Toxoplasmosis among pregnant women: high seroprevalence and risk factors in Kinshasa, Democratic Republic of Congo.

OBJECTIVE: To determine the seroprevalence of toxoplasmosis in pregnant women, as well as the proportion of acutely infected and risk factors in the Democratic Republic of Congo. METHODS: Thirty maternities in Kinshasa were randomly selected and women attending antenatal consultation were invited to participate. They were interviewed with a structured questionnaire about known risk factors (age, meat consumption, contact with soil, and presence of cat) and a venous blood sample was taken. Sera were analysed for total immunoglobulins (Ig) by VIDAS Toxo Competition using Enzyme Linked Fluorescent Assay. IgM was determined by VIDIA Toxo IgM and IgG avidity by VIDAS Toxo IgG avidity. RESULTS: A total of 781 women were included. Median age was 28 years old (IQR: 8.5). And 627 women (80.3%; 95% CI: 77.5-83.1) were found to be positive to total Ig and 17 out of 387 (4.4%; 95% CI: 2.3-6.4) were positive to IgM. IgG avidity was low for 2 (11.8%) women, intermediate for 2 (11.8%) and high for 13 women (76.4%). There was no statistically significant association between Toxoplasma gondii infection and any risk factors assessed. CONCLUSION: In Kinshasa, toxoplasmosis endemicity is highly prevalent. One woman out of twenty five had a recent toxoplasmosis infection and 20% were not protected against primo-infection, indicating a need for measures to prevent and control toxoplasmosis during pregnancy.

Street youths are the only high-risk group for HIV in a low-prevalence South American country.

OBJECTIVES: To measure HIV prevalence in various subpopulations in Bolivia. DESIGN: In 2002 in Cochabamba, we offered voluntary counseling and testing to homeless street youths, registered and unregistered commercial sex workers, truck drivers, and prisoners. We examined surveillance data of pregnant women and blood donors. RESULTS: Among street youths over 15, overall HIV prevalence was 3.5% (11/313), higher among those recruited in the street, lower among those recruited in centers for homeless; prevalence was 0.6% (2/334) and 0.5% (1/189) in female registered and nonregistered sex workers, respectively, and below 0.3% in all other groups. All HIV cases were attributed to sexual transmission. CONCLUSION: In a low-prevalence setting where intravenous drug use is uncommon, street youths are a threat for the expansion of the HIV epidemic. We argue that HIV prevention in this population requires a comprehensive approach to their health and social problems.