Abstract

The epidemiology of toxoplasmosis in pregnancy is a major issue in public health. Toxoplasmosis is caused by the protozoan parasite. Toxoplasma parasite is at high risk for life-threatening diseases during pregnancy. Congenital toxoplasmosis results from a maternal infection acquired during gestation. Therefore, this systematic review and meta-analysis was aimed to determine the seropositive prevalence of toxoplasmosis infection among pregnant women who attended antenatal care in a health facility in Africa. A systematic review and meta-analysis of published and unpublished studies were included. Databases such as MEDLINE, PubMed, EMBASE, CINAHL, Web of Science, African Journals Online were used with relevant search terms. The quality of the articles was critically evaluated using the tool of the Joanna Briggs Institute. Data were extracted on Microsoft word 2016. Meta-analysis was conducted using STATA 14 software. The heterogeneity and publication bias were assessed using the I2 statistics and Egger's test, respectively. Forest plots were used to present the pooled prevalence and odds ratio with a 95% confidence interval of meta-analysis using the random effect model. In total, 23 studies comprising 7,579 pregnant women across ten countries in Africa were included in this meta-analysis. The overall prevalence of seropositive toxoplasmosis among pregnant women in Africa was 51.01% (95% CI; 37.66, 64.34). The heterogeneity test showed that heterogeneity was high, I2 = 99.6%, P-value < 0.001. The variables responsible for the source of heterogeneity were included from Cameroon, the Democratic Republic of Congo, and Ethiopia. Overall prevalence of toxoplasmosis in Africa showed that more than one-half of pregnant women were infected. The risk of acquiring toxoplasmosis infection during pregnancy is high; hence, preventive measures to avoid exposure of pregnant women to Toxoplasma infection should be strictly applied.

Highlights

  • Toxoplasmosis is caused by the protozoan parasite, Toxoplasma gondii

  • An effective vaccine for use in humans, while serving to reduce mortality and morbidity associated with infection, would have economic benefits, as it would reduce the financial burden of lifelong care needed for those with severe chronic diseases [4]

  • This systematic review and meta-analysis included published and unpublished studies conducted on toxoplasmosis infection among pregnant women in Africa

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Summary

Introduction

Toxoplasmosis is caused by the protozoan parasite, Toxoplasma gondii. It accounts for over 60% of the populations that have been infected with Toxoplasma [1]. Toxoplasma gondii infects a large proportion of the world’s human population. Toxoplasma parasite causes life-threatening diseases like immunological impairments and congenital infection of the foetus. Congenital toxoplasmosis results from a maternal infection acquired during gestation [2]. The prevalence of toxoplasmosis infection in pregnant women of vertical via transmission in Brazil was 68.37%, which was suspected by IgM antibodies detection in the peripheral blood [3]. 4 out of 10 of such infections do pass from pregnant women to their babies [5]

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