Submitted:
13 July 2026
Posted:
14 July 2026
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Abstract
Background: Toxoplasma gondii infection during pregnancy may lead to congenital toxoplasmosis and serious pregnancy complications. In Kenya, however, toxoplasmosis is not screened during routine antenatal care, and there is limited local data on maternal seroprevalence and associated risk factors. This study determined the seroprevalence of T. gondii infection and examined its association with socio-demographic characteristics, awareness levels, and exposure behaviours among pregnant women visiting the antenatal clinic at Pumwani Maternity Hospital in Nairobi, Kenya. Methods: A cross-sectional study was conducted among 298 pregnant women consecutively recruited at Pumwani Maternity Hospital in Nairobi County between July and October 2025. Data on socio-demographic characteristics, knowledge, and exposure practices were collected using a pre-tested structured questionnaire. Blood specimens were obtained from consenting prenatal patients, and anti-T. gondii IgG antibodies were detected by indirect enzyme-linked immunosorbent assay (ELISA). Associations between seropositivity and risk factors were assessed using Pearson's chi-square or Fisher's exact tests, followed by multivariable logistic regression. Results: The overall anti-T. gondii IgG seroprevalence was 24.5% (73/298). In the adjusted analysis, unemployment (AOR = 2.95, 95% CI: 1.25–7.22; p = 0.02) and parity ≥4 (AOR = 3.25, 95% CI: 1.27–8.39; p = 0.01) were independently associated with seropositivity. Awareness of risk groups was associated with seropositivity in the univariable analysis but not independently after adjustment. Stratified analyses identified significant demographic differences in exposure practices, including consumption of undercooked meat in the third trimester of pregnancy (p = 0.021) and consumption of unwashed vegetables by pregnant women from Kamkunji Sub-County (p = 0.005). Parity of three (p = 0.007) increased the risk of infection. Conclusions: Approximately one-quarter (24.5%) of pregnant women showed evidence of exposure to T. gondii. Socioeconomic predictors, including unemployment, and obstetric history (parity ≥4) were independently associated with seropositivity, whereas awareness of risk groups showed only a univariable association that didn't persist after adjustment for confounders. Behavioural exposures varied across trimesters and regions, signalling a need for integrated antenatal education and food safety steps within a One Health framework. The results support integrating maternal health, food safety, and environmental health programs into Kenya's antenatal care to reduce the risk of congenital toxoplasmosis through a comprehensive One Health approach.
