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Background: Malaria and toxoplasmosis during pregnancy are each reported to cause severe negative consequences in both mother and child. In Ghana, efforts are ongoing to control malaria from all facets but there is no such effort yet for control of toxoplasmosis. In this study, we sought to estimate the prevalence of Plasmodium spp and T. gondii infections in mothers at delivery and their neonates in a malaria holo-endemic area where Sulphadoxine-pyrimethamine intermittent preventive therapy for malaria in pregnancy (SP-IPTp) is administered and assess the possible risk of congenital T. gondii transmission. Methods: A total of 185 women were recruited for this study of which 182 who delivered 186 babies voluntarily participated. Maternal and infant blood samples were obtained from the appropriate blood vessels of the expelled placenta after delivery, into clearly labeled serum separator tubes and blood blots were made on filter paper strips (Whatman No 3; GE Health Sciences, Japan). Serum obtained from blood samples were tested for anti-T. gondii IgG and IgM using commercial ELISA kits. Genomic DNA extracted from blood blots were amplified for detection of T. gondii SAG 3 gene marker and P. falciparum 18SrRNA gene by nested PCR. Risk factors associated with T. gondii and P. falciparum infections were assessed by responses to a structured questionnaire. Results: An overall sero-prevalence of 45.1% (82/182) anti-T. gondii IgG was recorded in mothers and 22.7% (42/185) anti-T. gondii IgG in their babies. Parasite DNA positivity as determined by PCR was 23.1% (42/182) for T. gondii and 3.8% (7/183) for P. falciparum in mothers only. Relative risk of congenital transmission of toxoplasmosis was determined to be 103.4 (CI 95%, p value = 0.001). Conclusion: The high level of exposure to T. gondii infections in pregnant women therefore suggests the need for establishment of an integrated management protocol during pregnancy to ensure improved quality maternal and child healthcare.

Effectiveness of SP-IPTp for Malaria and Evidence for the Need of T. Gondii Infection Preventive Policy during Pregnancy in Ghana