Background: The number of migrants working in Malaysia has increased sharply since the 1970's and there is concern that infectious diseases endemic in other (e.g. neighbouring) countries may be inadvertently imported. Compulsory medical screening prior to entering the workforce does not include parasitic infections such as toxoplasmosis. Therefore, this study aimed to evaluate the seroprevalence of T. gondii infection among migrant workers in Peninsular Malaysia by means of serosurveys conducted on a voluntary basis among low-skilled and semi-skilled workers from five working sectors, namely, manufacturing, food service, agriculture and plantation, construction and domestic work. Methods: A total of 484 migrant workers originating from rural locations in neighbouring countries, namely, Indonesia (n = 247, 51.0%), Nepal (n = 99, 20.5%), Bangladesh (n = 72, 14.9%), India (n = 52, 10.7%) and Myanmar (n = 14, 2.9%) were included in this study. Results: The overall seroprevalence of T. gondii was 57.4% (n = 278; 95% CI: 52.7-61.8%) with 52.9% (n = 256; 95% CI: 48.4-57.2%) seropositive for anti-Toxoplasma IgG only, 0.8% (n = 4; 95% CI: 0.2-1.7%) seropositive for anti-Toxoplasma IgM only and 3.7% (n = 18; 95% CI: 2.1-5.4%) seropositive with both IgG and IgM antibodies. All positive samples with both IgG and IgM antibodies showed high avidity (> 40%), suggesting latent infection. Age (being older than 45 years), Nepalese nationality, manufacturing occupation, and being a newcomer in Malaysia (excepting domestic work) were positively and statistically significantly associated with seroprevalence (P < 0.05). Conclusions: The results of this study suggest that better promotion of knowledge about parasite transmission is required for both migrant workers and permanent residents in Malaysia. Efforts should be made to encourage improved personal hygiene before consumption of food and fluids, thorough cooking of meat and better disposal of feline excreta from domestic pets. © 2017 The Author(s).

Migrant workers Seroprevalence Socio-demographic factors Toxoplasma gondii

parasitology Toxoplasma gondii transmission Toxoplasmosis protozoon antibody India Antibodies, Protozoan demography Toxoplasma human risk assessment middle aged Asia controlled study Agriculture social determinants of health geographic distribution nonhuman migrant worker Humans Occupations antibody detection male occupation female Socioeconomic Factors risk factor enzyme linked immunosorbent assay Risk Factors socioeconomics Indonesia Malaysia Myanmar immunology isolation and purification Article blood employment status adult major clinical study migration immunoglobulin M antibody infection risk seroepidemiology immunoglobulin G antibody Bangladesh parasite transmission ethnicity Transients and Migrants Nepal immunoglobulin G seroprevalence Seroepidemiologic Studies immunoglobulin M Enzyme-Linked Immunosorbent Assay health survey