Seroprevalence of Toxoplasma gondii IgG antibodies and behavioral risks of exposure among women of childbearing age from the Knoxville, Tennessee area

This study investigates if women of childbearing age (pregnant and nonpregnant) engage in behaviors that may increase their risk of exposure to Toxoplasma gondii and how these behaviors differ between age groups. Risky behaviors were identified as activities that could result in accidental ingestion of either the tissue stage in edible portions of meat or the environmental oocyst stage shed in feline feces. Serum samples and interview data were collected by a convenience sampling of 829 women between 18-53 years. The seroprevalence of T. gondii was 7.0%. Most women, 93.7%, were meat eaters with 8.7-50.2% preferring to eat some meats less than well-done. Those in the age groups of 18-24 years were more likely to eat meat less than well-done compared to most older age groups. Those 18-19 years old were more likely not always to wash vegetables and fruits before eating or wash hands before handling or eating food. Most women, 56.8%, garden at least occasionally, with those 30 years and older more likely to garden. Analysis of the behaviors of seronegative women (93.0%) show that many women may engage in more than one of these risky behaviors. In addition to published recommendations, educational programs for the prevention of T. gondii during pregnancy need to reinforce the importance of consuming only well-done meats, washing fruits and vegetables, and hand washing to reduce risk of exposure to tissue cysts and oocysts to 18-24 year olds. In women more likely to garden, >30 years old, the risk of oocyst exposure needs to be emphasized. These behaviors should be emphasized during prenatal classes. Risky behaviors for T. gondii infection were evaluated using the odds ratio; however, the data collected in this cross-sectional study cannot be used to prove a causal relationship between specific behaviors and T. gondii seropositivity. Time is a confounding factor in the analysis because chronic infections cannot be attributed to current behavior. The modified agglutination test was used as the screening tool to detect IgG antibodies to T. gondii