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  1. Fulltext Global seroprevalence of Toxoplasma gondii in pregnant women: a systematic review and meta-analysis
    Salari N, Rahimi A, Zarei H, Abdolmaleki A, Rasoulpoor S, Shohaimi S, et al.
    BMC Pregnancy Childbirth, 2025 Jan 30;25(1):90.
    PMID: 39885489 DOI: 10.1186/s12884-025-07182-2
    BACKGROUND: Toxoplasmosis in pregnancy is associated with serious and irreversible maternal and fetal detrimental consequences. Also, different seroprevalence of Toxoplasma gondii in pregnancy is reported in many countries. The present systematic review and meta-analysis study aimed to determine the global seroprevalence of Toxoplasma gondii in pregnant women.

    METHODS: This study was conducted based on the PRISMA 2020 criteria. Initial searching was conducted using MeSH (Medical Subject Headings)-based keywords with no time limitation (by August 1, 2024). Collected papers were transferred to Citation Management Software (EndNote). Duplicate studies were merged and primary and secondary screenings were applied based on the inclusion/exclusion criteria. Validation was considered to find high-quality assessments. Finally, eligible extractable papers were enrolled for data collection. Data was analyzed using Comprehensive Meta-Analysis software (v.2) The random effects model was used in case of I2 index above 50%.In order to investigate the factors affecting the heterogeneity of studies, meta-regression tests were used to examine factors such as sample size and year of study.

    RESULTS: One hundred thirty-eight eligible studies with a total sample size of 135,098 pregnant women individuals were selected for data extraction and analysis. The heterogeneity index was found high (I2:98.9) and the random effect model was used for analysis. The egger test revealed the absence of publication bias in collected studies (p:0.088). Thus, the global seroprevalence of Toxoplasma gondii in pregnant women was reported at 36.6% (95%CI:33.7-39.6). the highest prevalence reported based on meta-analysis was reported in South America with 52.8% (95% CI:46.6-59), while only 15 studies were reviewed in this continent, most of which were in Brazil. Therefore, after the continent, the highest prevalence reported was reported in Africa with 46.8% (95% CI:39.5-54.3). Also, the lowest prevalence reported based on meta-analysis was in North America with 19.7% (95% CI:8.4-39.6) and Europe with 24.6% (95% CI:17.8-32.9).

    CONCLUSION: This study revealed a high level of seroprevalence of Toxoplasma gondii in pregnant women worldwide. This value mostly depends on the individual's age, lifestyle, and disease awareness regarding toxoplasmosis in pregnant women. Thus, public awareness, along with comprehensive health programs regarding the detrimental effects of toxoplasmosis in pregnant women, seems necessary for prevention or even early diagnosis of toxoplasmosis in pregnant women.

