Sero-epidemiology of Toxoplasma gondii and risk factors among pregnant women in Africa

Citation: 
Debora Charles Kajeguka1, Motswedi Anderson2,3, Akili Mawazo4, Jacqueline James Mwakibinga1, Maseke Richard Mgabo5
Publication year: 
2019

Introduction

 Infections caused by Toxoplasma gondii is a great public health concern worldwide. Toxoplasma gondii infection in pregnant women may result in abortion, stillbirth, or lifelong disabilities of the fetus. Serologic studies have reported various estimates for seroprevalence of toxoplasmosis among African pregnant women. Estimation of the pooled seroprevalence of this infection is necessary for policy-making and target intervention.

 

Methods

We conducted this systematic review and meta-analysis according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. A rigorous literature selection was performed by using the databases of PubMed, Google Scholar, and ScienceDirect for the period Jan 1, 2001, to July 31, 2019. Sero-prevalence with 95% CI was presented for each study, and point estimates and their 95% CIs of pooled seroprevalence was then calculated.

 

Findings

The search process resulted in the inclusion of a total of 36 studies in the systematic review and meta-analysis. The pooled seroprevalence of Toxoplasma gondii Immunoglobulin G (IgG) in Africa was found to be 46.7% (95%CI: 37.0, 56.4). Geographical-based subgroup analysis showed that the seroprevalence of T. gondii among pregnant women was found to be 65.1% (95% CI: 44.7, 85.5), 50.2% (95% CI: 32.0, 68.3), 47.8% (95% CI: 31.7, 63.8), 38.3% (95% CI: 25.2, 51.4) and 5.8% (95% CI: 3.6, 8.1) in Central, Eastern, Northern, Western and Southern Africa respectively. The most common risk factors for T. gondii were living or contact with cat and consumption of raw vegetables or fruits.

 

Conclusion

The current systematic review and meta-analysis revealed a high seroprevalence of Toxoplasma gondii infection among pregnant women. There is a need to establish prevention and control measures that should be directed to educational programs. We recommend that periodic screenings for Toxoplasma gondii infection among pregnant women should be incorporated into routine clinical care in order to avoid serious clinical complications of mother and fetus.