Toxoplasma gondii seroprevalence at a tertiary care hospital in Makkah, Saudi Arabia


  • Dina A. Zaglool Al-Noor Specialist Hospital, Makkah, Saudi Arabia & Medical Parasitology Department, Assiut University, Assiut, Egypt.
  • Mohammed El-Bali Faculty of Medicine, Medical Parasitology Department, Umm Al-Qura University, Makkah, Saudi Arabia.
  • Hani S. Faidah Al-Noor Specialist Hospital, Makkah, Saudi Arabia & Faculty of Medicine, Microbiology Department, Umm Al-Qura University, Makkah, Saudi Arabia.
  • Saeed A. Al-Harthi Faculty of Medicine, Medical Parasitology Department, Umm Al-Qura University, Makkah, Saudi Arabia.


Toxoplasma gondii, Seroprevalence, Makkah, Saudi Arabia


Human toxoplasmosis is a cosmopolitan infection with a wide-ranging prevalence. The prevalence of Toxoplasma gondii infection is variable and depends on different eco-epidemiological factors. Both, active serological screenings and retrospective analytical methods are usually used for the investigation of toxoplasmosis seroprevalence in different populations. We conducted a two-year retrospective database search at a major tertiary care hospital to determine the prevalence of toxoplasmosis and its distribution in relation to gender and age among Makkah's population. In total, 806 females and 118 males with 33.1±9.1 years, mean age (±SD) were tested for anti-T. gondii antibodies in the last two years. Laboratory results revealed 229 seropositive subjects indicating 24.8% overall toxoplasmosis seroprevalence. Infection rate was significantly higher among male subjects (33.9%) than female subjects (23.4%). Seroprevalence increased considerably with age; from 9.7% in children less than 10 years old to 37.4% and 40.5% among adults between 40 and 49 and over 50 years, respectively. Only two anti-T. gondii IgM seropositive cases were recorded along this period, indicating possible active infection. In conclusion, overall T. gondii seropositivity rate is relatively low among Makkah's population, but moderate in adult males. Further investigations are required to determine the risk factors associated with toxoplasmosis transmission in the area. Also, adequate screening for anti-T. gondii specific antibodies are recommended, especially for immunocompromised patients and during pregnancy, in order to minimize prospective complications.


Download data is not yet available.


Montoya, J.G., Boothroyd, J.C. & Kovacs, J.A. (2010). Toxoplasma gondii. In: Mandell, G.L., Bennett, J.E. & Dolin, R. (eds.), Mandell, Douglas, and Bennett’s principles and practice of infectious diseases, vol. 2, 7th ed., Churchill Livingstone, Philadelphia, pp. 3495–3526.

Teutsch, S.M., Juranek, D.D., Sulzer, A., Dubey, J.P. & Sikes, R.K. (1979). Epidemic toxoplasmosis associated with infected cats. N. Engl. J. Med., 300(13): 695–699.

Montoya, J.G. & Liesenfeld, O. (2004). Toxoplasmosis. Lancet, 363(9425): 1965–1976.

Dubey, J.P. & Jones, J.L. (2008). Toxoplasma gondii infection in humans and animals in the United States. Int. J. Parasitol., 38(11): 1257–1278.

Tenter, A.M., Heckeroth, A.R. & Weiss, L.M. (2000). Toxoplasma gondii: from animals to humans. Int. J. Parasitol., 30(12-13): 1217–1258.

Weiss, L.M. & Dubey, J.P. (2009). Toxoplasmosis: A history of clinical observations. Int. J. Parasitol., 39(8): 895–901.

Hill, D.E., Chirukandoth, S. & Dubey, J.P. (2005). Biology and epidemiology of Toxoplasma gondii in man and animals. Anim. Health Res. Rev., 6(1): 41–61.

Hoffmann, C. (2005). Opportunistic infections. In: Hoffmann, C., Rockstroh, J.K. & Kamps, B.S. (eds.), HIV Medicine. Flying Publisher. (In Spanish)

Vutova, K., Peicheva, Z., Popova, A., Markova, V., Mincheva, N. & Todorov, T. (2002). Congenital toxoplasmosis: eye manifestations in infants and children. Ann. Trop. Paediatr., 22(3): 213–218.

Torrey, E.F. & Yolken, R.H. (2003). Toxoplasma gondii and Schizophrenia. Emerg. Infect. Dis., 9(11): 1375-1380.

Roberts, T., Murrell, K.D. & Marks, S. (1994). Economic losses caused by foodborne parasitic diseases. Parasitol. Today, 10(11): 419–423.

Stillwaggon, E., Carrier, C.S., Sautter, M. & McLeod, R. (2011). Maternal serologic screening to prevent congenital toxoplasmosis: a decision-analytic economic model. PLoS Negl. Trop. Dis., 5(9): e1333.

Bobić, B., Sibalić, D. & Djurković-Djaković, O. (1991). High levels of IgM antibodies specific for Toxoplasma gondii in pregnancy 12 years after primary toxoplasma infection. Case report. Gynecol. Obstet. Invest., 31(3): 182–184.