    Matched MeSH terms: Pregnancy Complications, Parasitic/epidemiology
  2. Fulltext Comparative study on Toxoplasma infection between Malaysian and Myanmar pregnant women
    Andiappan H, Nissapatorn V, Sawangjaroen N, Nyunt MH, Lau YL, Khaing SL, et al.
    Parasit Vectors, 2014;7:564.
    PMID: 25498432 DOI: 10.1186/s13071-014-0564-9
    Toxoplasma gondii, an obligate intracellular protozoan parasite, causes a disease called toxoplasmosis which can sometimes be acquired congenitally by a newborn from an infected mother. This study aimed to determine the seroprevalence of Toxoplasma infection and its associated risks among 219 and 215 pregnant women from Malaysia and Myanmar, respectively.
    Matched MeSH terms: Pregnancy Complications, Parasitic/epidemiology*
  3. Fulltext Toxoplasma infection in pregnant women: a current status in Songklanagarind hospital, southern Thailand
    Andiappan H, Nissapatorn V, Sawangjaroen N, Chemoh W, Lau YL, Kumar T, et al.
    Parasit Vectors, 2014;7:239.
    PMID: 24886651 DOI: 10.1186/1756-3305-7-239
    Toxoplasmosis, being one of the TORCH's infections in pregnant women, is caused by Toxoplasma gondii, an obligate intracellular protozoan parasite. This parasitic infection in pregnancy congenitally causes severe outcomes to their fetus and newborn. This study aimed to determine the seroprevalence and stages of Toxoplasma infection in pregnant women and its associated risks exposures.
    Matched MeSH terms: Pregnancy Complications, Parasitic/epidemiology*
  4. Prevalence and risk factors of Toxoplasma infection - an update in Malaysian pregnant women
    Chemoh W, Nur Farhana MN, Noor Azmi MA, Si Lay K, Sawangjaroen N, Tan TC, et al.
    Trop Biomed, 2019 Sep 01;36(3):694-702.
    PMID: 33597491
    Toxoplasma gondii is a protozoan parasite that is capable of causing a zoonotic disease, known as toxoplasmosis. Vertical transmission of T. gondii from the mother to the fetus, during pregnancy may cause severe complications to the developing fetus. This current study aimed to determine the seroprevalence and investigate the associated risk factors of Toxoplasma infection in pregnant women (n=219) visiting the antenatal clinic at UMMC. While the elevated level of anti-Toxoplasma IgG and IgM antibodies indicates the presence of infection, it fails to differentiate between a past and a recent infection. Thus, the study also demonstrates the usefulness of IgG avidity in validating the timing of infection. The serum samples were tested for the presence of anti-Toxoplasma IgG and IgM antibodies by ELISA test, and the seropositive samples for both anti-Toxoplasma IgG and IgM antibodies were further evaluated by IgG avidity. The results showed that the overall prevalence of T. gondii seropositivity was 34.7%. Of these, 30.6% (67/219) were positive for anti-Toxoplasma IgG antibody only, 2.3% (5/219) were positive for anti-Toxoplasma IgM only, and the remaining 1.8% (4/219) was positive for both anti-Toxoplasma IgG and IgM antibodies. All of the pregnant women who were positive for both anti-Toxoplasma IgG and IgM antibody were found to have past infection when evaluated by IgG avidity. In this study, Malay ethnicity and the number of existing previous children were significantly associated with T. gondii seropositivity (p<0.05). Based on these findings, information and education on the transmission and prevention of congenital toxoplasmosis are very crucial as a public health effort towards a healthier society.
    Matched MeSH terms: Pregnancy Complications, Parasitic/epidemiology*
  5. Sero-prevalence of toxoplasmosis among pregnant women attending an ante-natal clinic at a teaching hospital in Al Kharj, Saudi Arabia
    Qamer S, Rizvi SSR, Raoof S, Kamal SM, Khan S
    Trop Biomed, 2020 Mar 01;37(1):186-193.
    PMID: 33612729
    Toxoplasma gondii (T. gondii) is a zoonotic infection that may be transmitted to human beings either by consumption of raw or uncooked meat or by ingesting oocysts. Toxoplasma organisms can cross blood placenta barrier and may result in congenital toxoplasmosis. About 80% of immunocompetent individuals do not show any clinical manifestations and are silent carriers of this disease. Pregnant women especially in highly prevalent areas are recommended to be screened for this disease in order to prevent the potential vertical transmission. To our knowledge no such study has been conducted in this region of Saudi Arabia. This study attempted to carry out two objectives: first, to find out the seroprevalence of T. gondii infection in pregnant women attending prenatal care services in our hospital; second, to find out risk factors associated with T. gondii seroprevalence in our patients. It was carried out in Teaching Hospital in Al-Kharj over a period of one year. All 306 pregnant women attending antenatal clinic were involved in the study. A pretested selfexplanatory questionnaire was filled out by the patients and their sera were collected to be tested for IgG and/or IgM against T. gondii. The results were then statistically analyzed using SPSS software and p-value was calculated using Pearson Chi Square test. Out of the 306 blood samples tested, 99 (32.4%) were seropositive for specific anti T. gondii IgG antibodies and 3(1%) were seropositive for IgM. This show that seroprevalence of T. gondii antibodies was high among pregnant women and the prevalence showed a significant association with age. The study recommends conducting educational programs to raise awareness among women about risk factors and precautions to be taken.
    Matched MeSH terms: Pregnancy Complications, Parasitic/epidemiology*
  6. Fulltext Plasmodium knowlesi malaria during pregnancy
    Barber BE, Bird E, Wilkes CS, William T, Grigg MJ, Paramaswaran U, et al.
    J Infect Dis, 2015 Apr 1;211(7):1104-10.
    PMID: 25301955 DOI: 10.1093/infdis/jiu562
    BACKGROUND: Plasmodium knowlesi is the commonest cause of malaria in Malaysia, but little is known regarding infection during pregnancy.
    METHODS: To investigate comparative risk and consequences of knowlesi malaria during pregnancy, we reviewed (1) Sabah Health Department malaria-notification records created during 2012-2013, (2) prospectively collected data from all females with polymerase chain reaction (PCR)-confirmed malaria who were admitted to a Sabah tertiary care referral hospital during 2011-2014, and (3) malaria microscopy and clinical data recorded at a Sabah tertiary care women and children's hospital during 2010-2014.
