Cherotich Jesca Tangus

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 infections. It examined its association with socio-demographic, obstetric 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-demographics, obstetric characteristics, knowledge, and exposure practices were collected using a 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 univariable logistic regression, followed by two separate multivariable models. Variables with p < 0.25 were considered for multivariable analysis, followed by backward likelihood-ratio elimination. Model calibration was assessed using the Hosmer–Lemeshow test. Results: The overall seroprevalence of anti-T. gondii IgG was 24.5% (73 of 298). In the sociodemographic model, women who were self-employed (adjusted odds ratio [AOR] = 0.26, 95% CI: 0.13–0.53) and formally employed (AOR = 0.25, 95% CI: 0.11–0.59) had lower odds of seropositivity than unemployed women. Women aged 25–33 years had higher odds than those aged 18–24 years (AOR = 2.45, 95% CI: 1.06–5.62). Having two children was associated with lower odds than a first birth (AOR = 0.40, 95% CI: 0.18–0.90), while parity of four or more showed a borderline increase in odds (AOR = 3.11, 95% CI: 0.99–9.76). In the knowledge/exposure model, good awareness of population risk groups was linked to higher odds of seropositivity (AOR = 3.34, 95% CI: 1.21–9.24), but exposure-practice variables were not independently associated. Stratified analyses showed significant demographic differences in exposure practices, such as eating undercooked meat in the third trimester of pregnancy (p = 0.021) and unwashed vegetable consumption by pregnant women from Kamkunji Sub-County (p = 0.005). Parity of three increased infection risk (p = 0.007). Conclusions: About 25% of participants showed evidence of prior T. gondii exposure. Seropositivity correlated with specific sociodemographic and obstetric factors as well as awareness of groups at risk. These results endorse targeted antenatal education that emphasises practical food safety and environmental hygiene, aligned with a One Health approach. Further longitudinal and multicenter research, including IgM and IgG avidity testing, is needed to differentiate recent from past infections and to better understand risks associated with congenital toxoplasmosis.

Leishmaniasis is an emerging zoonotic disease recognized by WHO as a priority neglected tropical disease (NTD) targeted for elimination by 2030. The disease is transmitted through bites of infected female phlebotomine sand flies and presents in three main forms: cutaneous, mucocutaneous, and visceral leishmaniasis. Visceral leishmaniasis (VL) has two distinct epidemiological cycles: anthroponotic visceral leishmaniasis (AVL) cycle, caused by L. donovani and transmitted between humans, and zoonotic visceral leishmaniasis (ZVL) cycle, caused by L. infantum, with domestic dogs as the main reservoirs. ZVL represents the most severe clinical form and poses a public health risk due to a high fatality rate. In Kenya, the epidemiology and transmission dynamics of Leishmania infection among the canine population in endemic areas such as Baringo are poorly characterized. A cross-sectional epidemiological study was conducted in Baringo County, Kenya, one of the endemic foci for human visceral leishmaniasis. Blood samples were collected from 140 dogs in Rabai, Sabor, Mbechot, Kapkuikui, and Chemolingot and analyzed using Rapid Diagnostic Test (RDT) and Enzyme-linked immunosorbent assay (ELISA). Data on potential epidemiological factors and clinical status for dogs were collected using a questionnaire. Statistical analysis was performed using Pearson’s chi-square (χ²) test or Fisher’s exact test to assess associations between Leishmania seropositivity and potential risk factors. A stepwise logistic regression procedure with an entry significance level of p < 0.20 was employed to identify factors associated with leishmaniasis seroprevalence. Cohen’s kappa (κ) agreement was used to assess the diagnostic performance and accuracy of the two serological tests in the absence of a gold standard. The overall seropositivity in dogs was 7.79% and 12.14% at 95% CI for the RDT and ELISA, respectively. Multivariate analysis identified breed and clinical signs as significant factors associated with Leishmania seropositivity in dogs. Local-breed dogs were more likely to be Leishmania seropositive than mixed-breed dogs (OR = 11.92; 95% CI: 1.79–79.37; p = 0.010). Dogs without clinical signs exhibited significantly lower odds of ELISA seropositivity (OR = 0.06; 95% CI: 0.01–0.29; p < 0.001). Dogs with proper care and housing conditions had reduced risk of Leishmania seropositivity compared with poorly managed dogs. Significant association with seropositivity was observed for sex, age, origin, and reason for keeping dogs. Diagnostic evaluation showed that the RDT had an excellent specificity and Positive Predictive Value (100%), with good overall agreement with ELISA, although sensitivity was 64.7%. Hence, RDT can be a reliable alternative screening tool compared with ELISA as the reference standard. The study demonstrated the presence of Leishmania infection in the dog population in Baringo County, Kenya, a significant public health risk. Early detection and diagnosis of infections in dogs through an integrated One Health approach during routine surveillance are essential. This will facilitate treatment and/or culling of infected dogs and vector control, subsequently reducing the risk of human transmission. Hence, it will go a long way to achieving WHO’s roadmap of eliminating leishmaniasis by 2030.

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.