Joynson, D.H.M. & Guy, E.C. (2001). Laboratory diagnosis of Toxoplasma infection. In: Joynson, D.H.M. & Wreghitt, T.G. (eds.), Toxoplasmosis: a comprehensive clinical guide. Cambridge University Press, Cambridge, UK. pp. 296–318.

Robert-Gangneux, F. & Dardé, M.L. (2012). Epidemiology of and diagnostic strategies for toxoplasmosis. Clin. Microbiol. Rev., 25(2): 264–296.

Frenkel, J.K. (1990). Toxoplasmosis in human beings. J. Am. Vet. Med. Assoc., 196(2): 240–248.

Lopez, A., Dietz, V.J., Wilson, M., Navin, T.R. & Jones, J.L. (2000). Preventing congenital toxoplasmosis. MMWR Recomm. Rep., 49(RR-2): 59–68.

Jones, J.L. & Holland, G.N. (2010). Annual burden of ocular toxoplasmosis in the US. Am. J. Trop. Med. Hyg., 82(3): 464–465.

Jones, J.L., Kruszon-Moran, D., Wilson, M., McQuillan, G., Navin, T. & McAuley, J.B. (2001). Toxoplasma gondii infection in the United States: seroprevalence and risk factors. Am. J. Epidemiol., 154(4): 357–365.

Furtado, J.M., Smith, J.R., Belfort, R., Jr, Gattey, D. & Winthrop, K.L. (2011). Toxoplasmosis: a global threat. J. Glob. Infect. Dis., 3(3): 281–284.

Sakikawa, M., Noda, S., Hanaoka, M., Nakayama, H., Hojo, S., Kakinoki, S., Nakata, M., Yasuda, T., Ikenoue, T. & Kojima, T. (2012). Anti-Toxoplasma antibody prevalence, primary infection rate, and risk factors in a study of toxoplasmosis in 4,466 pregnant women in Japan. Clin. Vaccine Immunol., 19(3): 365–367.

Jones, J.L., Kruszon-Moran, D., Rivera, H.N., Price, C. & Wilkins, P.P. (2014). Toxoplasma gondii seroprevalence in the United States 2009-2010 and comparison with the past two decades. Am. J. Trop. Med. Hyg., 90(6): 1135–1139.

Cong, W., Dong, X.Y., Meng, Q.F., Zhou, N., Wang, X.Y., Huang, S.Y., Zhu, X.Q. & Qian, A.D. (2015). Toxoplasma gondii Infection in Pregnant Women: A Seroprevalence and Case-Control Study in Eastern China. Biomed Res. Int., 2015: Article ID 170278.

Flatt, A. & Shetty, N. (2013). Seroprevalence and risk factors for toxoplasmosis among antenatal women in London: a re-examination of risk in an ethnically diverse population. Eur. J. Public Health, 23(4): 648–652.

Nissapatorn, V., Suwanrath, C., Sawangjaroen, N., Ling, L.Y. & Chandeying, V. (2011). Toxoplasmosis-serological evidence and associated risk factors among pregnant women in southern Thailand. Am. J. Trop. Med. Hyg., 85(2): 243–247.

Ertug, S., Okyay, P., Turkmen, M. & Yuksel, H. (2005). Seroprevalence and risk factors for toxoplasma infection among pregnant women in Aydin province, Turkey. BMC Public Health, 5: 66.

Rosso, F., Les, J.T., Agudelo, A., Villalobos, C., Chaves, J.A., Tunubala, G.A., Messa, A., Remington, J.S. & Montoya, J.G. (2008). Prevalence of infection with Toxoplasma gondii among pregnant women in Cali, Colombia, South America. Am. J. Trop. Med. Hyg., 78(3): 504–508.

Wilking, H., Thamm, M., Stark, K., Aebischer, T. & Seeber, F. (2016). Prevalence, incidence estimations, and risk factors of Toxoplasma gondii infection in Germany: a representative, cross-sectional, serological study. Sci. Rep., 6: 22551.

Sroka, S., Bartelheimer, N., Winter, A., Heukelbach, J., Ariza, L., Ribeiro, H., Oliveira, F.A., Queiroz, A.J., Alencar, C., Jr, & Liesenfeld, O. (2010). Prevalence and risk factors of toxoplasmosis among pregnant women in Fortaleza, Northeastern Brazil. Am. J. Trop. Med. Hyg., 83(3): 528–533.

Ayi, I., Edu, S.A., Apea-Kubi, K.A., Boamah, D., Bosompem, K.M. & Edoh, D. (2009). Sero-epidemiology of toxoplasmosis amongst pregnant women in the greater accra region of ghana. Ghana Med. J., 43(3): 107–114.

Aqeely, H., El-Gayar, E.K., Perveen Khan, D., Najmi, A., Alvi, A., Bani, I., Mahfouz, M.S., Abdalla, S.E. & Elhassan, I.M. (2014). Seroepidemiology of Toxoplasma gondii amongst Pregnant Women in Jazan Province, Saudi Arabia. J. Trop. Med., Volume 2014; Article ID 913950.

