RISK-FACTORS FOR TOXOPLASMA INFECTION IN A REPRODUCTIVE AGE FEMALE-POPULATION IN THE AREA OF BELGRADE, YUGOSLAVIA

The contribution to Toxoplasma infection of known transmission risk fa ctors such as consumption of undercooked meat, contact with soil, and contact with cats, as well as that of age, degree of education, reside nce in central vs, suburban city communities, and year of entry into t he study, has been investigated in a group of 1157 female residents (a ge range 15 to 45 years) of a defined geographic area (Belgrade) durin g a 4-years period (1988-1991). The rate of infection increased with a ge, ranging from 57 % to 93 %, with an overall mean of 77 %. However, it decreased significantly over the study period (p < 0.01). Of the po tential risk factors examined, regression analysis showed that the fol lowing: age (relative risk (RR): 1.18, 95% confidence interval (CI): 1 .02-1.37, p = 0.022), undercooked meat consumption (RR: 2.22, 95% CI: 1.2-2.86, p = 0.001), and the year of entry into the study (RR: 0.69, 95% CI: 0.6-0.8, p = 0.000) were significantly associated with infecti on. However, while the consumption of undercooked meat contributed to the frequency of infection in the whole group, its significance increa sed with the degree of education but decreased with age, and was great er in women residing in the suburbs. In addition, in women below age 2 0, exposure to soil (farming, gardening) was significantly associated with infection (RR: 1.38, 95% CI: 1.12-1.97, p = 0.037). Since cats ar e the single source of toxoplasma oocysts, the above finding indicates that cats are an epidemiologically significant source of environmenta l contamination in Belgrade. However, cat ownership itself as a criter ion of contact with cats was not associated with infection (p = 0.326) . In the absence of a general screening in pregnancy program in Yugosl avia, these data point out the groups of pregnant women at the highest risk of infection and provide a basis for a region-appropriate educat ional program to prevent congenital toxoplasmosis.