Seroprevalence and risk factors of Toxoplasmosis in HIV positive and negative patients attending the Bamenda Regional Hospital, North West Region, Cameroon Séroprévalence et facteurs de risque de la Toxoplasmose chez les patients séropositifs et séronégatifs fréquentant l'Hôpital Régional de Bamenda, région du Nord-Ouest, Cameroun

Abstract

Background: Toxoplasmosis, caused by Toxoplasma gondii, can infect almost all warm-blooded animals including humans. T. gondii is regarded as an important opportunistic pathogen that can cause infection in HIV/AIDS patients associated with high mortality. The objective of this study is to determine the prevalence and risk factors of T. gondii infection in HIV-positive and negative patients and establish the relationship between HIV viral load and active toxoplasmosis in the Bamenda Regional Hospital Cameroon.
Methodology: Three hundred and three (201 HIV-positive and 102 HIV-negative) participants attending the Bamenda Regional Hospital, Cameroon, were randomly recruited into the study. Well-structured questionnaires were used to obtain information on demographic characteristics and potential risk factors from each participant. Venous blood samples were collected for serological detection of toxoplasmosis using One-Step Toxo IgG/IgM rapid diagnostic test (RDT) kits, followed by confirmation of all positive samples by Toxoplasma IgM ELISA test. Data were analysed on SPSS version 23.0. Association of potential risk factors with seroprevalence of toxoplasmosis was done using Chi square test, and comparison of means HIV loads between participant categories was done using Mann-Whitney U-test and Kruskal-Wallis as applicable, with p<0.05 considered as significant level.
Results: Of the 303 participants, 93 were positive for Toxoplasma IgG, giving latent toxoplasmosis seroprevalence rate of 30.7%, while 2 of the 303 participants were seropositive for Toxoplasma IgM, indicating active toxoplasmosis in 0.7%. The seroprevalence of latent toxoplasmosis was 28.9% (n=58/201) in HIV-positive compared to 34.3% (n=35/102) in HIV-negative participants (χ²=0.948, OR=0.775, p=0.330), while the seroprevalence of active toxoplasmosis was 1.0% (n=2/201) in HIV-positive compared to 0% (n=0/102) in HIV-negative participants (χ²=0.068, OR=2.568, p=0.552). Viral load was detectable (≥ 42 viral copies/ml) in 54 of the 201 HIV-positive participants, giving an overall detectable viral load rate of 26.9%. The seroprevalence of latent toxoplasmosis was higher in HIV-positive participants with detectable viral load than those with non-detectable viral load, and the two HIV-positive patients with active toxoplasmosis had detectable viral loads. The risk factors significantly associated (p<0.05) with the latent toxoplasmosis were owning a cat, presence of stray cats, playing with cats, and eating soya.
Conclusion: Latent toxoplasmosis is prevalent among HIV-positive and negative patients attending the Bamenda Regional Hospital in Cameroon, with active infection only among HIV-infected patients.