Seroprevalence of anti-Toxoplasma gondii and anti-Brucella spp. antibodies in pregnant women from Mogadishu, Somalia

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Dr. Abdullahi M. Yasin

MBChB, MD

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Benadir University

Faculty of Medicine and Surgery

Abrar University

College of Medicine and Health sceince

@SomaliOneHealth

22 - 24 March -2022

Outline

1. Background
2. Introduction to Toxoplasmosis
3. Introduction to Brucellosis
4. Detection of anti-Toxoplasma gondii and anti-Brucella spp. in pregnant woman from Mogadishu, Somalia
5. Conclusions

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@SomaliOneHealth

22 - 24 March -2022

Background

• Population: 15 million people
• Somalia is a Livestock dependent country

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22 - 24 March -2022

Background

• Source of Meat and Milk for human consumption:
• Camel: 8 million (1^st in the world)
• Cattle: 4.8 million
• Sheep and Goats: 31.3 million

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@SomaliOneHealth

22 - 24 March -2022

Problem statement and justification

• In Somalia,
• climatic and living conditions favors many pathogens, including zoonotic pathogens
• Limited data were available in Somali people and their animals.
• In addition, there are little or no concerted medical and veterinary efforts to maximize toxoplasmosis and brucellosis detection rates.

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@SomaliOneHealth

22 - 24 March -2022

Introduction

• Toxoplasmosis caused by Toxoplasma gondii
• Zoonotic disease
• Worldwide occurrence
• Toxoplasma gondii cause severe illness in immunocompromised people including pregnant women

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22 - 24 March -2022

Transmission

Toxoplasma can be transmitted to humans by three principal routes:

1. Ingestion of raw or inadequately cooked infected meat;
2. Ingestion of oocysts, an environmentally resistant form of the organism that cats pass in their feces, with exposure of humans occurring through exposure to cat litter or soil (e.g., from gardening or unwashed fruits or vegetables)
3. Consumption of unpasteurized goats milk
4. A newly infected pregnant woman passing the infection to her unborn fetus.

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@SomaliOneHealth

22 - 24 March -2022

Clinical Signs of Toxoplasmosis in Human

• Congenital Toxoplasmosis in humans is characterized by:
• Abortion
• Fetal anomaly/ defect
• Stillbirth
• Fetal growth restriction
• Hydrocephalus or microcephalus
• Learning disability as well as blindness

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22 - 24 March -2022

Prevention and Control of Toxoplasmosis

• Certain precautions can help prevent toxoplasmosis:
• Food and water should be kept away from cat’s faeces
• Education of farmers
• Vaccination
• Heating of meat to 67ºC or higher
• Pasteurization of milk.

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22 - 24 March -2022

Cont..

• Wear gloves when garden or handle soil. 
• Washing kitchen utensils thoroughly. 
• Washing all fruits and vegetables. 
• Avoid stray cats

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22 - 24 March -2022

Introduction

• Brucellosis caused by Brucella melitensis and Brucella abortus
• Zoonotic diseases
• worldwide occurrence

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22 - 24 March -2022

Transmission

• Brucellosis can be transmitted to humans by:
• Direct contact with Brucella infected animals
• Consumption of unpasteurized milk and milk products
• Medical doctors or laboratory workers
• Accidental self-inoculation with live vaccines

@SomaliOneHealth

22 - 24 March -2022

Clinical Signs of Brucellosis in Human

Brucellosis in human is characterized by:

• Continued intermittent or irregular fever
• Depression and weight loss,
• Hepatomegaly, splenomegaly and generalized aching
• Arthritis
• Epididymitis and orchitis
• Abortion and infertility
• Endocarditis with infection of the aortic valves
• Neurobrucellosis and liver abscesses

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@SomaliOneHealth

22 - 24 March -2022

Prevention and Control of Brucellosis

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• Minimizing/controlling disease in animals and reducing animal to human transmission:
• Pasteurization of milk will reduce Brucella transmission to humans
• Personal hygiene measures and adaption of safe working practices for exposed group of people can reduce the risk.

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@SomaliOneHealth

22 - 24 March -2022

Objectives

• General Objective
• To contribute in management of human toxoplasmosis and brucellosis in Somalia
• Specific Objective
• To evaluate the seroprevalence of anti-Toxoplasma gondii and anti-Brucella spp. antibodies in pregnant women in Mogadishu, Somalia.
• To determine factors associated with exposure/infection by T. gondii in pregnant women in Somalia

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@SomaliOneHealth

22 - 24 March -2022

Methods

• Study Design
• A cross-sectional study
• August 2017 to November 2018
• Banadir Maternity and Children Hospital and Maternal and Child Health (MCH) clinics in Mogadishu city
• All study participants were interviewed using a questionnaire which included demographics and obstetric information comprising age, gestational age and history of abortion.

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@SomaliOneHealth

22 - 24 March -2022

Methods

• Blood Sampling:
• Pregnant women (n=307)
• First trimester (n = 44),
• second trimester (n = 53) and
• third trimester (n = 210)

@SomaliOneHealth

22 - 24 March -2022

Methods

• Detection of anti-T. gondii antibodies
• Latex Agglutination Test (LAT)
• Detection of anti-Brucella spp. antibodies
• Rose Bengal Plate Test (RBPT)
• Competitive-ELISA (cELISA)

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22 - 24 March -2022

Methods

• Statistical Analysis
• Chi-square or the Fisher’s exact test
• Association of Age, gestational age and history of abortion with anti-T. gondii and anti-Brucella spp. antibodies
• Odds ratio, 95% CI, P-values
• P < 0.05
• SPSS version 25

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22 - 24 March -2022

Results

• Anti-T. gondii antibodies
• 159/307 (51.79%; 95% CI: 46.2–57.35%) pregnant women
• Anti-Brucella spp. antibodies
• Overall – 1.30% (4/307)
• 0.65% (2/307) for RBPT
• 0.98% (3/307) for cELISA.
• Two women were seropositive for both agents.

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@SomaliOneHealth

22 - 24 March -2022

Conclusions

• High seropositivity of anti-T. gondii antibodies
• Low seropositivity of anti-Brucella spp. antibodies
• Awareness on these zoonotic pathogens in Somalis is very low
• Somali people are at great public health risk.

@SomaliOneHealth

22 - 24 March -2022

�Conclusion�

• Additionally, there are little or no medical and veterinary efforts to maximize toxoplasmosis and brucellosis detection rates in humans and animals in the country.
• Therefore, there is a need to promote the One Health concept.

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@SomaliOneHealth

22 - 24 March -2022

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Thank you

@SomaliOneHealth

22 - 24 March -2022