Knowledge, Attitude And Preventive Behavior Towards Toxoplasmosis Among Kuwaiti Women With/Without Pregnancy Experience: A Cross Sectional Study

Abstract Background: Toxoplasmosis is caused by an obligate intracellular opportunistic protozoan parasite, Toxoplasma gondii, with a worldwide distribution. T. gondii infection among pregnant women during the first trimester may transmit infection to the fetus with serious congenital consequences. No data is available on knowledge, attitude and preventive behavior towards toxoplasmosis among pregnant women in Kuwait. This cross-sectional study evaluated knowledge, attitude, and preventive behavior towards toxoplasmosis among women in Kuwait, and reviewed the situation in the Middle east.Methods: Data related to socioeconomic status, knowledge and attitude towards toxoplasmosis were collected from 326 adult female school/university students, and 86 pregnant women through a self-administered online questionnaire during 2019-2021. Participants were divided into two main groups: women with pregnancy experience (PEG) and never-pregnant group (NPG).Results: PEG (n=212) included 114 currently pregnant and 98 women with history of an earlier pregnancy. NPG included 200 subjects. All participants belonged to a medium-to-high social status and minimum high school education. Nearly 50% of PEG women had inadequate knowledge towards toxoplasma infection, and only 33 (15.6%) knew its mode of transmission compared to 35 (17.5%) in the NPG (P=0.597). A significantly higher number of women in PEG (97 of 212, 45.8%) knew it can be prevented compared to 66 of 200 (33%) in NPG (P= 0.008). Only 35 (16.5%) of PEG women knew about screening tests for toxoplasma infection, and their main source of information on toxoplasmosis was healthcare professionals and family/friends compared with NPG women who got information through newspapers/books. PEG Women exhibited enhanced preventive behavior towards toxoplasmosis. Nearly 50% of all PEG participants lacked basic knowledge towards toxoplasmosis but >90% of them avoided most high-risk activities during their pregnancy. In addition, this is the first study in the Middle east conducted through an online survey to collect relevant information related to toxoplasmosis from pregnant women. Conclusions: This study highlights inadequate knowledge and preventive behavior towards toxoplasmosis among Kuwaiti women. Thus, health education on toxoplasmosis should be offered to all adult/pregnant women to reduce congenital toxoplasmosis.