Elsafi, S.H., Al-Mutairi, W.F., Al-Jubran, K.M., Abu Hassan, M.M. & Al Zahrani, E.M. (2015). Toxoplasmosis seroprevalence in relation to knowledge and practice among pregnant women in Dhahran, Saudi Arabia. Pathog. Glob. Health, 109(8): 377–382.

Almogren, A. (2011). Antenatal screening for Toxoplasma gondii infection at a tertiary care hospital in Riyadh, Saudi Arabia. Ann. Saudi Med., 31(6): 569–572.

Almushait, M.A., Dajem, S.M., Elsherbiny, N.M., Eskandar, M.A., Al Azraqi, T.A. & Makhlouf, L.M. (2014). Seroprevalence and risk factors of Toxoplasma gondii infection among pregnant women in south western, Saudi Arabia. J. Parasit. Dis., 38(1): 4–10.

Al-Mohammad, H.I., Amin, T.T., Balaha, M.H. & Al-Moghannum, M.S. (2010). Toxoplasmosis among the pregnant women attending a Saudi maternity hospital: seroprevalence and possible risk factors. Ann. Trop. Med. Parasitol., 104(6): 493–504.

Al-Qurashi, A.R., Ghandour, A.M., Obeid, O.E., Al-Mulhim, A. & Makki, S.M. (2001). Seroepidemiological study of Toxoplasma gondii infection in the human population in the Eastern Region. Saudi Med. J., 22(1): 13–18.

Kim, Y.H., Lee, J., Ahn, S., Kim, T.S., Hong, S.J., Chong, C.K., Ahn, H.J. & Nam, H.W. (2017). High Seroprevalence of Toxoplasmosis Detected by RDT among the Residents of Seokmo-do (Island) in Ganghwa-Gun, Incheon City, Korea. Korean J. Parasitol., 55(1): 9–13.

Alvarado-Esquivel, C., Rascón-Careaga, A., Hernández-Tinoco, J., Corella-Madueño, M.A., Sánchez-Anguiano, L.F., Aldana-Madrid, M.L., Velasquez-Vega, E., Quizán-Plata, T., Navarro-Henze, J.L., Badell-Luzardo, J.A., Gastélum-Cano, J.M. & Liesenfeld, O. (2016). Seroprevalence and Associated Risk Factors for Toxoplasma gondii Infection in Healthy Blood Donors: A Cross-Sectional Study in Sonora, Mexico. Biomed Res. Int., 2016: 9597276.

Cavalcante, G.T., Aguilar, D.M., Camargo, L.M., Labruna, M.B., de Andrade, H.F., Meireles, L.R., Dubey, J.P., Thulliez, P., Dias, R.A. & Gennari, S.M. (2006). Seroprevalence of Toxoplasma gondii antibodies in humans from rural Western Amazon, Brazil. J. Parasitol., 92(3): 647–649.

Gargaté, M.J., Ferreira, I., Vilares, A., Martins, S., Cardoso, C., Silva, S., Nunes, B. & Gomes, J.P. (2016). Toxoplasma gondii seroprevalence in the Portuguese population: comparison of three cross-sectional studies spanning three decades. BMJ Open, 6(10): e011648.

Mahdy, M.A., Alareqi, L.M., Abdul-Ghani, R., Al-Eryani, S.M., Al-Mikhlafy, A.A., Al-Mekhlafi, A.M., Alkarshy, F. & Mahmud, R. (2017). A community-based survey of Toxoplasma gondii infection among pregnant women in rural areas of Taiz governorate, Yemen: the risk of waterborne transmission. Infect. Dis. Poverty, 6(1): 26.

Liesenfeld, O., Press, C., Montoya, J.G., Gill, R., Isaac-Renton, J.L., Hedman, K. & Remington, J.S. (1997). False-positive results in immunoglobulin M (IgM) toxoplasma antibody tests and importance of confirmatory testing: the Platelia Toxo IgM test. J. Clin. Microbiol., 35(1): 174–178.

Dhakal, R., Gajurel, K., Pomares, C., Talucod, J., Press, C.J. & Montoya, J.G. (2015). Significance of a Positive Toxoplasma Immunoglobulin M Test Result in the United States. J. Clin. Microbiol., 53(11): 3601–3605.

Konishi, E. (1987). A pregnant woman with a high level of naturally occurring immunoglobulin M antibodies to Toxoplasma gondii. Am. J. Obstet. Gynecol., 157: 832–833.

Sensini, A. (2006). Toxoplasma gondii infection in pregnancy: opportunities and pitfalls of serological diagnosis. Clin. Microbiol. Infect., 12(6): 504–512.




How to Cite

Zaglool, D. A., El-Bali, M., Faidah, H. S., & Al-Harthi, S. A. (2017). Toxoplasma gondii seroprevalence at a tertiary care hospital in Makkah, Saudi Arabia. Journal of Advanced Laboratory Research in Biology, 8(2), 36–40. Retrieved from