):e0307941.
13. Malary M, Hamzehgardeshi Z, Moosazadeh M, et al. Seroprevalence of Toxoplasma gondii infection among Iranian pregnant women: a systematic review and meta-analysis. East Mediterr Health J. 2018; 24(5):488-496.
14. Jones JL, Dargelas V, Roberts J, et al. Risk factors for Toxoplasma gondii infection in the United States. Clin Infect Dis. 2009;49(6):878-84.
15. Salehi M, Niazkar HR, Mahmoudian A, et al. Seroepidemiological Survey of toxoplasm-osis Among Pregnant and Abortive Women of Gonabad. Crescent Journal of Medical & Biological Sciences. 2021;8(2): 114–121.
16. Jamshidipour A. Evaluation of geotourism for Gonabad Qasabeh Qanat: Potentials and capabilities. Geoconservation Research. 2022;5(2): 347-356.
17. Qaim Maghami SA. About Some of the Geographical Names of Shahnameh. The Quarterly Journal Ayeneh-ye-Pazhoohesh. 2023;34(199):77-85.
18. Tafahomi R. Application of physical and nonphysical elements in the conservation of historic core of city. South African Journal of Geomatics. 2021;10(1):75-86.
19. Ghadamgahi F, Bahadoran M, Shariat-Bahadori E, et al. Study of serological toxoplasmosis and risk factors associated with infection in women referred to labs of northern Tehran, Iran. Journal of Isfahan Medical School. 2013;31(248):1257-66.
20. Al-Hamdani MM, Mahdi NK. Toxoplasmosis among women with habitual abortion. East Mediterr Health J. 1996; 3(2):310–315.
21. Sultana M, Hossain MS, Dewan F, et al. Association of Toxoplasma gondii infection with spontaneous abortion. Bangladesh J Obstet Gynaecol. 2014;29(2):87-93.
22. Yousefi M, Sefidgar S, Hassanjani-Roshan M, et al. Seroepidemiological survey in women referred to pre-marriage consultant center in Babol. Iranian Journal of Infectious Diseases and Tropical Medicine. 2005;10(28):31-33.
23. Mohammadi A, Shojaee S, Salimi M, et al. Seroepidemiological study of toxoplasmosis in women referred to arak marriage consulting center during 2012–2013. Iran J Public Health. 2015;44(5):654-658.
24. Ajami A, Sharif M, Ziaee H. Serological study of toxoplasmosis in Mazandaran rehabilation centers.J Mazandaran Univ Med Sci. 2005; 15(46): 64-69.
25. Zalei B, Pourmand D. Seroepidemiology of toxoplasmosis in pregnant women referred to reference laboratory in Kermanshah, 2014-2015. Journal of Clinical Research in Paramedical Sciences. 2016; 5(2):e81462.
26. Mostafavian Z, Bazzazan S, Mokhtari H. Evaluation of knowledge and practice of pregnant women about toxoplasmosis in Mashhad. Medical Journal of Mashhad university of Medical Sciences. 2020;63(4):2539-2549.
27. Kalantari N, Sheikhansari M, Ghaffari S, et al. Seroprevalence and molecular detection of Toxoplasma gondii in young healthy blood donors in Northern Iran. Trop Biomed.2018; 35(4):1017-1027.
28. Badparva E. Prevalence of Toxoplasma gondii in pregnant women referred to health-treatment centers of Khoramabad. Yafteh. 2001; 3(9): 32-35.
29. Maani S, Kazemi M, Solhjoo K, et al. Serological study of toxoplasmosis in pregnant women in Jahrom city, 2018. Pars J Med Sci. 2020;18(2):1-8.
30. Shabanian H, Jafari-Shakib R, Sharifdini M, et al. Seroepidemiology of Toxoplasmosis in Pregnant Women Referring to the Pregnancy Care Center of Ramsar. JGUMS. 2023;32(2):106-115.
