Burden of Toxoplasmosis and Tuberculosis Co-Infection - A Cross-sectional Study from Central India

Context: Co-infections of tuberculosis (TB) with other pathogens, including HIV, Cryptococcus , and parasitic diseases such as toxoplasmosis, are a growing concern in co-endemic, resource-limited settings. Although TB – toxoplasmosis co-infection has been reported in China, no epidemiological data are available from India, despite its high TB burden. Given this context, co-infection may pose a significant public health threat, underscoring the need for further investigation. Aims: The aim of the study was to determine the seroprevalence and associated risk factors of toxoplasmosis in TB patients in India. Settings and Design: This cross-sectional study was conducted in the Department of Microbiology of a tertiary care Centre in Central India over a period of 2½ years. Material and Methods: Serum samples obtained from the different groups of confirmed TB patients were subjected to toxoplasma immunoglobulin M, immunoglobulin G (IgG), and IgG avidity testing by enzyme-linked immunosorbent assay. Statistical Analysis Used: Data were analyzed using Microsoft Excel, with tables and graphs employed to address the study objectives. Chi-square test was used to assess associations between variables. Results: Toxoplasma seropositivity was observed in 31.1% of TB patients, with the highest prevalence in Multidrug-resistant TB. Most IgG-positive samples exhibited high avidity, suggesting past infection. Among the evaluated risk factors, only residential area showed a significant association with seropositivity ( P < 0.05). Conclusions: The study is the first of its kind in India to provide valuable insights into toxoplasmosis and TB co-infection. It revealed the highest seropositivity among patients with multidrug-resistant TB and significantly increased rates among individuals from rural areas.