Acute Toxoplasma infection in pregnant women worldwide: A systematic review and meta-analysis

Abstract

BackgroundAcute Toxoplasma infection (ATI) during pregnancy, if left untreated, can cause severe adverse outcomes for the fetus and newborn. Here, we undertook a meta-analysis to estimate the worldwide prevalence of ATI in pregnant women.MethodsWe searched international databases for studies published between January 1988 and November 2018. We included population-based cross-sectional and prospective cohort studies that reported the prevalence of ATI in pregnant women. Data were synthesized using a random effect model to calculate the overall prevalence of ATI (with a 95% CI) in six WHO regions and globally. We also performed linear meta-regression analyses to investigate associations of maternal, socio-demographic, geographical and climate parameters with the prevalence of ATI.ResultsIn total, 217 studies comprising 902,228 pregnant women across 74 countries were included in the meta-analysis. The overall prevalence of ATI in pregnant women globally was 1.1% (95% CI: 0.9–1.2%). In studies where more strict criteria for ATI were used, the overall prevalence was 0.6% (95% CI: 0.4–0.7%). The prevalence was highest in the Eastern Mediterranean region (2.5%; 95%CI: 1.7–3.4%) and lowest in the European region (0.5%; 95% CI: 0.4–0.7%). A significantly higher prevalence of ATI was found in countries with lower income levels (P = 0.027), lower human development indices (P = 0.04), higher temperatures (P = 0.02) and lower latitudes (P = 0.005) and longitudes (P = 0.02).ConclusionsThe risk of acquiring ATI during gestation is clinically important and preventive measures to avoid exposure of pregnant women to Toxoplasma infection should be strictly applied.

High Exposure to Toxoplasma gondii and Neospora Spp. in Donkeys in Israel: Serological Survey and Case Reports

“…The high exposure to both parasites may be the result of the poor sanitation associated with low-income populations, which may increase the chance of exposure to oocysts in water sources or the environment. The association between low income and higher exposure to T. gondii has been previously described in humans and in horses [ 7 , 37 , 38 ]. In addition, in poor sanitary conditions, stray dogs and cats may have access to and feed on donkey carcasses, thus enhancing the maintenance and transmission of Neosporosis and Toxoplasmosis in these areas.…”

Toxoplasmosis in Humans and Animals in Ghana (1962 – 2020): A Review

“…To reduce morbidity and mortality in neonates, pregnant women are periodically screened for congenital diseases. So far, three European countries, namely Slovenia, France and Austria have instituted national policies that mandate prenatal, serological screening for T. gondii [25]. This has resulted in a six-fold decrease in congenital transmission in women treated as compared to those without treatment in Austria [26], while France has seen a decrease in maternal toxoplasmosis, from 83% in 1965 to 37% in 2010 [27].…”

“…Early detection of infections and administration of anti-Toxoplasma prophylaxis during pregnancy prevents congenital transmission and reduces sequelae in neonates [27]. Neonates and infants infected with toxoplasmosis may remain asymptomatic or present with several symptoms, including jaundice, cerebral calcification, transaminitis, vision loss, hydrocephaly, chorioretinitis, hepatosplenomegaly, hearing loss, and/or anaemia [25]. Serological tests in children in Ghana has shown an average prevalence of 58%.…”

Serum IgG Anti-Toxoplasma gondii Antibody Concentrations Do Not Correlate Nested PCR Results in Blood Donors

“…The infection by Toxoplasma gondii is frequent around the world and its prevalence range from <30% to more than 60% (Pappas et al, 2009;Dubey et al, 2012;Wallon and Peyron, 2018;Greigert et al, 2019). Different clinical forms of toxoplasmosis resulting from the infection by this Apicomplexan parasite arises and drawn attention especially for pregnant women, newborns and other immunosuppressed patients (Robert-Gangneux and Dardé, 2012;Neu et al, 2015;Rostami et al, 2019;Vidal, 2019).…”