31. Hariri SS, Heidari Z, Habibzadeh S, et al . Seroprevalence of Toxoplasma gondii among Pregnant Women in Ardabil, Iran (2021–2022). Iran J Parasitol. 2023; 18(1):93–99.
32. Gharavi MJ, Roozbehani M, Miahipour A, et al. Prevalence of anti-Toxoplasma gondii antibodies in young Iranians: the CASPIAN III study. Arch Pediatr Infect Dis. 2017; 6(1):e61640.
33. Sadeghi Dehkordi Z, Partoandazanpour A, Adolmaleki N. Seroprevalence and risk factors of Toxoplasma gondii infection among pregnant women in Sanandaj, west of Iran: A Cross-Sectional Study. J Zoonotic Dis. 2022;6(2):78-83.
34. Shahighi M, Heidari A, Keshavarz H, et al. Seroepidemiological study of toxoplasmosis in women referred to a pre-marriage counseling center in Alborz Province, Iran. BMC Res Notes. 2021;14(1):163.
35. Khademi SZ, Ghaffarifar F, Dalimi A, et al. Toxoplasma gondii in slaughtered sheep in high‐and low‐humidity regions in the South of Iran: molecular prevalence and genotype identification. Vet Med Int. 2021;2021:5576771.
36. Zeinali S, Khademvatan S, Jafari R, et al. Prevalence and risk factors of Toxoplasma gondii infection among women with miscarriage and their aborted fetuses in the northwest of Iran. PLoS One. 2023;18(10):e0283493.
37. Abdi Gheshlaghi S, Babaeinejad Z, Saraei M, et al. Maternal Serological Screening for Congenital Toxoplasmosis During Pregnancy and Evaluating the Pregnant Women’s Knowledge on Toxoplasmosis in Qazvin, Iran. Journal of Kerman University of Medical Sciences. 2022;29(5):428-435.
38. Soltani S, Tavakoli S, Sabaghan M, et al. The Probable Association between Chronic Toxoplasma gondii Infection and Type 1 and Type 2 Diabetes Mellitus: A Case‐Control Study. Interdiscip Perspect Infect Dis. 2021;2021:2508780.
39. Teimouri A, Nassrullah OJ, Hedayati P, et al. Prevalence and predictors of Toxoplasma gondii infection in psychiatric inpatients in Fars Province, Southern Iran. Front Psychiatry. 2022;13:891603.
40. Bashour N, Aminpour A, Vazifehkhah S, et al. Seromolecular study on the prevalence and risk factors of Toxoplasma gondii infection in pregnant women referred to a gynecology hospital in Urmia, northwest part of Iran in 2022. BMC Infect Dis. 2024;24(1):410.
41. Ahmadpour E, Daryani A, Sharif M, et al. Toxoplasmosis in immunocompromised patients in Iran: a systematic review and meta-analysis. J Infect Dev Ctries. 2014;8(12):1503-10.
42. Mahmoudvand H, Saedi Dezaki E, Soleimani S, et al. Seroprevalence and risk factors of Toxoplasma gondii infection among healthy blood donors in south‐east of Iran. Parasite Immunol. 2015;37(7):362-7.
43. Mohammadnejad AE, Eslami G, Shamsi F, et al. Prevalence of food-borne Toxoplasma in pregnant women population of Urmia, Iran. Journal of Food Quality And Hazards Control. 2018;5:17-23.
44. Nematollahi S, Hajimohammadi B, Eslami G, et al. Prevalence and Risk Factors of Toxoplasmosis Among Women of Reproductive Age, Southwestern Iran. J Egypt Soc Parasitol. 2022;52(2):341-348.
45. Mizani A, Alipour A, Sharif M, et al. Toxoplasmosis seroprevalence in Iranian women and risk factors of the disease: a systematic review and meta-analysis. Trop Med Health. 2017;45:7.
