Toxoplasma Gondii Seropositivity in Sickle Cell Disease Patients and Blood Transfusion History

03 Apr 20264 min read0 viewsJournal Feed

GIST

by Verner N. Orish, Renosten E.

Tetteh, David Adzah, Chinecherem A. Ndiokwelu, Emmanuel A.

Allotey, Evans A. Yeboah, Sylvester Y.

Lokpo, Kenneth Ablordey, Duneeh R. Vikpebah, Ekene K.

Nwaefuna, Precious K. Kwadzokpui, Noble D.

Dika, Elom Y. Dzefi, Kokou H.

Amegan-Aho, Aninagyei Enoch, Senyo Tagboto Background Toxoplasma gondii ( T. gondii ) is a successful protozoan parasite infecting up to a third of the human population.

It has varied transmission routes including ingestion of food and water contaminated by cat feces containing oocysts of the parasite and ingestion of bradyzoites in poorly cooked meat. Blood transfusion is another possible route of transmission especially among people with medical conditions requiring blood transfusion, such as those with sickle cell disease (SCD).

This study aimed at finding out the prevalence of T. gondii infection and the association of blood transfusion among patients with SCD.

Method This study was a cross-sectional study involving SCD patients attending the SCD clinic at the Ho Teaching Hospital in the Volta Region of Ghana.

Clinical Editorial

Context and objective

gondii is a widespread protozoan with several transmission routes, including ingestion of contaminated food or water and consumption of undercooked meat.

Blood transfusion is noted as a potential route, particularly for individuals with medical conditions requiring transfusions, such as SCD.

The study investigates how common Toxoplasma gondii infection is among patients with sickle cell disease (SCD) and explores whether a history of blood transfusion relates to seropositivity.
T.

Study design and setting

Blood samples were obtained to assess T.

gondii exposure.

Design: Cross-sectional evaluation at a single clinical site.
Population: SCD patients attending the SCD clinic at Ho Teaching Hospital, located in the Volta Region of Ghana.
Data collection: Participants completed a questionnaire capturing sociodemographic details, cat ownership, consumption of poorly cooked meat, and transfusion history.

Laboratory methods and serologic definitions

gondii immunoglobulin G (IgG) and immunoglobulin M (IgM) were measured using a rapid diagnostic test (RDT), with enzyme-linked immunosorbent assay (ELISA) employed as the reference standard.

Diagnostic approach: Anti-T.
Seropositivity criteria: Positive results were defined if either IgG or IgM (or both) were detected.

Key population characteristics

Total participants: 156 SCD patients.
Hemoglobin phenotypes: 124 with HbSS and 32 with HbSC.
Transfusion history: 105 participants (67.3%) reported a history of blood transfusion.

Primary serologic findings

gondii by RDT.

gondii serodiagnosis was observed in both testing modalities (RDT: p = 0.003; ELISA: p = 0.001).

RDT results: 60 participants (38.5%) tested positive for T.
ELISA results: 83 participants (53.2%) tested positive by ELISA.
Associations with exposure risks:
Cat ownership: No meaningful association with seropositivity by either RDT (p = 0.891) or ELISA (p = 0.673).
Consumption of poorly cooked meat: No significant association with seropositivity by RDT (p = 0.370) or ELISA (p = 0.211).
Age: Seropositivity was more common in older patients (age ≥20 years) across both assays (RDT: p = 0.002; ELISA: p = 0.002), indicating an age-related increase in seroprevalence.
Blood transfusion history: A significant association with T.

Quantitative association with transfusion exposure

gondii by ELISA.

This indicates roughly a threefold increase in odds after adjustment for other factors measured in the study.

Among transfused individuals, 66 of 105 (62.9%) tested positive for T.
In multivariable consideration, transfusion history was associated with higher odds of ELISA-determined seropositivity, with an adjusted odds ratio of 3.14 (95% CI 1.50–6.58; p = 0.002).

Interpretation and contextual notes

gondii, including a statistically significant adjusted estimate suggesting elevated odds in transfused patients.

Seroprevalence differences: ELISA detected a higher proportion of seropositive individuals (53.0%) than the RDT method (38.5%), underscoring methodological variation in serodiagnosis.
Transfusion-related signal: The data show a consistent association between transfusion history and seropositivity to T.
Age-related pattern: Older age (≥20 years) correlated with higher seropositivity, aligning with cumulative exposure risk over time.

Limitations and uncertainties

Bottom-line: The investigation reports higher T.

gondii seroprevalence by ELISA than by rapid testing and identifies a meaningful association between prior blood transfusion and seropositivity among SCD patients.

The authors emphasize reinforcing transfusion safety protocols and considering T.

gondii screening in high-risk groups such as those with SCD.

They also call for longitudinal studies to clarify the causal contribution of transfusion to T.

gondii transmission, given the cross-sectional design.

Study design: Being cross-sectional, the analysis cannot establish causality or quantify the direct contribution of transfusion-derived transmission versus other exposure pathways.
Setting and population: Findings originate from a single hospital-based cohort in Ghana, which may limit generalizability to broader SCD populations or different geographic settings.
Diagnostic scope: The divergence between RDT and ELISA results highlights potential variability in serologic assays; reliance on ELISA as reference is stated, but both tests carry inherent sensitivity and specificity considerations not elaborated in the report.
Unmeasured factors: While cat ownership and meat consumption were assessed, other potential exposure routes or comorbid conditions were not detailed in the provided content.