Background: Abnormal folate metabolism might predispose to neural tube defects and Down syndrome
(DS). T. gondii employs folates for its biosynthetic processes and has been implicated as a cause of altered
folate levels, which may be a predisposing factor for DS.
Objective: As little is known about the association between toxoplasmosis and DS, we aimed to assess the
predisposing factors, and potential risk factors of toxoplasmosis and relation to folate metabolism among
children with DS.
Subjects and Methods: A case-control study was conducted including 90 children with DS, 90 healthy
controls, and their mothers. They were investigated for anti-T. gondii IgG antibodies and serum folic acid
levels. A questioner was also formulated to investigate the potential risk factor for each participant.
Results: Anti-T. gondii IgG antibodies were significantly detected in 17.78% of children with DS and 6.67%
of controls (P=0.023). Exposure to toxoplasmosis risk factors such as contact with the farm animals, soil
exposure and drinking raw milk were more frequent among mothers of DS children. Serum folic acid
levels were lower in mothers of DS children (53.3%) than mothers of the control group (33.3%), and in
toxoplasmosis positive-DS children than toxoplasmosis negative-DS children.
Conclusion: Toxoplasmosis appeared to be more frequent among DS children with major contributing
effects of the socio-demographic factors. Maternal folate deficiency is apparently associated with
toxoplasmosis in children with DS.