46. Mousavi-Hasanzadeh M, Sarmadian H, Ghasemikhah R, et al. Evaluation of Toxoplasma gondii infection in western Iran: seroepidemiology and risk factors analysis. Trop Med Health. 2020;48:35.
47. Yılmaz A, Yazıcı E, Turk C. Assessment of seroprevalence of Toxoplasma gondii in blood donors applied to the blood center of Gazi university hospital. Iran J Microbiol. 2021;13(2):243-247.
48. Daryani A, Sarvi S, Aarabi M, et al. Seroprevalence of Toxoplasma gondii in the Iranian general population: a systematic review and meta-analysis. Acta Trop. 2014;137:185-94.
2. Sanchez SG, Besteiro S. The pathogenicity and virulence of Toxoplasma gondii. Virulence. 2021;12(1):3095-3114.
3. Dubey J. Toxoplasmosis of animals and humans, CRC Press. Boca Raton. 2010; doi.org/10.1201/9781003199373.
4. Chaudhry SA, Gad N, Koren G. Toxoplasmosis and pregnancy. Can Fam Physician. 2014;60(4):334-336.
5. Shojaee S, Teimouri A, Keshavarz H, et al. The relation of secondary sex ratio and miscarriage history with Toxoplasma gondii infection. BMC Infect Dis. 2018;18(1):307.
6. McCluskey JM, Sato AI. Vertical Transplacental Infections. StatPearls [Internet]: StatPearls Publishing; 2024.
7. Faral-Tello P, Pagotto R, Bollati-Fogolín M, et al. Modeling the human placental barrier to understand Toxoplasma gondii´ s vertical transmission. Front Cell Infect Microbiol. 2023;13:1130901.
8. Rostami A, Riahi S, Gamble H, et al. Global prevalence of latent toxoplasmosis in pregnant women: a systematic review and meta-analysis. Clin Microbiol Infect. 2020;26(6):673-683.
9. Liu Q, Wang Z-D, Huang S-Y, et al. Diagnosis of toxoplasmosis and typing of Toxoplasma gondii. Parasites & Vectors volume. 2015;8(1):292.
10. Teimouri A, Mohtasebi S, Kazemirad E, et al. Role of Toxoplasma gondii IgG avidity testing in discriminating between acute and chronic toxoplasmosis in pregnancy. J Clin Microbiol. 2020; 58(9):e00505-20.
11. Teimouri A, Mahmoudi S, Behkar A, Sahebi K, et al. Current and emerging techniques for diagnosis of toxoplasmosis in pregnancy: A narrative review. Iran J Parasitol. 2024;19(4):384-396.
12. Hamidi F, Rostami A, Hosseini SA, et al. Anti-Toxoplasma gondii IgG seroprevalence in the general population in Iran: A systematic review and meta-analysis, 2000–2023. PLoS One. 2024;19(8):e0307941.
13. Malary M, Hamzehgardeshi Z, Moosazadeh M, et al. Seroprevalence of Toxoplasma gondii infection among Iranian pregnant women: a systematic review and meta-analysis. East Mediterr Health J. 2018; 24(5):488-496.
14. Jones JL, Dargelas V, Roberts J, et al. Risk factors for Toxoplasma gondii infection in the United States. Clin Infect Dis. 2009;49(6):878-84.
15. Salehi M, Niazkar HR, Mahmoudian A, et al. Seroepidemiological Survey of toxoplasm-osis Among Pregnant and Abortive Women of Gonabad. Crescent Journal of Medical & Biological Sciences. 2021;8(2): 114–121.
16. Jamshidipour A. Evaluation of geotourism for Gonabad Qasabeh Qanat: Potentials and capabilities. Geoconservation Research. 2022;5(2): 347-356.
17. Qaim Maghami SA. About Some of the Geographical Names of Shahnameh. The Quarterly Journal Ayeneh-ye-Pazhoohesh. 2023;34(199):77-85.