    RESULTS: During 2012-2013, 774 females with microscopy-diagnosed malaria were notified, including 252 (33%), 172 (20%), 333 (43%), and 17 (2%) with Plasmodium falciparum infection, Plasmodium vivax infection, Plasmodium malariae/Plasmodium knowlesi infection, and mixed infection, respectively. Among females aged 15-45 years, pregnancy was reported in 18 of 124 (14.5%), 9 of 93 (9.7%), and 4 of 151 (2.6%) P. falciparum, P. vivax, and P. malariae/P. knowlesi notifications respectively (P = .002). Three females with knowlesi malaria were confirmed as pregnant: 2 had moderate anemia, and 1 delivered a preterm low-birth-weight infant. There were 17, 7, and 0 pregnant women with falciparum, vivax, and knowlesi malaria, respectively, identified from the 2 referral hospitals.
    CONCLUSIONS: Although P. knowlesi is the commonest malaria species among females in Sabah, P. knowlesi infection is relatively rare during pregnancy. It may however be associated with adverse maternal and pregnancy outcomes.
    KEYWORDS: Plasmodium knowlesi; malaria; maternal anemia; pregnancy; preterm delivery
    Matched MeSH terms: Pregnancy Complications, Parasitic/epidemiology*
  7. Fulltext Occurrence of Toxoplasma gondii antibodies and associated risk factors in women in selected districts of Punjab province, Pakistan
    Ali S, Amjad Z, Khan TM, Maalik A, Iftikhar A, Khan I, et al.
    Parasitology, 2020 Sep;147(10):1133-1139.
    PMID: 32517832 DOI: 10.1017/S0031182020000967
    Toxoplasmosis is a parasitic zoonotic disease caused by Toxoplasma (T.) gondii. Limited data are available on the occurrence of T. gondii in women especially pregnant women in Pakistan. The present study aimed to determine the occurrence and risk factors associated with T. gondii in pregnant and non-pregnant women in Punjab Province, Pakistan. A cross-sectional study was conducted and 593 samples were collected from pregnant (n = 293) and non-pregnant (n = 300) women of District Headquarter Hospitals of Chiniot, Faisalabad, Jhang and Okara, Pakistan. Data related to demographic parameters and risk factors were collected using a pretested questionnaire on blood sampling day. Serum samples were screened for antibodies (IgG) against T. gondii using ELISA. A univariant and binomial logistic regression was applied to estimate the association between seropositive and explanatory variables considering the 95% confidence interval. P value ⩽0.05 was considered statistically significant for all analysis. Out of 593, 44 (7.42%) women were seropositive for T. gondii IgG antibodies. Occupation, age, sampling location, socioeconomic status, contact with cat, pregnancy status and trimester of pregnancy were significantly associated with seropositivity for T. gondii antibodies. Location and trimester of pregnancy were identified as potential risk factors for T. gondii seropositivity based on binomial logistic regression. Toxoplasma gondii is prevalent in pregnant and non-pregnant women. Therefore, now a necessitated awareness is required to instruct the individuals about these infectious diseases (toxoplasmosis) and their control strategies to maintain the health of human population. Moreover, health awareness among public can help the minimization of T. gondii infection during pregnancy and subsequent risk of congenital toxoplasmosis.
    Matched MeSH terms: Pregnancy Complications, Parasitic/epidemiology*
  8. Fulltext Review on human toxoplasmosis in Malaysia: the past, present and prospective future
    Nissapatorn V, Abdullah KA
    Southeast Asian J Trop Med Public Health, 2004 Mar;35(1):24-30.
    PMID: 15272740
    We reviewed various studies regarding human toxoplasmosis in Malaysia. They showed a varying prevalence of specific Toxoplasma antibodies among the Malaysian population. The Malays have shown the highest seroprevalence of toxoplasmosis, by most studies, when compared to other races. Demographic profiles have shown that Toxoplasma seropositivity is higher in males than females, lower in people with higher incomes, higher in the unemployed and tends to increase with age. In general, the route of transmission, such as contact with a cat, consumption of undercooked meat and blood transfusion were shown to have no significant association with Toxoplasma seropositivity (p > 0.05). The immune status (CD4 cell count < 200 cell/mm3) was strongly associated with toxoplasmic encephalitis (p < 0.05).
    Matched MeSH terms: Pregnancy Complications, Parasitic/epidemiology*
  9. Toxoplasmosis: prevalence and risk factors
    Nissapatorn V, Noor Azmi MA, Cho SM, Fong MY, Init I, Rohela M, et al.
    J Obstet Gynaecol, 2003 Nov;23(6):618-24.
    PMID: 14617462
    A total of 200 pregnant women were recruited in this cross-sectional study. The overall seroprevalence of toxoplasmosis in pregnant women was found to be 49%, in which 39%, 4% and 6% for anti-Toxoplasma IgG, IgM and both anti-Toxoplasma IgG and IgM antibodies, respectively. We found the differences in Toxoplasma seroprevalence rates among the races were significant: the highest rate was in the Malays (55.7%), followed by the Indian (55.3%) and the Chinese (19.4%) (P<0.05) populations. An increase in Toxoplasma seroprevalence with increasing parity was detected (P<0.05). Women with no children had a prevalence of 39.7%, while women with one or more than two children had a prevalence of 44.2% and 62.9%, respectively. In this study, there was no significant association between Toxoplasma seroprevalence and various possible risk factors in pregnant women (P>0.05). When multivariate analysis was performed, no significant association between Toxoplasma seroprevalence and history of contact with cats, consumption of undercooked meat and blood transfusion was found (P>0.05). We did not find any newly diagnosed cases of acute acquired toxoplasmosis in pregnancy during the study period.
    Matched MeSH terms: Pregnancy Complications, Parasitic/epidemiology*
  10. Fulltext A community-based survey of Toxoplasma gondii infection among pregnant women in rural areas of Taiz governorate, Yemen: the risk of waterborne transmission
    Mahdy MA, Alareqi LM, Abdul-Ghani R, Al-Eryani SM, Al-Mikhlafy AA, Al-Mekhlafi AM, et al.
    Infect Dis Poverty, 2017 Feb 13;6(1):26.
    PMID: 28190399 DOI: 10.1186/s40249-017-0243-0
    BACKGROUND: Toxoplasma gondii is a zoonotic coccidian parasite causing morbidity and mortality. In Yemen, T. gondii infection has been reported among pregnant women seeking healthcare in the main cities. However, no data are available on the prevalence of T. gondii infection and its associated risk factors among pregnant women in the rural communities of the country. Thus, the present study aimed to determine the seroprevalence of T. gondii and identify its risk factors among pregnant women in the rural communities of Taiz governorate, Yemen.