Leishmaniasis is an emerging zoonotic disease recognized by WHO as a priority ne-glected tropical diseases (NTDs) targeted for elimination by 2030. The disease is trans-mitted through bites of infected female phlebotomine sand flies and present in three main forms, cutaneous, mucocutaneous and visceral leishmaniasis. VL has two distinct epidemiological cycles: anthroponotic visceral leishmaniasis (AVL) cycle, caused by L. donovani, and transmitted between humans and zoonotic visceral leishmaniasis (ZVL) cycle, caused by L. infantum with domestic dogs as the main reservoirs. ZVL represents the most severe clinical form and pose a public health risk due to high fatality rate. In Kenya, the epidemiology and transmission dynamics of L. infantum among canine population in endemic areas such as Baringo is poorly characterized. A cross-sectional epidemiological study was conducted in Baringo County, Kenya, one of the endemic foci for human visceral leishmaniasis. Blood samples were collected from 140 dogs Rabai, Sabor, Mbechot, Kapkuikui and Chemolingot and analyzed using Rapid Diagnostic Test (RDT) and Enzyme-linked immunosorbent assay (ELISA). Data on potential epidemiological risk factors and clinical status for dogs was captured using a questionnaire. Statistical analysis was done using Pearson’s chi-square (χ²) or Fisher’s exact tests to determine associations between seropositivity and potential risk factors. Bayesian Latent Class Model used to assess the diagnostic performance and accuracy of the two serological tests in absence of a gold standard. Overall prevalence of infection in dogs was 7.79% and 12.14% at 95% CI by the RDT and ELISA respectively. Multivariate analysis identified breed and clinical signs as significant risk factors associated with Leishmania infections. Local breed of dogs was more likely to be infected as compared to mixed breeds (OR = 11.92; 95% CI: 1.79–79.37; p = 0.010). Dogs without clinical signs exhibited significantly lower odds of ELISA positivity (OR = 0.06; 95% CI: 0.01–0.29; p < 0.001). Dogs with proper care and housing conditions had reduced risk of infection compared to poorly managed. Significant association with seropositivity was observed for sex, age, origin, and reason for keeping dogs. Diagnostic evaluation showed that RDT had a specificity and Positive Predictor Value of 100% with good overall agreement with ELISA, although sensitivity was 64.7%. Hence, RDT can be a reliable alternative screening tool compared with ELISA as reference standard. The study demonstrated the presence of Leishmania infection among the dog’s population in Baringo county, Kenya which is significant public health risk. Early detection and diagnosis of the infections in dogs through an integrated One Health approach in routine surveillance is essential. This will facilitate treatment and or culling of infected dogs and vector control subsequently reducing the risk of human transmission. Hence will go a long way to achievement of WHO’s roadmap of eliminating leishmaniasis by 2030.

Toxoplasmosis is a widely distributed zoonosis caused by the protozoan parasite Toxoplasma gondii. Infection during pregnancy is a major public health concern due to its potential impact on both maternal health and fetal development. Early detection of maternal infection is critical to prevent adverse outcomes; however, maternal signs are often subtle, non-specific or absent, complicating timely diagnosis. This scoping review aimed to map and synthesise existing evidence on early maternal signs, pregnancy and foetal outcomes, frequently assessed risk factors, and diagnostic approaches of toxoplasmosis in expectant mothers in Africa. The review was done in accordance with the PRISMA-ScR guidelines. A literature search of PubMed, Scopus, ResearchGate, and Google Scholar was performed to identify studies published between 2000 and 2025. Retrieved records were managed using Zotero (version 8.0.4) for deduplication and screening. Only English-language studies conducted in Africa and reporting relevant maternal or clinical data were included. A total of 28 cross-sectional studies were included. Lymphadenopathy (25.0%) was the most frequently reported maternal early sign, followed by flu-like illness, asymptomatic infection, low-grade or mild fever, and fatigue or malaise (each 10.7%). Congenital anomalies (50.0%) and miscarriage or spontaneous abortion (42.9%) were the most commonly reported foetal and pregnancy outcomes. Frequently reported risk factors were exposure to cat faeces (57.1%) and ingestion of undercooked or raw meat (42.9%). Diagnostic approaches were commonly enzyme-based immunoassays (78.6%), with limited use of RDTs and molecular methods. These findings suggest the need for improved early detection and prevention strategies in high-risk, low-resource African settings. Enhancing routine screening, health education, and access to appropriate diagnostics are considered. Future studies should consider adopting standardised reporting and integrating sensitive, affordable, rapid diagnostic approaches to enhance early detection and reduce the burden of congenital toxoplasmosis.

Toxoplasma gondii causes toxoplasmosis, a zoonosis of global importance, seriously affecting foetuses congenitally infected by their mother. Although early detection is important to prevent adverse fetal outcomes, maternal infections are frequently asymptomatic or present with mild, nonspecific signs. The present systematic review sought to synthesize evidence on early signs, risk factors, and diagnosis of toxoplasmosis in pregnant women. The study was conducted following the PRISMA 2020 guidelines. A literature search was conducted across PubMed, Scopus, ResearchGate, and Google Scholar for studies published between 2000 and 2025. The articles were exported to Zotero, citation management software. Duplicate articles were merged; those not published in English and lacking reference materials were excluded. After secondary screenings, 31 out of 407 articles met the inclusion criteria. Major maternal signs were lymphadenopathy (19.4%) and flu-like symptoms (19.4%), while major foetal effects were congenital anomalies (25.8%) and miscarriage (22.6%). Associated risk factors were contact with cat faeces and contaminated soil, consumption of undercooked or raw meat, raw vegetables, and contaminated water. Diagnosis was mainly by ELISA (65.5%). Therefore, routine screening awareness campaigns and timely diagnosis are recommended to safeguard maternal and fetal health in high-risk regions with limited diagnostic resources.