18. Tafahomi R. Application of physical and nonphysical elements in the conservation of historic core of city. South African Journal of Geomatics. 2021;10(1):75-86.
19. Ghadamgahi F, Bahadoran M, Shariat-Bahadori E, et al. Study of serological toxoplasmosis and risk factors associated with infection in women referred to labs of northern Tehran, Iran. Journal of Isfahan Medical School. 2013;31(248):1257-66.
20. Al-Hamdani MM, Mahdi NK. Toxoplasmosis among women with habitual abortion. East Mediterr Health J. 1996; 3(2):310–315.
21. Sultana M, Hossain MS, Dewan F, et al. Association of Toxoplasma gondii infection with spontaneous abortion. Bangladesh J Obstet Gynaecol. 2014;29(2):87-93.
22. Yousefi M, Sefidgar S, Hassanjani-Roshan M, et al. Seroepidemiological survey in women referred to pre-marriage consultant center in Babol. Iranian Journal of Infectious Diseases and Tropical Medicine. 2005;10(28):31-33.
23. Mohammadi A, Shojaee S, Salimi M, et al. Seroepidemiological study of toxoplasmosis in women referred to arak marriage consulting center during 2012–2013. Iran J Public Health. 2015;44(5):654-658.
24. Ajami A, Sharif M, Ziaee H. Serological study of toxoplasmosis in Mazandaran rehabilation centers.J Mazandaran Univ Med Sci. 2005; 15(46): 64-69.
25. Zalei B, Pourmand D. Seroepidemiology of toxoplasmosis in pregnant women referred to reference laboratory in Kermanshah, 2014-2015. Journal of Clinical Research in Paramedical Sciences. 2016; 5(2):e81462.
26. Mostafavian Z, Bazzazan S, Mokhtari H. Evaluation of knowledge and practice of pregnant women about toxoplasmosis in Mashhad. Medical Journal of Mashhad university of Medical Sciences. 2020;63(4):2539-2549.
27. Kalantari N, Sheikhansari M, Ghaffari S, et al. Seroprevalence and molecular detection of Toxoplasma gondii in young healthy blood donors in Northern Iran. Trop Biomed.2018; 35(4):1017-1027.
28. Badparva E. Prevalence of Toxoplasma gondii in pregnant women referred to health-treatment centers of Khoramabad. Yafteh. 2001; 3(9): 32-35.
29. Maani S, Kazemi M, Solhjoo K, et al. Serological study of toxoplasmosis in pregnant women in Jahrom city, 2018. Pars J Med Sci. 2020;18(2):1-8.
30. Shabanian H, Jafari-Shakib R, Sharifdini M, et al. Seroepidemiology of Toxoplasmosis in Pregnant Women Referring to the Pregnancy Care Center of Ramsar. JGUMS. 2023;32(2):106-115.
31. Hariri SS, Heidari Z, Habibzadeh S, et al . Seroprevalence of Toxoplasma gondii among Pregnant Women in Ardabil, Iran (2021–2022). Iran J Parasitol. 2023; 18(1):93–99.
32. Gharavi MJ, Roozbehani M, Miahipour A, et al. Prevalence of anti-Toxoplasma gondii antibodies in young Iranians: the CASPIAN III study. Arch Pediatr Infect Dis. 2017; 6(1):e61640.
33. Sadeghi Dehkordi Z, Partoandazanpour A, Adolmaleki N. Seroprevalence and risk factors of Toxoplasma gondii infection among pregnant women in Sanandaj, west of Iran: A Cross-Sectional Study. J Zoonotic Dis. 2022;6(2):78-83.
34. Shahighi M, Heidari A, Keshavarz H, et al. Seroepidemiological study of toxoplasmosis in women referred to a pre-marriage counseling center in Alborz Province, Iran. BMC Res Notes. 2021;14(1):163.