    METHODS: A total of 359 pregnant women living in the rural communities of Taiz governorate were enrolled in this study by house-to-house visits. Data were collected using a pre-designed questionnaire, and blood samples were collected and tested for the detection of anti- T. gondii IgM and IgG antibodies by enzyme-linked immunosorbent assay.

    RESULTS: The prevalence of T. gondii infection among pregnant women in this study was 46.2% (166/359). Bivariate analysis identified the age of  ≥ 30 years (odds ratio [OR] = 1.7; 95% confidence interval [CI] = 1.09-2.65, P = 0.019) and unimproved water sources (OR = 2.2; 95% CI = 1.10-4.55, P = 0.023) as factors associated with T. gondii infection among pregnant women. The multivariable analysis, however, identified unimproved water sources as an independent risk factor (adjusted OR = 2.4; 95% CI = 1.16-5.0, P = 0.018) associated with T. gondii infection among pregnant women.

    CONCLUSIONS: Pregnant women in the rural communities of Taiz, Yemen are at high risk of contracting T. gondii infection. Unimproved water sources (wells, water streams and water tanks) are significantly associated with T. gondii infection and should be considered in prevention and control strategies, especially among pregnant women.

    Matched MeSH terms: Pregnancy Complications, Parasitic/epidemiology*
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