PDF(Pubmed)
Abstract：
BACKGROUND: Toxoplasmosis is a serious endemic zoonotic disease caused by the protozoan parasite Toxoplasma gondii. Toxoplasma infection during pregnancy can result in congenital transmission and serious fetal and neonatal complications. This systematic review and meta-analysis aimed to assess the pooled seroprevalence of T. gondii infection and its determinants among pregnant women in African countries.
METHODS: All articles reporting the seroprevalence of toxoplasmosis among pregnant women in African countries and published from 2010 to 2023 were searched using various databases. The pooled prevalence of toxoplasmosis was calculated using a random-effect model. The variation between the included studies was assessed using a funnel plot and I2 heterogeneity statistics. To identify the sources of heterogeneity, sub-group analysis was further conducted by country, diagnostic method, and sub-African region. The association of prevalence rates with the socio-economic level and geoclimatic parameters was also explored.
RESULTS: In total, 29,383 pregnant women from 60 articles were included for analysis. The pooled T. gondii seroprevalence was 42.89% with high heterogeneity (I2 = 99.4%, P < 0.001). Sub-group analysis revealed variation by country (ranging from 2.62% in Namibia to 80.28% in Congo), diagnostic method used (from 8.66% in studies using a rapid diagnostic test to 55.69% in those using an agglutination test), and sub-African region (from 4.14% in regions of Southern Africa to 53.96 in Central Africa). Cat ownership (OR = 1.58) and the consumption of raw meat (OR = 1.50) and raw vegetables (OR = 1.48) had a statistically significant combined effect on T. gondii seroprevalence. No association was found between T. gondii prevalence and the level of income of the country or geoclimatic parameters.
CONCLUSIONS: The prevalence of toxoplasmosis infection among pregnant women in Africa is high, particularly in Central and Eastern Africa. The determinants of prevalence are multifactorial. Therefore, efforts should be made to increase the awareness of women concerning the risk factors for toxoplasmosis.
METHODS: All articles reporting the seroprevalence of toxoplasmosis among pregnant women in African countries and published from 2010 to 2023 were searched using various databases. The pooled prevalence of toxoplasmosis was calculated using a random-effect model. The variation between the included studies was assessed using a funnel plot and I2 heterogeneity statistics. To identify the sources of heterogeneity, sub-group analysis was further conducted by country, diagnostic method, and sub-African region. The association of prevalence rates with the socio-economic level and geoclimatic parameters was also explored.
RESULTS: In total, 29,383 pregnant women from 60 articles were included for analysis. The pooled T. gondii seroprevalence was 42.89% with high heterogeneity (I2 = 99.4%, P < 0.001). Sub-group analysis revealed variation by country (ranging from 2.62% in Namibia to 80.28% in Congo), diagnostic method used (from 8.66% in studies using a rapid diagnostic test to 55.69% in those using an agglutination test), and sub-African region (from 4.14% in regions of Southern Africa to 53.96 in Central Africa). Cat ownership (OR = 1.58) and the consumption of raw meat (OR = 1.50) and raw vegetables (OR = 1.48) had a statistically significant combined effect on T. gondii seroprevalence. No association was found between T. gondii prevalence and the level of income of the country or geoclimatic parameters.
CONCLUSIONS: The prevalence of toxoplasmosis infection among pregnant women in Africa is high, particularly in Central and Eastern Africa. The determinants of prevalence are multifactorial. Therefore, efforts should be made to increase the awareness of women concerning the risk factors for toxoplasmosis.
摘要：
背景：弓形虫病是由原生动物寄生虫弓形虫引起的一种严重的地方性人畜共患疾病。怀孕期间弓形虫感染可导致先天性传播和严重的胎儿和新生儿并发症。本系统评价和荟萃分析旨在评估非洲国家孕妇弓形虫感染及其决定因素的合并血清阳性率。
方法：使用各种数据库检索了2010年至2023年发表的所有报告非洲国家孕妇弓形虫病血清阳性率的文章。使用随机效应模型计算弓形虫病的合并患病率。使用漏斗图和I2异质性统计来评估所包括的研究之间的差异。为了确定异质性的来源，分组分析进一步按国家进行，诊断方法,和次非洲地区。还探讨了患病率与社会经济水平和地气候参数的关系。
结果：总计，纳入60篇文章的29,383名孕妇进行分析。合并的弓形虫血清阳性率为42.89%，具有高异质性(I2=99.4%，P<0.001)。分组分析显示不同国家的差异（从纳米比亚的2.62％到刚果的80.28％），使用的诊断方法（从使用快速诊断测试的研究中的8.66％到使用凝集测试的研究中的55.69％），和次非洲地区（从南部非洲地区的4.14％到中部非洲的53.96）。猫的所有权（OR=1.58）以及生肉（OR=1.50）和生蔬菜（OR=1.48）的消费对弓形虫血清阳性率具有统计学上的显着综合影响。弓形虫患病率与国家收入水平或地气候参数之间未发现关联。
结论：非洲孕妇中弓形虫感染的患病率很高，特别是在中非和东非。患病率的决定因素是多因素的。因此,应努力提高妇女对弓形虫病危险因素的认识。
方法：使用各种数据库检索了2010年至2023年发表的所有报告非洲国家孕妇弓形虫病血清阳性率的文章。使用随机效应模型计算弓形虫病的合并患病率。使用漏斗图和I2异质性统计来评估所包括的研究之间的差异。为了确定异质性的来源，分组分析进一步按国家进行，诊断方法,和次非洲地区。还探讨了患病率与社会经济水平和地气候参数的关系。
结果：总计，纳入60篇文章的29,383名孕妇进行分析。合并的弓形虫血清阳性率为42.89%，具有高异质性(I2=99.4%，P<0.001)。分组分析显示不同国家的差异（从纳米比亚的2.62％到刚果的80.28％），使用的诊断方法（从使用快速诊断测试的研究中的8.66％到使用凝集测试的研究中的55.69％），和次非洲地区（从南部非洲地区的4.14％到中部非洲的53.96）。猫的所有权（OR=1.58）以及生肉（OR=1.50）和生蔬菜（OR=1.48）的消费对弓形虫血清阳性率具有统计学上的显着综合影响。弓形虫患病率与国家收入水平或地气候参数之间未发现关联。
结论：非洲孕妇中弓形虫感染的患病率很高，特别是在中非和东非。患病率的决定因素是多因素的。因此,应努力提高妇女对弓形虫病危险因素的认识。