35. Khademi SZ, Ghaffarifar F, Dalimi A, et al. Toxoplasma gondii in slaughtered sheep in high‐and low‐humidity regions in the South of Iran: molecular prevalence and genotype identification. Vet Med Int. 2021;2021:5576771.
36. Zeinali S, Khademvatan S, Jafari R, et al. Prevalence and risk factors of Toxoplasma gondii infection among women with miscarriage and their aborted fetuses in the northwest of Iran. PLoS One. 2023;18(10):e0283493.
37. Abdi Gheshlaghi S, Babaeinejad Z, Saraei M, et al. Maternal Serological Screening for Congenital Toxoplasmosis During Pregnancy and Evaluating the Pregnant Women’s Knowledge on Toxoplasmosis in Qazvin, Iran. Journal of Kerman University of Medical Sciences. 2022;29(5):428-435.
38. Soltani S, Tavakoli S, Sabaghan M, et al. The Probable Association between Chronic Toxoplasma gondii Infection and Type 1 and Type 2 Diabetes Mellitus: A Case‐Control Study. Interdiscip Perspect Infect Dis. 2021;2021:2508780.
39. Teimouri A, Nassrullah OJ, Hedayati P, et al. Prevalence and predictors of Toxoplasma gondii infection in psychiatric inpatients in Fars Province, Southern Iran. Front Psychiatry. 2022;13:891603.
40. Bashour N, Aminpour A, Vazifehkhah S, et al. Seromolecular study on the prevalence and risk factors of Toxoplasma gondii infection in pregnant women referred to a gynecology hospital in Urmia, northwest part of Iran in 2022. BMC Infect Dis. 2024;24(1):410.
41. Ahmadpour E, Daryani A, Sharif M, et al. Toxoplasmosis in immunocompromised patients in Iran: a systematic review and meta-analysis. J Infect Dev Ctries. 2014;8(12):1503-10.
42. Mahmoudvand H, Saedi Dezaki E, Soleimani S, et al. Seroprevalence and risk factors of Toxoplasma gondii infection among healthy blood donors in south‐east of Iran. Parasite Immunol. 2015;37(7):362-7.
43. Mohammadnejad AE, Eslami G, Shamsi F, et al. Prevalence of food-borne Toxoplasma in pregnant women population of Urmia, Iran. Journal of Food Quality And Hazards Control. 2018;5:17-23.
44. Nematollahi S, Hajimohammadi B, Eslami G, et al. Prevalence and Risk Factors of Toxoplasmosis Among Women of Reproductive Age, Southwestern Iran. J Egypt Soc Parasitol. 2022;52(2):341-348.
45. Mizani A, Alipour A, Sharif M, et al. Toxoplasmosis seroprevalence in Iranian women and risk factors of the disease: a systematic review and meta-analysis. Trop Med Health. 2017;45:7.
46. Mousavi-Hasanzadeh M, Sarmadian H, Ghasemikhah R, et al. Evaluation of Toxoplasma gondii infection in western Iran: seroepidemiology and risk factors analysis. Trop Med Health. 2020;48:35.
47. Yılmaz A, Yazıcı E, Turk C. Assessment of seroprevalence of Toxoplasma gondii in blood donors applied to the blood center of Gazi university hospital. Iran J Microbiol. 2021;13(2):243-247.
48. Daryani A, Sarvi S, Aarabi M, et al. Seroprevalence of Toxoplasma gondii in the Iranian general population: a systematic review and meta-analysis. Acta Trop. 2014;137:185-94.
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| Issue | Vol 20 No 4 (2025) | |
| Section | Original Article(s) | |
| Keywords | ||
| Toxoplasma Prevalence Women Iran | ||
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How to Cite
1.
Salehi M, Solati A, Gholizad S, Khajavian N, Hajavi J. Seroprevalence and Risk Factors for Toxoplasma gondii Infection among Women of Reproductive Age in Northeast Iran. Iran J Parasitol. 2025;20(4):524-533.
