Seroprevalence and clinical correlation in suspected cases of neurotoxoplasmosis

Objectives: Toxoplasmosis is a zoonotic protozoan infection prevalent worldwide and has recently been associated with neuro-psychiatric conditions. The aim of this study was to retrospectively review suspected neurotoxoplasmosis cases tested at the center in the past 3 years (2020-2022) and describe the demography, clinical features, radiologic findings, risk factors, and prevalence of anti-toxoplasma antibodies in this patient population. Materials and Methods: A retrospective records review was carried out at a public-sector tertiary-level hospital and research center serving as a referral center for patients from all over India. Statistical analysis: Continuous variables were expressed in terms of median, interquartile range, maximum, and minimum; nominal variables were expressed in terms of frequencies and percentages. Chi-square test or Fisher’s test was used to establish associations between categorical variables. The Wilcoxon rank-sum test and the Welch two-sample t -test were used for continuous variables, as per the normality of the data. Results: A total of 225 sera from 281 patients were tested for anti-Toxoplasma antibodies, out of which 111 tested positive; therefore, the overall seroprevalence rate among suspected toxoplasmosis cases was 49.33%. The mean and median duration of illness were 84.82 days and 15 days, respectively. Altered sensorium, speech impairment, and limb weakness were significantly associated with the presence of anti-Toxoplasma antibodies in patient sera. Human Immunodeficiency Virus (HIV)-positive status and low CD4 T-cell count were also significantly associated with seropositivity. Conclusions: This study presents a comprehensive analysis of suspected neurotoxoplasmosis cases, identifies diagnostic clues, and highlights the challenges prevalent in the diagnosis of neurotoxoplasmosis.